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“If we take Marcel’s complaints seriously, then his health was deteriorating, he was growing increasingly tired and it was becoming ever more difficult for him to work. Particular problems badly disrupted his way of life. Occasionally his beloved Quies ear plugs would give him otitis, for which he consulted Wicart, ‘charming but too intelligent’: the doctor’s aim was actually to cure Marcel of his asthma. ‘Ah! How soothing our doctors like the good Bize, who hadn’t examined my chest for ten years’. Sometimes he poisoned himself by mixing a packet of veronal and opium. In October his asthma attacks became so bad that for the first time Dr Bize had to give him morphine injections, the only effect of which would daze him totally. He was convinced that he was soon going to die; ‘a strange woman has chosen to make her home in my brain’, he wrote. (Tadie, Jean-Yves. Marcel Proust. A Life. New York: Viking; 2000:728)

The neural pathological correlates of autism continue to be defined. Abnormalities of the cerebellum have been a consistent pathological finding. Investigators from the University of Chicago have now demonstrated that in patients with high functioning autism saccadic abnormalities can be observed as the result of this cerebellar dysfunction. Individuals with autism had increased variability in saccadic accuracy. Those with delayed language development showed a mild saccadic hypometria. The different patterns of ocular motor deficits in individuals with autism with and without delayed language developments suggest that the path of pathology and the cerebellum may differ depending on the individual’s history of language development. (

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Mass antibiotic antimicrobial administrations have been used in several programmes in an attempt to eliminate trachoma. In a recent study from the Proctor Foundation in San Francisco a longitudinal investigation of 24 randomly selected villages in Ethiopia suggests that the rate of ocular chlamydia infection following mass antibiotic therapy is relatively slow. The authors suggest that the elimination of Chlamydia trachomatis infection in a hyperendemic area is feasible with a biannual mass antibiotic administration. (

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Ginseng is a popular herbal supplement taken to improve energy and vitality. It may promote bleeding and delay clot formation. A paradoxical effect has been noted by investigators at the University of Chicago, who found that patients taking ginseng had a reduced effect of the anticlotting medication warfarin. It is not clear how ginseng interferes with this anticlotting mechanism. (

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It well recognised that depression is a risk factor for the development of cardiovascular disease. The biological mechanism by which depression might increase this risk is unclear. In a study from Baltimore investigators demonstrated that major depression is strongly associated with an increased level of C reactive protein. The reason for this association is yet to be determined. (

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There are several adverse effects associated with the frequent consumption of caffeinated beverages. A study from the University of Georgia has recently shown that in adolescents, especially African-American adolescents, caffeine intake may increase blood pressure and therefore increase the risk of hypertension. Alternatively, caffeinated drink consumption may be a marker for dietary and lifestyle practices that together influence blood pressure. The authors suggest that further study is warranted. (

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The Gilles de la Tourette syndrome is characterised by verbal and motor ticks. The neuropathological mechanisms responsible for it have been little studied. Recent postmortem data suggest that in these patients there is abnormal basoganglion function. Genetic studies suggest that chromosome 8 may be involved in the pathogenesis of this syndrome. Neuroimaging studies suggest that the caudate nuclei are smaller than normal in patients affected with this syndrome. (

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Gaze evoked tinnitus was first described in 1982 and thought to be relatively rare. Since then it is found to be surprisingly common, particularly in patients with post-resection of vestibular tumours. It may develop months after surgery and is usually heard in and caused by the moving of the eyes towards the diseased ear. The exact mechanism is not known. Functional imaging studies of patients with gaze evoked tinnitus have shown anomalous activation of the auditory lateral pons and auditory cortex. (

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Central retinal vein occlusion is one of the most frequent vascular causes of visual loss. Radial optic neurotomy is a controversial procedure that has been suggested as a treatment for central retinal vein occlusion. In a study from Duke University, using a pig model, radial optic neurotomies were performed and the eyes examined histopathologically. Ophthalmoscopic examination demonstrated engorged blood vessels at the site of the surgery after 3 weeks with minimal or no haemorrhage. Histological examination of the optic nerve demonstrated foci haemorrhage, interstitial oedema, reactive gliosis, and minimal inflammatory cells. The neurotomy site was filled with fibrous tissue at 1 week. It is not clear, therefore, how long the radial optic neurotomy can relieve any mechanical forces on retinal veins. The authors suggest further animal studies measuring blood flow and retinal veins after radial optic neurotomy should be performed. (

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Most of us have had the unfortunate experience of overindulging in the consumption of wine or spirits at some time. The morning after this type of indiscretion is less than pleasant. Now there is good news to suggest that one can avoid the dreaded hangover by drinking the extract of the fruit of a prickly pear cactus before any alcohol consumption. This routine seems to cut the risk of a severe hangover in half. Go to: www.sciam.com/

The emergence of new pathogenic viruses in clinical medicine in the past two decades has been noteworthy. In the case of the henipavirus there are only two members Hendra and Nipah, both named for the location of the first related infections. The Nipah virus has recently re-emerged killing 35 people in Bangladesh. Public health officials are concerned since it appears that the virus was at least partially transferred from person to person which had not been noted previously. The Nipah virus is a distant relative of measles and appears to reside naturally in flying foxes, the world’s largest bats. (

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