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PTSD may affect brains of boys, girls differently

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A recent study conducted at Stanford University School of Medicine suggests that a brain region that integrates emotions and actions appears to undergo accelerated maturation in adolescent girls with post-traumatic stress disorder (PTSD), but not in boys with the condition.

Researchers at Stanford found structural differences between the sexes in one part of the insula, a brain region that detects cues from the body and processes emotions and empathy.

Victor Carrion, professor of psychiatry and behavioral sciences at Stanford and senior author of the study published online in Depression and Anxiety said:

“The insula appears to play a key role in the development of PTSD. … The difference we saw between the brains of boys and girls who have experienced psychological trauma is important because it may help explain differences in trauma symptoms between sexes.”

Not all persons who are exposed to traumatic experiences develop acute or post-traumatic stress disorder. However, people diagnosed with PTSD may experience flashbacks of traumatic events; may avoid places, people and things that remind them of the trauma; and may suffer a variety of other problems, including social withdrawal and difficulty sleeping or concentrating.

Moreover, most people who have been suffering with PTSD tend to be more easily re-traumatized and they are generally not as good at coping with stress as they were prior to their initial trauma.

Another symptom that is often observed is problems concentrating, and being prone to depression and other stress-related disorders. Some individuals, especially those who suffered complex or repeated trauma, are prone to developing chronic and complex clusters of symptoms which can be debilitating.

The Stanford research team conducted MRI scans of the brains of 59 subjects ages 9 to 17. Thirty of them, 14 girls and 16 boys, had trauma symptoms; and 29 others, the control group of 15 girls and 14 boys, did not.

The researchers assured that the participants had similar ages and IQs. Of the traumatized participants, five had experienced one episode of trauma, while the remaining 25 had experienced two or more episodes or had been exposed to chronic trauma.

The researchers saw no differences in brain structure between boys and girls in the control group. However, among the traumatized boys and girls, they saw differences in a portion of the insula called the anterior circular sulcus.

This brain region had larger volume and surface area in traumatized boys than in boys in the control group. In addition, the region’s volume and surface area were smaller in girls with trauma than among girls in the control group. The insula normally changes during childhood and adolescence, with smaller insula volume typically seen as children and teenagers grow older.

The findings imply that traumatic stress could contribute to accelerated cortical aging of the insula in girls who develop PTSD, said Megan Klabunde, the study’s lead author and an instructor of psychiatry and behavioral sciences. “There are some studies suggesting that high levels of stress could contribute to early puberty in girls.”

The researchers also concluded that: “By better understanding sex differences in a region of the brain involved in emotion processing, clinicians and scientists may be able to develop sex-specific trauma and emotion dysregulation treatments.”

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Indian couple who faked their Everest climb banned from the mountain for 10 years

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Dinesh and Tarakeshwari Rathod, who claimed to be the first Indian couple to have climbed Mt Everest have been banned from the mountain for 10 years after reports of the “fake climb” surfaced. Adding to the embarrassment is that both worked for the Maharashtra Police Department.

In 2016 Dinesh and Tarakeshwari Rathod claimed they had successfully climbed Mt Everest, which is 8,850 m high. However, the international community of climbers is tightly-knit, and the pair’s claim did not convince other climbers, who launched inquiries into their expedition.

An investigation showed that photos used by the couple for their claim to fame were apparently “morphed” which is not conclusive but strong circumstantial evidence for the “fake climb claim”.

More suspicions arose after authorities checked their timeline between the day the couple claimed to have completed the expedition and the day when they announced their success to the media.

That investigation led to the conclusion that the couple also would have had to set an impossible speed-climb record because the couple could not have reached the summit and be back to their base camp so soon. Sahebrao Patil, Commissioner of Police – Administration told reporters:

“The couple faked about the Everest ascent, morphed the photographs, shared misleading information and while doing this, brought disrepute to the Maharashtra Police department and did not report to duty. Based on the inquiry, we dismissed the couple from the department and an order to this effect was issued on Saturday,”

Ironically, the couple may have actually faked their Everest climb only in an attempt to escape dismissal from their job police job as they had not reported to duty for three months and when asked for an explanation, they claimed they were the first Indian couple to have conquered the summit and tried to support their claim with the fake pictures.

The government of Nepal has also banned the couple from entering the country for 10 years.

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Experts urge WHO to urgently revise its post-vaccination philosophy

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Two leading doctors and experts in immunization from India have urged the World Health Organization (WHO) to urgently revise its methodology to classify adverse events following immunization. (AEFI).

Research SqeezeDr. Jacob Puliyel, a pediatrician and member of the National Technical Advisory Group on Immunization, and Anant Phadke, an executive member of the All India Drug Action Network argue that WHO’s methodology does not address children’s safety. Doctors Puliyel and Phadke styled an urgent letter to the WHO, published in the Indian Journal of Medical Ethics, on July 4, 2017, are stressing that they are :

“…Concerned about the changes effected by the WHO to the assessment methodology of adverse events following immunization (AEFI), which, according to Puliyel and Phadke, make it almost impossible to classify adverse events (deaths in this case) noticed for the first time in phase IV post-marketing surveillance, as “consistent causal association to immunization” (full letter HERE)

The authors stress that the WHO’s new classification of  AEFI, in essence, implies that no death can result from  vaccination and, if any death does occur, it is  only coincidental and not due to the vaccine.

One of the major, and potentially dangerous flaws with the methodology is, according to Puliyel and Phadke, that only reactions that have been previously acknowledged in epidemiological studies   can be considered as vaccine related in the new scheme.

All deaths   seen in   large post marketing phase are simply labeled as coincidental   or unclassifiable deaths. They can therefore not be classified as vaccine related if the vaccine had not caused a statistically significant increase in deaths in the small Phase 3 trials.

In their letter, published in the prestigious Indian Journal of Medical Ethics, Puliyel and Phadke have expressed their concerns over this new classification system. “By simply denying deaths, the new AEFI classification is liable to miss the safety signals and therefore potential dangers with new vaccines.”

The authors note that Sri Lanka suspended the use of a pentavalent vaccine after five deaths within four months after its introduction in January 2008 and, in 2013 and Viet Nam shelved the  pentavalent vaccine   because it had been associated with 12  deaths.  However, in both cases, the WHO teams which investigated the deaths declared they were ‘unlikely’ to be related to the vaccines used.

The authors point out that the consequences of using the new classification are illustrated starkly in the causality assessment of 132 serious AEFI cases uploaded on the website of the Ministry of Health and Family Welfare in India.

78 of these babies survived and 54 died. Among those who survived, the causality assessment shows nearly 50%, were reactions to the vaccine.  On the other hand not even one death was classified as vaccine related.  96% deaths were simply classified as unclassifiable or coincidental.

“The resulting paradox is evident,” Puliyel and Phadke point out. “If a child is admitted to hospital with intractable convulsions after vaccination, if it survives, the reaction could be classified as vaccine-product–related, but if it dies it will be classified as ‘coincidental death’”.

WHO has redefined ‘cause and effect’ in AEFI. According to the revised AEFI

Manual, the term ‘causal association’ refers to “a cause and effect relationship between causative factor and a disease with no other factor intervening in the processes”. This would mean that AEFI in children with an underlying heart disease who may develop symptoms of cardiac de-compensation after vaccination (due to a vaccine-caused elevation in temperature or stress from a local reaction at the site of vaccination), would not be considered causally related to the vaccine although vaccination contributed to cardiac failure in this specific situation.

This is of particular concern since the Global Advisory Committee on Vaccine safety documented that a large number deaths in children after receiving Pentavalent vaccine were those with some pre-existing heart disease, the authors say.  “The new definition of ‘cause and effect’ is potentially harmful to children with underlying diseases as it removes the impetus to provide them special care during immunization,” the authors note.

“In view of the above, it is necessary that the WHO’s  AEFI manual be reevaluated and revised urgently” the authors said  pointing out that AEFI reporting is meant to ensure that vaccines given to children are safe. “Safety of children (child safety) rather that safety for vaccines (vaccine safety) needs to be the emphasis,” the authors point out.  “Also many ambiguities in evaluating AEFI under the new classification scheme erode confidence in the scheme’s ability to evaluate rare adverse events and act decisively to protect children.”

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Woman in Belgium attacked by wild boar saved by her dog

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A woman in the Belgian town of Beringen was attacked by a wild boar and probably protected by her dog. The woman was out jogging and was returning to her car when she was attacked in a car park.

The unlucky woman, Verlee Vanhove, tried to flee from the boar but in vain. Ms. Vanhove sustained several grazes as a result of her encounter with the wild animal.

Commenting on the attack and the fact that her dog protected her she told reporters:

 

“The wild boar jumped on me and my dog. I let out a yell. The boar receded but then stood stock still glaring at me. My dog stayed on top of me protecting me!”

Wild boar attacks are rare but can be dangerous and even fatal. Most attacks occur during the animals rutting season between November and January.

Wild boars, especially in areas where they are hunted, tend to shy away from contact with humans.

Once a boar or boars attack they initially inflict injuries on the lower extremities, using their tusks. Once the victim falls to the ground they tend to continue the attack until the victim stops moving.

Boars then tend to step back, take position, and charge again if the victim moves. The fact that Verlee Vanhove has had her dog with her may have prevented further attacks.

The local mayor maintains that the wild boar was a specimen that had been living in captivity as animals living in the wilds do not seek contact with human beings.

While this may be so, it is also worth noting that the attack took place at a car park. Boars, especially those who lack access to a sustainable natural habitat, can be attracted by leftovers and garbage and be protective of their “food source”.

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