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Tuesday, April 23, 2024
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Photo Taken In Oradea, Romania

A new study has identified how ketamine can combat difficult-to-treat depression.

New research has revealed the specific parts of the brain that ketamine affects when doctors use it to treat people with difficult-to-treat depression.

The study, which appears in the journal Translational Psychiatry, may open the door to new therapies in the treatment of depression.

According to the Centers for Disease Control and Prevention (CDC), in the United States, about 7.6% of people over the age of 12 have depression during any 2-week period. The CDC describe depression as a sad mood that extends for a long period and affects a person’s ability to live a normal life.

When severe, depression can have a serious negative effect on a person’s life, sometimes leading to suicidal thoughts.

Experts do not fully understand why some people experience depression, although the National Institute of Mental Health suggest that genetic, environmental, biological, and psychological factors may play a role. It is treatable with medication, psychological therapy, or a combination of the two.

Previous research has made it clear that the drug ketamine can be an effective antidepressant, and some scientists have proposed it as a treatment in cases of depression that do not respond to conventional treatments.

However, precisely how and why ketamine functions as an antidepressant is less clear. As a consequence, the authors of the present study wanted to identify precisely what effects ketamine has on the brain of a person who is not responding to conventional treatments. They hope that this research may lead to better treatment options for these individuals.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can call 800-799-4889.

Looking at ketamine’s effect in the brain

To do this, the researchers gave participants doses of ketamine that were low enough not to have an anesthetic effect and then took images of their brains using a positron emission tomography (PET) camera.

According to the study’s first author, Dr. Mikael Tiger, a researcher at the Department of Clinical Neuroscience at the Karolinska Institutet in Solna, Sweden, “In this, the largest PET study of its kind in the world, we wanted to look at not only the magnitude of the effect but also if ketamine acts via serotonin 1B receptors.”

“We and another research team were previously able to show a low density of serotonin 1B receptors in the brains of people with depression.”

By using a radioactive marker that binds to a person’s serotonin receptors, the PET images could highlight what effects ketamine was having on these receptors, which play a crucial role in depression by modulating the amount of serotonin that a person receives. Experts believe that low levels of serotonin correlate to more severe experiences of depression.

The authors of the study recruited people through internet advertising. After receiving 832 volunteers, the authors reduced this number to 30 to make sure that the participants were as relevant to the study as possible.

Other than having major depressive disorder (MDD), the participants were healthy. They had not responded to previous treatment for MDD.

The researchers split the participants into two groups, treating 20 people with ketamine and the other 10 with a placebo.

The study was a randomized, double-blind, placebo-controlled study, meaning that neither the doctors nor the participants initially knew to which group each participant belonged.

Prior to the treatment, the researchers took a baseline scan of the participants’ brains. They took a second scan in the days following the treatment.

For the second phase of the study, 29 of the participants agreed to take ketamine twice a week for 2 weeks.

Serotonin reduced, dopamine increased

Using a rating scale for depression, the researchers found that 70% of the participants in the second phase of the study responded to the ketamine.

Furthermore, after analyzing the PET images, the authors found that the ketamine was affecting the participants’ brains in a previously unidentified manner, reducing the output of serotonin but increasing the output of dopamine, which is also important for mood regulation.

According to the last author of the study, Dr. Johan Lundberg, research group leader at the Department of Clinical Neuroscience, Karolinska Institutet, “We show for the first time that ketamine treatment increases the number of serotonin 1B receptors.”

“Ketamine has the advantage of being very rapid-acting, but at the same time, it is a narcotic-classed drug that can lead to addiction. So it’ll be interesting to examine in future studies if this receptor can be a target for new, effective drugs that don’t have the adverse effects of ketamine.”

– Dr. Johan Lundberg

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A Professor of Clinical Pharmacy, Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Okonta Matthew, talks about hepatitis B and ways to avoid it.

What is hepatitis B?

The liver is a vital organ in the body; it is responsible for the biotransformation of nutrients and chemical substances like drugs and alcohol into acceptable forms the body can utilise or excrete as wastes. The liver can be affected or inflamed by any of these chemical substances, viruses or both at anytime to cause this vital organ to be unable to properly carry out its biotransformation role.

When the liver becomes inflamed, the person is said to suffer hepatitis. Hepatitis B refers to an inflammatory disease of the liver caused by hepatitis-B virus.

Anybody could be at risk of hepatitis B; adult or children. In highly endemic area like Nigeria, risk of hepatitis B infection is increased by somebody having unprotected sex with multiple sex partners such as commercial sex workers, having sex with known hepatitis B infected person(s); scarification with unsterilised sharp blades, needles and knives, such as tattooing, circumcision and piercings of the skin; sharing of blades used for hair cutting, injection needles used by drug addicts, in some health facilities especially the ones operated by quacks; having sexual relationship with men, and people that indulge in oral sex; and somebody receiving blood transfusion especially from an infected source.

The age at which a person is infected with hepatitis B influences the extent to which the disease can become chronic.  Infants who are infected with hepatitis B have higher tendencies of developing the chronic form of the disease than children. Less than five percent of normal adolescents and adults infected with hepatitis B develop the chronic infection.

Are there different types of hepatitis B?

Yes, hepatitis B infection is of two different types -the acute hepatitis B and chronic or long-lived type. Acute hepatitis B symptoms can last for a few days to six months and most of these symptoms are mild. In most people with acute hepatitis, symptoms resolve over weeks to months and they are cured of the infection. Chronic hepatitis B is more severe than the acute hepatitis form. Chronic inflammation of the liver can lead to scarring of liver tissue, liver failure, and liver cancer. Chronic hepatitis B is not curable, but it is treatable. The goal of therapy is to reduce the risk of complications, including premature death.

What are the symptoms of hepatitis B?

Most people that suffer from hepatitis B infection do not know that they have such infection until the symptoms begin to manifest or through general screening during recruitment exercise, before blood donation, or any other circumstances. Before some of the symptoms of the infection are manifested, the liver may have been damaged. This is why it is called silent killer. If somebody is with/without symptoms, such a person can be screened for hepatitis B surface antigen (a protein on the surface of the hepatitis B virus). A positive test means the person has an acute or chronic hepatitis B virus infection and can pass the virus to others; hence such a person needs to be treated. Some common symptoms of hepatitis B are abdominal pain, dark urine, clay-coloured bowel movements, joint pain and jaundice (yellow colour of the skin or the eyes) among others.

Any positively tested person requires the attention of gastroenterologist or an appropriately trained physician to further evaluate and treat them properly.

How is hepatitis B diagnosed? 

Based on patient’s presentation, the difference between hepatitis B and other viral hepatitis may not be too obvious. It is essential that laboratory confirmation is done to differentiate between acute and chronic infections.

It can be diagnosed by detection of hepatitis B surface antigen in the blood sample of the person. The laboratory diagnosis can also be used to differentiate the hepatitis B infection types into acute and chronic infection.

How is it treated?

The treatment of hepatitis B is complex, life-long and expensive once diagnosed. Treatment is based on the type of hepatitis B.

Patient needs to be properly counselled before and during the treatment especially when it is the chronic type. Patients must be fully informed of the possibility of passing on the infection to their loved ones if there is any failure in treatment compliance.

Chronic hepatitis B infection can be treated with anti-viral agents to slow down the disease progression to cirrhosis and reduction of liver cancer incidence and improve patient survival.

The drugs that are needed to manage the disease must be prescribed, administered and monitored by a gastroenterologist or any other trained and certified healthcare professional. A patient with acute hepatitis B infection, most times, requires no specific treatment. The patient must be kept in a comfortable state, reduce liver load such as proteinous meal, maintaining adequate nutritional balance and fluid replacement to cover for fluid lost from vomiting and diarrhoea.

Can hepatitis B be cured?

No, but it is treatable. Until this moment, no drug in use has been able to cure patients of hepatitis B but it can be managed. Available medications have only been able to slow down the progression of liver cirrhosis due to chronic hepatitis B infection.

Can one be vaccinated for hepatitis B? 

Yes. It is the major way of preventing hepatitis B infection for a normal or uninfected person that has been proven through negative HBsAg from blood sample screening.   If you are at increased risk for hepatitis B virus infection vaccination is very necessary especially if you belong to any of the categories below: if you are a sex partners of hepatitis B surface antigen -positive persons; if you are sexually active and have had multiple sex partners in the last six months; if you have sexual intercourse with men (gay relationship); if you inject drug and share devices with other users; if you are from susceptible household contacts of HBsAg-positive persons; and if you are a health care and public safety workers at risk of  exposure to blood or blood-contaminated body fluids.

Can hepatitis B cause liver cancer? 

Yes, people with hepatitis B have an increased risk of liver cancer. And these people with hepatitis B are at risk of liver cancer even if they do not have cirrhosis. The most common primary liver cancer in adults is hepatocellular carcinoma called hepatoma. It is caused majorly by hepatitis B worldwide. The common risk factors are chronic hepatitis B infection. Cirrhosis is linked to more than 80 percent of all HCC.

How common is hepatitis B in Nigeria?

Nigeria is an area of high endemicity for HBV with over 70 percent of the population showing evidence of past infection of the virus while average of 13.7 percent still has serological evidence of current infection. Since the current population of Nigeria is about 170 million according to the 2006 national census, the level of current infection is estimated to be 23 million in Nigeria according to current Nigerian treatment guidelines. The ratio of HBV infection in Nigeria is estimated at one in every eight persons. The prevalence of the disease is estimated at three times more than HIV/AIDS according to specialists.

If this disease spread must be arrested and reversed, the following steps may need to be adopted: awareness of the fatality of this HBV infection must be created among Nigerians with every available opportunity, in all institutions, service delivery and gathering points of all sorts; every Nigerian must be encouraged to be screened for HBV at any given opportunity free of charge; all recruitment points must include opportunities to screen for HBV and be willing to do the needful by not discriminating against people who are found to be positive. The government must be able to put up structures such as policies and health facilities to help control and prevent this disease. Thus, vaccine for the immunisation of those infected with HBV albi initio.

Can hepatitis B cause cirrhosis of the liver?

Yes, chronic hepatitis B virus is one of the major causes of liver cirrhosis. It was estimated that more than 200,000 chronic HBV carriers worldwide die of liver cirrhosis annually. Chronic hepatitis B infection contributes to the scarring of the liver tissue and distortion of the liver structure with the associated blood circulatory system leading to liver cirrhosis. These changes develop over time.

Is it true that one can develop cirrhosis even if one doesn’t take alcohol?

Yes, liver cirrhosis is majorly caused by chronic hepatitis B infection, and a greater percentage of hepatitis is caused by viral agents. The majority of the cirrhosis patients that are seen in the hospitals do not consume alcohol yet are cirrhotic. But most of them have HBsAg present in their blood samples, an indication that they have hepatitis B virus infection.

Cirrhosis can also be caused by excessive amount of fat in the liver. Two other common types of liver disease include non-alcoholic fatty liver disease and non-alcoholic steatohepatitis. These are conditions in which the liver contains excessive amounts of fat. People who have non-alcoholic steatohepatitis have excessive amounts of fat in their livers and also have inflammation and scarring of liver tissue. Risk factors of these conditions include: obesity, high blood cholesterol levels, high triglyceride (blood fat) levels and diabetes

Even if excessive alcohol consumption can cause liver cirrhosis, this liver disease can also be developed in non-consumer of alcohol.

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Alcohol consumption caused more than 700,000 new cancer cases and around 366,000 cancer deaths in 2012, mainly in rich countries, according to data reported Wednesday to the World Cancer Congress in Paris.

Comparing the cancer risk of people who drink, to that of people who do not, researchers calculated that alcohol was responsible for an estimated five percent of all new cancer cases, and 4.5 percent of deaths per year.

“A large part of the population is unaware that cancer can be caused by alcohol,” study co-author Kevin Shield of the International Agency for Research on Cancer, told AFP of the preliminary report, not yet published.

Alcohol was most strongly linked to new breast cancer diagnoses — more than one in four of all alcohol-attributable cancer cases, the researchers found, followed by colorectal cancer at 23 percent.

For breast cancer, particularly, it was clear that “the risk increases with the dose” of alcohol, said Shield.

Measuring alcohol’s contribution to cancer deaths, the researchers found it was most strongly linked to oesophagus cancer fatalities, followed by colorectal cancer.

The IARC, the cancer agency of the World Health Organisation, lists alcohol as a “group 1 carcinogen”, which means it is considered cancer-causing, though Shield said the mechanism was “not exactly known”.

Globally, the burden was highest in north America, Australia and Europe, particularly eastern Europe, but this was slowly changing as people in developing nations start imbibing more, the researchers said.

AFP

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Some lifestyle choices you make can mess up your performance in bed. For instance, if you have been drinking a lot of alcohol with your friends lately, you may score low points with your spouse under the sheets.

Consultant Gynaecologist, Dr. James Onore, notes that while a little alcohol can help lower inhibitions, too much of it can impair the nervous system and lead to fatigue — making it difficult to get aroused.

The trick, he says, is to know when to stop on the bottle.

Onore states, “Men who take alcohol so they can be more efficient in bed are actually doing the opposite. Alcohol inhibits sexual performance, it does not boost it.

“If you must indulge in it, a glass of wine is all you need to feel good about yourself, which may make you more receptive to the idea of sex. It does not make you enjoy it. It is better to steer clear of alcohol when you are already experiencing low desires for sex.”

Some recreational drugs and herbal medications which some men use to get it up may be getting in the way too.

It is common knowledge that there are recreational drugs, like Viagra or herbal medications that are sold to improve sexual performance; doctors have warned that this social habit could dampen libidos and also lead to some serious medical problems.

Consultant Gynaecologist, Dr. Olusola Akinniyi, explains that these recreational drugs increase pulmonary actions abnormally and cause heart attacks or sudden death in some cases.

Akinniyi said,“We have been saying that these drugs are very dangerous. We see the consequences every day. Viagra, for example improves the activities of the heart abnormally and this could lead to heart attack during sex. This is what happens most times, a situation that Yorubas erroneously call ‘Magun’ ”.

A research published in the Journal of Sexual Medicine reveals that bad lifestyle choices have been associated with male sexual dysfunction.

Although sexual libido is expected to decrease with age, doctors are saying that, unlike before, younger men and women are experiencing less desire for intimacy due to some social habits.

Danish researchers, after surveying more than 5,500 adult men and women, found that unhealthy habits increased their chances of not having sex by up to 78 per cent in men and 91 per cent in women.

Professor, Morten Frisch of Statens Serum Institute, Denmark concluded that bad lifestyle choices, such as smoking, high alcohol consumption and the use of hard drugs are associated with sexual dysfunction, particularly in men.

He said,” Hopefully our findings can be used in future counselling of patients with unhealthy lifestyles. Knowing about possible negative consequences of an unhealthy lifestyle to one’s sexual health may help people quit smoking, consume less alcohol, exercise more and lose weight,” added Frisch.

On how important a good sexual health is to healthy living, another gynaecologist, Dr. Olarenwaju Ekunjimi, says the act of love making is just not for pleasure or satisfaction.

Ekunjimi states that a good sexual relationship between couples does not only improve bonding, it has been proven to protect the heart, boost the body’s immunity against diseases, reduce stress levels and increase longevity.

He explains further that some hormones released during love making, such as oxytocin, endorphins and antibody immunoglobulin A reduce aches, pains , stress levels and the chances of developing diseases like cold and fever.

Ekunjimi said, “Sex is a form of exercise that improves the condition of the heart. You lose calories and shed fat that could be injurious to the heart. It is a recreation that reduces stress. Its benefits range from keeping families together, reducing divorce rates to preventing heart diseases.”

Other benefits of sex according to the experts include increased blood circulation, good sleep, body fitness and increased levels of oestrogen and testosterone, hormones which help protect women against heart diseases.

Is your sex drive isn’t what it used to be? Here are some natural libido boosters, from Dr. Catherine Hood that may put the spark back into the family:

Eat the right things

If your body becomes frail due to bad health, sex invariably suffers. Five to nine fruits and vegetables a day can provide the cornerstone to your health. The vitamins and antioxidants will help maintain good blood flow to the sex organs and prevent certain chronic diseases.

Lose weight

Being overweight can affect not only your self-esteem and your feelings of sexuality, but you’re likely to suffer from blood vessel disease which can reduce essential blood flow to the genitals.

Keep fit

Moderate regular exercise will help improve blood flow to the sexual organs. In addition, exercise helps you feel good about yourself. Anything that improves self-esteem will improve libido.

Stop smoking

It is well known that smoking can have a terrible affect on blood flow to the sexual organs as it causes the blood vessels to narrow. It also saps your stamina and so kiss the ashtray goodbye.

PUNCH.

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