Nail Fungus and Nail Salons, Even Celebrities Aren't Immune

For millions of suffers, nail fungus is an unsightly and potentially painful problem. Recently, nail salons have been in the news because of reports of unsanitary practices. Singer and American Idol judge, Paula Abdul went before the California Senate and Business Committee to urge them to pass legislation to provide stricter rules and regulations for nail salons in California.

Abdul's concern stemmed from an incident in 2004, which had her in and out of hospitals for a year after a manicure gave her a nail infection. The infection had her thumb so sensitive that even the touch of hair on her hand made her scream. Nail fungus is a common infection that affects more than 2.5 million Americans annually.

The most common way that nail fungus is spread is by using utensils that haven't been properly sterilized. One California salon spread infection through more than 110 of their clients. The sources were spa chairs that hadn't been properly cleaned. This company wasn't thoroughly cleaning out the bowls on their spa chairs; as a result, microorganisms were growing inside the filters. The cleaning regulations for footbaths were vague, and didn't include instructions for cleaning the filters. When investigators checked behind the screens, they found that bacteria and other microorganisms were thriving. Even though this was an extreme case, it is indicative of what happens because of lax regulations throughout the industry. The most common infections that are passed from salons are fungal infections, specifically nail fungus.

If you find yourself in a position where you have nail fungus, what are your options for eliminating it? You could try a topical over-the-counter medication, which you would just rub over the surface of the nail. This is typically a relatively inexpensive method for treating nail fungus. The difficulty with a purely topical medicine is that, alone, it's virtually ineffective for treating the infection. It would only provide temporary relief from the pain and discomfort. The next option would be to go to your physician and get a prescription medication. This would actually get into your blood stream to treat the nail fungus from the inside out. Terbinafine is the antifungal medication that would be used to treat this infection and if you bought a generic brand of Terbinafine it would cost around $100 for a month supply. The side effects of Terbinafine vary and some can be staggering. They range from itching, rash, and diarrhea to change in vision, liver and even kidney damage.

If you are more interested in nutraceuticals and an all natural approach to medications, then you should consider Leucatin. Leucatin has both an oral and topical approach to eliminating the fungus. The topical treatment is sprayed directly onto the nail 3 times daily for 7 days. The oral treatment is taken twice daily for 7 days. For $67 you would receive enough product to rid yourself of nail fungus, and the best part is that these products are sold with a one year money back guarantee, to ensure that if you're unsatisfied with the product, you can return it, no questions asked.

Leucatin is a good choice for people who want to treat their fungal infections from the inside and out. Leucatin only takes a week to make nails look healthier and shinier; whereas, some of the other products could take you anywhere from 6 to 12 weeks before the nail would be healed. A person's nails are important to keep maintained. Trying a natural treatment would expedite the healing process, which will get you back to wearing sandals in no time! If you want more information on the product, Leucatin, simply go to http://www.leucatin.com.

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Nanowires for Detecting Molecular Signs of Cancer

Harvard University researchers have found that molecular markers indicating the presence of cancer in the body are readily detected in blood scanned by special arrays of silicon nanowires -- even when these cancer markers constitute only one hundred-billionth of the protein present in a drop of blood. In addition to this exceptional accuracy and sensitivity, the minuscule devices also promise to pinpoint the exact type of cancer present with a speed not currently available to clinicians.

A paper describing the work will appear in October in the journal Nature Biotechnology and is now posted on the journal's web site.

"This is one of the first applications of nanotechnology to healthcare and offers a clinical technique that is significantly better than what exists today," says author Charles M. Lieber, Mark Hyman Jr. Professor of Chemistry in Harvard's Faculty of Arts and Sciences. "A nanowire array can test a mere pinprick of blood in just minutes, providing a nearly instantaneous scan for many different cancer markers. It's a device that could open up substantial new possibilities in the diagnosis of cancer and other complex diseases."

Lieber and his colleagues linked slender nanowires conducting a small current with antibody receptors for certain cancer markers -- such as prostate specific antigen (PSA), PSA-a1-antichymotrypsin, carcinoembryonic antigen and mucin-1. When these telltale proteins come into contact with a receptor, it sparks a momentary change in conductance that gives a clear indication of the marker's presence. The detectors differentiate among various cancer markers both through the specific receptors used to snag them and because each binds its receptor for a characteristic length of time before dislodging.

"Our results show that these devices are able to distinguish among molecules with near-perfect selectivity," Lieber says, adding that the risk of false readings is minimized by the incorporation of various control nanowires.

The scientists also fitted some nanowires in the arrays with nucleic acid receptors for telomerase, an enzyme inactive in most of the body's somatic cells but active in at least 80 percent of known human cancers. In testing of extracts from as few as 10 tumor cells, these receptors allowed real-time monitoring of telomerase binding and activity.

Lieber says nanowire arrays could easily be scaled up to detect many different cancer markers -- more of which are being found all the time, thanks to the current boom in proteomics. Widespread use of these cancer markers in healthcare will ultimately depend upon the development of techniques that allow rapid detection of many markers with high selectivity and sensitivity.

"Genomics and proteomics research has elucidated many new biomarkers that have the potential to greatly improve disease diagnosis," the scientists write. "The availability of multiple biomarkers is believed to be especially important in the diagnosis of complex diseases like cancer, for which disease heterogeneity makes tests of single markers inadequate. Patterns of multiple cancer markers might, however, provide the information necessary for robust diagnosis of disease � [and] detection of markers associated with different stages of disease pathogenesis could further facilitate early detection."

While initial rounds of cancer testing today identify only whether or not cancer is present, nanowire arrays have the potential to immediately fill in details on exactly what type of cancer is present. Nanowires could also track patients' health as treatment progresses. Because the arrays detect molecules suspended in fluids, drops of blood could be tested directly, in a physician's office, without any need for biochemical manipulation.

Lieber's co-authors are Gengfeng Zheng, Fernando Patolsky, Yi Cui and Wayne U. Wang, all of Harvard's Department of Chemistry and Chemical Biology, Biophysics Program and Division of Engineering and Applied Sciences. The work was supported by the Defense Advanced Research Projects Agency and the National Cancer Institute.

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Is Obesity a Risk Factor for Asthma?

Obesity is a known risk factor for type II diabetes, heart disease and some forms of cancer. Evidence is now mounting that obesity is also a risk factor for asthma. Reports have shown that nearly 75 percent of emergency room visits for asthma have been among obese individuals and studies have shown that obesity pre-dates asthma. The risk for developing asthma increases with increasing obesity among individuals. Yet little is known about how obesity influences asthma.

In the May issue of the Journal of Allergy and Clinical Immunology, researchers from the Physiology Program at the Harvard School of Public Health describe factors that may contribute to this link between obesity and asthma. In obese people the lungs are under-expanded and the size of breaths is smaller. These factors make it more likely that their airways will narrow. In addition, there is chronic low grade systemic inflammation in the obese. This systemic inflammation appears to originate in fat tissue. Inflammation can affect the smooth muscle in the airways causing the airways to narrow excessively.

There are also changes in the blood levels of hormones derived from fat tissue in the obese that may affect the airways. One of these hormones, leptin, is pro-inflammatory and obese individuals have higher leptin levels than lean individuals. Leptin is found at higher levels among asthmatics regardless of the extent of obesity. In contrast, blood levels of another hormone, adiponectin, which has anti-inflammatory properties, are actually lower among obese individuals.

Jeffrey Fredberg, a co-author of the study and professor of bioengineering and physiology at the Harvard School of Public Health commented, "Obesity has the capacity to impact lung function in a variety of ways. None of them are good and all of them are poorly understood. More research is needed to explain the relationship between asthma and obesity."

Research on the link between obesity and asthma in the authors' labs is supported through grants from the National Institutes of Health and the National Institute of Environmental Health Sciences.

Harvard School of Public Health is dedicated to advancing the public's health through learning, discovery, and communication. More than 300 faculty members are engaged in teaching and training the 900-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children's health to quality of care measurement; from health care management to international health and human rights. For more information on the school visit: http://www.hsph.harvard.edu

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Hard Training Boosts Muscle Power 8% - Lance Armstrong through a Physiological Lens

Catch an athlete with clear potential early in his career, study his physiology over an incredibly eventful seven years including victory in the Tour de France, and you might uncover some incredibly important, indeed amazing facts about what training and dedication can accomplish.

What Edward F. Coyle of the University of Texas-Austin found out about Lance Armstrong was that from 1992-1999, the year of his first of now six consecutive Tour de France wins, "the characteristic that improved most (was) an 8% improvement in muscular efficiency and thus power production when cycling at a given maximal oxygen uptake." Combining the increased muscular efficiency with a planned 7% reduction in body weight and fat leading up to each Tour de France race, "contributed equally to a remarkable 18% improvement in his steady-state power per kilogram" output, the Coyle paper reported.

The study, "Improved muscular efficiency displayed as 'Tour de France' champion matures," appears in the June issue of the Journal of Applied Physiology, published by the American Physiological Society. The research was conducted by Edward F. Coyle, Human Performance Laboratory, Department of Kinesiology and Health Education, University of Texas at Austin.

*[Another study also appearing in the June issue of JAP reports on a different cycling approach: "Six sessions of sprint interval training increases muscle oxidative potential and cycle endurance capacity in humans," by Kirsten A. Burgomaster and Martin J. Gibala, et al., of McMaster University, Canada. See brief report after the Coyle-Armstrong study.]

"Amazing, quantified changes that get more guys off his wheel"

An independent physiologist familiar with the study commented: "This study shows that long term training has a lot bigger effects than we thought. They followed Armstrong - a well-known hard trainer - and the changes in his efficiency over seven years are really quite amazing. We wouldn't be surprised if some major physiological changes happened, but here's a real quantified example."

He added: "Generally there are two ways to improve efficiency: Train your maximum capacity to be very high, or train your sub-maximal capacity to be very efficient. In Armstrong's case, he did both. In the lab they measured his performance against standard oxygen consumption and by the end of the study he was much more efficient utilizing the same amount of oxygen. But on the road," he pointed out, "it means he can go faster and get more guys off his wheel."

Effect of cancer, therapy nil

The period that started when Armstrong was 21 and just turning professional and ending at age 28 with his first TdF victory, also included his cancer diagnosis, surgery, chemotherapy and recovery. About eight months after chemotherapy ceased (August 1997), Armstrong was tested in Coyle's laboratory in the same manner as in his other four visits. The results showed that he "displayed no ill-effects from his previous surgeries and chemotherapy" and were in line with measurements expected from highly trained athletes during periods of detraining, Coyle added later.


The study notes that these findings could be "important because it provides insight, although limited, regarding the recovery of 'performance physiology' after successful treatment for advanced cancer."

Muscular efficiency through possible fiber change: making it look easy

Coyle concedes in the study that the "physiological mechanisms responsible for the 8% improvements in (muscle) efficiency when cycling, as well as the stimuli that provided this adaptation, are unclear. The observation that both gross and delta efficiency improved to the same extent and also with the same time course suggests an improved efficiency of ATP turnover within muscle fibers during contraction." (ATP, or adenosine triphosphate, is a nucleotide present that serves as an energy source for many metabolic processes.)

"One possible mechanism for increased efficiency is that (Armstrong) increased his percentage of type I muscle fibers, (indeed) we predict that he might have increased his percentage of type I muscle fibers from 60% to 80%," the report said. "Interestingly, this magnitude of increase�is remarkably similar to our predictions made in 1991 based on cross-sectional observations of competitive cyclists."

This change in muscle type may account for the apparent ease with which Armstrong seems to be pedaling, albeit at a high cycling cadence.

Whereas the lab tests were held constant at 85 revolutions per minute (rpm) for comparison purposes, Armstrong's "freely chosen cycling cadence during time trial races of 30- to 60-minute duration increased progressively during this y-year period from about 85-95 rpm to about 105-110 rpm. This increase in freely chosen rpm when cycling at high intensity is indeed consistent with increase in type I muscle fibers because cyclists with a higher percentage of type I fibers choose a higher pedaling cadence when exercising at high power outputs," the report said. "Although this may initially seem paradoxical, higher cycling cadence serves to both bring muscle fiber contraction velocity closer to that of maximum power and reduce the muscle and pedaling force required for each cycling stroke," it noted.

As body matures, it gets "smarter"

Coyle said increased muscle efficiency means that "for the same amount of cardiovascular and lung stress Armstrong is producing 8% more power, and yet producing less heat. These results have shown us how to improve already highly trained athletes by aiming at efficiency, which is a muscle phenomenon. But it's also nice to know," he added, "that as you get older that your body becomes wiser in how it does its job and less wasteful in energy usage."

Coyle added later: "There's no doubt that Armstrong started with a strong genetic makeup, but he maximized his abilities and got where his is through dedication and hard training."

Source

The study, entitled "Improved muscular efficiency displayed as 'Tour de France' champion matures," appears in the June issue of the Journal of Applied Physiology, published by the American Physiological Society. The research was conducted by Edward F. Coyle, professor at the Human Performance Laboratory, Department of Kinesiology and Health Education, University of Texas at Austin.

Publisher's note: The research paper by Edward Coyle on Lance Armstrong is being made available at no charge to the public by the American Physiological Society, publisher of the Journal of Applied Physiology: jap.physiology.org/cgi/content/full/98/6/2191.

* McMaster study sees gains from different cycling training approach

Another study in the June issue considers at a different approach to training: "Six sessions of sprint interval training increases muscle oxidative potential and cycle endurance capacity in humans," by Kirsten A. Burgomaster, Martin J. Gibala et al., McMaster University, Hamilton, Canada.

In an editorial, Ed Coyle noted that the Burgomaster et al. study "reminds us of the 'potency' of very intense exercise, performed as 30-second sprints, for stimulating metabolic adaptations within skeletal muscle," in this case totaling as little as 15 minutes over 2 weeks.

The McMaster group "employed 'sprint interval training' on a bicycle ergometer, involving 30-second sprints performed 'all out,' with 4 minutes of recovery," Coyle summarized.

"Recreationally active college students performed only 2-4 minutes of exercise per session and just six sessions over 2 weeks. The remarkable find of this study was that this small total amount of very intense exercise training was sufficient to 'double' the length of time that intense aerobic exercise could be maintained (ie. from 26 to 51 minutes). Although peak oxygen uptake was not increased, aerobic adaptations did occur within active skeletal muscle as reflected by a 38% increase in activity of the mitochondrial enzyme citrate synthase," Coyle noted.

Mechanisms of physiological changes need further study

The Burgomaster et al. paper said the validity of their findings on the doubling of endurance time to fatigue "is bolstered by the fact that all subjects performed extensive familiarization trials before testing and that a control group showed no change in endurance performance when tested 2 weeks apart with no sprint training intervention." In addition, though previous studies showed increases in citrate synthase (CS) activity and glycogen content after several weeks of sprint interval training with equivocal data, "we show here that the total training volume necessary to stimulate these metabolic adaptations is substantially lower than previously suggested."

Nevertheless, they note: "We can only speculate on potential mechanisms responsible for the dramatic improvement in cycle endurance capacity, but it is plausible that a training-induced increase in mitochondrial potential, as measured by CS maximal activity, improved respiratory control sensitivity during exercise as classically proposed (by J Holloszy and E. Coyle)�.We hope that the present observations will stimulate additional research to clarify the precise nature, time course, and significance of the physiological adaptations induced by short sprint interval training."

The study, "Six sessions of sprint interval training increases muscle oxidative potential and cycle endurance capacity in humans," by Kirsten A. Burgomaster, Scott C. Hughes, George J.F. Heigenhauser, Suzanne N. Bradwell and Martin J. Gibala, of McMaster University, Hamilton, Ontario, appears in the June issue of the Journal of Applied Physiology, published by the American Physiological Society. Except for Heigenhauser, researchers are with the Exercise Metabolism Research Group, Dept. of Kinesiology; Heigenhauser is in the Dept. of Medicine.

The media may obtain an electronic version of Burgomaster, Gibala et al., and interview members of the research team by contacting Mayer Resnick at the American Physiological Society, 301.634.7209, cell 301.332.4402 or mresnick@the-aps.org.

The American Physiological Society was founded in 1887 to foster basic and applied bioscience. The Bethesda, Maryland-based society has more than 10,000 members and publishes 14 peer-reviewed journals containing almost 4,000 articles annually.

APS provides a wide range of research, educational and career support and programming to further the contributions of physiology to understanding the mechanisms of diseased and healthy states. In May 2004, APS received the Presidential Award for Excellence in Science, Mathematics and Engineering Mentoring (PAESMEM).

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New Kind of Appetite Suppressant - Hope for the Obese?

Overweight or obese people who are stout around the waist and abdomen are particularly at high risk for developing type 2 diabetes and high blood pressure. The most effective way to reduce blood pressure and the risk for secondary diseases is to reduce weight. But most patients do not succeed in losing weight and keeping it off. A possible alternative could be an entirely new substance group which simultaneously blocks feelings of hunger and reduces blood lipid levels, thereby reducing the risk for cardiovascular diseases and type 2 diabetes.

The new drug, called Rimonabant, has been tested in clinical trials for over two years in Europe and the USA. The European Director of the clinical trials, Professor Luc Van Gaal of the University Hospital in Antwerp, Belgium, presented results of this study at the 4th International Symposium on Obesity and Hypertension at the Max Delbr�ck Center for Molecular Medicine (MDC) Berlin-Buch on Saturday, October 29, 2005. The meeting, which began on October 27, and ran for three days, was organized by Professor Arya Sharma (McMaster University, Hamilton, Ontario, Canada) and Professor Friedrich Luft (Franz Volhard Clinic, Charit� University Medical School Berlin/Helios Clinics Berlin-Buch and the MDC). About 200 experts from Europe, North and South America, and Asia participated.

Lose weight and, most importantly, get rid of abdominal fat - that is what doctors recommend. However, most patients are unable to either lose weight or to keep lost weight off on a permanent basis, regaining the pounds that took them such an effort to loose. Professor Sharma defends the patients: "It is too simple to make the patients alone responsible for this lack of success. Genetic factors play a role in the regulation of bodyweight, as do the fat cells themselves. Frequently, too, medications for blood pressure and diabetes make losing weight more difficult."

A possible alternative could be an entirely new substance group which simultaneously blocks feelings of hunger and reduces blood lipid levels, thereby reducing the risk for cardiovascular diseases and type 2 diabetes. The new drug, called rimonabant, has few side effects. It intervenes exactly where the body controls the hunger feeling, namely in the endocannabinoid system (ECS).

Endocannabinoids are the body's own substances similar to cannabis (hashish), which are released upon feelings of stress, hunger, and pain, as Vincenzo di Marzo explained in Berlin. He is a professor at the Institute for Biomolecular Chemistry of the Italian Research Council in Pozzuoli. Endocannabinoids also play a role in the intricate regulation of the cardiovascular system.

Up to now, particularly two endocannabinoids were known - one of them is anandamide. The name originates from Sanskrit and means "bliss". According to Vincenzo di Marzo, the system was discovered during research on how cannabis (hashish) works, which gave the system its name. When hungry, the organism releases increased amounts of anandamide, he continued. This is in line with the known fact that hashish users frequently have attacks of the "munchies".


Endocannabinoids bind and activate two cannabinoid receptors. In particular, cannabinoid receptor1 (CB1) is of great interest to research and medical practice. CB1 is mainly found in the brain, in different organs, and in fatty tissue. According to Professor di Marzo "[CB1] is obviously primarily responsible for food intake after a starvation period. It sees to it that fat is deposited in the fat cells." This is how the body creates fat reserves in order to survive hunger periods better.

Experiments with obese lab rats have shown that, the more they eat, the more endocannabinoids bind to the CB1-receptor, which is hyperactive in these animals. The result: The binding of endocannabinoids to CB1 increases appetite, Professor George Kunos demonstrated. He is from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), which is part of the National Institutes of Health (NIH) in Bethesda, Maryland, USA. Furthermore, Professor Kunos, who was unable to attend the Berlin meeting, showed in experiments with mice that blocking this receptor with the substance rimonabant reduces appetite. The animals become thin and stay that way despite being offered an overabundance of food. And rimonabant not only reduces the animals' weight but also their blood pressure.

RIO in Europe - Clinical Studies

For over two years, rimonabant has been tested in clinical trials. Director of the RIO (Rimonabant in Obesity) clinical trial in Europe is the diabetologist and metabolism expert Professor Van Gaal. Included in the trial are 1,507 patients from 60 clinics in Belgium, Germany, Finland, Sweden, the Netherlands, and the US with a Body Mass Index (BMI)* of over 30 kg/m2 and of over 27 kg/m2 who additionally have high blood pressure and elevated blood lipid levels. The RIO trial is one of a total of four Phase III trials (testing effects and side effects in a larger number of patients) with 6,600 patients. The patients were put on a diet and also had to complete an exercise program. They were divided into three groups: the first group received 20 mg of rimonabant daily, the second group received 5 mg, a day and the third group received a placebo.

Reduces Bodyweight and Improves Metabolic Parameters As Professor Van Gaal reported in Berlin, one year later, patients who had received daily doses of 20 mg of rimonabant had lost 6.6 kg on average; patients who took the lesser dose of 5 mg lost an average of 3.4 kg; patients who received the placebo lost only an average of 1.8 kg. The group of patients with a daily dosage of 20 mg of rimonabant not only lost the most weight of all of the trial participants, but they lost it in the critical places of abdomen and waist. It is remarkable, according to Prof. Van Gaal, that in these patients, the risk factors for metabolic syndrome and cardiovascular diseases were reduced more than could be expected from mere loss of weight. He estimates that 50 percent of this effect is due to rimonabant. The reason: while patients who received the 5 mg dose of rimonabant clearly lost weight, their blood lipid levels were not as improved as in patients with the higher dose.

Exhibited side effects were nausea, diarrhea, and dizziness, but according to Professor Van Gaal, they were mild and transient. "According to current findings, rimonabant appears to be very promising, especially for the treatment of patients with abdominal obesity," Professor Van Gaal said in Berlin. The two-year study has now been concluded, and it is anticipated that the findings will be published next year.

*The Body Mass Index (BMI) is calculated by dividing the body weight in kilograms by height in meters squared. According to the World Health Organization (WHO), a person with a BMI of more than 25 kg/m�� is considered overweight; whereas a person with a BMI of 30 kg/m�� or more is considered obese. For example, a man who is 1.8 m tall and a weight of 81 kg has a BMI of 25 kg/m��; with a weight of 97 kg, his BMI would be over 30 kg/m��. "

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Know Your Ejection Fraction for a Healthy Heart - February is American Heart Month

Los Angeles - Odds are, most people don't know their ejection fraction, or even what it is - but knowing this number could help protect against sudden cardiac death.

Cardiac electrophysiologist Leslie A. Saxon, M.D., professor of medicine at the Keck School of Medicine of USC, says an ejection fraction is the percentage of blood squeezed out of the left ventricle with each heartbeat.

"Everyone should know their ejection fraction, just like they know their cholesterol level, blood pressure and other measures of cardiovascular health," says Saxon.

Saxon explains that with every heartbeat, oxygen-rich blood is squeezed or ejected out of the heart's left ventricle, the biggest and most muscular of the heart's four chambers. Using tests such as an echocardiogram, doctors can see how well the left ventricle works by taking a measure, or the ejection fraction. An ejection fraction of 50 percent means the ventricle spurts out half its volume each time it contracts.

Healthy ejection fractions are 50 percent or higher; lower ejection fractions can mean cardiomyopathy - a disease of the heart muscle that saps the muscle's strength. Cardiomyopathy is a major cause of sudden cardiac death.

For most patients on Medicare with cardiomyopathy and an ejection fraction of 30 percent or less, a recent announcement by the federal government provides for expanded coverage of implantable cardioverter defibrillators (ICDs), which can interrupt cardiac arrest by monitoring the heart's rhythm and delivering an electrical shock when a life-threatening arrhythmia is detected.

"Sudden cardiac death causes about a thousand deaths in this country every single day," says Saxon. "Research shows that 95 percent of people who experience cardiac arrest die, often before they can even reach an emergency room. But with an implantable defibrillator, sudden death could actually be prevented in 98 percent of cases."

Many patients with heart trouble who have needed the defibrillators have been unable to afford them, until now. Medicare's expanded coverage will allow patients who have never had a heart attack - but who have a serious heart condition - to benefit from the ICDs.

For more information about determining your ejection fraction or who is eligible for an ICD, call 1-800-USC-CARE or visit http://www.usc.edu/cardiacep

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Pregnancy Morning Sickness - Ginger as Effective as Vitamin B6

Ginger works as well as vitamin B6 at reducing nausea and vomiting in pregnant women without any side effects to the fetus, according to a review of previous studies that is published in the April 1 issue of... Obstetrics & Gynecology, Reuters Health reports. Dr. Francesca Borrelli of the Department of Experimental Pharmacology at the Universita Degli Studi di Napoli Federico II and colleagues reviewed six double-blinded studies with a combined total of 675 pregnant women reporting nausea. In four of the studies, ginger was more effective than a placebo in controlling nausea and vomiting, even in women with a severe form of morning sickness called hyperemesis gravidarum, Reuters Health reports. The other two studies randomly assigned participants to take three times per day for three weeks either a capsule containing 350 milligrams of ginger or one containing 25 milligrams of vitamin B6. Both studies found that ginger and vitamin B6 improved nausea, vomiting and dry retching symptoms in slightly more than half of the participants. Some of the women taking ginger reported side effects such as headache, diarrhea and drowsiness, but there were no differences in pregnancy outcomes among women taking ginger, vitamin B6 or placebo, according to Reuters Health. The review's authors concluded that the data are still "preliminary" and more studies are needed to confirm the safety of ginger use by pregnant women, Reuters Health reports (Reuters Health, 4/4).

"Reprinted with permission from kaisernetwork.org kaisernetwork.org. You can view the entire Kaiser Daily Reproductive Health Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/repro The Kaiser Daily Reproductive Health Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . � 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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Vegan Athletes Flex Their Muscles

In a recent interview Olympic track star Carl Lewis, who was a vegan during his best years, says he believes that "most athletes have the worst diet in the world, and they compete in spite of it."

Members of Organic Athlete's "Vegan Pro-Activist" team are out to prove that a plant-based diet is the best diet for optimal health and performance, and that they can succeed at high levels in sports because they are vegan.

Many people are resistant about becoming vegan because of dietary myths like not getting enough protein, but elite vegan athletes and health professionals are participating in the 2005 Organic Athlete Conference to dispel these myths. Scheduled for September 24th, the goal of the conference is to share information about the benefits of a plant-based diet.

"At first other athletes told me I should really start eating meat," says Brendan Brazier, a professional tri-athlete and vegan for six years. According to Brazier, those same friends now realize, based on his outstanding athletic example, that a vegan diet is optimal for high performance athletes.

The conference schedule includes talks from endurance athletes like Brazier and Christine Vardaros, a world class cyclo-cross racer, who has risen to the top of her sport as a vegan. But even in the protein-crazed sport of bodybuilding vegans are finding success. Kenneth G. Williams, a bodybuilder who placed 3rd at the 2004 Natural Olympia, and Charlie Abel, a raw vegan muscleman and personal trainer, will both speak at the event.

Leading nutritionists Dr. Doug Graham, Rozalind Gruben, Dr. Ruth Heidrich and Dr. Rick Dina will join the athletes in explaining the science of vegan nutrition. Dr. Graham, who has trained many Olympic caliber athletes, explains: "Every nutrient known to be essential for human health is available, in proper concentration, in plant foods. This is not so with animal-based foods, as there are many essential nutrients totally absent in them."

The conference will be held at Sports Basement's Presidio store. The $65 fee includes all educational seminars, food demos, training sessions, lunch and a gift certificate to Sports Basement. The World Vegetarian Day Celebration will be held the following day in Golden Gate Park. For more information about the OrganicAthlete conference, visit organicathlete.org/conference or call 707-360-8511.

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Meditation skills of Buddhist monks yield clues to brain's regulation of attention

In an unusual but fruitful collaboration between Tibetan Buddhist monks and neuroscientists, researchers have uncovered clues to how mental states--and their underlying neural mechanisms--can impact conscious visual experience. In their study, reported in the June 7 issue of Current Biology, the researchers found evidence that the skills developed by Tibetan Buddhist monks in their practice of a certain type of meditation can strongly influence their experience of a phenomenon, termed "perceptual rivalry," that deals with attention and consciousness.

The work is reported by Olivia Carter and Jack Pettigrew of the University of Queensland, Australia, and colleagues at the University of Queensland and the University of California, Berkeley.

Perceptual rivalry arises normally when two different images are presented to each eye, and it is manifested as a fluctuation--typically, over the course of seconds--in the "dominant" image that is consciously perceived. The neural events underlying perceptual rivalry are not well understood but are thought to involve brain mechanisms that regulate attention and conscious awareness.

Some previous work had suggested that skilled meditation can alter certain aspects of the brain's neural activity, though the significance of such changes in terms of actually understanding brain function remains unclear.

To gain insight into how visual perception is regulated within the brain, researchers in the new study chose to investigate the extent to which certain types of trained meditative practice can influence the conscious experience of visual perceptual rivalry.

With the support of His Holiness the Dalai Lama, 76 Tibetan Buddhist monks participated in the study, which was carried out at or near their mountain retreats in the Himalaya, Zanskar, and Ladakhi Ranges of India. The monks possessed meditative training ranging from 5 to 54 years; among the group were three "retreatist" meditators, each with at least 20 years of experience in isolated retreats.

The researchers tested the experience of visual rivalry by monks during the practice of two types of meditation: a "compassion"-oriented meditation, described as a contemplation of suffering within the world combined with an emanation of loving kindness, and "one-point" meditation, described as the maintained focus of attention on a single object or thought, a focus that leads to a stability and clarity of mind.

Whereas no observable change in the rate of "visual switching" during rivalry was seen in monks practicing compassion meditation, major increases in the durations of perceptual dominance were experienced by monks practicing one-point meditation. Within this group, three monks, including two of the retreatists, reported complete visual stability during the entire five-minute meditation period. Increases in duration of perceptual dominance were also seen in monks after a period of one-point meditation.

In a different test of perceptual rivalry, in this case prior to any meditation, the duration of stable perception experienced by monks averaged 4.1 seconds, compared to 2.6 seconds for meditation-na�ve control subjects. Remarkably, when instructed to actively maintain the duration, one of the retreatist monks could maintain a constant visual perception during this test for 723 seconds.

The findings suggest that processes particularly associated with one-point meditation--perhaps involving intense attentional focus and the ability to stabilize the mind--contribute to the prolonged rivalry dominance experienced by the monks. The researchers conclude from their study that individuals trained in meditation can considerably alter the normal fluctuations in conscious state that are induced by perceptual rivalry and suggest that, in combination with previous work, the new findings support the idea that perceptual rivalry can be modulated by high-level, top-down neural influences.

The researchers include O.L. Carter, C. Callistemon, Y. Ungerer, G.B. Liu, and J.D. Pettigrew of University of Queensland; and D.E. Presti of University of California, Berkeley.

Carter, O.L., Presti, D.E., Callistemon, C., Ungerer, Y., Liu, G.B., and Pettigrew, J.D. (2005). Meditation alters perceptual rivalry in Tibetan Buddhist monks. Publishing in Current Biology, Vol. 15, June 7, 2005, pages R412-R413. http://www.current-biology.com

Contact: Heidi Hardman
hhardman@cell.com
1-617-397-2879
Cell Press
http://www.cellpress.com

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Wild Versus Farmed Salmon, The Pros And Cons

On the one hand, farmed salmon has more heart-healthy omega-3 fatty acids than wild salmon. On the other hand, it also tends to have much higher levels of chemical contaminants that are known to cause cancer, memory impairment and neurobehavioral changes in children. What's a consumer to do?

In general, a new study shows that the net benefits of eating wild Pacific salmon outweigh those of eating farmed Atlantic salmon, when the risks of chemical contaminants are considered, although there are important regional differences.

Those are the conclusions of Barbara Knuth, Cornell professor of natural resources who specializes in risk management associated with chemical contaminants in fish, and Steven Schwager, Cornell associate professor of biological statistics and computational biology and an expert in sampling design and statistical analysis of comparative data. The two have co-authored a benefit-risk analysis of eating farmed versus wild salmon in the Journal of Nutrition (November, Vol. 135).

"None of us [study authors] argues that the benefits of salmon are not real. But the dirty little secret is that there are risks," said Schwager, noting that even taking into account the risks, the benefits of salmon may be particularly worthwhile for some groups.

"For a middle-aged guy who has had a coronary and doesn't want to have another one, the risks from pollutants are minor ones, and the omega-3 benefits him in a way that far outstrips the relatively minor risks of the pollutants," he said. "But for people who are young -- and they're at risk of lifetime accumulation of pollutants that are carcinogenic -- or pregnant women -- with the risks of birth defects and IQ diminution and other kinds of damage to the fetus -- those risks are great enough that they outweigh the benefits."

Knuth added: "Because we found regional differences in contaminants in farmed salmon, with Chilean salmon showing the lowest levels and European (particularly Scottish) farmed salmon showing the highest levels, careful consumers with a history of heart disease could choose farmed salmon from Chile for their high omega-3 content and relatively lower level of contaminants." She noted that farmed salmon from North America would be a better second choice than European farmed salmon.

The researchers' benefit-risk analysis showed that consumers should not eat farmed fish from Scotland, Norway and eastern Canada more than three times a year; farmed fish from Maine, western Canada and Washington state no more than three to six times a year; and farmed fish from Chile no more than about six times a year. Wild chum salmon can be consumed safely as often as once a week, pink salmon, Sockeye and Coho about twice a month and Chinook just under once a month.

In a study published last spring (Environmental Health Perspectives, May 2005), the research team reported that the levels of chlorinated pesticides, dioxins, PCBs and other contaminants are up to 10 times greater in farm-raised salmon than in wild Pacific salmon, and that salmon farmed in Europe are more contaminated than salmon from South and North American farms.

The team also published a study this fall (Environmental Science and Technology, Vol. 39:8622) that found that farmed salmon, on average, contain roughly two to three times more beneficial fatty acids than wild salmon, presumably because of the differences in the diet on which the fish are raised.

"Our results also support the need for policy and regulatory efforts to limit pollution of our waters and clean up pollution that has occurred, and thus ultimately reduce the risk side of this equation by reducing the potential for human exposure to these contaminants," said Knuth, adding that the country of origin of fish sold should be clearly labeled so consumers can make informed decisions.

Other co-authors of the risk-benefit study include lead author Jeffrey Foran, University of Illinois-Chicago; David Carpenter, University at Albany; David Good, Indiana University; and Coreen Hamilton, AXYS Analytical Services Ltd., British Columbia, Canada. The study was funded by the Environmental Division of the Pew Charitable Trusts.

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Morphine May Help In The Final Stage Of Life For Patients With Breathing Difficulties

A report written by an OHSU physician with more than a half century of medical experience contradicts both public and professional bias against the use of morphine in the final stage of life for patients with breathing difficulties. Because large amounts of morphine slows breathing, doctors have avoided prescribing the drug to dying patients with breathing difficulties for fear it would shorten life. However, the author of this new case series suggests that some patients who receive an appropriate level of morphine live a little longer because their fear and struggle for breath are reduced. The research is published in the current issue of the Journal of Palliative Care.

"Much has changed in health care since the initial concerns about morphine and breathing difficulties were documented in the 1950's," said Miles Edwards M.D., Professor of Medicine Emeritus in the OHSU School of Medicine and a clinical consultant the Center for Ethics in Health Care at OHSU. "For decades, physicians have been advised to avoid prescribing even small doses of morphine to dying patients with breathing difficulties based on the traditional belief that the drug made breathing more difficult and hastened death. However that line of thinking seems to be a medical urban legend. In fact, this age-old advice should likely be reversed for some patients. By slowing down breathing with morphine and controlling panic, patients become fatigued less quickly. They are breathing at a slower pace, but they also require less oxygen so the condition and the drug don't act in conflict with one another as one might think."

The research paper focused on five case examples involving patients who had been given appropriate doses of morphine to control their suffering in the final stage of life after a ventilator was removed. This case series focused on patients who were on ventilators at the end of life and who wanted the ventilators withdrawn. The major finding of this case series was that each of the patients lived longer than predicted by their physicians when morphine and sedation were provided. The paper provides details about each of these cases, contradicting the longstanding beliefs that moderate doses of morphine hasten death by suppressing breathing.

"Overall, the appropriate use of morphine in the final minutes, hours or days of life is becoming a more accepted practice by doctors nationwide," explained Susan Tolle, MD., Director for the Center for Ethics in Health Care at OHSU. "If a person feels that they are suffocating, they struggle for oxygen and panic sets in. Much like a scuba diver who panics, these patients are trying to use more oxygen than is available to them. What Dr. Edwards has learned is that an appropriate level of morphine can suppress this anxiety allowing a person to survive on less oxygen and live longer. It also allows these patients to live out their final minutes, hours or days of life in a more peaceful manner."

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Herbal Supplement, N-Acetylcysteine (NAC), Helps Reduce Cocaine Cravings

A new study funded by the National Institutes of Health (NIH) suggests that a common over-the-counter herbal supplement can reduce the cravings associated with chronic cocaine use. This research, released at the American College of Neuropsychopharmacology's (ACNP) annual conference is among the first to identify N-acetylcysteine (NAC) as a potential agent to modulate the effects of cocaine addiction. There is also early evidence in animal models of addiction to suggest that this chemical works similarly in the treatment of heroin addiction, and possibly alcoholism.

NAC is available over the counter as an herbal supplement known for its antioxidant effects. Antioxidants are agents that clean up damaging free radicals in the body and are therefore thought to slow down the aging process of cells. The research was conducted specifically on because of its known metabolic pathway in the brain - affecting one of the same proteins as cocaine use.

"Cocaine is highly addictive and can have devastating effects on the health and well being of users," says lead researcher Peter Kalivas, Ph.D., Professor and Chair of the Department of Neurosciences at the Medical University of South Carolina (MUSC). "The discovery that a readily available herbal supplement can reduce the intense cravings associated with cocaine use is an important finding for individuals undergoing treatment for cocaine addiction. Reduced craving might help addicted individuals restrain from abusing cocaine."

In the first phase of the study, Dr. Kalivas and the research team conditioned rats on a regimen of cocaine to establish their addiction. The rats in the treatment group were then treated with NAC. After treatment, the cocaine-addicted rats exposed to NAC were significantly less likely to seek out cocaine than those without NAC. Those treated with NAC ceased to actively seek cocaine, but showed normal food-seeking behaviors.

In the second phase of the study headed by Drs. Robert Malcolm, Hugh Myrick, Steve LaRowe, and Pascale Mardikian in the Department of Psychiatry at MUSC, NAC treatment was investigated in a small inpatient study (n=15) involving non-treatment seeking cocaine-dependent subjects. In this phase of research, subjects were asked to look at pictures that were either neutral (e.g., trees, boats) or cocaine-related (e.g., drug paraphernalia). Those individuals treated with NAC reported less craving for cocaine and spent less time looking at the cocaine-related pictures. In addition, when using a functional magnetic resonance imaging (fMRI) test, subjects treated with NAC had reduced brain activity in the prefrontal cortex, the area of the brain activated during cocaine craving and used to modulate the addictive behavior of chronic cocaine use. An open label trial, which was recently completed, indicated that cocaine-dependent patients could take NAC on an extended outpatient basis, with minimal side effects. More importantly, patients taking higher doses of NAC were more likely to complete the trial, providing further indication of the potential benefits of NAC.

"The potential to use NAC for the treatment of individuals addicted to cocaine is a major finding," emphasized Dr. Kalivas. "For those individuals who have the desire to end their addictive habit, a NAC supplement might help to control their cravings."

A larger clinical trial that will follow 282 cocaine-dependent individuals has just begun in order to further understand and corroborate how NAC works in the brain to reduce cocaine craving. Dr. Kalivas stresses that while the initial findings are very promising, the widespread use of NAC in cocaine treatment is not advised until larger scale studies are complete.

In addition to its antioxidant properties, NAC is currently used in a variety of other ways: to counteract the effects of an overdose of acetaminophen (i.e., Tylenol�), to break up mucus in respiratory ailments, to lessen the symptoms of colds or the flu, and even to reduce the effects of hangovers. It is important to note that over-the-counter NAC may not be produced in the same manner as the prescription version used in this study, and that all herbal supplements should be used in moderation.

Cocaine is an illegal drug that acts as a powerful stimulant in the body. There are approximately 1.5 million Americans dependent on or abusing cocaine (i.e., chronic users). In addition, 2.7 percent of the general U.S. population has tried cocaine during their lifetime. Adults aged 18 to 25, particularly men, have the highest rates of cocaine use.

ACNP is holding its Annual Meeting December 11-15, 2005, in Waikoloa, Hawaii.

ACNP, founded in 1961, is a professional organization of more than 700 leading scientists, including three Nobel Laureates. The mission of ACNP is to further research and education in neuropsychopharmacology and related fields in the following ways: promoting the interaction of a broad range of scientific disciplines of brain and behavior in order to advance the understanding of prevention and treatment of disease of the nervous system including psychiatric, neurological, behavioral and addictive disorders; encouraging scientists to enter research careers in fields related to these disorders and their treatment; and ensuring the dissemination of relevant scientific advances. A non-profit organization, ACNP receives revenues from a variety of sources including membership dues, publication sales, registration fees, and pharmaceutical industry grants.

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Common Cause of Neck and Arm Pain, Cervical Disc Degeneration - Porous Coated Motion (PCM) Artificial Disc Trial

Rush University Medical Center is one of the few sites in the country selected to participate in a clinical trial for the Artificial Cervical (neck) Disc, the latest technology in the field. The objective of the study is to evaluate the safety and effectiveness of the Porous Coated Motion (PCM) Artificial Disc for treatment of degenerative disc disease compared to conventional anterior cervical discectomy and spinal fusion surgery.

Cervical disc degeneration is a common cause of neck and arm pain that can greatly impact quality of life. The disc is a flexible material between the vertebrae that holds the bones together while still allowing for movement. Because of the demands put on the disc, it sometimes can 'herniate' or wear down causing pain. If treatments, such as rest, medications, physical therapy and activity modification are not successful, the standard surgical treatment is to remove the disc and then use a graft of bone and plate with screws to fuse the two vertebrae together.

According to Dr. Frank Phillips, orthopedic surgeon at Rush and primary investigator for the PCM Artificial Disc trial, spinal fusion is a highly successful operation for relieving symptoms, but there are potential drawbacks over time. The permanent fusion of bone eliminates natural movement between the vertebrae resulting in increased stress on the discs above and below the fusion. This additional pressure may cause excessive wear and tear on the adjacent discs, which may lead to more pain and the need for additional surgery.

"The goal is to find an implant that can simulate the natural function of the cervical disc and restore the physiologic motion of the cervical spine," said Phillips.

The PCM Artificial Cervical Disc combines the use of metal and plastic, the same materials that have been in use for 30 years in hip and knee replacements, to mimic the function of the disc. The implant has two halves: an upper metal (Cobalt Chrome alloy) endplate, and a lower metal endplate to which a plastic (polyethylene) spacer is attached. The endplates are designed to bond with the neighboring vertebrae. The interface between the two halves is like a ball and socket, allowing the upper half to slide and rotate forward and backward relative to the lower half.

The surgical approach to implant the PCM device is the same as that used for cervical discectomy and fusion. A small incision is made in the front of the neck and the damaged disc is removed along with any other tissue that is compressing the nerve. After shaping the edges of the vertebrae to ensure a proper fit, the PCM Artificial Disc is inserted. The surgery lasts approximately one to two hours and most patients leave the hospital the following day. A soft collar is optional for comfort and there are few activity restrictions recommended for the first six weeks.

If the cervical device is demonstrated to be safe and effective and is approved by the FDA, Philips believes it will be more widely used than the artificial lumbar disc, which has already received FDA approval for use in the lower lumbar spine. "The anterior surgical approach to the cervical spine is more straight forward than the approach in the lumbar spine. Spine surgeons have used this approach routinely for many years. As a result, if it became necessary to replace or revise the cervical device, there would be considerably less risk compared to revising a lumbar disc," said Philips.

Developed in consultation with leading cervical spine surgeons from the United States, Europe, and Brazil, the PCM Artificial Disc was approved by the FDA for US clinical trials in December 2004. Up to twenty centers across the country will participate in the prospective, randomized, controlled study.

Patients in the study will be randomly selected in a 2 to 1 ratio to receive either the PCM Artificial Cervical Disc surgery or anterior cervical discectomy and fusion surgery. Qualified participants must be between the ages of 18 and 65; have been diagnosed with disc degeneration or disk herniation in the cervical spine and have arm or shoulder pain and weakness or other symptoms or nerve compression. In addition, they must have been treated by a physician for more than six weeks for pain and symptoms. Patients will be required to return for follow-up visits at Rush for at least two years.

Dr. Edward Goldberg and Dr. Howard An, both orthopedic surgeons, are be co-investigators along with Phillips. All of the physicians on staff at Rush University Medical Center and members of the private practice group Midwest Orthopaedics at Rush.

For more information on this clinical trial call 1-888-DOC-DISC (1-888-362-3472).

http://www.rush.edu

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Chronic Wound Dressings - New Matrix Restores A More Normal Healing Environment

Johnson & Johnson Wound Management, division of ETHICON, INC, a Johnson & Johnson company, today announced PROMOGRAN PRISMA� Matrix as the latest addition to their family of chronic wound dressings. Developed to provide protection and growth in a changing wound environment, PRIMSA� Matrix absorbs destructive components of wound exudate while promoting healthy tissue healing.

The unique combination of collagen, oxidized regenerated cellulose (ORC) and silver-ORC� delivers a balanced combination of protection and growth for a variety of wound types and conditions at any exudate level. PRISMA� Matrix removes destructive elements and components in wound fluid, kills clinically relevant bacteria in the dressing to help maintain bacterial balance and reduces bacterial growth, which may reduce the risk of infection. The dressing also promotes healthy tissue growth while delivering silver to the wound. The collagen provides a biodegradable matrix for cellular invasion and capillary growth while creating an environment that promotes the formation of granulation tissue, epithelialization and optimal wound healing.

"With PRISMA� Matrix, Johnson & Johnson Wound Management continues its pioneering role as a wound care industry leader," stated William Li, M.D., president of the Angiogenesis Foundation in Cambridge, MA. "This single product is an integrated technology that addresses multiple factors causing impaired healing. PRISMA� Matrix can be used as part of the standard approach to restoring proper balance in the wound bed to promote successful healing."

PRISMA� Matrix is intended for the management of exuding wounds. Under the supervision of a health care professional, PRISMA� Matrix may be used for the management of diabetic, venous and pressure ulcers, ulcers caused by mixed vascular etiologies, full- and partial-thickness wounds, donor sites and other bleeding surface wounds, abrasions, traumatic wounds healing by secondary intention and dehisced surgical wounds. PRISMA� Matrix may be used under compression therapy with health care professional supervision.

PRISMA� Matrix is not indicated for third-degree burns or patients with known sensitivity to silver, ORC or collagen. PRISMA� Matrix may be used when visible signs of infection are present in the wound area only when proper medical treatment addresses the underlying cause. PRISMA� Matrix is not intended to be a substitute for appropriate treatment of infection.

Johnson & Johnson Wound Management, a division of ETHICON, INC., a Johnson & Johnson company, continues the Company's 100-year commitment to skin and wound care today with inventive products for chronic and acute wound management, burn care and hemostasis. For more information about Johnson & Johnson Wound Management or other ETHICON divisions, visit or http://www.advancedwoundcare.com or http://www.ethiconinc.com.

� Silver-ORC contains 0.25 percent ionically-bound silver.

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New Natural Extract for Treating MRSA

A presentation at the American Society for Microbiology meeting in Atlanta hears today about a safe, natural and effective treatment for MRSA infections that are multi-drug resistant. The new formulations of capsules, liquid and cr�me are extracted from fresh garlic to yield the ONLY commercially available presentation of Allicin. Allicin is an excellent natural antimicrobial that can deal with a range of drug resistant bacteria.

How does Allicin work?

Stabilised allicin has now been formulated into an active range of products called Allimed�. Powdercapsules, liquid, soap and cream presentations all show highly significant activity against multi-drug resistant organisms including MRSA.

The mechanism of action of allicin may be due to inhibition of certain thiolcontaining enzymes in the microorganisms by the rapid reaction of thiosulfinates with thiol groups.

This was assumed to be the main mechanism involved in the antibiotic effect of allicin. Recent studies have suggested that the mechanism of action of Allicin may be its ability to react with a model thiol compound (L-cysteine) to form the S-thiolation product S-allylmercaptocysteine.

The identification of the thiolation product was proven by nuclear magnetic resonance as well as by mass spectroscopy.

The main antimicrobial effect of allicin is due to its interaction with important thiol-containing enzymes. In the amoeba parasite, allicin was found to strongly inhibit the cysteine proteinases, alcohol dehydrogenases as well as the thioredoxin reductases (Ankri et al., unpublished results) which are critical for maintaining the correct redox state within the parasite. Inhibition of these enzymes was observed at rather low concentrations (<10 mg/mL).

Allicin also irreversibly inhibited the well known thiol-protease papain, the NADP+ dependent alcohol dehydrogenase from Thermoanaerobium brockii and the NAD+ dependent alcohol dehvdrogenase from horse liver. Figure A shows the effect of allicin on alcohol dehydrogenase activity using 2 different alcohol substrates. This indicates the level of alcohol dehydrogenase activity in the solution. There is a clear relationship between reduction in activity and increasing allicin concentration (mg/I)

How to use ALLIMED formulations

Allimed capsules contain 450mg of stabilised allicin powder, which consists of non GM maltodextrin, gum acacia and allicin. Normal daily dose is 3 capsules per day all at once or split makes no difference.

Allimed 30ml liquid spray contains only stabilised allicin liquid at a concentration approaching 1000ppm (parts per million) and this can be sprayed into an open wound. Sometimes it might sting a little but this indicates activity. When a wound begins to heal and a fine red layer of new skin develops it is best to stop using the spray as it can irritate new sking growth. At this stage in the haling process it is better to apply a little more cream over the healing wound - or directly into a dressing.

Allimed cream contains 500ppm allicin and at this concentration so far ALL tested strains of MRSA have been easily irradicated. Apply the cream around the edge of the wound (or onto cuts bites etc). A little goes a long way!

For further information please contact Peter Josling
Peter Josling
Director
Allicin International Limited
Delivering Nature's Antimicrobial
Telephone 011 44 1424 892 440
Email info@allicin.co.uk
http://www.allicin.co.uk

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Antibiotic Treatment Successful Against Elephantiasis

A single course of one antibiotic can successfully treat elephantiasis (filariasis)-a parasitic worm disease that is one of the most common causes of global disability, concludes a study published in this week's issue of The Lancet.

Bancroftian filariasis is a disease characterised by severe and debilitating swelling of the limbs. The search for compounds active against the causative organism, Wuchereria bancrofti adult worms, has so far failed to deliver a radical curative treatment. The antifilarial drugs currently used, diethylcarbamazine and ivermectin, are predominantly active against the larval offspring of the parasite. These treatments form the basis of global programmes used to eliminate lymphatic filariasis. However, drugs with adult worm activity could greatly improve the prospects of programme closure.

Mark Taylor (Liverpool School of Tropical Medicine, Liverpool, UK) and colleagues tested whether treatment against Wolbachia-a bacterium the adult worms are dependent on- could be effective for filariasis. They recruited 72 men infected with W bancrofti from Kimang'a village, Pangani, Tanzania, aged 15-68 years. Half were assigned to placebo and half to an 8-week course of the antibiotic doxycycline.

They found that doxycycline treatment resulted in almost complete elimination of adult worms 14 months after treatment and a sustained loss of larval offspring from at least 8 to 14 months after treatment. Dr Taylor concludes: "In our study, an 8-week course of doxycycline against W bancrofti induced both sustained reductions in the larval offspring and, most notably, the adult worm activity.

This is especially important since the adult worms cause the disease pathology in lymphatic filariasis and no safe, effective treatment against adult worms exists�However, an 8-week course of doxycycline treatment is not applicable to mass treatment strategies because of both the logistical difficulties of delivering long-term treatments and doxycycline being contraindicated in children younger than 8 years and pregnant women." (Quote by e-mail; does not appear in published paper)

Dr Mark J Taylor, Molecular and Biochemical Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, LIVERPOOL, L3 5QA, UK

Comment Wilma Stolk, Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, PO Box 1738, 3000 DR Rotterdam, Netherlands.

http://www.thelancet.com
In an accompanying Comment Wilma Stolk (Erasmus MC, Rotterdam, Netherlands) states: "Research should now focus on identification of regimens, based on doxycycline or other antibiotics, that are practical for use in mass treatment . . ."

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Vaccine to Stop Smoking effective in Phase II Trials

Cytos Biotechnology AG announced that its vaccine candidate CYT002-NicQb to treat nicotine addiction has achieved proof of efficacy. The phase II clinical trial results were presented by Prof. Dr. Jacques Cornuz (CHUV Lausanne), principal investigator, at the Annual Meeting of the American Society of Clinical Oncology (ASCO) in Orlando, USA, on behalf of the three Swiss study centres. The study included 341 smokers and assessed safety, tolerability and efficacy of the vaccine candidate.

Efficacy of the vaccine was determined by continuous abstinence from smoking between week 8 and 24 after treatment start and was measured by self-reporting of the participating smokers and by independent biochemical validation.

Two thirds of the smokers received the vaccine, whereas one third received placebo. All smokers who received the vaccine mounted an anti-nicotine antibody response, which corresponds to an immunological response rate of 100%. Based on the measured levels of antibodies, the vaccinetreated smokers were grouped into a high, a medium, and a low responder group.

All smokers who received placebo had no measurable anti-nicotine antibodies in their blood. The following table provides the continuous abstinence values of the analysis of all smokers from whom complete antibody measurements were available and who refrained from using nicotine replacement products (NRT) (NRT use was considered a major protocol violation):

The difference of continuous abstinence between the high responder group and the placebo group was highly significant (p=0.004). Overall cigarette consumption in the high responder group was less than half of that seen in the placebo group (p=0.004). Moreover, the average cigarette consumption by those people who did not achieve continuous abstinence was also lower in the high responder group than in the placebo group (p=0.16). The vaccine was safe and generally well tolerated with common side effects being local injection site reactions and flu-like symptoms, which usually resolved within 24 hours.

Prof. Dr. Jacques Cornuz commented: "I am very excited about the outcome of this study, as the data clearly suggest that antibodies against nicotine are effective in helping people quit smoking. There is certainly no doubt that new approaches such as vaccination are urgently needed. Despite the fact that smoking causes 30% of all cancer deaths, including 87% of deaths from lung cancer, there are 1.3 billion smokers worldwide. And each smoker looses on average more than 10 years of lifetime as a result from this serious addiction. I believe that the vaccine approach has the potential to dramatically alter the way how we will treat smoking addiction in the future."

Dr. Wolfgang Renner, Chief Executive Officer of Cytos Biotechnology, added: "We are extremely pleased about the results as the data in the high responder group are better than anything we have seen so far. The clear correlation between antibody levels and clinical effect greatly supports us in the further development of this vaccine. It is now our goal to get everybody into this high antibody response range; and to achieve this we have several measures at hand: A) We will increase the dose of the vaccine, as we have already done with other clinical candidates in different indications,
B) we can add more injections as even after the fourth injection there appeared to be no antibody plateau, and

C) we will certainly use these findings in our ongoing formulation development. But most importantly, the data show elegantly that we can use the body's own defence, the immune system, to modulate even such complex conditions like addiction. This finding is extremely important with respect to our pipeline of 27 vaccine candidates in other major disease areas like high blood pressure, obesity or Alzheimer's disease where we use the same basic ImmunodrugTM principle."

More information about the phase II study, the vaccine candidate CYT002-NicQb and general information about smoking and nicotine addiction can be found on http://www.smokersvaccine.com.

About nicotine addiction

According to the World Health Organization, 1.3 billion people smoke. With 5 million tobacco-related deaths per year, tobacco use is the leading cause of preventable death in the world today.

Smoking harms nearly every organ of the body and 30% of all cancer deaths, including 87% of deaths from lung cancer, are attributable to smoking (American Cancer Society, 2005). Nicotine, an alkaloid derived from tobacco leaves, has been shown to be the principal addictive component of tobacco.

Upon inhalation of cigarette smoke, nicotine passes into the bloodstream and within seconds penetrates through the blood-brain barrier, where it stimulates specific neurons in the brain.

Stimulation of these neurons leads to the release of messenger molecules, which give rise to an almost immediate reward and a feeling of pleasure. This sensory stimulus is critical to the addictive properties of nicotine and causes a high relapse rate after quitting attempts. Although nearly 75% of smokers in the U.S. report that they want to quit smoking, less than 5% of those who try quitting are able to stay tobacco-free for 3 to 12 months (Surgeon's General Report, USA, 2004).

About CYT002-NicQb

CYT002-NicQb is a therapeutic vaccine in development for the treatment of nicotine addiction. Vaccination with CYT002-NicQb has been shown to induce high levels of nicotine-specific antibodies that bind nicotine in the blood. As the complex of nicotine attached to an antibody is too large to pass the blood-brain-barrier, nicotine uptake into the brain and the subsequent stimulation of nicotine-perceptive neurons in the brain is believed to be significantly reduced or even prevented. In this way the addiction-driving and satisfaction-inducing stimulus of nicotine is minimized.

About the phase II study

The study, the largest ever performed with a vaccine to treat nicotine addiction, was a randomized, double blind, placebo-controlled, multicenter phase II clinical trial to assess safety, tolerability and efficacy of the vaccine candidate. It was carried out at the Kantonsspital St. Gallen, the Centre Hospitalier Universitaire Vaudois (CHUV) Lausanne, and the Lung Center Hirslanden Zurich, all in Switzerland. The study was conducted in 341 healthy male and female smokers, aged 18-70 who have been smoking between 10 and 40 cigarettes per day for at least 3 years and who were motivated to quit smoking. 5 injections of the vaccine or placebo were given at monthly intervals at month 0, 1, 2, 3, and 4. All participants received smoking cessation counselling by the study collaborators at each visit during three months. One month after the first injection, the participants were asked to make a serious attempt to quit smoking. Smoking behaviour was recorded by the participants in personal diaries, and independent biochemical validation was performed by measuring carbon monoxide in exhaled air (a by-product of cigarette burn that remains in the blood for up to 24 hours).

About the analysis

Out of 341 smokers enrolled in the study, all participants were included in the efficacy analysis from whom complete antibody measurements were available and who refrained from using nicotine replacement therapy (NRT) (n=239). NRT is believed to have a different effect on the two treatment groups (CYT002-NicQb and placebo). Based on the proposed mechanism of action, NRT products and the vaccine are expected to neutralize each other, whereas in smokers on placebo NRT has a documented positive effect.

An intent-to-treat analysis of the entire study population has not achieved statistical significance; therefore, the sub-group analysis based on antibody levels was performed.

In this analysis, NRT users were excluded, then, the vaccinated smokers with complete antibody measurements were divided into three groups of increasing antibody levels (low, medium, and high responder group), and efficacy analysis was performed on each group. The placebo group was treated identically: NRT users were excluded and all participants with complete antibody measurements were included. Study participants were counted as continuously abstinent only when at all visits between week 8 and 24 the carbon monoxide concentration in their exhaled air was below 10 ppm and when throughout the entire period between week 8 and 24 they declared themselves as being non-smokers.

Media and Analyst Conferences for CYT002-NicQb phase II study results

Cytos Biotechnology will hold the following media and analyst conferences related to the CYT002- NicQb phase II study results:

- 2 Media Conferences on Tuesday, May 17, 2005, 10.30am (CET) at Cytos Biotechnology, Wagistrasse 25, CH-8952 Schlieren, and at the CHUV, Rue du Bugnon 46, CH-1011 Lausanne, room "Andros" at level 8, room No 1205.

At Cytos Biotechnology in Schlieren: Dr. Wolfgang Renner, CEO, and Dr. Philipp M�ller, Executive Vice President Clinical Development of Cytos Biotechnology, and the study investigators Dr. Felix Jungi and Dr. Karl Klingler will be available for interviews. The presentation will be in German (or on demand in English).

At the CHUV in Lausanne: Jakob Schlapbach, CFO of Cytos Biotechnology, and Prof. Dr. Jacques Cornuz, principal investigator of the study will be available for interviews. The presentation will be in French.

- Conference for analysts and investors on Tuesday, May 17, 2005, 2pm (CET) at Cytos Biotechnology, Wagistrasse 25, CH-8952 Schlieren.
Dr. Wolfgang Renner, CEO, and Dr. Philipp M�ller, Executive Vice President Clinical Development of Cytos Biotechnology, and the study investigators Dr. Felix Jungi and Dr. Karl Klingler will be available for interviews. The presentation will be in English and will also be accessible by live webcast via the internet site http://www.cytos.com.

About Cytos Biotechnology AG

Cytos Biotechnology AG is a public Swiss biotechnology company that specializes in the discovery, development and commercialization of a new class of biopharmaceutical products - the ImmunodrugsTM. ImmunodrugsTM are intended for use in the treatment and prevention of common chronic diseases, which afflict millions of people worldwide. ImmunodrugsTM are designed to instruct the patient's immune system to produce desired therapeutic antibody or cytotoxic T-cell responses that modulate chronic disease processes. Taking advantage of the high flexibility of its ImmunodrugTM platform, Cytos Biotechnology has built a pipeline of 27 different ImmunodrugTM candidates in various disease areas, of which six are currently in clinical development. The Immunodrug� candidates are developed both in-house (24) and together with Novartis (1) and Pfizer Animal Health (2).

Founded in 1995 as a spin-off from the Swiss Federal Institute of Technology (ETH) in Zurich, the company is located in Schlieren (Zurich). Currently, the company has 110 employees. Cytos Biotechnology AG has been listed on the SWX Swiss Exchange (SWX:CYTN) since October 2002.

For further information please contact:

For all requests
Cytos Biotechnology AG
Dr. Claudine Blaser
Director Corporate Communications
Phone: +41 44 733 47 20
Fax: +41 44 733 47 18
e-Mail: claudine.blaser@cytos.com
Websites: http://www.smokersvaccine.com
http://www.cytos.com

For US and on site ASCO requests
Ms. Gina Cella
Mobile: +1 781 799 31 37
Office phone: +1 781 334 46 92
e-Mail: ginacella@comcast.net

This foregoing press release may contain forward-looking statements that include words or phrases such as "believe", "has the potential", "it is the goal", "will", "can", "is believed", designed to", "intend", or other similar expressions. These forward-looking statements are subject to a variety of significant uncertainties, including scientific, business, economic and financial factors, and therefore actual results may differ significantly from those presented. There can be no assurance that any other therapeutic entities will enter clinical trials, that clinical trial results will be predictive for future results, that therapeutic entities will be the subject of filings for regulatory approval, that any drug candidates will receive marketing approval from the U.S. Food and Drug Administration or equivalent regulatory authorities, or that drugs will be marketed successfully. Against the background of these uncertainties readers should not rely on forward-looking statements. The company assumes no responsibility to update forward-looking statements or adapt them to future events or developments. This document does not constitute an offer or invitation to subscribe or purchase any securities of Cytos Biotechnology AG.

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ACE First To Evaluate Curves for Women(reg) - World's Most Popular Fitness Franchise

Exclusive ACE (American Council on Exercise) Study Examines Intensity of Curves for Women Workout -

With more than four million female members and over 8,500 locations worldwide, Curves(reg) for Women is the fastest growing franchise in U.S. history. In an exclusive study, the American Council on Exercise (ACE), America's nonprofit fitness advocate, commissioned researchers from the Exercise Physiology Department at the University of Wisconsin-LaCrosse to determine the exercise intensity and number of calories burned in a typical Curves for Women workout.

Lead researchers Kristin A. Greany; John P. Porcari, FACSM; and Carl Foster, FACSM, tested 15 healthy women from two Curves locations in the greater La Crosse area (average age of 42). The heart rate and oxygen consumption of each participant was monitored as they participated in two complete Curves workouts.

The study found that the 30-minute Curves workout, including five minutes of stretching and cool-down, burns an average of 184 calories making it a good "moderate-intensity" workout for those who are not very active. The aerobic benefit of exercising at this intensity is equivalent to walking at a speed of four miles per hour on a level treadmill.

"At first glance, the results of the study suggest that the Curves workout offers modest training benefits because of the limited calories burned," said Dr. Cedric X. Bryant, chief exercise physiologist for ACE. "However, this specifically-designed circuit workout does provide participants an effective aerobic training stimulus plus the added benefit of a total-body resistance training workout."

Researchers did express some concerns about the Curves workout. The hydraulic resistance machines used in the circuit workout are not adjustable. Therefore, the machines may not perfectly fit some individuals causing them to sacrifice proper form. Women should also avoid the temptation to turn their Curves workouts into a social hour. Researchers noted some of the women in the study were more focused on chatting during their workouts than exercising.

Finally, not all Curves franchises are staffed with skilled fitness professionals and researchers feel Curves members may benefit from having their workouts supervised by more highly-trained individuals. Curves does offer basic fitness training for its franchise owners, however, that fitness knowledge may not effectively trickle down to individual franchise employees.

Complete study results appear in the March/April edition of ACE Fitness Matters magazine or on our Web site at acefitness.org/getfit/curves.cfm.

About ACE

The American Council on Exercise (ACE), America's Authority on Fitness, is a nonprofit organization dedicated to promoting the benefits of physical activity and protecting consumers against unsafe and ineffective fitness products and instruction. As the nation's "workout watchdog," ACE sponsors university-based exercise science research and testing that targets fitness products and trends. ACE sets standards for fitness professionals and is the world's largest nonprofit fitness certifying organization. For more information on ACE and its programs, call (800) 825-3636 or log onto the ACE Web site at http://www.acefitness.org.

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Botox Injections Effective for Treating Stroke Spasticity

New research shows that repeated treatments of botulinum toxin type A (BoNTA) over one year after a stroke can improve muscle tone and reduce pain in the arms and hands, making it easier for patients to dress themselves and perform personal hygiene.

"The treatment resulted in sustained and meaningful functional improvement that makes a difference in the daily lives of stroke patients and the people who care for them," said Allison Brashear, M.D., professor and chairman of neurology at Wake Forest University Baptist Medical Center.

The findings were presented today at the 2005 Annual Meeting of the American Association of Physical Medicine and Rehabilitation (AAPM&R) in Philadelphia. The study was conducted by Brashear and colleagues while she was at Indiana University School of Medicine.

This was the first long-term study to evaluate repeated treatment with BoNTA for post-stroke spasticity, a muscle tightness that inhibits movement. Brashear and colleagues had previously reported (New England Journal of Medicine, August 2002) that one-time injections of BoNTA are safe and effective in people with wrist and finger spasticity after a stroke.

The study reported on today involved 35 centers and included 279 stroke patients with wrist, hand or elbow spasticity. Disabling spasticity affects between 17 percent and 30 percent of stroke survivors and can lead to functional limitations, discomfort and pain. Upper limb spasticity can interfere with patients' mobility, comfort and their ability to dress, wash or feed themselves and perform other activities of daily living.

During the year-long study, all study participants received up to five treatments with BoNTA, which is sold under the trade name BOTOX. For the study, the BoNTA injections were given at the wrist, thumbs, fingers and elbows to block overactive nerve impulses that trigger excessive muscle contractions.

Researchers found that at week six of the study, muscle tone in the wrist, fingers, thumb, and elbow was markedly improved from baseline, and was sustained throughout the study. The study also measured functional disability in four areas: hygiene, dressing, limb posture and pain. Before the first treatment, patients selected an area that was most important to them. On a four-point scale that ranged from "no disability" to "severe disability," at least 50 percent of patients achieved a 1-point or greater improvement in the area they targeted.

"If it isn't managed effectively, post-stroke spasticity can result in very disabling complications such as contractures, a condition that leaves the muscles and tendons permanently shortened," said Brashear. "Early intervention with effective therapies is absolutely vital to prevent the profound disability that afflicts many stroke patients, and to lessen the emotional and financial toll on caregivers and the health care system as a whole."

The study found that adverse events related to treatment, such as headache, pain in the arm, or an influenza-like illness, were reported in 7 percent of patients. Brashear said these results show that the treatment is safe and well-tolerated in post-stroke patients and may represent a significant advantage over many oral anti-spasticity medications.

"Such drugs are associated with a high incidence of systemic effects such as sedation, mental confusion, dizziness and muscle weakness, all of which can seriously hinder rehabilitation after a stroke," she said.

Every year, about 700,000 Americans suffer a new or recurring stroke. Stroke is a leading cause of serious, long-term disability in the United States, and it is estimated that the costs associated with lost productivity due to stroke-related disability will total $21.8 billion in 2005.

The research was funded by Allergan Inc., the pharmaceutical company that developed BoNTA. Brashear's co-researchers were Elie Elovic, M.D., of Kessler Medical Rehabilitation Research and Education Corporation and New Jersey Medical School, Darryl Kaelin, M.D., of the Shepherd Center, Atlanta, and Robin McIntosh, Jingyu Liu, Ph.D., and Catherine Turkel, PharmD., M.B.A., all with Allergan Inc.

Wake Forest University Baptist Medical Center is an academic health system comprised of North Carolina Baptist Hospital and Wake Forest University Health Sciences, which operates the university's School of Medicine. The system comprises 1,187 acute care, psychiatric, rehabilitation and long-term care beds and is consistently ranked as one of "America's Best Hospitals" by U.S. News & World Report.

Karen Richardson
krchrdsn@wfubmc.edu
Wake Forest University Baptist Medical Center
http://www.wfubmc.edu

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Misdiagnosing Narcissism - The Bipolar I Disorder

Bipolar patients in the manic phase exhibit many of the signs and symptoms of pathological narcissism - hyperactivity, self-centeredness, lack of empathy, and control freakery. During this recurring chapter of the disease, the patient is euphoric, has grandiose fantasies, spins unrealistic schemes, and has frequent rage attacks (is irritable) if her or his wishes and plans are (inevitably) frustrated.

The manic phases of the Bipolar Disorder, however, are limited in time - NPD is not. Furthermore, the mania is followed by - usually protracted - depressive episodes. The narcissist is also frequently dysphoric. But whereas the Bipolar sinks into deep self-deprecation, self-devaluation, unbounded pessimism, all-pervasive guilt and anhedonia - the narcissist, even when depressed, never forgoes his narcissism: his grandiosity, sense of entitlement, haughtiness, and lack of empathy.

Narcissistic dysphorias are much shorter and reactive - they constitute a response to the grandiosity gap. In plain words, the narcissist is dejected when confronted with the abyss between his inflated self-image and grandiose fantasies - and the drab reality of his life: his failures, lack of accomplishments, disintegrating interpersonal relationships, and low status. Yet, one dose of narcissistic supply is enough to elevate the narcissists from the depth of misery to the heights of manic euphoria.

Not so with the Bipolar. The source of her or his mood swings is assumed to be brain biochemistry - not the availability of narcissistic supply. Whereas the narcissist is in full control of his faculties, even when maximally agitated, the Bipolar often feels that s/he has lost control of his/her brain ("flight of ideas"), his/her speech, his/her attention span (distractibility), and his/her motor functions.

The Bipolar is prone to reckless behaviors and substance abuse only during the manic phase. The narcissist does drugs, drinks, gambles, shops on credit, indulges in unsafe sex or in other compulsive behaviors both when elated and when deflated.

As a rule, the Bipolar's manic phase interferes with his/her social and occupational functioning. Many narcissists, in contrast, reach the highest rungs of their community, church, firm, or voluntary organization. Most of the time, they function flawlessly - though the inevitable blowups and the grating extortion of narcissistic supply usually put an end to the narcissist's career and social liaisons.

The manic phase of Bipolar sometimes requires hospitalization and - more frequently than admitted - involves psychotic features. Narcissists are never hospitalized as the risk for self-harm is minute. Moreover, psychotic microepisodes in narcissism are decompensatory in nature and appear only under unendurable stress (e.g., in intensive therapy).

The Bipolar's mania provokes discomfort in both strangers and in the patient's nearest and dearest. His/her constant cheer and compulsive insistence on interpersonal, sexual, and occupational, or professional interactions engenders unease and repulsion. Her/his lability of mood - rapid shifts between uncontrollable rage and unnatural good spirits - is downright intimidating. The narcissist's gregariousness, by comparison, is calculated, "cold", controlled, and goal-orientated (the extraction of narcissistic supply). His cycles of mood and affect are far less pronounced and less rapid.


The Bipolar's swollen self-esteem, overstated self-confidence, obvious grandiosity, and delusional fantasies are akin to the narcissist's and are the source of the diagnostic confusion. Both types of patients purport to give advice, carry out an assignment, accomplish a mission, or embark on an enterprise for which they are uniquely unqualified and lack the talents, skills, knowledge, or experience required.

But the Bipolar's bombast is far more delusional than the narcissist's. Ideas of reference and magical thinking are common and, in this sense, the Bipolar is closer to the Schizotypal than to the Narcissistic.

There are other differentiating symptoms:

Sleep disorders - notably acute insomnia - are common in the manic phase of Bipolar and uncommon in narcissism. So is "Manic speech" - pressured, uninterruptible, loud, rapid, dramatic (includes singing and humorous asides), sometimes incomprehensible, incoherent, chaotic, and lasts for hours. It reflects the Bipolar's inner turmoil and his/her inability to control his/her racing and kaleidoscopic thoughts.

As opposed to narcissists, Bipolar in the manic phase are often distracted by the slightest stimuli, are unable to focus on relevant data, or to maintain the thread of conversation. They are "all over the place" - simultaneously initiating numerous business ventures, joining a myriad organization, writing umpteen letters, contacting hundreds of friends and perfect strangers, acting in a domineering, demanding, and intrusive manner, totally disregarding the needs and emotions of the unfortunate recipients of their unwanted attentions. They rarely follow up on their projects.

The transformation is so marked that the Bipolar is often described by his/her closest as "not himself/herself". Indeed, some Bipolars relocate, change name and appearance, and lose contact with their "former life". Antisocial or even criminal behavior is not uncommon and aggression is marked, directed at both others (assault) and oneself (suicide). Some Biploars describe an acuteness of the senses, akin to experiences recounted by drug users: smells, sounds, and sights are accentuated and attain an unearthly quality.

As opposed to narcissists, Bipolars regret their misdeeds following the manic phase and try to atone for their actions. They realize and accept that "something is wrong with them" and seek help. During the depressive phase they are ego-dystonic and their defenses are autoplastic (they blame themselves for their defeats, failures, and mishaps).

Finally, pathological narcissism is already discernible in early adolescence. The full-fledged Bipolar Disorder - including a manic phase - rarely occurs before the age of 20. The narcissist is consistent in his pathology - not so the Bipolar. The onset of the manic episode is fast and furious and results in a conspicuous metamorphosis of the patient.

More about this topic here:

Stormberg, D., Roningstam, E., Gunderson, J., & Tohen, M. (1998) Pathological Narcissism in Bipolar Disorder Patients. Journal of Personality Disorders, 12, 179-185

Roningstam, E. (1996), Pathological Narcissism and Narcissistic Personality Disorder in Axis I Disorders. Harvard Review of Psychiatry, 3, 326-340

By: Dr. Sam Vaknin

First published in my
"Narcissistic Personality Disorder" Topic Page on Suite 101

(The use of gender pronouns in this article reflects the clinical facts: most narcissists are men).

The manic phase of Bipolar I Disorder is often misdiagnosed as Narcissistic Personality Disorder (NPD).

AUTHOR BIO:

Sam Vaknin is the author of Malignant Self Love - Narcissism Revisited and After the Rain - How the West Lost the East. He served as a columnist for Global Politician, Central Europe Review, PopMatters, Bellaonline, and eBookWeb, a United Press International (UPI) Senior Business Correspondent, and the editor of mental health and Central East Europe categories in The Open Directory and Suite101.

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