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SALT AFFECTS ORGANS EVEN IN ABSENCE OF HYPERTENSION

You may think you're one of the lucky ones who can eat all the salty snacks and convenience foods you want and still register low numbers on the blood pressure cuff. But, new research suggests you may not be so lucky after all

A review paper co-authored by two faculty members in the University of Delaware College of Health Sciences and two physicians at Christiana Care Health System provides evidence that even in the absence of an increase in blood pressure, excess dietary sodium can adversely affect target organs, including the blood vessels, heart, kidneys and brain.

Authors of the paper, "Dietary Sodium and Health: More Than Just Blood Pressure," include William Farquhar and David Edwards in UD's Department of Kinesiology and Applied Physiology; William Weintraub, chief of cardiology at Christiana Care; and Claudine Jurkovitz, a nephrologist epidemiologist and senior scientist in the Value Institute Center for Outcomes Research at Christiana Care.

The paper was published in the March 17 issue of the Journal of the American College of Cardiology.

"Blood pressure responses to alterations in dietary sodium vary widely, which has led to the concept of 'salt-sensitive' blood pressure," says Farquhar. "There are no standardized guidelines for classifying individuals as having salt-sensitive blood pressure, but if blood pressure increases during a period of high dietary sodium or decreases during a low-sodium period, the person is considered salt sensitive. If there's no change in blood pressure with sodium restriction, an individual is considered salt resistant."

However, the research cited in the paper points to evidence of adverse effects on multiple target organs and tissues, even for people who are salt resistant.

Bad news for the body

Potential effects on the arteries include reduced function of the endothelium, which is the inner lining of blood vessels. Endothelial cells mediate a number of processes, including coagulation, platelet adhesion and immune function. Elevated dietary sodium can also increase arterial stiffness.

Farquhar and Edwards have done previous work in this area, with one study showing that excess salt intake in humans impairs endothelium-dependent dilation and another demonstrating that dietary sodium loading impairs microvascular function. In both cases, the effects are independent of changes in blood pressure.

They review their work and the growing body of evidence to support a deleterious effect of dietary salt on vascular function independent of blood pressure in a recent invited paper in Current Opinion in Nephrology and Hypertension.

"High dietary sodium can also lead to left ventricular hypertrophy, or enlargement of the muscle tissue that makes up the wall of the heart's main pumping chamber," Edwards says. "As the walls of the chamber grow thicker, they become less compliant and eventually are unable to pump as forcefully as a healthy heart."

Regarding the kidneys, evidence suggests that high sodium is associated with reduced renal function, a decline observed with only a minimal increase in blood pressure.

Finally, sodium may also affect the sympathetic nervous system, which activates what is often termed the fight-or-flight response.

"Chronically elevated dietary sodium may 'sensitize' sympathetic neurons in the brain, causing a greater response to a variety of stimuli, including skeletal muscle contraction," Farquhar says. "Again, even if blood pressure isn't increased, chronically increased sympathetic outflow may have harmful effects on target organs."

Difficult detective work

Jurkovitz points out that studying the effects of salt restriction on clinical outcomes is not easy. Challenges include accurate assessment of intake, long-term maintenance on a defined salt regimen, and the need for large numbers of patients and extended follow-up to obtain enough outcomes for meaningful analysis.

However, she says, "A large body of evidence confirms the biological plausibility of the association between high sodium intake and increases in blood pressure and cardiovascular events."

This evidence has resulted in the American Heart Association's recommendation that we consume less than 1,500 mg of sodium a day.

Shaking the salt habit

Taking the salt shaker off the table is a good way to start, but it's probably not enough, says Weintraub, whose work focuses on cardiology outcomes.

"Approximately 70 percent of the sodium in our diets comes from processed foods, including items that we don't typically think of as salty such as breads and cereals," he says. "Also, restaurant food typically contains more salt than dishes prepared at home, so eating out less can help reduce salt intake, especially if herbs and spices -- instead of salt -- are used to add flavor to home-cooked meals."

But the authors acknowledge that shaking the salt habit won't be easy, and it won't happen overnight.

"Reducing sodium will take a coordinated effort involving organizations like the AHA, food producers and processors, restaurants, and public policy aimed at education," Weintraub says.

Neuropathy In The Winter

Very topical at the moment in the Northern hemisphere (and in 6 months, applicable to the Southern hemisphere too) today's post from blog.dana-farber.org (see link below) gives some helpful and timely hints about taking care in the winter if you have neuropathy. It's all to do with lack of feeling in your feet and hands and not being able to judge your footing in slippery circumstances. It's vital that you are always aware of the possibility of falling. Many neuropathy patients suffer broken bones from falls in the winter purely because the wrong signals reach your brain. This article is simply put and worth a read, if only to remind you of what you are probably already well aware of.

Tips for Managing Neuropathy During Winter 
January 15, 2014 Dana-Farber 

Staying warm and healthy during the winter can be challenging for anyone in most parts of the country, but it can be especially difficult for cancer patients, particularly those who may be experiencing treatment-related neuropathy.

Peripheral neuropathy is a temporary or long-lasting nerve problem that may occur as a result of certain chemotherapy drugs. It can cause pain, numbness, tingling, or loss of feeling, usually in the hands or feet, making snowy weather and freezing temperatures all the more challenging.

Clare Sullivan, BNS, MPH

“Peripheral neuropathy occurs from certain treatments affecting the nerves in the body, especially the nerves that sense pain, heat, cold, touch, balance, and fine motor movement,” says Clare Sullivan, BSN, MPH, Clinical Program Manager, Patient Education at Dana-Farber Cancer Institute, who urges patients with neuropathy to take extra precautions in cold weather.

If you experience numbness in the hands and feet as a result of cancer treatment, consider these tips from Sullivan:

Keep hands and feet warm and dry

Invest in good, warm gloves and extra socks during the winter. Layers will help keep your hands and feet dry, which may help ease numbness in colder weather.

Wear boots with traction

This will create an extra layer between your feet and the snow or ice, giving you additional protection against the elements, while helping keep you steady on slippery ground and prevent falls.

Dress warm

Wear a warm coat with thick padding to protect your body, especially your lower arms. Staying warm will help maintain circulation to and from the hands, and may lessen pain and help maintain your range of motion.

Walk with hands out of pockets

Keep your hands free and stretched out to prevent falls and protect yourself when they do occur. Rather than confining your hands to your pockets, which can create cramping and increase the likelihood of falls, wear warm gloves and keep your hands free instead.

View this Dana-Farber Slideshare presentation to learn more about neuropathy diagnosis, treatment, and management from Cindy Tofthagen, PhD, ARNP, an assistant professor of nursing at the University of South Florida, and post-doctoral fellow at Dana-Farber and the University of Massachusetts.

http://blog.dana-farber.org/insight/2014/01/tips-for-managing-neuropathy-during-winter/

MUSIC THERAPY REDUCES DEPRESSION IN YOUTH

Researchers at Queen's University Belfast have discovered that music therapy reduces depression in children and adolescents with behavioral and emotional problems.

In the largest ever study of its kind, the researchers in partnership with the Northern Ireland Music Therapy Trust, found that children who received music therapy had significantly improved self-esteem and significantly reduced depression compared with those who received treatment without music therapy.

The study, which was funded by the Big Lottery fund, also found that those who received music therapy had improved communicative and interactive skills, compared to those who received usual care options alone.

251 children and young people were involved in the study which took place between March 2011 and May 2014. They were divided into two groups -- 128 underwent the usual care options, while 123 were assigned to music therapy in addition to usual care. All were being treated for emotional, developmental or behavioral problems. Early findings suggest that the benefits are sustained in the long term.

Professor Sam Porter of the School of Nursing and Midwifery at Queen's University, who led the study, said: "This study is hugely significant in terms of determining effective treatments for children and young people with behavioral problems and mental health needs."

Dr Valerie Holmes, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences and co-researcher, added: "This is the largest study ever to be carried out looking at music therapy's ability to help this very vulnerable group, and is further evidence of how Queen's University is advancing knowledge and changing lives."

Ciara Reilly, Chief Executive of the Northern Ireland Music Therapy Trust, said: "Music therapy has often been used with children and young people with particular mental health needs, but this is the first time its effectiveness has been shown by a definitive randomized controlled trial in a clinical setting. The findings are dramatic and underscore the need for music therapy to be made available as a mainstream treatment option. For a long time we have relied on anecdotal evidence and small-scale research findings about how well music therapy works. Now we have robust clinical evidence to show its beneficial effects."

Neuropathy In Cats And Dogs

Today's post from wikipedia.org (see link below) talks about neuropathy in cats and dogs. Of course this blog concentrates mainly on humans who suffer from nerve damage but it is long well known that dogs and cats can suffer terribly from neuropathic symptoms too, however that's not widely known. Very often neuropathic problems are associated with particular breeds. If you have neuropathy yourself, you may be aware of what these animals can be feeling and may be able to alert pet owners in the family or among friends to the possibilities that their pets may be suffering but aren't capable of verbalising it. Definitely worth a read for all pet lovers.

Polyneuropathy in dogs and cats 
From Wikipedia, the free encyclopedia

Polyneuropathy in dogs and cats is a collection of peripheral nerve disorders that often are breed-related in these animals. Polyneuropathy indicates that multiple nerves are involved, unlike mononeuropathy.

 Polyneuropathy usually involves motor nerve dysfunction, also known as lower motor neuron disease.

 Symptoms include decreased or absent reflexes and muscle tone, weakness, or paralysis. It often occurs in the rear legs and is bilateral. Most are chronic problems with a slow onset of symptoms, but some occur suddenly.
Most common types of polyneuropathy 

Birman Cat distal polyneuropathy - This is an inherited disorder caused by decreased numbers of myelinated axons in the central and peripheral nervous systems.[1] Astrogliosis (an increase in the number of astrocytes) is also noted. The lesions are most commonly found in the lateral pyramidal tract of the lumbar spinal cord, the fasciculi gracili of the dorsal column of the cervical spinal cord, and the cerebellar vermian white matter.[2] Symptoms start at the age of 8 to 10 weeks, and include frequent falling and walking on the hock.[3] The prognosis is poor. The disease is suspected to have a recessive mode of inheritance.[4]

Botulism - Botulism is very rare in dogs and usually follows feeding on carrion.[5] Symptoms include weakness, difficulty eating, acute facial nerve paralysis, and megaesophagus. Compared to other species, dogs and cats are relatively resistant to botulism.[6]

Dancing Doberman disease - This primarily affects the gastrocnemius muscle in Dobermans. It usually starts between the ages of 6 to 7 months.[3] One rear leg will flex while standing. Over the next few months it will begin to affect the other rear leg. Eventually, the dog is alternatively flexing and extending each rear leg in a dancing motion. Dancing Doberman disease progresses over a few years to rear leg weakness and muscle atrophy. There is no treatment, but most dogs retain the ability to walk and it is painless.[7]
Diabetic neuropathy - This condition is more common in cats than dogs. It is caused in part by prolonged hyperglycemia (high blood sugar) and results in dysfunction of one or both tibial nerves and a plantigrade stance (down on the hocks). It may resolve with treatment of the diabetes.[8] The pathology of this condition in cats has been shown to be very similar to diabetic neuropathy in humans.[9]
Distal symmetric polyneuropathy - Symptoms include atrophy of the distal leg muscles and the muscles of the head, and rear limb weakness. There is no treatment and the prognosis is poor. This is most commonly seen in Chesapeake Bay Retrievers, St. Bernards, Great Danes, Newfoundlands, Collies and Labrador Retrievers.[3]

Dysautonomia - This is primarily seen in cats. Symptoms include vomiting, depression, not eating, weight loss, dilated pupils, third eyelid protrusion, sneezing, slow heart rate, and megaesophagus. There is a poor prognosis and supportive treatment is necessary. Cats can recover, but it may take up to one year.[10]

Giant axonal neuropathy - This is a rare disease in the German Shepherd Dog. It usually becomes evident between the ages of 14 and 16 months.[1] Symptoms include rear limb weakness, decreased reflexes, muscle atrophy, megaesophagus, and loss of bark. There is no treatment and a poor prognosis.

Hyperchylomicronemia or hyperlipoproteinemia - This a type of hyperlipidemia that is inherited in cats. Polyneuropathy is caused by stretching or compression of nerves near bone by xanthomas, which are lipid deposits. It can cause Horner's syndrome, facial nerve paralysis, and femoral nerve, tibial nerve, radial nerve, trigeminal nerve, or recurrent laryngeal nerve paralysis. 
[3]
Hypertrophic neuropathy - This is also known as canine inherited demyelinative neuropathy (CIDN) and is inherited in the Tibetan Mastiff. Symptoms usually start between the ages of 7 to 10 weeks,[3] and include weakness, decreased reflexes, and loss of bark. Sensory fumction remains, but there may be a poor gait or an inability to walk. There is no treatment and a guarded prognosis. It is inherited as an autosomal recessive trait.[11]
Hypoglycemia - Polyneuropathy is especially seen in conjunction with insulinoma.
Myasthenia gravis

Polyradiculoneuritis - This is inflammation of the nerve roots. The most common type is Coonhound paralysis. This is similar to Guillain-Barré syndrome in humans. Coonhound paralysis seems to be secondary to a raccoon bite, probably due to some factor in the saliva. However, it can also occur without any interaction with a raccoon. It can happen in any breed of dog. When associated with a raccoon bite, the symptoms start 7 to 11 days after the bite,[3] and include rear leg weakness progressing rapidly to paresis, and decreased reflexes. When not associated with a raccoon bite, the same symptoms occur, with the paresis taking about 3–4 days to reach its maximum effect. Severe cases will have a loss of bark, trouble breathing, and an inability to lift the head. Typically the duration of the paralysis is 2 to 3 months.[3] However, the paralysis can last up to 6 months. Treatment is proper nursing care, and the prognosis is good in mild cases.[12] In bad cases[12] the dog doesn't completely recover their initial muscular capability but still are able to live and enjoy life for years. In very bad cases it is possible for breathing to be impaired, and unless the dog is placed on a ventilator, suffocation will occur. Polyradiculoneuritis has also been seen one to two weeks post-vaccine in dogs and cats.[13] It can also be caused by toxoplasmosis.

Rottweiler distal sensorimotor polyneuropathy - This is characterized by distal muscle denervation, but the cause is unknown.[7] It affects young adult Rottweilers. The symptoms include weakness of all four legs and decreased reflexes. The disease is gradually progressive. Treatment is possible with corticosteroids, but the prognosis is poor.
Sensory neuropathies - These are inherited conditions in dogs and cause an inability to feel pain and a loss of proprioception. Self-mutilation is often seen. There is no treatment, and the prognosis is poor in severe cases. There are several affected breeds.
Boxer - usually occurs at around two months of age as a slowly progressive disease.[3]
Dachshund (longhaired) - usually occurs between 8 and 12 weeks of age,[3] and causes urinary incontinence, loss of pain sensation all over the body, and penis mutilation. It is probably inherited as an autosomal recessive trait.[11]
English Pointer - usually occurs between the ages of 3 and 8 months[3] and most commonly involves licking and biting at the paws. There is no treatment and a poor prognosis. It is inherited as an autosomal recessive trait.[11]
Spinal muscular atrophy - This occurs in cats and dogs both, and is caused by the death of nerve cells in the spinal cord. This progressive disease has no treatment and a poor prognosis. Affected dog breeds include the Swedish Lapland Dog, Brittany Spaniel, English Pointer, German Shepherd Dog, Rottweiler, and Cairn Terrier.[3] Maine Coon cats are one of the affected cat breeds.[14]

Tick paralysis - This is an acute, ascending motor paralysis that occurs in dogs and cats.[15] The cause is a neurotoxin in the saliva of certain species of adult ticks. Dermacentor species predominate as a cause in North America, while Ixodes mainly causes the disease in Australia.[1] The onset of symptoms is 5 to 9 days after tick attachment,[16] and include incoordination progressing to paralysis, changed voice, and difficulty eating. Death can occur secondary to paralysis of the respiratory muscles, but in North America there is a good prognosis once the ticks are removed. Recovery is usually in 1 to 3 days.[1] In Australia, however, it is a more severe disease with cranial nerve effects, and death can occur in 1 to 2 days.[3]

Toxic neuropathies - The most common causes are vincristine, thallium, and lead. In cats, the symptoms include paresis, hyporeflexia, and muscle tremors.[17]
 
References

Chrisman, Cheryl; Clemmons, Roger; Mariani, Christopher; Platt, Simon (2003). Neurology for the Small Animal Practitioner (1st ed.). Teton New Media. ISBN 1-893441-82-2.
Braund, K.G. (2003). "Neuropathic Disorders". Braund's Clinical Neurology in Small Animals: Localization, Diagnosis and Treatment. Retrieved 2006-09-05.
Ettinger, Stephen J.;Feldman, Edward C. (1995). Textbook of Veterinary Internal Medicine (4th ed.). W.B. Saunders Company. ISBN 0-7216-6795-3.
LeCouteur, Richard A. (2003). "Feline Neuromuscular Disorders". Proceedings of the 28th World Congress of the World Small Animal Veterinary Association. Retrieved 2006-09-05.
Elad D, Yas-Natan E, Aroch I, Shamir M, Kleinbart S, Hadash D, Chaffer M, Greenberg K, Shlosberg A (2004). "Natural Clostridium botulinum Type C Toxicosis in a Group of Cats". J Clin Microbiol 42 (11): 5406–8. doi:10.1128/JCM.42.11.5406-5408.2004. PMC 525276. PMID 15528757.
"Botulism". The Merck Veterinary Manual. 2006. Retrieved 2007-02-10.
"Diseases of the Peripheral Nerve and Neuromuscular Junction: Degenerative Diseases". The Merck Veterinary Manual. 2006. Retrieved 2007-02-10.
"Diseases of the Peripheral Nerve and Neuromuscular Junction: Metabolic Disorders". The Merck Veterinary Manual. 2006. Retrieved 2007-02-10.
Mizisin, Andrew P.; Nelson, RW; Sturges, BK; Vernau, KM; Lecouteur, RA; Williams, DC; Burgers, ML; Shelton, GD (2007). "Comparable myelinated nerve pathology in feline and human diabetes mellitus". Acta Neuropathol (Berl) 113 (4): 431–42. doi:10.1007/s00401-006-0163-8. PMID 17237938.
"Feline Dysautonomia". The Merck Veterinary Manual. 2006. Retrieved 2007-02-10.
"Peripheral Nerve and Muscle Disorders: Small Animals". The Merck Veterinary Manual. 2006. Retrieved 2007-02-11.
"A case study of handling Coonhound Paralysis". 2007. Retrieved 2007-02-18.
"Diseases of the Peripheral Nerve and Neuromuscular Junction: Inflammatory Disorders". The Merck Veterinary Manual. 2006. Retrieved 2007-12-11.
Dr. John C. Fyfe. "Spinal muscular atrophy in Maine Coon Cats (SMA)". 2209 Biomedical Physical Sciences, Michigan State University, East Lansing, MI 48824: Laboratory of Comparative Medical Genetics. Retrieved 9 March 2011.
Edlow, J. A. & McGillicuddy, D. C, (2008). "Tick Paralysis". Infectious Disease Clinics of North America 22 (3): 397–413. doi:10.1016/j.idc.2008.03.005. PMID 18755381.
"Tick Paralysis: Introduction". The Merck Veterinary Manual. 2006. Retrieved 2007-02-11.
Chandler , E. A.; et al. (2004) Feline Medicine and Therapeutics. Oxford, UK: Blackwell Pub.; Ames, Iowa: Iowa State Press, pp. 159–160, ISBN 978-1-4051-2814-8.

http://en.wikipedia.org/wiki/Polyneuropathy_in_dogs_and_cats

EXPOSURE IN ALUMINIUM MAY IMPACT ON MALE FERTILITY

New research from scientists in the UK and France suggests that human exposure to aluminum may be a significant factor in falling sperm counts and reduced male fertility.

Fluorescence microscopy using an aluminum-specific stain confirmed the presence of aluminum in semen and showed aluminum inside individual sperm.

And the team of scientists, at the universities of Lyon and Saint-Etienne in France and Keele in the UK, found that the higher the aluminum, the lower sperm count.

The research, led by Professor Christopher Exley, a leading authority on human exposure to aluminum at Keele, and Professor Michele Cottier, a specialist in cytology and histology at Saint-Etienne, measured the aluminum content of semen from 62 donors at a French clinic.

Professor Exley said: "There has been a significant decline in male fertility, including sperm count, throughout the developed world over the past several decades and previous research has linked this to environmental factors such as endocrine disruptors.

"Human exposure to aluminum has increased significantly over the same time period and our observation of significant contamination of male semen by aluminum must implicate aluminum as a potential contributor to these changes in reproductive fertility."

The mean aluminum content for all 62 donors was found to be very high at 339 ppb with the aluminum content of semen from several donors being in excess of 500 ppb. A statistically significant inverse relationship was found between the aluminum content of semen and the sperm count. Higher aluminum resulted in a lower sperm count.

My Photos in Februarys Herbal Roots

I'm simply delighted that my photographs of Willow will be featured in the upcoming edition of Herbal Roots Zine.

If you have not yet encountered this enchanting, all-ages, magic portal into the world of herbs and herbal healing, well get on it! You will NOT find this quality and quantity of grassroots herbal learning anywhere else for this price.

Kristine your work in the world is beautiful and invaluable. I'm lucky to share my Willow photos with you!

REPROGRAMMED CELLS GROW IN TO NEW BLOOD VESSELS

By transforming human scar cells into blood vessel cells, scientists at Houston Methodist may have discovered a new way to repair damaged tissue. The method, described in an upcoming issue of Circulation, appeared to improve blood flow, oxygenation, and nutrition to areas in need

Cardiovascular scientists at Houston Methodist, with colleagues at Stanford University and Cincinnati Children's Hospital, learned that fibroblasts -- cells that causes scarring and are plentiful throughout the human body -- can be coaxed into becoming endothelium, an entirely different type of adult cell that forms the lining of blood vessels.

"To our knowledge, this is the first time that trans-differentiation to a therapeutic cell type has been accomplished with a small molecules and proteins," said Houston Methodist Research Institute Department of Cardiovascular Sciences Chair John Cooke, M.D., Ph.D., the study's principal investigator. "In this particular case, we've found a way to turn fibroblasts into 'shapeshifters' nearly on command."

Cooke said the regenerative medicine approach provides proof-of-concept for a small molecule therapy that could one day be used to improve the healing of cardiovascular damage or other injuries.

Other research groups have managed to generate endothelial cells cells using infectious virus particles specially engineered to deliver gene-manipulating DNA to cells. The DNA encodes proteins called transcription factors to alter gene expression patterns in such a way that cells behave more like endothelial cells.

"There are problems with using viruses to transfer genes into cells," Cooke said. "This gene therapy approach is more complicated, and using viral vectors means the possibility of causing damage to the patient's chromosomes. We believe a small-molecule approach to transforming the cells will be far more feasible and safer for clinical therapies."

The new method described by Cooke and his coauthors starts with exposing fibroblasts to poly I:C (polyinosinic:polycytidylic acid), a small segment of double-stranded RNA that binds to the host cell receptor TLR3 (toll-like receptor 3), tricking the cells into reacting as if attacked by a virus. Cooke and coauthors reported to Cell in 2012 that fibroblasts' response to a viral attack -- or, in this case, a fake viral attack -- appears to be a vital step in diverting fibroblasts toward a new cell fate. After treatment with poly I:C, the researchers observed a reorganization of nuclear chromatin, allowing previously blocked-off genes to be expressed. The fibroblasts were then treated with factors, such as VEGF, that are known to compel less differentiated cells into becoming endothelial cells.

Cooke and his colleagues reported to Circulation that about 2 percent of the fibroblasts were transformed from fibroblasts into endothelial cells, a rate comparable to what other research groups have accomplished using viruses and gene therapy. But Cooke said preliminary, as-yet-unpublished work by his group suggests they may be able to achieve transformation rates as high as 15 percent.

"That's about where we think the yield of transformed cells needs to be," Cooke said. "You don't want all of the fibroblasts to be transformed -- fibroblasts perform a number of important functions, including making proteins that hold tissue together. Our approach will transform some of the scar cells into blood vessel cells that will provide blood flow to heal the injury."

In a second part of the study, the scientists introduced the transformed human cells into immune-deficient mice that had poor blood flow to their hind limbs. The human blood vessel cells increased the number of vessels in the mouse limb, improving circulation.

"The cells spontaneously form new blood vessels -- they self assemble," Cooke said. "Our transformed cells appear to form capillaries in vivo that join with the existing vessels in the animal, as we saw mouse red blood cells inside the vessels composed of human cells."

Cooke, who is also the director of the Houston Methodist Center for Cardiovascular Regeneration, said that figuring out how to manipulate adult cells of one type into becoming a completely different type of cell will be an important part of the development of regenerative medicine as a scientific and clinical field. Humans are generally unable to regenerate heavily damaged tissue, whereas other animals, such as some newts and flat worms, can regenerate entire lost limbs -- even entire heads.

"It is likely that modifications of this small molecule approach may be used to generate other body cells of therapeutic interest," Cooke said. "What we are seeing is evidence of the fluidity of cell fate with the proper stimulation. If we can understand the underlying pathways and how to manipulate them, we may very well learn how reawaken primordial mechanisms for regeneration that are active in lower vertebrates such as newts."

Cooke said more animal model studies are needed before his group begins clinical trials.

"One of the next steps will be to see if we can rescue an animal from an injury," Cooke said. "We want to know if the therapy enhances healing by increasing blood flow to tissues that may have been damaged by a loss of blood because of ischemia."

FACIAL MASCULINITY NOT ALWAYS A TELLING FACTOR IN MATE SELECTION

Women living where rates of infectious disease are high, according to theory, prefer men with faces that shout testosterone when choosing a mate. However, an international study says not so much, says University of Oregon anthropologist Lawrence S. Sugiyama

The new study, on which Sugiyama is one of 22 co-authors, ended with that theory crumbling amid patterns too subtle to detect when tested with 962 adults drawn from 12 populations living in various economic systems in 10 nations.

The study -- coordinated by Ian S. Penton-Voak of the School of Experimental Biology at the University of Bristol in the United Kingdom -- appears online ahead of print this week in the Early Edition of the Proceedings of the National Academy of Sciences.

"It's not the case that women have a universal preference for high testosterone faces, and it's not the case that such a preference is greater in a high-pathogen environment," Sugiyama said. "And the opposite is also the case. Men don't uniformly appear to have a preference for more feminine faces, at least within the ranges of cultures shown in this study. In cultures tied to pastoralism, agriculture, foraging, fishing and horticulture, not so much, the authors concluded.

The closest the theory came to confirmation was in market economies in the study populations in the U.K., Canada and China, perhaps because, as Sugiyama's prior work has shown, preferences shift in response to the local range of variation in traits, and men in market economies have higher testosterone.

Also, Sugiyama said: "In large-scale societies like ours we encounter many unfamiliar people, so using appearance to infer personality traits can help cope with the overwhelming amount of social information. For instance, in all cultures tested, high testosterone faces were judged to be more aggressive, and this is useful information when encountering strangers."

Sugiyama and three other UO co-authors contributed to the study based on their work with the Shuar, a rural population with a long history of warfare in Ecuador and whose mixed economy today is based on horticulture, hunting, foraging and small-scale agro-pastoralism.

The Shuar did not come into contact with the outside world until the 1880s, and only since the 1960s have they organized into communities, Sugiyama said. The UO's research there is looking at the impacts of culture change on Shuar health. Data for the PNAS study were collected during routine sessions with 30 males and 31 females.

Each was shown culturally appropriate facial representations of potential opposite-sex mates and asked which one they'd prefer. Shuar women didn't like the faces of men whose faces suggested high testosterone levels. "Shuar women preferred slightly less testosterone-looking faces," Sugiyama said. The reason why was not clear, but he suggests that maybe Shuar women possibly have grown weary of years of warfare and would prefer mates who would be less likely to participate and encourage their offspring to engage in violent behaviors.

UO co-authors are J. Josh Snodgrass, a professor of biological anthropology, doctoral student Melissa A. Liebert, who has spent seven research seasons with the Shuar, and undergraduate student Ruby Fried, who has since earned a bachelor's degree from the UO and now is a doctoral student in anthropology at Northwestern University in Evanston, Illinois.

As with the UO team, the paper's other researchers contributed with data collected from the populations that they study. The study encompassed students and Cree populations in Canada, students and urban residents in two Chinese cities, the Tuvans in Russia, students in the United Kingdom, the Kadazan-Dusun in Malaysia, villagers in Fiji, the Miskitu in Nicaragua, the Tchimba in Namibia and the Aka in the Central African Republic.

"Performance by the different populations wasn't chance," Sugiyama said. "For each society there was a pattern. There were significant preferences in each culture. Market economies do play a part, but something more was going on.

"I think the real message of this study is that we in this field need to stop and rethink how we have been thinking about these things," he said. "Maybe the idea of infectious disease -- the presence of pathogens -- isn't the main driving factor. The underlying adaptations are likely to track other ecological considerations and local cultural factors that we don't have data on and may eventually be very important in understanding attractiveness."

Can Poor Sleep Patterns Cause Chronic Pain In Older People

Today's article from sciencedaily.com (see link below) looks at the link between restless and disturbed sleep patterns and chronic pain, especially amongst older people. I think almost everybody living with chronic pain can identify with that. A bad night's sleep almost always results in more pain in the morning. Whether it's the pain that causes the poor sleep, or the other way around, is the question.
 

Could Restless Sleep Cause Widespread Pain in Older People? 
Date:
February 13, 2014
Source:
Wiley
 
Summary:
Researchers in the U.K. report that non-restorative sleep is the strongest, independent predictor of widespread pain onset among adults over the age of 50. According to the study anxiety, memory impairment, and poor physical health among older adults may also increase the risk of developing widespread pain. Muscle, bone and nerve (musculoskeletal) pain is more prevalent as people age, with up to 80% of people 65 years of age and older experiencing daily pain. Widespread pain that affects multiple areas of the body —- the hallmark feature of fibromyalgia —- affects 15% of women and 10% of men over age 50 according to previous studies.

Researchers in the U.K. report that non-restorative sleep is the strongest, independent predictor of widespread pain onset among adults over the age of 50. According to the study published in Arthritis & Rheumatology (formerly Arthritis & Rheumatism), a journal of the American College of Rheumatology (ACR), anxiety, memory impairment, and poor physical health among older adults may also increase the risk of developing widespread pain.

Muscle, bone and nerve (musculoskeletal) pain is more prevalent as people age, with up to 80% of people 65 years of age and older experiencing daily pain. Widespread pain that affects multiple areas of the body -- the hallmark feature of fibromyalgia -- affects 15% of women and 10% of men over age 50 according to previous studies.

Led by Dr. John McBeth from the Arthritis Research UK Primary Care Centre, Keele University in Staffordshire, this newly published population-based prospective study identified factors that increase the risk of the development of widespread pain in older adults. The team collected data on pain, psychological and physical health, lifestyle and demographic information from 4326 adults over the age of 50 who were free of widespread pain at the start of the study (1562 subjects reported no pain and 2764 had some pain). These participants were followed up three years later for the development of widespread pain.

Results show that at follow-up, 800 (19%) reported new widespread pain. The development of new widespread pain was greater in those with some pain at the start of the study; 679 (25%) of those with some pain and 121 (8%) of those with no pain at the start developed new widespread pain at three year follow-up.

Analyses determined that pain status, anxiety, physical health-related quality of life, cognitive complaint and non-restorative sleep were associated with increased risk of widespread pain development, after adjusting for osteoarthritis (OA). Increasing age was associated with a decreased likelihood of the development of widespread pain.

"While OA is linked to new onset of widespread pain, our findings also found that poor sleep, cognition, and physical and psychological health may increase pain risk," concludes Dr. McBeth. "Combined interventions that treat both site-specific and widespread pain are needed for older adults."

Story Source:

The above story is based on materials provided by Wiley. Note: Materials may be edited for content and length.

Journal Reference:
John McBeth, Rosie J Lacey, Ross Wilkie. Predictors of new onset widespread pain in older adults Results from the prospective population-based NorStOP study. Arthritis & Rheumatology, 2013; DOI: 10.1002/art.38284

http://www.sciencedaily.com/releases/2014/02/140213083711.htm

DELAY IN AGE OF WALKING CAN HERALD MUSCULAR DYSTROPHY IN BOYS WITH COGNITIVE DELAYS

The timing of a toddler's first steps is an important developmental milestone, but a slight delay in walking is typically not a cause of concern by itself.

Now a duo of Johns Hopkins researchers has found that when walking and cognitive delays occur in concert, the combination could comprise the earliest of signals heralding a rare but devastating disorder known as Duchenne muscular dystrophy (DMD).

The study, published ahead of print in The Journal of Pediatrics and conducted by a medical student and a pediatric neurologist, reveals that delays in the onset of walking -- which should occur between 9 and 16 months of age -- are common among boys with DMD and often happen alongside cognitive delays. That combination, the investigators say, can give pediatricians a critical early diagnostic clue and tip them off to the presence of DMD.

"Our review of patient records shows that delayed walking along with cognitive delays represents an ominous combination that should prompt pediatricians to conduct further testing and could speed up diagnosis and treatment," says Kara Mirski, a fourth-year medical student at the Johns Hopkins University School of Medicine. "Earlier diagnosis means that we can start treating these kids sooner and greatly improve their long-term outcomes."

DMD is caused by a defective muscle protein. It is marked by progressive loss of muscle strength and function and, eventually, inability to walk at all. In its advanced forms, the condition can also compromise the function of the heart and breathing muscles. DMD, which almost exclusively affects males, is estimated to occur in one out of 3,500 boys.

Current guidelines from the American Academy of Neurology and the Child Neurology Society do not include DMD on the suspected diagnoses list for boys with developmental delays. While neither cognitive delays nor delayed walking by themselves are necessarily caused by DMD, when the two occur in tandem they should raise the index of suspicion and seriously narrow the range of diagnostic possibilities, the team says.

"The bottom line is that any delay in walking should lead to further probing, or at least vigilant monitoring, and when late walking occurs in the context of other developmental delays, it should put DMD on every pediatrician's radar as a possible cause," says study author Tom Crawford, M.D., a pediatric neurologist and muscular dystrophy expert at the Johns Hopkins Children's Center.

Once a physician suspects DMD, a child can be screened further with a cheap and widely available test that measures the blood levels of creatinine kinase (CK), a protein released as a result of muscle damage or muscle cell death. Normal CK levels rule out DMD.

Once diagnosis is made, treatment with steroids and physical therapy can halt or slow muscle damage and help preserve mobility and function, the researchers say. In addition, because most cases of DMD are inherited, earlier diagnosis would allow families to consult a genetic counselor who can help them make informed decisions about subsequent pregnancies.

DMD can be easily missed during the infant and toddler years, even among children with developmental delays, Crawford notes. The condition's characteristic muscle weakness does not present at such an early age, and the absence of the disease's defining symptom can easily throw off pediatricians. This is why, Crawford says, any developmental delay should prompt pediatricians to probe deeper.

In addition, while most cases of DMD stem from inherited genetic defects, some genetic mutations can arise spontaneously in families without history of the disorder. In those cases, diagnosis can be delayed even further, until a child is 5 or 6 years old, the researchers say.

For the study, the investigators examined the clinical records of 107 children with DMD referred to the Johns Hopkins Children's Center between 1989 and 2012 for diagnosis or treatment. Nearly half (42 percent) had a history of delayed walking (age 16 months or later). Toddlers who started walking late were three times as likely to have cognitive delays as those who began walking on time. The link between the time of a child's first steps and cognitive delay persisted even when investigators eliminated other factors such as the speed and severity of muscle degeneration or age of diagnosis. The study also revealed that DMD patients who started walking late were not referred for diagnostic work-up any earlier than their counterparts who started walking at what is deemed a typical age. In other words, delayed walking did not emerge as the red flag it should have been, the investigators say.

Do You Feel Believed When Youre In Pain

Today's post from the ever reliable pain-topics.org (see link below) looks critically at how other people's (and thus patients') pain is judged. Neuropathy sufferers will be well aware of how this can work and how you can feel disbelieved by both doctors and those around you. There is no sensation like neuropathy pain, tingling or numbness and unless the other person understands that, it can be difficult convincing them that your suffering is genuine. Doctors are just as guilty of making judgements based on body language, especially if the patient tries just a little too hard to convince them that what they're feeling is real. People with neuropathy need to find ways of describing their symptoms in a way that is relevant to the listener (the 'walking with a sock full of wet sand' is a good one for the numbness; or 'like walking on bare bones' for neuropathic aching; or 'like being connected to the mains' for the tingling. The actual pain you feel is more difficult but if you feel you are being doubted by a doctor, ask him or her directly then at least you'll know if you still have work to do. Most doctors will hear the story and symptoms of a neuropathy patient and immediately know what's going on - the symptoms are pretty unique - but friends, family and colleagues may take a bit more persuading. Don't give up; you have the right to be taken seriously.

Pain Doubted if Medical Basis is Missing
Posted bySB. Leavitt, MA, PhD Tuesday, December 11, 2012

Many chronic pain sufferers often feel that their maladies are misunderstood, disbelieved, or unaccepted by others. New research confirms that if there is no clear and convincing biomedical cause identified to satisfactorily explain the pain other people tend to discount it and have little sympathy toward the patient.

Researchers at Ghent University in Belgium conducted a pair of studies to investigate the impact of medical and psychosocial information on estimations of another person’s pain, along with observers’ emotional responses and their behavioral tendencies toward the person with pain [De Ruddere et al. 2012]. Study participants were recruited from the community: Study 1: N = 29 women, 10 men; Study 2: N = 29 women, 12 men.

Participants variously viewed photographs of 4 alleged patients (2 men, 2 women; ages 44 to 57 years) described as having shoulder pain conditions. With each photograph there was a written brief vignette describing 2 of 4 different circumstances: either the presence or absence of a medical explanation for the pain, along with either the presence or absence of psychosocial influences attributed to the pain experience.
For example, pain was medically explained as associated with either “a little fracture,” “an inflammation,” or a “muscle strain”; in the no-cause condition the vignette simply stated that “based upon medical examination there appeared to be no injury to the shoulder.”

Psychosocial influences were described in Study 1 vignettes from the patients’ perspectives: eg, “[Fictitious patient name] reports having more pain when experiencing job stress” or “…more stress at home.” In Study 2, these influences were more authoritatively attributed to medical opinion: eg, “…the doctor decided that psychosocial factors have an impact upon the pain, in particular job stress and feelings of anxiety” or “…in particular relationship problems and a depressive mood.”

If psychosocial influences did not exist, in Study 1 they simply were not mentioned. In Study 2, however, there was a more explicit declaration that “…the doctor decided that psychosocial factors do not have an impact upon the pain.” Thus Study 1 and 2 were similar, except for a much stronger attribution of psychosocial factors, or lack thereof, in the second study.

After examining each vignette/photo, study participants were shown a brief video segment (8 seconds) displaying the respective patient having his/her shoulder examined and expressing facial signs of moderate pain. Then, on 4 different 100mm visual analog scales (VAS), participants rated each patient’s pain, their own distress upon viewing the patient in pain as well as their sympathy toward the patient, and their inclination to help the patient.

Writing in the December 2012 edition of the Journal of Pain, the researchers report that, in both Studies 1 and 2, results indicated significantly lower ratings on all measures when medical evidence for pain was absent. That is, when a medical explanation for a patient’s pain was missing, participants rated the pain as lower and their own distress at viewing the patient as lower, as well as less sympathy toward the patient and less willingness to help.

Surprisingly, there was no overall effect found on any of the 4 outcome measures due to claimed psychosocial influences on patients’ pain. The one small exception was in Study 2, in which participants indicated feeling less personal distress when psychosocial factors were explicitly indicated (ie, noted by examining physicians as having an impact).

The researchers conclude that the findings suggest pain is taken less seriously when there is no medical evidence to help explain it, and psychosocial influences on the patient — eg, stress at work or home, anxiety, relationship issues — are not considered as important contributors to pain. This line of investigation is important, the researchers note, for better understanding how patients’ pain for which there is no clear medical explanation is interpreted and judged by other persons.

COMMENTARY: Research in the social psychology field is often most interesting when it confirms — more or less scientifically — what most people already think they intuitively know. This present study confirms what many patients already have expressed in prior comments to various UPDATES articles; that is, when chronic pain is unexplained by a diagnosis of some severe biopathology patients often face significant obstacles to being taken seriously by their families, friends, and healthcare providers.

In the study by De Ruddere et al. it was somewhat puzzling that psychosocial factors appeared to have so little influence on participants’ perceptions. It seemed that medical evidence for the pain superseded all other information when judging the genuineness of pain and consequent feelings of sympathy or helpfulness toward the patient.

As often is the case in the pain management field, more research is needed before leaping to any firm conclusions. For one thing, patients in the video segments displayed what had been determined as representing moderate pain; expressions of more severe pain might have had much greater impact on assessments — evoking higher ratings of pain (whether or not medically explained) and greater empathy by study participants.

Another important limitation was that participants had no personal relationships or direct interactions with the fictitious patients; completely unlike what would be the case in clinical settings or among family/friends. Essentially, the researchers attempted to create a laboratory setting for assessing human variables that are far more complex in everyday life or clinical practice.

Participant-group sizes — Group 1, N= 39; Group 2, N=41 — were probably adequate to provide reasonable statistical power for detecting significant differences, avoiding Type II (false negative) findings. [Readers should note that numbers of participants indicated in the study abstract and the article text itself are grossly discordant; we are using numbers from the text.]

However, composition of the participant groups must be considered: overall, the two groups were unequally balanced toward women, average participant age was significantly lower than the test patients (roughly 28 vs 51 years), and approximately half of participants were college students. So, generalizing the findings at this time to how older persons, healthcare providers, or family/friends might react could be erroneous.

Therefore, there are still unanswered questions about how the qualities of patients and those interacting with them, as well as available information about patient medical condition and/or psychosocial influences, affect judgments when it comes to pain assessment, sympathy, and helping behavior. The researchers, themselves, acknowledge most of these limitations; yet, this study is an important step toward a better understanding of several factors that might significantly bias perceptions of patients’ pain and impact the care that they receive in medical settings and at home.

REFERENCE: De Ruddere L, Goubert L, Vervoort T, et al. We Discount the Pain of Others When Pain Has No Medical Explanation. J Pain. 2012(Dec);13(12):1198-1205

http://updates.pain-topics.org/2012/12/pain-doubted-if-medical-basis-is-missing.html

HOMOEOPATHIC REMEDIES FOR SUICIDAL TENDENCY IN TEENAGERS

It is shocking to read in the papers almost every day the rate at which teenagers  are committing suicides. Teenage suicide has become a growing concern among our Isociety. So what is it that triggers these young brains to take such a big step? Fast life? Stress? Depression? Loneliness? Peer pressure? Exam and study related anxiety? Issues with parents? Inability to cope with life? Or all of this? Most students today agree to the fact that they have had suicidal thoughts at least once in their life. Isn’t this scary? Well, it is high time parents and teachers need to get together and address this issue more strongly.

Many teens who attempt or die by suicide have a mental health condition. As a result, they have trouble coping with the stress of being a teen, such as dealing with rejection, failure, breakups and family turmoil. They might also be unable to see that they can turn their lives around — and that suicide is a permanent response, not a solution, to a temporary problem.

Causes--Causes of teenage suicide can be difficult to pinpoint and may involve several factors. Teens go through a vulnerable period at this stage in their lives. No matter how small or big their problems, their troubles may feel unbearable or overwhelming. Noticeable changes in behavior, such as withdrawal from friends and family or violent and aggressive behavior, are among the many signs of potential teen suicide, but parents and mental health care providers also need to understand the causes of suicide in teens for effective prevention.

Major Disappointment

Suffering through a major disappointment such as rejection, loss of a boyfriend or girlfriend and failure at school or in sports may trigger suicidal tendencies in teens, who have difficulty coping with these kinds of situations. These circumstances alone may not be responsible for suicide, but they are factors that contribute to a teen's taking extreme measures, the National Alliance on Mental Illness, or NAMI, points out.

Stress

Stress, confusion, pressure and worries about self-worth are common problems in many teens that can trigger suicide, according to the American Academy of Child and Adolescent Psychiatry. Teens may have to go through parental divorce, moving in with a new family, living in a new location or going to a different school. In some cases, teens may be victims of physical or sexual abuse. These are unsettling matters that intensify uncertain feelings such as distress, anxiety or agitation.

Depression

Depression is a major cause of suicide that can be present in the teenage years. This mental disorder can cause feelings of hopelessness and worthlessness, according to Kids Health. Depression can be particularly harmful for teens who experience violence at home or at school and feel isolated from their peers or lack a social network of friends. Approximately 75 percent of people who commit suicide suffer from depression, according to the Harris County Psychiatric Center at the University of Texas.

Substance Abuse

Drug or alcohol abuse can lead to impulsive behavior, especially if a teen is haunted by other problems such as a mental disorder or family difficulties. Like adults who turn to alcohol or drugs, teens may believe that substance abuse will bring them relief from surrounding difficulties, but it only worsens the problems. Substance abuse and mental disorders play prominent roles in a majority of suicides, Kids Health notes.

Biology

Genetic components related to brain chemistry may be involved in teen suicides, NAMI notes. Teens with a family history of mental disorders or suicide are at increased risk of suicide or suicide attempts. Being in an environment in which a suicide has occurred with a relative could produce thoughts of suicide for vulnerable teens. Low levels of the brain chemical serotonin may be a cause of suicide, NAMI says. Serotonin controls impulsive actions. Low levels of the chemical may lead to impulsive behavior, including suicide

Risk factors

A teen might feel suicidal due to certain life circumstances such as:

·         Having a psychiatric disorder, including depression

·         Loss of or conflict with close friends or family members

·         History of physical or sexual abuse or exposure to violence

·         Problems with alcohol or drugs

·         Physical or medical issues, for example, becoming pregnant or having a sexually transmitted infection

·         Being the victim of bullying

·         Being uncertain of sexual orientation

·         Exposure to the suicide of a family member or friend

·         Begin adopted

·         Family history of mood disorder or suicidal behaviour

HOMOEOPATHIC REMEDIES

AURUM METALLICUM 200-Aurum Met is one of the top remedies for suicidal tendency in teenages. There is a feeling   feeling of self-condemnation and utter worthlessness. Profound despondency, with increased blood pressure, with thorough disgust of life, and  thoughts of suicide.Talks ofcomitting suicide. Looks on the dark side, weeps, prays, thinks she is not fit for this world, longs for death, strong inclination to commit suicide. Brood over some sin which they have committed. Sense of unworthiness. Violent if contradicted . Aurum met. is  the most common and most definite of all the depression remedies. In a case of acute depression the patient is brooding melancholy and just sits and peers in front of him and will not speak .  They look extremely depressed and have all sorts of strange ideas. They think they have lost the affection of their friends and family, or that they have done something frightful and that they are therefore feeling like this because they are to blame for it. They blame themselves for everything and get a real disgust of life. They are the patients who become suicidal.

MAGNESIUM CARBONICUM 200-Magnesium carb is another effective remedy for suicidal tendency in teenagers.There is  forsaken feeling,feels as if not beloved  by his parents, friends, etc.  Intolerant of disharmony. Sensitive to what people think about them. Reserved. Easily hurt and depressed. –   Sensitive to noise, touch, etc. This remedy is suitable to  orphans, abandoned children and  adopted children.  They are  very irritable and  discontented. There is  anxiety and fears all through the day, worse from  warm food, and better when  going to bed.   Biting nails is another indication of this remedy.

IGNATIA AMARA 200—Ignatia can be helpful when  depression follows from bereave­ment, loss, or a shock, such as witness­ing a fatal road accident. The symptom picture is typified by emotional ups and downs with mood swings . Often the sufferer can prove difficult for friends and loved ones to deal with as they are so up and down, being resist­ant to sympathy and oversensitive to well meaning advice, which may be wrongly taken as criticism. It may be hard for them to talk if they are overcome with their miser­able situation and friends can find it well high impossible to cheer up such patients. Poor sleep is common.

KALI PHOSPHORICUM 200- Kali phos is for mental depression caused by excitement, overwork, worry, insomnia and suicidal tendency. If a person feels depression after working too hard , being physically ill, or going through prolonged emotional stress or excitement this remedy can be helpful. Exhausted , nervous and jumpy, they may have difficulty in working or concentrating and become discouraged and lose confidence . Headaches from mental effort, easy perspiration , sensitive to cold, anemia, insomnia and indigestion are often seen when this remedy is needed .

MAGNESIUM MURIATICUM 200-Magnesium mur. is an effective remedy for suicidal tendency in teenagers . There is emotional vulnerability and  sensitive to any kind of confrontation. Magnesium mur. people are  pacifists and  tries to resolve conflicts. No cowardice. Ailments from quarrels, even between others.    Suppresses emotions for the sake of others . Want others to be happy.  Introverted. Avoid being hurt. Develop bitterness. Sour temperament.  Dissatisfaction. Irritable. Depressed. Stronge sense of duty. Overload themselves. Become overwrought. Nervous restlessness. Normal sleep cycle becomes disturbed. Never quite catch up. Completely unable to relax under any circumstance.There is restlessness and anxiety on lying down and closing eyes.  Magnesium mur. patients are   tries to run on nervous energy and  break down with hysterical fits. Anxious over little things .Every thought tends to repeat itself in the mind.  While reading felt she must keep reading faster and faster.

NATRUM MURIATICUM 200-Natrum mur. patients are emotionally sensitive and vulnerable. Mentally they have a high degree of objectivity and awareness, as well as a great sense of responsibility. Throughout life this  individuals  experience deeply all impressions of life and accumulating awareness and understanding beyond their age. At first, they enjoy company and thrive on the nourishment of emotional contact with others.They are   reluctant to date, for fear of rejection. Even imagined slights can cause suffering. After being hurt several times, they learn to become cautious. They will think twice before becoming involved in an emotional experience. They turn to introverted activities which are emotionally “safe”, i.e. reading books (usually romantic fiction or things having practical value in human relations), listening to music, dwelling on ideas and fantasies.  Natrum mur patients are   very sensitive to disharmony. If the parents fight they may not react immediately but will suffer inside, perhaps even to the point of acquiring a physical ailment. As the emotional vulnerability becomes increasingly pathological the patient becomes depressed. This is a depression which is inconsolable, and may even become suicidal.

NATRUM SULPH 200-Natrum Sulph is an important medicine for the treatment of major depression where psychotic symptoms of suicidal thoughts are in a greater magnitude, where the patient has to be physically refrained from committing such an act.Dislikes to speak , to to be spoken to.