Active lifestyle facilitates recovery after spinal cord injury

In recent research, scientist have described the influence of an active lifestyle on the regenerative capacity of the peripheral nervous system, that is, the set of cranial and spinal nerves that control motor and sensory functions.

The research for the first time has identified a molecular pathway related to physical activity that stimulates nerve regeneration after a spinal cord injury. The study was carried out in mice and rats.
It was already known, by studies with rodents, the benefits for the brain of an active lifestyle, explained the lead author of the study.

Laboratory animals that live in enriched environments, with wheels for exercise, toys and the presence of other animals, show better performance in memory and orientation tests, have more neurogenesis in the hippocampus, and also more dendritic spines, the structures of neurons that allow the formation of synapses or contacts between neuronal cells. And now, this work shows that the peripheral nervous system also benefits from an active lifestyle, highlighted the Dr.

The finding explained why people who have led an 'active lifestyle' recover more after spinal cord injury than those with 'less active' lifestyles.

Although the work is still at an early stage, the findings open a ' realistic path' that tests the links between pre-existing active lifestyle and subsequent recovery from a spinal injury, and possibly paves the way for clinical trials in human patients, said researchers. 

Essentially, by increasing the activity of neurons that detect environmental atimuli, we have been able to promote the regenerative potential of the nerves after a spinal cord injury, explained the Dr. who was part of the study.

We have shown that environmental enrichment, how housing the mice in a larger cage than usual, with other mice, with more toys, tunnels, swings, wheels etc, increases the activity of the neurons. 
This enriched environment leads to changes in gene expression that cause the nerves to be more likely to regenerate, added the Dr.

In addition, the researchers identified a key molecule in this process called CREB-Binding Protein (CBP), a regulator of gene expression capable that alters the expression of several genes, and thus increases the ability to regenerate damaged nerves.

Each cell of the human body contains a long strand of DNA, about 2 meters long, with genetic information. To fit inside the cell nucleus this DNA is wound in proteins called histones, forming a kind of pearl necklace. In order for genes to be expressed, the collar must unwind partially and accurately at the right time. And it is at this point where the CBP protein intervenes.

The research team has been working with the CBP protein for a long time, and they have a mouse model that lacks this protein in specific neuronal types.

By putting the deficient animals in CBP in an enriched environment, we saw that they are not able to respond to these stimuli and there is no increase in the repair of injuries, explained the Dr. Thanks to this animal model, it was clear that CBP is a key molecule, capable of becoming a therapeutic target to increase regeneration after spinal cord injury.

In tests with mice and rats, administering a compound that increases the activity of the CBP protein six hours after the injury of the column, and subsequently, once a week promoted the regeneration of the damaged nerve fibres.

After the injury and treatment with the drug, the rats, which otherwise could not walk correctly, recovered significant mobility in their hind legs, compared to the control animals, without treatment.

Although this treatment may not be fat from being tested in the clinic, more studies are needed to show that the drug is safe in humans. Once verified, it could potentially be combined with neuro-rehabilitation to treat people who have suffered a spinal cord injury.

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Beware of glaucoma, it spreads silently

There is an imperative need to educate people on the bane of glaucoma, said glaucoma specialist.

Speaking after flagging off a ‘Glaucoma Walk’ organised to mark the launch of World Glaucoma Awareness Week from March 9 to March 15, Dr.  said glaucoma was a condition of increased pressure within the eyeball, causing gradual loss of sight.

“Glaucoma is a complicated disease in which damage to the optic nerve leads to progressive, irreversible vision loss. Glaucoma is the second leading cause of blindness,” he said, adding that as many as six crore people across the world were afflicted with this ailment in 2013, while 75 lakhs people lost their eye sight. In India alone, 1.10 crore people are afflicted by it and nearly 15 lakhs people had lost sight.

He said it develops slowly and sometimes without noticeable sight loss for many years. 

Most people who have open-angle glaucoma feel fine and do not notice a change in their vision at first because the initial loss of vision was of side or peripheral vision, and the visual acuity or sharpness of vision was maintained until late in the disease, he said, adding that by the time a patient is aware of vision loss, the disease is usually quite advanced. Vision loss from glaucoma is not reversible with treatment, even with surgery, he warned.

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Causes, diagnosis, treatment for Ankle Swelling

Swelling of the lower leg and ankle is a common problem. Determining the cause of ankle swelling is the first step to finding effective treatment. Once the cause of the ankle swelling is determined, effective treatment can be initiated.

Answer: Ankle swelling causes the accumulation of fluid within the ankle joint or in the soft tissues surrounding the ankle.

Common causes of ankle swelling include:

• Traumatic Injury
  A traumatic injury, such as an ankle sprain or abroken ankle, is the most common cause of ankle swelling. Patients almost always remember the particular injury, but occasionally even subtle injuries can also lead to ankle swelling. Also, stress fracturescan occur around the ankle joint leading to swelling.
• Gout
  Gout is due to the accumulation of uric acid crystals within the fluid of your ankle. Uric acid is a substance produced as part of digestion. In order to properly digest food and rid our body of waste, our bodies produce substances such as uric acid to transport waste material. People with gout abnormally accumulate uric acid crystals within joints, leading to inflammation and swelling.
• Ankle Arthritis
  Ankle arthritis is much less common than degenerative changes in other joints. However, ankle arthritis can occur and can be quite painful. Ankle arthritis is most common in patients with rheumatoid arthritis or in patients with a previous injury to the ankle joint.
  Surgical treatments for ankle arthritis depends on the severity of the condition. In mild cases of arthritis, such as anterior impingement, a less-invasive ankle arthroscopy may be helpful in removing bone spurs. As arthritis progresses, the options are usually limited to either ankle fusion or ankle replacement surgery.
• Infection
  Infection is an unusual cause of ankle swelling. Infections can either occur in the soft tissues around the ankle joint (cellulitis) or in the joint itself (septic joint). Infections can often be treated with medications alone, but may also require surgery.
• Vascular Obstruction
  Numerous problems with blood flow can impair normal circulation and lead to swelling around the ankles. The most common cause of vascular obstruction is a blood clot, also known as a DVT. This type of vascular problem usually occurs in one leg (not both), and leads to swelling of the soft-tissues throughout the foot and ankle. The swelling can also extend further up the leg.
• Peripheral Edema
  Peripheral edema is also a circulation problem, but is seen in both legs, not just one. Lower extremity edema can be due to aging of the veins leading to chronic swelling, as well as other conditions that can place pressure on the leg veins. These conditions include pregnancy, obesity, and varicose veins.

Septic Arthritis

Swelling in the soft tissues surrounding the ankle joint or in the septic knee joint itself, could be a sign of an infection. It is caused by a bacterial, viral or fungal infection that spreads through the bloodstream to the joint. Consult a doctor immediately, if you notice any infected blisters and sores on your swollen foot.

Excessive Salt Intake

Unreasonable intake of salt, alcohol, coffee, tea, soda, etc., can result in abnormal buildup of fluid in the ankle joints which causes the ankle to swell. So, lower the intake of salt and other processed or packed foods to bring down the swelling.

Side Effects of Certain Medication

Intake of medication like steroids, antidepressants, oral contraceptives, laxatives used to induce bowel movement could also cause ankles to swell. Consult your doctor if you notice swelling around the ankles or on the feet after taking any medication.

Diagnosis

A doctor will begin by taking a medical history and provide a medical examination, which will help rule out other health conditions. This is essential because it is important to find the underlying cause of ankle swelling to determine what treatment plan is appropriate.

Some medications, such as hormone replacement therapy, birth control pills, blood pressure medication, steroids and antidepressants often have the side effect of swelling. It is important that your physician be made aware of any medications you are currently taking and the amounts to determine if medication is a contributing factor.

X-rays are normally ordered if there was an injury involved and they can also help to rule out other medical conditions. In some cases, more detail is needed, so a CT scan or a DVT ultrasound may be used to examine the veins in the leg to detect clots.

A blood test analysis and urinalysis might be conducted if an infection or gout is suspected. If a blood clot is being considered, an ultrasound might be ordered to determine the size and location of the clot. A physician might also order an ECG to determine if there is a cardiovascular problem.

Treatments

Here are some remedies to reduce swelling and inflammation of the ankles. If the swelling turns very painful and does not subside within the next two or three days, then you must consult a doctor, immediately.

Use leg wedges to elevate your feet while sleeping. This can help lower the pain and swelling, too.

Applying an ice pack on the swollen area for fifteen to twenty minutes could also help reduce the swelling and pain.

To reduce swelling, soak your swollen ankle in 3 litres of warm water mixed with a cup of Epsom salt.

Lower the intake of sodium in your diet.

Avoid wearing tight-fitting clothes as they can restrict blood and fluid circulation in the body leading to swollen ankles.

Wear comfortable shoes and support stockings. Specialized shoes and elastic stockings are available on-line for those with ankle or foot problems.

Walk more frequently, exercise, stretch and rotate your ankles in small circular movements. Avoid standing or sitting in one place for too long.

Even if you suffer from arthritis, exercise is still important for strengthening the joints. Try tai chi or slow yoga, before starting any routine discuss your exercise plan with your doctor.

On long distance travel, make sure you get up at regular intervals and walk around a little.

If there is no underlying medical cause to swelling of the ankles then the above-mentioned remedies will definitely prove helpful. Persistent pain and any unusual accompanying symptoms should be reported to the doctor immediately.

ps- this is only for information, always consult you physician before having any particular food/ medication/exercise/other remedies.

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