'Night vision eyedrops' improve vision up to 50 meters in dark

An independent research group called Science for the Masses have developed eyedrops that allow the user to identify symbols and people in darkened areas up to 50 meters away.

The patent the researchers based their eyedrops on was originally given to patients that had lost their low light vision.

The eyedrops utilize a mixture of insulin and chlorin e6 (Ce6) - a chlorophyll analog that has be used for many years in laser-assisted cancer treatment. Ce6 has light-amplifying properties, allowing surgeons to use energy from low-power light sources to destroy tumor cells.

However, recent research has found that Ce6 could also be used to treat night blindness and improve the vision of people with certain visual disturbances, through direct application to the eye.

In addition to Ce6 and saline, insulin was used in the mixture in order to achieve greater absorption of Ce6 into the chamber of the eyes. Another substance, dimethylsulfoxide (DMSO) was also used in order to increase the permeability of the eye's cellular membranes.

The eyedrops were applied to researcher Gabriel Licina with a micropipette while his eyes were held open with a speculum to guarantee absorption. Prior to the eyedrops being administered, the subject's eyes were cleaned with saline to remove any small particles that may have been present.

Once the eyedrops had been applied, Licina wore protective contact lens and sunglasses to protect himself from exposure to bright light as the solution began to work, increasing the intensity of light.

After allowing the subject's eyes to adjust for two hours, their vision was then tested in a darkened area alongside four control subjects. The participants were asked to identify different symbols at a distance of 10 meters, symbols on varying background colors and moving symbols with varying background colors at varying distances.

The participants were also asked to identify a number of individuals who were located in a small grove of trees with a laser pointer. Each individual was located between 25-50 meters away from the participants' observation point.

With the help of the Ce6 eyedrops, the subject was able to consistently recognize symbols that the controls were unable to see. When identifying the individuals in the dark wooded area, the subject had a 100% success rate, compared with a 33% success rate for the control participants.

Further tests planned to quantify improvements to vision

The researchers plan to conduct further tests in order to measure the improvements to vision more objectively.

"A Ganzfeld stimulator and electroretinigraph will be used to measure the actual amount of electrical stimulation increase from the eye, giving a hard quantifiable number to the degree of amplification," write the researchers. "It is also possible to test which ranges of vision are being amplified as well."

The subject did not report any adverse effects over the 20 days following the use of the eyedrops. His vision had returned to normal by the following day.

Science for the Masses subscribe to the notion of "citizen science," whereby access to tools and resources is available to anyone who wishes to perform scientific research.

"Citizen scientists and 'DIY biologists' are under no pressure to reach or hold a position of tenure and often do not have the need to produce for monetary reasons," write the researchers. "It is possible that this will allow for less bias in publishing and a more open release of work due to the lack of external motivators."

Due to their independent status, however, the researchers note that they do not have access to certain tools and resources that would enable them to verify their findings swiftly and efficiently. Consequently, there is still much to be done by the team, but in these early stages their research has already made illuminating reading.

Recently, Medical News Today investigated retinal degeneration disorders and what forms of treatment are currently being developed to tackle blindness.

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Does an apple a day really keep the doctor away?

The proverbial advice to eat an apple a day first appeared in print in 1866. Nearly 150 years later, a medical journal has used the excuse of April Fool's Day to publish a study that asks - seriously - whether this wisdom really does keep the doctor away.

The daily apple eaters in the study were more likely to successfully avoid prescription medication use than people who did not eat apples.

The study tells us that the "an apple a day keeps the doctor away" aphorism was coined in 1913 but was based on the original form with a different rhyme, some 149 years ago in Wales: "Eat an apple on going to bed and you'll keep the doctor from earning his bread," went the proverb in Pembrokeshire.

The University of Michigan School of Nursing researchers in Ann Arbor believe giving such medical proverbs an empirical evaluation "may allow us to profit from the wisdom of our predecessors."

For the study's measure of keeping the doctor away, Matthew Davis, PhD, and co-authors evaluated an outcome of no more than one visit a year to the doctor as a means of investigating the proverb's success in daily apple eaters compared with non-apple eaters.

So did a daily apple succeed in keeping the doctor away? No, it did not. There was no statistically meaningful difference in visits to the doctor for daily apple eaters in the analysis. But the study did find that an apple a day kept the pharmacist away.

'Avoiding the use of health care services'

When socio-demographic and health-related characteristics such as education and smoking were taken into account, daily apple eating was not associated with successfully keeping to a maximum of one self-reported doctor visit a year.

Of the 8,399 participants who answered a questionnaire to recall their dietary intakes, 9% (753) were apple eaters and the remainder, 7,646, were non-apple eaters.

The apple eaters showed higher educational attainment, were more likely to be from a racial or ethnic minority, and were less likely to smoke. The data for the analysis came from the National Health and Nutrition Examination Survey conducted during 2007-08 and 2009-10.

"While the direction of the associations we observed supports the superiority of apple eaters over non-apple eaters at avoiding the use of health care services, these differences largely lacked statistical significance," say the authors after accounting for the differences in apple-eaters that - beyond the effects of the apple-eating itself - could have explained why they used health care services less.

An apple a day means one of at least 7 cm diameter

To analyze apple-eating against visits to the doctor, the researchers compared daily apple eaters with non-apple eaters. An apple a day counted if the participants answered that they had at least 149 g of raw apple.

Eating less than this amount counted as no daily apple-eating, and apple consumption based purely on juices or sauces was also excluded. The study also looked for any response to increasing the amount of daily apple-eating by comparing doctor visits from people who ate no apples with those who ate one small apple, one medium apple or one large apple daily.

The analysis shows no relationship between apple "dose" and the likelihood of keeping the doctor away in terms of "avoiding health care services." Except, found the authors, for avoidance of prescription medications.

The study found that apple eaters were more likely to keep the doctor away, but this was before adjusting for the socio-demographic and health characteristics of the survey respondents - 39.0% of apple-eaters avoided more than one yearly doctor visit, compared with 33.9% of non-apple eaters.

The daily apple eaters were also more likely to successfully avoid prescription medication use (47.7% versus 41.8%) - and this difference survived statistical analysis.

The association between eating an apple a day and keeping the pharmacist away, then, was a statistically significant finding, whereas keeping the doctor away failed to hold true.

Nor did the proverb show any effect in an analysis of overnight hospital stays or mental health visits - there was no difference for apple eaters in the likelihood of keeping either of these two away.

The overall conclusion of this study was that only one finding supported the long-standing wisdom. Apple eaters "were somewhat more likely to avoid prescription medication use than non-apple eaters."

The authors say in their final analysis that promotion of apple consumption may have only "limited benefit" in reducing national health care spending, adding:

"In the age of evidence-based assertions, however, there may be merit to saying, 'An apple a day keeps the pharmacist away.'"

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First Asia-Pacific vision-restoring "bionic eye" implant performed

Groundbreaking bionic retinal implant surgery has been performed in Honolulu by a team at the Eye Surgery Center of Hawaii. The procedure is the first of its kind in the Asia-Pacific region to help restore vision for the blind.

The Argus II "bionic eye implant has the potential to restore vision to patients, who have been in total or near total darkness."

The team of doctors, led by Dr. Gregg T. Kokame, completed the cutting-edge procedure on March 24, 2015. Dr. Mark Humayun, Prof. of Ophthalmology at the University of Southern California (USC) Eye Institute, Los Angeles, CA and the co-inventor of the Argus II implant was also present for this historic event.

The Eye Surgery Center of Hawaii is an ophthalmology specialty surgery center and a portfolio company of SKAI Ventures that is focused exclusively on the surgical treatment of the eye in Hawaii and the Asia-Pacific region. There are presently eighteen eye surgeons who perform ophthalmologic surgeries at the center.

Dr. Kokame, founder and president of Retina Consultants of Hawaii, and the president of the Eye Surgery Center of Hawaii says:

"Today is a historical day for many reasons. This 'bionic eye' implant has the potential to restore vision to patients, who have been in total or near total darkness. This can dramatically change the quality of life of these patients."

"I have been involved in the care of hereditary blindness since the beginning of my career in Ophthalmology at the UCLA Jules Stein Eye Institute," he adds. "I have watched patients progressively lose vision, but this new futuristic technology is now available to allow potential vision recovery to patients who are functionally blind."

World's first approved vision-restoring device

"We are excited to bring this life-changing technology to Hawaii residents and to the Asia-Pacific region," comments Dr. Hank Wuh, CEO of SKAI Ventures. "As the leading center of excellence for vision surgery, we hope to help people with retinal blindness throughout the region."

The "bionic eye," known officially as the Argus II Retinal Prosthesis System (Argus II), is the world's first approved device intended to restore some functional vision for people suffering from blindness. The Argus II, developed at USC, has shown dramatic clinical results to help patients with retinal blindness be able to utilize artificial vision to see.

Argus II is approved for use in the United States and the European Economic Area and is available in European countries and the Middle East.

The implantation of the Argus II novel vision-restoring device at the Eye Surgery Center of Hawaii is the first time the procedure has been performed in the Asia-Pacific region. The Eye Surgery Center of Hawaii is also only the second center in the western US to perform the procedure - the first being USC.

Argus II headband and Argus II glasses.
Image credit: Second Sight

The doctors have scheduled more artificial retinal bionic implant transplants at the Eye Surgery Center of Hawaii.

Patients with blindness from retinitis pigmentosa, who are interested in being evaluated for this procedure, should contact Dr. Gregg Kokame's office at 808-487-8928 or email inquiries to research@retinahi.com.

Patients from the Asia-Pacific region interested in bionic retina transplantation should contact SKAI Ventures Concierge Program at gulloa@skaiventures.com or 808-949-2208 ext. 129.

Medical News Today recently reported that a blind man affected by a degenerative condition known as retinitis pigmentosa is now able to see objects and people again with the help of a bionic eye implant.

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1,000-year-old potion shows promise against MRSA

MRSA has become one of the deadliest bacteria of modern times. The cause of more than 80,000 severe infections in the US every year, the "superbug" has evolved to develop resistance to many antibiotics that once killed it. But researchers from the University of Nottingham in the UK say they may have uncovered a new treatment for MRSA: a 1,000-year-old remedy for eye infections taken from a manuscript found in the British Library.

The ancient potion - made of garlic, onion or leek, wine and cow bile - proved effective against the superbug MRSA.

Dr. Christina Lee, associate professor in Viking studies and a member of the Institute for Medieval Research at the University of Nottingham, and colleagues say the remedy killed up to 90% of MRSA (methicillin-resistantStaphylococcus aureus) in vivo.

What is more, studies in mouse models of MRSA conducted by researchers from Texas Tech University in Lubbock found the ancient potion presented "astonishing" results against the superbug.

The researchers are due to present their findings at the Annual Conference of the Society for General Microbiology in Birmingham, UK.

MRSA is a type of Staphylococcus, or "staph," bacteria that can be spread through skin-to-skin contact. It can cause skin infections and - particularly in health care settings - bloodstream infections, pneumonia and surgical site infections.

The Centers for Disease Control and Prevention (CDC) estimate that in 2011, MRSA was the cause of 80,461 invasive infections and was related to 11,285 deaths in the US. Most MRSA infections occur in health care settings.

MRSA infections are becoming harder to treat. Many antibiotics that were once effective against the bacteria - including methicillin, oxacillin and nafcillin - no longer work. As a result, researchers across the globe are trying to find new ways to kill the superbug.

Now, Dr. Lee and colleagues believe a 10th century Old English manuscript may hold a remedy for MRSA infections.

Ancient potion requires cow bile, garlic, onion and wine

The manuscript was found in Bald's Leechbook, which is believed to be one of the earliest ever medical textbooks. The book contains an array of Anglo-Saxon remedies for a number infections, and a potion for an eye infection caught Dr. Lee's attention.

"Medieval leech books and herbaria contain many remedies designed to treat what are clearly bacterial infections," says Dr. Lee. "Given that these remedies were developed well before the modern understanding of germ theory, this poses two questions: How systematic was the development of these remedies? And how effective were these remedies against the likely causative species of bacteria?"

"Answering these questions will greatly improve our understanding of medieval scholarship and medical empiricism," she continues, "and may reveal new ways of treating serious bacterial infections that continue to cause illness and death."

Dr. Lee translated the recipe for the ancient eye infection potion. The recipe requires garlic, onion or leek, wine and bile from a cow's stomach, called oxgall. The potion must be brewed in a brass vessel, strained for purification and left for 9 days before being applied to the infected site.

Following the recipe's strict instructions, Dr. Lee and her colleagues made four batches of the potion using fresh ingredients for each batch.

Researchers 'blown away' by the potion's effectiveness against S. aureus

The team created artificial wounds infected with S. aureus by growing the bacteria in collagen. They then exposed the wounds to each potion ingredient individually or the full potion.

Applying each separate potion ingredient to the wounds appeared to have no effect against S. aureus. When the full potion was applied, however, they found it killed almost all of the bacteria, with only around one bacterial cell in every 1,000 surviving.

Next, the researchers diluted the potion and applied it to the infected wounds to determine how much of it would be needed to treat a real infection.

They found that diluting the potion to the extent that it is unable to kill S. aureus interrupts communication between bacterial cells. Dr. Lee and colleagues say this is an important discovery because bacterial cells have to communicate with each other in order to cause tissue damage, and many scientists believe halting such behavior could treat infection.

Study leader Dr. Freya Harrison, also of the University of Nottingham, says the team was surprised by the findings:

"We thought that Bald's eyesalve might show a small amount of antibiotic activity, because each of the ingredients has been shown by other researchers to have some effect on bacteria in the lab - copper and bile salts can kill bacteria, and the garlic family of plants make chemicals that interfere with the bacteria's ability to damage infected tissues. But we were absolutely blown away by just how effective the combination of ingredients was."

Dr. Harrison says the potion even proved effective in harsher conditions, killing S. aureus in "biofilms" created from extended growth of artificial infections. Biofilms occur when each bacterial cell clumps together, creating a sticky coating that can stop antibiotics from reaching them.

"When we found that [the potion] could actually disrupt and kill cells in S. aureus biofilms, I was genuinely amazed," says study co-author Dr. Steve Diggle.

"Biofilms are naturally antibiotic resistant and difficult to treat so this was a great result. The fact that it works on an organism that it was apparently designed to treat [an infection of a stye in the eye] suggests that people were doing carefully planned experiments long before the scientific method was developed."

The researchers explain their findings further in the video below:

Effectiveness of ancient remedy on par with previously used antibiotics

The ancient potion was also tested on mice with MRSA-infected skin wounds by Dr. Kendra Rumbaugh from Texas Tech University, and she found it was highly effective against the superbug.

"We know that MRSA infected wounds are exceptionally difficult to treat in people and in mouse models," says Dr. Rumbaugh. "We have not tested a single antibiotic or experimental therapeutic that is completely effective; however, this 'ancient remedy' performed as good if not better than the conventional antibiotics we used."

The researchers are now looking for further funding to test the effectiveness of this potion and other ancient remedies that may be effective against modern-day bacterial infections.

Dr. Harrison says further research into alternative treatments for such infections is crucial if we are to tackle the increasing problem of antibiotic resistance.

"There is a pressing need to develop new strategies against pathogens because the cost of developing new antibiotics is high and eventual resistance is likely," she explains. "This truly cross-disciplinary project explores a new approach to modern health care problems by testing whether medieval remedies contain ingredients which kill bacteria or interfere with their ability to cause infection."

Medical News Today recently reported on a study published in the Proceedings of the National Academy of Sciences, in which researchers claim an increase in the use of antibiotics in livestock over the next 15 years may fuel drug resistance.

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Gene identified that drives aggressive form of breast cancer

A team of researchers have identified a gene that drives one of the most aggressive forms of breast cancer. They hope that by finding a way to block the gene they may be able to make the cancer less aggressive.

The authors believe the most aggressive form of triple-negative breast cancer originates from stem cells.

In their study, published in Nature Communications, the researchers found that the gene known as "inhibitor of differentiation 4" (ID4) not only indicates a highly aggressive form of triple-negative breast cancer but also appears to control it.

"We found that ID4 is produced at high levels in roughly half of all triple-negative breast cancers, and that these cancers have a particularly poor prognosis," says project leader Dr. Alex Swarbrick. "We also showed that if you block the ID4 gene in experimental models of triple negative breast cancer, the tumor cells stop dividing."

Triple negative breast cancers are breast cancers that lackestrogen, progesterone and HER2 receptors. Breast cancers that have these receptors can be targeted by drugs.

Around 15% of all breast cancer cases are triple-negative breast cancers. Patients that develop them typically have a higher risk of recurrence and shorter survival than patients with other forms of breast cancer.

There appears to be a division among patients with triple-negative breast cancer; some patients succumb to the disease within 3-5 years while others can survive disease-free for much longer than many non-triple-negative breast cancer patients.

The researchers discovered a likely explanation for this differentiation in survival prospects - there are two distinct forms of triple-negative breast cancer, appearing to originate from different cell types.

While the more benign form of triple-negative breast cancer appears to originate from specialized cells, the team found that the aggressive form of the disease seems to originate from stem cells.

Could blocking ID4 make aggressive forms of breast cancer respond to tamoxifen?

Stem cells have the capacity to develop into a variety of different cell types in the body, and in many bodily tissues they divide to replenish other cells, providing the body with a form of internal repair. The manner in which stem cells are flexible and can spread into other tissues is similar to the way that many cancers operate.

Previous research has shown that breast stem cells are a vital part of breast growth and development during both puberty and pregnancy. The new study has now demonstrated that ID4 is responsible for determining whether these stem cells develop into specialist cells or not.

When ID4 is blocked in a stem cell, other genes that drive cell specialization are activated. In addition, the estrogen receptor and a number of other genes expressed by forms of breast cancer with better prognoses are also activated.

"Estrogen receptor-positive breast cancers have a relatively good prognosis because the drug tamoxifen is very effective at blocking the estrogen receptor and hence their growth," explains Dr. Swarbrick.

"We speculate, therefore, that by blocking ID4 it might be possible to turn stem-cell-like breast cancers into less aggressive breast cancers that may even respond to tamoxifen. If we are correct, that would be remarkable."

Following their discovery, the team will now investigate ID4 in order to work out the best strategy for blocking it in humans. They are also planning a mouse study to assess whether blocking ID4 can make tumors vulnerable to tamoxifen.

"We don't know yet whether we are seeing a real estrogen-dependent cancer after ID4 is blocked - one with an effective estrogen receptor - or just a caricature of one," states Dr. Swarbrick.

The team will be working in collaboration with a world expert on estrogen receptor function and studying these biochemical processes on a genome-wide scale as they attempt to fully understand the role that ID4 could play in the development and treatment of breast cancer.

Earlier this month, Medical News Today reported on a study finding that the shape of breast cancer cells can influence a tumor's response to treatment. Changing the shape of these cells could be a way of making them more sensitive to treatment.

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Exploding head syndrome could affect 1 in 5 young people

Exploding head syndrome might not be a condition that people are familiar with, but according to new research published in the Journal of Sleep Research, a surprisingly high percentage of young people could experience the psychological phenomenon.

Exploding head syndrome involves hearing abrupt loud noises without any external cause, typically occurring when waking up or going to sleep.

The syndrome is characterized by the perception of abrupt loud noises when waking up or going to sleep. Although typically painless, these noises can cause fear and distress to the person experiencing them, who may be unable to rationalize what has caused their symptoms.

Little is understood about exploding head syndrome though many experts have previously suggested that the rare condition primarily affects older adults.

"I didn't believe the clinical lore that it would only occur in people in their 50s," says study author Brian Sharpless, PhD, of Washington State University. "That didn't make a lot of biological sense to me."

After conducting a review of the scientific literature on exploding head syndrome in the journal Sleep Medicine Reviews, Dr. Sharpless decided that more research was required to fully understand the rare condition.

Experts believe that exploding head syndrome occurs due to the brain having problems when shutting down to go to sleep. Usually, when people go to sleep, different parts of the brain - motor, auditory and visuals neurons - turn off in different stages.

Dr. Sharpless suggests that in exploding head syndrome, the auditory neurons may activate all at once instead of shutting down properly. "That's why you get these crazy-loud noises that you can't explain, and they're not actual noises in your environment," he says.

This phenomenon occurs in the brainstem's reticular formation, the same part of the brain that is involved in isolated sleep paralysis - a condition in which individuals are unable to move or speak upon waking up.

Experiencing the condition was frequently associated with fear

In the study - the largest of its kind - 211 undergraduate students were assessed for both exploding head syndrome and isolated sleep paralysis through interviews conducted by psychologists or graduate students.

Nearly 1 in 5 (18%) of the participants reported experiencing exploding head syndrome at least once. More than a third (37%) of these participants also reported experiencing isolated sleep paralysis.

Participants that had experienced exploding head syndrome frequently reported clinically significant levels of fear, with a small minority (3%) reporting clinically significant distress and impairment in association with these episodes.

Dr. Sharpless states that exploding head syndrome can often lead individuals to interpret their experiences as more severe health problems, such as seizures or bleeding in the brain, or even attribute them to unnatural events.

"Some people have worked these scary experiences into conspiracy theories and mistakenly believe the episodes are caused by some sort of directed-energy weapon," he says. "For this scary noise you hear at night when there's nothing going on in your environment, well, it might be the government messing with you."

Dr. Sharpless also reports that very few clinicians or researchers assess for the little-understood condition. Unfortunately, there are currently no well-articulated or empirically supported treatments for exploding head syndrome, although a couple of drugs are showing promise in early testing.

"One of the drugs they gave for exploding head syndrome actually didn't make the noises go away," Dr. Sharpless explains. "It just turned the volume down."

Despite a lack of treatment options for the condition, increasing awareness could work to improve people's lives. Dr. Sharpless says that just being able to recognize exploding head syndrome could reduce fear and make patients with this condition feel better in themselves.

Although the study involved a relatively small number of participants, it still suggests that the condition may be more prevalent than first thought.

"Contrary to some earlier theorizing, exploding head syndrome was found to be a relatively common experience in younger individuals," the author concludes. "Given the potential clinical impacts, it is recommended that it be assessed more regularly in research and clinical settings."

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Higher coffee consumption may protect against liver cancer

Coffee is the morning pick-me-up of millions - every day people drink coffee to increase wakefulness and improve concentration and focus. A new report has shown that regular coffee intake could also reduce liver cancer risk caused by daily alcohol consumption.

Higher consumption of coffee may protect against liver cancer.

According to research conducted by the London, UK-based World Cancer Research Fund International, drinking three alcoholic drinks a day can be enough to cause liver cancer.

Amanda McLean, Director of World Cancer Research Fund UK, says: "Around three or more drinks per day can be enough to cause liver cancer. Until now we were uncertain about the amount of alcohol likely to lead to liver cancer. But the research reviewed in this report is strong enough, for the first time, to be more specific about this."

The findings were published in the Continuous Update Project (CUP) 2015 report on "diet, nutrition, physical activity and liver cancer." They are based on an analysis of 34 studies that included 8.2 million people - more than 24,500 of whom had liver cancer.

The American Cancer Society estimates that each year in the US there are around 35,660 new cases diagnosed with liver and around 24,550 people that die from liver and intrahepatic duct cancers.

Evidence emerged from the same research finding strong evidence that drinking coffee can reduce the risk of liver cancer. This discovery follows research the World Cancer Research Fund published in 2013 showing that coffee reduced the risk of womb cancer.

Dr. Kate Allen, Executive Director of Science and Public Affairs at World Cancer Research Fund International, says:

"The new findings around alcohol, obesity and coffee are particularly interesting. There are also interesting new suggestions relating to exercise and fish."

"The evidence about the relationship between diet, nutrition, physical activity and cancer is becoming well established. We hope that these new findings will inform the debate about possible public health implications and policy responses," she adds.

'Significantly decreased risk of liver cancer' per one cup of coffee per day

Mechanisms that support a protective effect of coffee on liver cancer relate largely to studies in animals, although some human studies contribute to the evidence.

Both coffee and coffee extracts have also been shown to reduce the expression of genes involved in inflammation, and the effects appear to be most pronounced in the liver.

There is evidence from small intervention studies that coffee consumption reduces DNA damage in blood cells and prevents ex vivo-induced DNA damage in healthy volunteers.

Specifically, the study determined that the risk of developing liver cancer might be reduced by approximately 14% if individuals consume one cup of coffee per day.

The CUP panel reveals:

"The evidence for coffee was generally consistent, and the dose-response meta-analysis showed a significantly decreased risk of liver cancer per one cup per day."

This evidence is consistent with findings from three published meta-analyses. When stratified by sex, the association was significant for men but not for women.

There is no evidence regarding specific components of coffee that were attributable to the decreased risk.

There is uncertainty about the various variables that may affect the association between coffee consumption and reduced liver cancer risk, such as caffeine, sugar and milk. Due to the effect of coffee on other medical conditions, recommendations for coffee consumption cannot yet be made.

CUP concludes that a "higher consumption of coffee probably protects against liver cancer."

Further strong research has emerged from the CUP showing that being overweight or obese is associated with an increased risk of the disease.

The CUP monitors and analyses research on cancer prevention and draws conclusions on how lifestyle factors such as weight, diet and physical activity can reduce the risk of developing the disease.

Medical News Today recently reported that in a new study, researchers found that drinking three to four cups of coffee a day could reduce the risk of endometrial cancer by almost a fifth.

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How important is the name of a disease? Do names influence treatment?

There are a number of factors that can alter the manner in which a disease and its patients are treated. The opinions of patients, clinicians and policymakers can all have an impact, but to what extent are these affected by the name of a disease?

Can a name affect the kind of treatment that patients can expect to receive?

In Shakespeare's Romeo and Juliet, it is claimed "that which we call a rose by any other name would smell as sweet." But would someone's reaction to a rose be different if, for example, they were instead named "stink blossoms," as suggested by Bart Simpson in an episode of The Simpsons?

This might be a slightly silly and trivial example, but it serves to make a point. The way in which objects and people are perceived can be altered purely on account of their name.

If offered a choice of two hospitals to visit without seeing any credentials, I would certainly be more inclined to visit the "Good Heart Clinic" over "Dr. Giggles' Bouncy Fun Hospital." But outside of extreme hypothetical decisions such as this, what extent does this form of bias exist within medicine?

Some diseases have got reputations so fearsome that clinicians avoid speaking their names. A recent report from the Alzheimer's Association found that many health care providers decided against disclosing a diagnosis of Alzheimer's disease due to the fear of causing a patient or their caregivers distress.

Last month, the Institute of Medicine (IOM) convened a committee of health experts that proposed new diagnostic criteria and a new name for chronic fatigue syndrome. The changes were recommended to more accurately reflect the main characteristics of the condition and improve levels of treatment.

In this Spotlight article, we take a look at these recommendations and examine the reactions they have received from patients and clinicians alike. We will also examine a number of other examples of medical name changes from around the world in order to assess just what is in a name.

Introducing 'systemic exertion intolerance disease'

The IOM-convened committee suggested that previous names myalgic encephalomyelitis (ME) and chronic fatigue syndrome(CFS) may have contributed to misconceptions about the illness.

Encephalomyelitis refers to brain inflammation, and there is a lack of evidence to suggest that the illness causes this to occur in patients. Myalgia - muscle pain - is also not considered to be a core symptom of the disease. Similarly, previous research has suggested that the name "chronic fatigue syndrome" could lead to the disease being trivialized.

"Due to the stigma in the name 'chronic fatigue' just about everyone wrote off my newly discovered syndrome, causing a major loss in friendships, relationships, jobs, etc.," reports Lindsey Beres, the founder of Bent But Not Broken, a nonprofit organization dedicated to providing support to patients with the disease and their caregivers.

The IOM committee recommended that a new, more representative name be adopted - systemic exertion intolerance disease (SEID):

"This name captures a central characteristic of the disease: the fact that exertion of any sort - physical, cognitive or emotional - can adversely affect patients in many organ systems and in many aspects of their lives. The committee believes systemic exertion intolerance disease appropriately captures the complexity and severity of the illness."

For Beres, the announcement was a positive one. "Calling it a disease instead of a syndrome and getting national attention vindicates my years of failed explanations attempts," she writes.

The recommendation was still made only recently, and so it is likely that its impact will not be measurable for a considerable amount of time. Beres told Medical News Today that Bent But Not Broken expect the name change will take a while to be fully adopted, "so we will continue using CFS/SEID to describe the patients we serve for the time being."

How might this recommendation and potential widespread adoption of the new name affect treatment of the disease? The answer to this question could be found in a previous instance of renaming that occurred in Japan in 2002.

The problem with 'mind-split-disease'

Schizophrenia is a chronic mental disorder that can be severely disabling to those who develop it. It is characterized by a range of deficits in emotional responsiveness, perceptions and thought processes.

The belief that all people with schizophrenia have split personalities is just one common misconception about the disorder.

In a Spotlight article last year, MNT found that there is a large amount of public misunderstanding around the disease, with many people mistakenly believing that schizophrenia means having a split personality or a violent temperament.

A report conducted in 1999 even reported that 61% of Americans believed people with schizophrenia were likely to be violent toward other people.

These misperceptions may have been caused by a combination of media portrayals of the disease and the name itself. The word comes from the Greek words skhizein meaning "to split" and phren meaning "mind." While this term was originally intended to suggest a fragmented way of thinking, it lends itself readily to the idea of split or multiple personalities.

In Japan, schizophrenia used to be referred to as Seishin Bunretsu Byo, translating as "mind-split-disease." In a paper published in World Psychiatry, Prof. Mitsumoto Sato describes how many psychiatrists were reticent to inform patients of a schizophrenia diagnosis because of the negative consequences such a diagnosis could confer.

"The old term identified the patient as a person with a disorganized personality even after recovery or full remission. That is, once the diagnosis of 'Seishin Bunretsu Byo' was made, the patient was usually regarded as an essentially ill person throughout his or her life," writes Sato.

A new term Togo Shitcho Sho, translating as "integration disorder" was introduced by the Japanese Society of Psychiatry and Neurology in 2002, following a request from a patients' families group.

"The new term for schizophrenia ("Togo Shitcho Sho") refers to the vulnerability-stress model, and implies that the disorder may be treated and that recovery is possible if a combination of advanced pharmacotherapy with appropriate psychosocial intervention is used," Sato explains.

Seven months after the renaming, a survey found that the new term had replaced the old in around 78% of cases. The percentage of cases in which patients were fully informed of their diagnosis rose from 36.7% to 69.7% over the course of 3 years.

A survey of the Miyagi College of Psychiatrists also reported that 82% of respondents found the new name better for obtaining patient consent, improving treatment compliance, reducing stigma and achieving social integration for patients.

Negative reactions to the proposed renaming of ME/CFS

These outcomes suggest that the renaming of schizophrenia in Japan has been a success, and it is perhaps not surprising that there have been calls to rename the disease elsewhere.

In Korea, for example, a new term has also been coined to replace "mind-splitting disease" with "attunement disorder." "This term literally refers to tuning a string instrument, and metaphorically it describes schizophrenia as a disorder caused by mistuning of the brain's neural network," explain the authors of a study published in the Asian Journal of Psychiatry.

Not everyone is supportive of change, however. Concerning schizophrenia, Jeffrey A. Lieberman and Michael B. First argue in an article published in The BMJ that renaming schizophrenia would not have the desired effect:

"Unfortunately, changing the name of the condition (or even abolishing the concept) will not affect the root cause of the stigma - the public's ignorance and fear of people with mental illness. Renaming may even have the unintended effect that the person, rather than the illness, is blamed for the symptoms."

The proposed renaming of ME/CFS to SEID has also provoked some negative responses from clinicians and the general public alike.

In the comments section of MNT's article about the recommendations, readers have described the proposals as "absurd," "less descriptive" and could set back treatment of the condition by another 20 years.

Prof. Leonard A. Jason, a professor of psychology at DePaul University, Chicago, IL, recently wrote a blog post addressing the recommended name change and he states the reaction he had received from patients "was mixed at best."

"Our research group has found that a more medically-sounding term like ME is more likely to influence medical interns to attribute a physiological cause to the illness," Prof. Jason writes. And while the term ME is deemed to be medically inaccurate, he argues that many other diseases that are accepted have inaccurate names. Malaria, for example, means "bad air."

Prof. Jason suggests that the recommendation was made without proper consultation with the public, the committee making critical decisions in a secretive process. While this approach may be necessary for some IOM initiatives, "in this area - due to patients being historically excluded and disempowered - there was a need for a more transparent, interactive and open process."

A more inclusive approach to instigating a name change was demonstrated by the Association of Early Pregnancy Units (AEPU) and the Miscarriage Association in the UK. The publication of a charter for miscarriage care by the online organization Mumsnet suggested there was a need for more sensitive terminology in British health care.

In particular, the commonly used term evacuation of retained products of conception was found to be both upsetting and confusing by women and their partners. A research team conducted several online surveys targeting both health professionals and patients and found there was an overwhelming interest in changing this term.

The surveys found that the alternative term surgical management of miscarriage (SMM) was the most popular, and it has since been recommended by the AEPU and the Miscarriage Association that the term should be introduced as standard in the UK.

'I am excited for the awareness it has brought to the disease'

Although there has been negativity from some quarters to the recommended name change for ME/CFS, there have also been positive reactions. At the forefront of this positivity appears to be the implication that the proposed name change has now legitimized the disease.

Only time will whether the recommended new name for ME/CFS will lead to improved research and rates of diagnosis.

"To some, the IOM report may not sound like a major feat, but to longtime supporters, sufferers, and researchers of CFS/SEID, the attention surrounding the report is exactly what they have been striving for," writes Deanna Lee for Bent But Not Broken. "For the first time, CFS/SEID is relevant and it is getting national coverage."

Lindsey Beres was surprised by the negative reaction to the proposed name, having expected more positive comments or celebrations of recognition. "Personally, I am not a huge fan of the name," she told MNT, "but I am excited for the awareness it has brought to the disease."

The nonprofit organization is already feeling the impact of this raised awareness. Bent But Not Broken report an increase in their receipt of financial application submissions, patient testimonials and overall interest in the disease since the IOM's recommendation was made.

"Regardless of your feelings about the name, try to look past just the title and look at the implications for research, funding, backing, social legitimacy, treatments and insurance coverage," Beres writes.

Beres told MNT she believes education, acceptance and clinical adoption of the disease within the medical community are major problems for the treatment of CFS/SEID that are yet to be addressed.

"Once practitioners believe in the condition and the ranges of severity, then proper diagnosis can occur," she said. "Once that happens, I believe having a full range of treatment options available is the next step."

In the IOM report, the committee states that many people struggle with their symptoms for years before receiving a diagnosis. Bringing the disease back to the attention of health care providers could be a surefire way of improving this situation.

Despite the flaws in the recommended new name, it is clear that there are potential benefits to be had. While it can be difficult to accurately label conditions such as CFS/SEID and schizophrenia that can affect patients in a wide variety of different ways, it is important that people - both clinicians and patients alike - are aware of them.

The renaming of schizophrenia in Japan suggests that the naming of a disease can have a positive impact on how it is treated. Only time will tell what the impact of the IOM's recommendations for CFS/SEID will be, but there is hope that, despite some criticism, it could be a change that benefits between 836,000 and 2.5 million Americans estimated to have the disease.

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