WHO?

If you ever wondered about the [ WHO ] World Health Organization's  value, wonder no more. WHO else could have handled the following situation w such deftness & sensitivity? The WHO. That'S WHO.

"The World Health Organization announced yesterday it would begin referring to the monkeypox virus as "mpox," the result of a six-month effort to find a nondiscriminatory alternative to avoid stigma. The name "monkeypox" will be phased out over the next year. "

SOURCE 1440 Daily Digest

Lower Back Pain -- Most of Us Have It.

More From Dr. Mike Evans

Sophie, the diary of a Southern Belle (Epilepsy)

10/24/12 

Sophie had two gran mal seizures over the wknd followed by a couple of petit mal seizures. 

If a dog is epileptic it is usually seen between ages 1-2. As Sophie is a rescue we have no record / information on that so we are assuming old dog epilepsy which can be caused by a number of factors: electrolytes out of whack, kidney problems, tick infection, stress, brain tumor. 

We are testing for what can be tested for up to MRI for brain tumor. Rationale being if she has a brain tumor (painless), then what? Sophie has not had a recurrence since Sat night & I am up most of the night every night watching her b/c that's when the episodes occur. 

So far nothing out of the ordinary has been revealed by the tests. She had xrays of chest, kidneys, pancreas, stomach w/o any negative results. We are waiting for urinalysis. Ticks negative. 

If Sophie has more episodes we will put her on anticonvulsants, i.e. phenobarbital or some variant. The prognosis for controlling epilepsy medically is optimistic, short of a brain tumor. If she has no other seizures it will be chalked off to idiopathic (don't know what the f**k it is) or possibly stress. 

There is some logic to the stress diagnosis as the first & most serious episode occurred within 24 hrs of bringing Ziggy into the mix. His extremely high level of activity causes stress even on us but he is sloooowly calming down, learning the routine of the house & some modicum of manners (he's +/- 7 mos old), very smart, very willing to learn, is a lover & is extremely cute. However, Sophie's health comes first so we're keeping our fingers crossed -- no more seizures & Ziggy's learning curve. 

I discussed all this w Sophie's foster mom as she has a right to know what's going on & she told me that she took in another foster shortly after Sophie came to live with her & that Sophie became so agitated that she moved the other foster elsewhere. Sophie had very little confidence when I got her (more than she had when she was first rescued) & she certainly has a lot more now but possibly not enough to convince herself of her position within the household. Stella, OTOH, could give less of a damn. 

I will update this entry as warranted. 

WSJ Article > TICKing Time Bomb

They can wait for months, clinging to the edge of a blade of grass or a bush, for the whiff of an animal's breath or vibration telling them a host approaches.

Around the country, state and federal health officials are battling a continued rise in tick-borne diseases including Lyme, babeosis, and Rocky Mountain spotted fever. Laura Landro has details on Lunch Break.

They are ticks—and when they attach to your skin and feed on your blood over many days, they can transmit diseases. Often hard to diagnose and tricky to treat, tick-borne illnesses—led by Lyme disease—can cause symptoms ranging from headache and muscle aches, to serious and long-term complications that affect the brain, joints, heart, nerves and muscles. Preventing bites to head off illness is particularly important, experts say, because the complex interaction between ticks, their hosts, bacteria and habitats isn't completely understood.

Warmer temperatures are leading some experts to warn that tick activity is starting earlier than usual this year, putting more people at risk.

"This is going to be a horrific season, especially for Lyme," says Leo J. Shea III, a clinical assistant professor at the Rusk Institute of Rehabilitation Medicine, part of New York University Langone Medical Center. He is also president of the International Lyme and Associated Diseases Society.

Lyme may be identified after a tick bite, for example, by an expanding rash that looks like a bull's-eye. But that doesn't always happen, and even after a tick bite, antibodies against Lyme may not show up for weeks, so early blood tests can turn up false negatives. Symptoms such as fatigue, chills, fever, headache and swollen lymph nodes may be misdiagnosed. Some infections can go undetected for months or even years. When caught early, tick-borne diseases can be treated successfully with two weeks of antibiotics, but doctors and researchers still argue about whether a chronic form of Lyme exists, and whether it should be treated with longer courses of the drugs.

To Fight Ticks

Several steps to reduce the chance of picking up disease bearing ticks.

Between 1992 and 2010, reported cases of Lyme doubled, to nearly 23,000, and there were another 7,600 probable cases in 2010, according to the Centers for Disease Control and Prevention. But CDC officials say the true incidence of Lyme may be three times higher. Other infections, including babesiosis, Rocky Mountain spotted fever, and anaplasmosis are steadily increasing, too. While not all ticks carry disease, some may spread two or three types of infections in a single bite.

Researchers say the primary reasons for the global rise of tick-borne illness include the movement of people into areas where animal hosts and tick populations are abundant, and growth in the population of animals that carry ticks, including deer, squirrels and mice.

"We haven't even begun to scratch the surface of the type of pathogens ticks can be harboring and transmitting," says Kristy K. Bradley, state epidemiologist and public health veterinarian for the Oklahoma State Department of Health.

Animals "are a traveling tick parade," Dr. Bradley adds, with pet dogs "bringing them into the home and onto furniture and carpets."

Photo Researchers, Inc.

The brown dog tick, pictured, can transmit Rocky Mountain spotted fever.

Regularly checking the body for ticks can reduce exposure, because removing them quickly can prevent transmission of disease, says Kirby C. Stafford III, chief entomologist at the Connecticut Agricultural Experiment Station, or CAES, in New Haven.

Showering or bathing quickly after being outdoors can also help wash off crawling ticks or make it easier to find them. What won't work: simply jumping in the pool or lake, because ticks can hide in bathing suits and don't quickly drown in water. There are tick-repellent sprays for clothes, but it is wise to immediately launder and dry garments at high temperatures after hiking or golfing in areas where ticks are present.

The CDC is conducting the first study of its kind to determine whether spraying the yard for ticks can not only kill pests, but also reduce human disease. Participating households agreed to be randomly assigned a single spray with a common pesticide, bifenthrin, or one that contained water, without knowing which they would receive.

Paul Mead, chief of epidemiology and surveillance activity at CDC's bacterial-illness branch, says preliminary results from about 1,500 households indicate that a spray reduced the tick population by 60%.

"But there was far less of a reduction in tick encounters and illness," indicating that even a sharp drop in tick populations leaves infected ones behind. "We may have to completely wipe out ticks to get an effect on human illness," he says. The CDC is enrolling households for a second arm of the study and expects final results late in the fall. Organic repellents such as Alaska cedar are also being tested in other studies.

Sometimes fire is the only solution: Wildlife biologist Scott C. Williams roams Connecticut's woods armed with a propane torch to incinerate clumps of Japanese barberry, an invasive plant species that chokes off native vegetation and provides a favorite habitat for ticks.

The CAES program to control the red-berried shrub—once cultivated as decorative—is part of the growing, multifaceted effort around the country to prevent the spread of infections like Lyme, which Dr. Williams has been treated for twice since beginning the project in 2007.

Dr. Bradley's home state of Oklahoma is one of several working with the One Health Initiative, a global program to improve communication between physicians and veterinarians to prevent the spread of infectious disease from animals to people, such as recommending tick collars, sprays or topical treatments with pesticides for dogs.

One problem, says Laura Kahn, a founder of One Health, is that "vets don't like to advise people on human health and physicians don't typically think about these things, so it falls through the cracks." About 75% of new diseases that have emerged globally in the last 30 years are spread from animals to people, many of them through ticks, says Dr. Kahn, who is also a science-and-global-security researcher at Princeton University.

Jason Lipsett, 21 years old, was diagnosed with Lyme in November, after suffering for three years with symptoms including problems with his jaw, recurring sinus infections, migraines and trouble sleeping. He had to give up playing tennis and take a medical leave from Bentley University in Waltham Mass., where he was a senior. He doesn't remember being bitten by a tick but had been camping in the woods in New Hampshire and often spent time outdoors during the summers at a family home in Cape Cod.

Doctors told him he might have chronic fatigue syndrome or fibromyalgia. Depressed about his health, he began seeing a therapist who knew about the symptoms of Lyme and referred him to another physician. That doctor determined he had Lyme—and babesiosis, caused by a parasite that destroys red blood cells.

Mr. Lipsett has been on an antibiotic regimen for four months. He says he has felt better each month and that he is prepared to stay on the drugs until he and his doctor are confident the disease is under control. He is making up courses and hopes to graduate next year. He plans to participate in a 5K run on April 29 to raise money for Time for Lyme, a Stamford, Conn. nonprofit that supports research into Lyme and other tick-borne illnesses.

"I may not be able to run, but I'm going to try to walk it," he says.

Write to Laura Landro at laura.landro@wsj.com

A version of this article appeared Mar. 27, 2012, on page D1 in some U.S. editions of The Wall Street Journal, with the headline: This Season's Ticking Bomb.

Diary of a Soutern Belle - Weeks 4 & 5

It was Thursday night. The Soph & I were cuddling on the sofa & we both fell asleep. About 1:00am Sophie's panting (not heavy) as she began to re-arrange her large frame, awakened me. She had decided to get off the sofa & I watched her step off, uncertainly pausing on her front legs while her rear was still on the cushions (not a pretty sight I might add).

After a few seconds in this position, she hopped off, walked unsteadily for a few feet & unceremoniously dropped to the floor. She moved onto her side. Frightened by this unusual behavior, I got down on the floor with her, stroked & talked to her while checking for bloat (sometimes successful but not always) & otherwise felt around what I could get to. She wasn't moving b7t she wasn't panting hard either.

I called for Carol and we determined that something was definitely wrong. What it was we couldn’t tell. I considered some kind of convulsion or stroke or heart/blood problem. She was quiet, calm, motionless for the longest time and then, as it turned out, gathered her strength, overcame or emerged from her problem to get to her feet. But couldn't.

That's when we made emergency calls. Sophie weighing 120# or so is not easy to move around as you can imagine. Carol searched for a veterinary ambulance to no avail, then contacted the emergency hospital we use to ask some quick questions of the vet on duty & to alert them that we were coming. Carol went off to move the car to the front of the house (shortest distance).

Sliding a large towel under Sophie was a chore but we managed; she whimpered a little. Then all three of us tried to get her up at which point she let out a scream & standing I could see she was holding her left paw aloft, refusing to put any weight on it.

I searched for a broken bone, something in the pad, all for naught but when I got up under her arm/leg pit, she let out another yelp so I moved the towel back & we started to move her to the car. It was a struggle. Sophie helped as much as possible but her rear was working too well either so it was like carrying dead (gulp) weight. I started to consider some kind of spine injury as we moved her closer & closer to the door, resting at 3 or 4 stages. At the car, don't ask me how but I was able to lift her into the rear of the station wagon & I got in with her.

Sophie is not yet confident enough to lie down while traveling by car so she sat, keeping weight off that one leg, leaning her body against my arm which was squashed between her & the side of the car. But I knew by then her spine, spinal column was ok which was some solace. In that condition we made the 20 minute trip to the emergency hospital.

There two/three emergency vet techs met us with a gurney which we transferred Sophie onto without much of a struggle (I think she knew we were trying to help) and the techs wheeled her into the emergency room where we could not follow. Two went with Sophie. One remained with us, to gather some history.

Eventually the vet, Michele Roch, came out to confer with us. Her cursory analysis was a leg problem in the elbow area. It was hot, swollen & produced an immediate reaction from the Soph when extended but she didn't know the cause. We authorized x-rays, blood tests, and whatever else was necessary to deduce what was going on & we waited, dozing off in the waiting room.

Nose was cold, wet -- not always a good barometer. Infection? A high white cell count might point that way but the result was a low white blood count. Conveniently, this could mean body was fighting infection & running low on ammunition.

Medication to relax Sophie enough for the x-ray didn't kick in so we agreed to anesthesia and signed a form authorizing CPR in an emergency. About an hour later we all looked at the digital x-rays together. Joints were good, sockets & seatings looked clean, no fractures, no bone spurs, chips & the like were in evidence. So Ms. Roche reasoned the damage was in the tissue surrounding the joint.

And what could that mean? Anything from an infection discharge to soft tissue cancer.

Sophie was resting comfortably, a surgeon was coming in & would examine her later in the morning so about 5:30am we decided there was nothing more we could do until the surgical consult & we went home, had an early breakfast & waited.... and waited.... and waited. Carol couldn't go to work.

About 10:00am Fri surgeon Judith Feldstein (a Brit) called to discuss Sophie's case. We reviewed what we had observed from 1:00 AM, what we knew of her background, what experiences we had had with her in the three weeks she had been with us: an active, playful, limber, wiggly, romping, chow hound who ate everything in sight, licked all bowls clean, drank water like a Bouvier, was smart as hell, had a winsome personality and perfect bathroom habits, resulting in good deposits left in various spots on the front lawn.

Ms.Feldstein decided to withdraw some liquid, put it under a microscope & send it out for a culture. Same with the blood work. Her concern was that infectious materials left to fester too long could lead to damaged tissues or even the joint, itself. To prevent that she would have to cut the knee open & flush it out thoroughly. However, as a first step, she wanted to put Sophie under again, drain what she could by needle, put her on massive dosages of intravenous antibiotics & wait one day (Sat) to see if there was marked improvement. I asked for her criteria for marked improvement. "If she puts weight on the leg". Sounded reasonable & made sense to us.

I had elected not to visit Sophie out of fear of making her even more anxious with my coming and going but I conferred with the emergency techs taking care of her 2-3x daily. Sophie was NEVER left alone. I was comforted by that and felt I was doing the right thing.

Since Sophie met the criteria, Ms. Feldstein decided to continue intravenous antibiotics rather than cut her open. Sunday, her day off, she came in to check on her & was pleased with Sophie's progress. However, Sophie was not eating despite the fact that we had dropped off her favorite foods.

Sunday night's conference with the emergency vet resulted in the idea of picking Sophie up on Monday, subject to the surgeon's ok, to get her to eat at home, and to follow up with oral antibiotics, a return visit with the surgeon within a week, and only walking on lead to take care of business and then home again to rest up.

But you can't keep a good girl down.

Sophie wanted to run, jump, wriggle & bump -- all bad things. And I had to stop her which made me feel guilty as hell since one goal in her adoption was to give her total freedom to wander & play, something she lacked in her prior life. 

 

At home, we were to keep her off the furniture, medicated: 6 pills in the AM + 7 pills in the PM. We were to put hot compresses on her elbow 3-4x daily. Smart girl that she is, she wouldn't take her pills stuffed in a hot dog, in a pill pocket, mixed in with her dinner (she wouldn't eat), in cream cheese or wrapped in baloney. For one session, peanut butter did the trick. Then she saw it coming. You can put a pill into this girl's mouth wrapped in anything and she can shake her head until the pill falls out of one her jowls but the rest stays in. So we watched her shake her head violently with each attempt and stared helplessly as a little white pill dropped to the floor. I finally took to shoving them down her throat (last resort). A bit of treat, a pill, a bit of treat, a pill, a bit of treat, a pill....

Upchuck once, feeling punky each time but eventually good appetite, lots & lots of water and frequent trips to pee. Stella who is also a chow hound, walks out of the kitchen during the pill routine, wanting no part of it. I know how she thinks: "I don't want to be next. Out of sight, out of mind."

Tuesday we go for a checkup with the surgeon. Sophie is now licking her back left thigh. I don't know what that means. I hope nothing. She looks like an oddly shaved poodle, done by a groomer on hallucinogenics (Remember those days, Timothy Leary?). But she's still Sophie.

The saga continues.

Next step, Newt Gingrich

By John Roach 

After six years and several million dollars, scientists have created a 3-D model of a rat brain circuit.

The accomplishment is a first step toward creating a complete computer model of the brain that will allow a deeper understanding of how our noggins work — and what causes them to malfunction, according to the scientists behind the feat. 

For a starting point, researchers at the Max Planck Florida Institute are focused on how the rat brain processes information gathered by a single whisker. 

They did so because studies in their lab and elsewhere have shown that a single whisker is able to detect, in complete darkness, whether a gap is safe to jump over and, if so, trigger the order to jump. 

What's more, there's a specific region of the brain "that is dedicated to processing information from a dedicated whisker," Marcel Oberlaender, a researcher at the institute and the first author of a paper explaining the research in the journal Cerebral Cortex, told me today.

That region is called the cortical column, a vertically-organized series of connected neurons that form a brain circuit and an elementary building block of the cortex. 

The cortex is the part of the brain responsible for many of the higher functions, such as memory and consciousness.

To build the model, the researchers studied the cortical column in awake and anesthetized rats as well as brain slices and then used computer software and other tools to reconstruct it.

"The model we built is really based on a complete reconstruction of these nerve cells," Oberlaender said. "So how the model looks in the end resembles how it would look in the real animal."

It is composed of 16,000 neurons, each of which can be divided into one of nine different cell types that has characteristic functional, structural and connectivity properties, he added.

The model can now be used to run computer simulations that show, in realistic detail, how signals flow within the brain. So, they can begin to understand, for example, what neurons fire as the rat detects the gap and decides whether or not to jump.

Until now, researchers have only been able to see how a single neuron or a small group of neurons interact during such a process. "We can now, in simulation experiments, mimic what is really going on in these circuits," Oberlaender said.

Going forward, the researchers should be able to use the methodology developed to build this model to add more parts to it, thus incorporating other brain functions such as the motor system that sends a signal down the spinal cord and makes the limbs move so that rat can jump over the gap.

*  *  *

John Roach is a contributing writer for msnbc.com. To learn more about him, check out his website.

A must read > "Topic of Cancer" by Christopher Hitchens

German study > stare at boobs for longer life..... REALLY?

I hope to live to be at least 105.

Frankfurt, Germany, December 6 -- A rather bizarre study carried out by German researchers suggests that staring at women's breasts is good for men's health and increases their life expectancy. The rest of the story

Just in case you were shopping around for cheap open heart surgery

From The Huffington Post: MUMBAI, India -- It looks like an iPad, only it's 1/14th the cost: India has unveiled the prototype of a $35 basic touchscreen tablet aimed at students, which it hopes to bring into production by 2011.

If the government can find a manufacturer, the Linux operating system-based computer would be the latest in a string of "world's cheapest" innovations to hit the market out of India, which is home to the 100,000 rupee ($2,127) compact Nano car, the 749 rupees ($16) water purifier and the $2,000 open-heart surgery.  Read the complete article here.

Living With An Old Dog

Truman @ 14.... Well the old boy is still a bit unsteady on his feet & his head is still slightly tilted after his bout with old age vestibular syndrome but he runs, goes up & down stairs, etc. at an age appropriate speed. Truman was extremely agile, athletic & afraid of nothing & he still exhibits those traits however it's obvious it would be easy to knock him off his feet. 

And he still remembers some of his duties, i.e. closing the door behind himself when he comes in & other such things. He still follows commands when I talk quietly into his right ear & follow up w hand signals but he frequently has senior moments which might be mini episodes of some kind where he stops where ever -- could be facing a wall or in the middle of the yard -- & sometimes has to be distracted from his reverie by hand clapping or a slight touch. Given enough time he seems to come out of these 'episodes' by himself so I'm not too worried.

OTOH, his sense of timing remains impeccable. He still wakes me to go out when needed, gets me up @ 5:30 every morning no matter what, reminds me when it's treat time or dinner time. And he still shows some sexual interest in Stella. Of course she just brushes him off like an errant fly.

I must say that I love living with this old gentleman. It's such a privilege for me to be able to give back to him. It's not that he's very demanding but, whatever his needs, I'm prepared to help him as best as I can for the remainder of his life. It's payback time & that sense of obligation is over powering in me. How could it not be so?

At last report, all his organs & vitals are in great shape so, except for the natural aging process, there doesn't seem to be anything special on the horizon.

Peripheral (Old Age) Vestibular Syndrome

click here for article or here for more information

At age 14  Truman is experiencing this now & it is very upsetting to witness.  His head tilts to one side, his eyes dart back & forth like he's watching a tennis match resulting in vertigo, a loss of appetite, a disinterest in  drinking water, an inability to keep his balance, stand or walk properly. If his eyes were moving up & down  (rather than  back & forth) it would be a death knell.

The syndrome is caused by an inflammation of the nerve that runs between  the ear & brain. In Truman's case, it seemed to come on suddenly. One minute he was playing outside, the next minute he was panting in distress.

The prognosis depends on the possible cause: idiopathic (unknown origin), ear infection, brain tumor. It is feasible the first two could resolve themselves, possibly with residuals (head tilt + walking in circles). The third cause is inoperable.

My heart breaks every time I see him in the hospital (2x daily). Today I got him to wag his tail, we traded kisses & he tried his best to stand on his own when I asked him to.

Day 10 -> 02 Mar 10   Today Truman received his 2nd acupuncture session. When he saw me,  he wanted to get up to greet me, needles & all. He is on Tramadol, eating, drinking, peeing & pooping.  His eyes have stopped shifting from side to side but he has a confused look about him.

He can stand by himself if he's on a surface that offers some traction.  Walking is a veeeery slow process w frequent rest stops & he leans to the left against his handler. For his own protection, he is held aloft by a harness but currently he is carrying most of his weight.

The vets feel he is on the right track, recovering from an episode of idiopathic old age vestibular disease. That's good. It could have been much worse.

Most dogs recover; some w residual weakness & head tilt, some enjoy a full recovery. I don't care as long as he is comfortable & not in pain.  Other than this, the vets concur that he is in fine health.

Day 17 -> 09 Mar 10 Truman has been home for less than a week. In that time I don't think he has improved much although he is getting around by himself for the most part.

We spread runners & mats all over the house but he walks around them. He won't even sleep on them, instead preferring the hard wood floor. However, in the last day or so  he  has agreed to lie on his beds scattered around the house & office.

We've decided to rename him "Lurch" (from the Addams Family) because he walks in spurts, i.e. he no longer has his light, agile movements. And he definitely lists to the left. Frequently he pauses, either because he's lost in thought or he's gathering his forces for the next lurching steps.

When stopped & looking at us, his head seems a little straighter but when walking his head tilts left (where else?) so he is prone to walking in circles.

We do not let him out alone, i.e. he is always on a lead just in case he needs help balancing himself.

However, he is compensating & where I can say he has improved is that he now climbs a few steps without much ado & he can get through a body shake w/o falling over. He cleans out his dish with his head twisted & his appetite hasn't been affected.

He refused my help climbing onto the sofa the other day but did it himself & then got off because he couldn't find a comfortable spot for himself. This was good because I got to sit on the sofa.

He manages a three legged piddle with more grace than before & is eating, drinking, peeing & pooping normally.

His personality is pretty much intact, as charmingly demanding & demonstrative as before. He is a little less vocal but definitely makes his wishes known.

He was discharged with Tramadyl (pain med) which is being tapered so we can see what happens & an antibiotic as a precaution against an inner ear infection which could possibly aggravate his situation.

He is noticeably stiff in his hind quarters but that's his arthritis. And he is getting acupuncture & rehabilitation for that. He has legitimate loss of hearing for normal communication but I lean down & yell in his ear when necessary. He still remembers commands.

The vets tell me he may never get over the disease but  will compensate to the point where I might not even notice the difference.

He will never be the graceful & precocious Truman that I once knew but he's still my best pal & I know he has good spirit & a strong, stubborn, independent will which will serve him well. There is no reason to believe that he won't be with us for a while longer.