Monthly Archives: January 2015

Next Steps for Depression Treatment

Written by Karen Carlson, SIU School of Medicine
When you’re suffering from chronic depression, life seems, well, lifeless. What if medications and therapy don’t work?
Depression is a serious medical illness affecting more than 14 million American adults every year, according to the National Institutes of Mental Health. Women are almost twice as likely as men to suffer from depression, although depression in men may be under-reported.
Psychotherapy and medication are the preferred methods of depression treatment. For those who haven’t reached success with those methods, some additional treatments are available. Dr. Jeffrey Bennett, psychiatrist at SIU School of Medicine, explains the next steps to ward off the shadows of depression.
1. Transcranial Magnetic Stimulation Therapy – a specialized chair, looking like a dentist chair, this non-invasive treatment focuses magnetic fields on the brain. Magnetic pulses produced by the device are the same type and strength as a magnetic resonance imaging scan. Patients receive rapid magnetic pulses in 30-second intervals. The pulses, which feel like a tapping on the scalp, induce a small electrical current in the brain that the patient can’t feel. The charge stimulates brain neurons, which affects the “feel good” chemicals serotonin and dopamine. “With TMS, patients are alert, and there are almost no side effects,” Dr. Bennett says. “It’s extremely easy to endure, something somebody could get for 38 minutes a day and be ready for the rest of their day without feeling side

TMS

Dr. Bennett explains TMS.

effects. There may be some headache or scalp irritation, but it’s minimal.”
“TMS therapy brought me from darkness to light. It changed my life,” said Marie S., 63, who has suffered from chronic depression since she was 18. She underwent TMS therapy in 2012 and says the weight of depression has lifted. “I saw a light at the end of the tunnel. I don’t have the heaviness on my chest and shoulders. Things just seem better.”
Dr. Bennett was named a Medical Innovator for his neurostimulatory treatment methods for mental disorders, such as depression, that resist treatment. This 5-minute video describes TMS and includes a patient’s personal story.
Read more TMS Therapy at SIU School of Medicine in Aspects magazine.
2. Electroconvulsive Therapy – Also known as electroshock therapy, this is a safe and effective treatment with a high success rate for people suffering from various forms of depression.
3. Light Therapy – Exposure to full spectrum light provides relief for many people suffering with seasonal depression.
4.Vagus Nerve Stimulation – sometimes referred to as a “pacemaker for the brain.”
This device stimulates a particular cranial nerve alerting the electrical activity in the brain to control depressive symptoms that are resistant to treatment. This method of treatment has been shown to stimulate the area of the brain that affects mood and has been used to treat patients with epilepsy as well.
Ask your primary care physician or mental health provider about these FDA-approved treatments or call SIU HealthCare psychiatry at 217-545-8000.
Copyright © SIU School of Medicine, Springfield, Illinois

The sexual virus you probably already have: HPV

Written by Lauren Murphy, SIU School of Medicine
Researchers estimate that three out of every four Americans will, at some point during their lives, play host to a sexually transmitted illness that can cause everything from genital warts and cervical cancer couple hpvto neck and oral cancer. The good news is that in 80-90% of cases, the virus will clear up on its own within two years.
Human papilloma virus (HPV), the cause of almost all cervical cancers, affects more than 79 million Americans. And while condoms are somewhat effective at preventing the illness, they aren’t a guarantee since the virus can infect areas not covered by a condom. Luckily, two vaccines, Gardasil and Cervarix, offer more protection against most of the most harmful HPV strains. Both vaccines can be given to females age 9-26, while Gardasil can be given to males age 9-26.
“The goal is to reach these kids long before they become sexually active and exposed to HPV,” says OB-GYN Dr. Assaad Semaan. “Additionally, the vaccines produce a higher immune response in preteens than it does it older teens and young women.”
The vaccines involve series of three shots given in a six month period. A physician should administer the second shot within one to two months of the first, and the third dose should be given six months after the first dose.
In addition to receiving an HPV vaccine, physicians urge women to schedule the appropriate screenings. The National Cancer Institute recommends that women undergo a Pap test every three years beginning at age 21. At age 30, women should schedule both a Pap test and an HPV test every five years. Women with certain risk factors may need to have more frequent screenings or continue screening beyond age 65.
As many as 93% of cervical cancer cases could be prevented by cervical screenings and

hpv pap

Pap smear from Dr. Lance Liotta’s Laboratory

the HPV vaccine, according to a 2014 report by the U.S. Centers for Disease Control and Prevention. Do yourself a favor and schedule an appointment today. Or, if you’re an uninsured female, age 21 or older, register for a free cervical cancer screening during the month of January. For more details, click here.
Copyright © SIU School of Medicine

Mickey, Minnie & measles, oh my!

Written by Lauren Murphy, SIU School of Medicine
Disneyland likely failed to be so magical for several visitors who contracted measles at the California theme park in mid-December. The illness, which was declared “eliminated” in the U.S. in 2000, has spanned four states and sickened 39 people since the Disney outbreak occurred. But this is far from the first time Americans have seen measles since 2000.
“In 2014, the United States recorded the highest number of reported cases of measles since it was declared eliminated. More than 600 cases were reported to CDC’s National Center for Immunization and Respiratory Diseases (NCIRD) from 27 states,” explains infectious disease specialist at SIU School of Medicine Dr. Vidya Sundareshan.
Though this burst in activity has mainly remained confined to the western half of the United States so far, doctors warn of the possibility of rapid spread of this highly contagious virus.
Should you be concerned? Here’s what you need to know about measles:
What is measles and how is it spread?
Measles is caused by a virus in the paramyxovirus family. It is a highly contagious respiratory disease that spreads through the air from coughing and sneezing as well as close personal contact or direct contact with the infected nasal or throat secretions. The measles virus can remain contagious in the air as well as on infected surfaces for up two hours and can be spread from four days before the onset of the rash to four days after the rash appears.
measlesWhat are the symptoms?
Symptoms of measles, which begin to appear about 10-12 days after exposure to the virus, last 4 to 7 days. A high fever is typically the first sign of measles, followed by red and watery eyes, a cough, runny nose and small white spots inside the cheeks. About 7-18 days after initial exposure, a rash, usually on the face and upper neck, appears and then spreads to other areas of the body, including the hands and feet. This rash will last about 5-6 days before fading.
If the U.S. declared the virus eliminated, how did it reappear?
“Measles is still common in many parts of the world including some countries in Europe, Asia, the Pacific and Africa, and travelers with measles continue to import the disease into the U.S.,” Dr. Sundareshan explains. The majority of the people who got measles are unvaccinated, so the virus can spread when it reaches a community in the U.S. where groups of people are unvaccinated.
How serious is measles? Who’s most at risk?
Though a safe, cost-effective vaccine exists, the virus is still one of the leading causes of death among young children worldwide. In 2013, 145,700 people from around the world died due to measles, the World Health Organization (WHO) reports. About 95% of these deaths occurred in countries with low per capita income and weak health infrastructures. Unvaccinated children, especially those who are malnourished, are most at risk of measles. Unvaccinated pregnant women are also at a higher risk.
What complications may occur?
The CDC estimates that about three out of 10 people who get measles will develop one or more complications, including pneumonia, ear infections or diarrhea. Complications are more common in adults and young children, and severe measles is also more likely to occur among young children with vitamin A deficiencies or who have weakened immune systems.
How can I prevent contracting the measles?
Vaccines are the most effective way to prevent the measles. From 2000 to 2013, measles vaccination prevented an estimated 15.6 million deaths, according to WHO. In 2013, less than 150,000 people died due to measles. By comparison, measles took the lives of approximately 2.6 million people each year before the vaccine was made widely available in 1980. In 2012, more than 90% of children 19-35 months had received the measles, mumps and rubella vaccine, according to a report by the CDC.
If I have the measles vaccine, should I still be worried?
According to Dr. Sundareshan, “You can still get the disease, but symptoms are less severe and complications are lower as well.”
Copyright © SIU School of Medicine, Springfield, Illinois

 

Pain medication: when the solution becomes the problem

Written by Rebecca Budde, SIU School of Medicine
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Physicians prescribed enough painkillers in 2010 to medicate every American adult every four hours for a month, according to estimates from the CDC.  The goal of the medication is to lessen the impact of pain, whether chronic or acute, in order to make daily activities more manageable.
While these medications offer the benefit of managing pain, physicians caution that they can also produce some unpleasant side effects. Internal medicine physician and hospitalist Dr. Zak Gurnsey says that the effectiveness and side effects of pain medication vary from person to person.
Possible side effects of pain medication:
1.  Dependence or addiction
2.  Restlessness
3.  Trouble sleeping
4.  Constipation
5.  Drowsiness
6.  Trouble concentrating
7.  Slowing of breathing
8.  Initial queasy feeling and/or vomiting
9.  Itching and/or rash
10. Chronic tiredness
11. Decreased sex drive
While some of these side effects subside over time, others may stick around or worsen. For those h2owho feel drowsy from their pain medications, Dr. Gurnsey cautions that using alcohol, marijuana and street drugs can heighten the effect. Drowsiness can also lead to falls and accidents so it’s important that people refrain from driving when taking certain painkillers. If constipation is a concern, Dr. Gurnsey recommends drinking plenty of fluids to stay hydrated, increasing fiber and increasing exercise.
To avoid the worsening of side effects, use pain medications safely:
1.  Always take the prescribed dose.
2.  Avoid alcohol and street drugs.
3.  Inform your doctor before taking new medications.
4.  Store your medication in a cool, dry place, away from pets and children.
5.  Do not let others use your medication.
6.  If you want to stop your medication or need an increased dose, discuss with your doctor first to avoid any side effects.
7.  Fill all prescriptions at the same pharmacy so that the pharmacist can check for possible interactions.
Copyright © SIU School of Medicine, Springfield, Illinois

 

Death by sleep deprivation

Written by Lauren Murphy, SIU School of Medicine
sleep infographicIn one of the latest documentaries by the National Geographic, entitled “Sleepless in America,” experts link poor sleep habits to some of the deadliest illnesses: Alzheimer’s disease and cancer. In the film, Dr. David Gozal of the University of Chicago suggests that recurrent sleep issues can directly affect cancer growth. In fact, his laboratory research has shown cancer cells can grow twice as fast in animals with chronic, disrupted sleep. Dr. Gozal suggests humans respect sleep as a part of our culture in order to prevent illness.
SIU School of Medicine neurologist and director of the Center for Alzheimer’s Disease and Related Disorders, Dr. Tom Ala agrees. He says sleep is a crucial element of maintaining a healthy lifestyle.
“Poor sleep increases cognitive and physiological stress, interferes with our memory and interferes with the rest that helps our bodies recover from physiological stress. It also interferes with our ability to pursue healthy activities, such as eating healthy, exercising and taking proper care of ourselves,” Dr. Ala explains.
Dr. Ala goes on to explain that inadequate sleep could worsen the symptoms of Alzheimer’s disease. “The symptoms [of Alzheimer’s disease] are worsened because the patient would have even more difficulty concentrating, and one of the theories of sleep is that it reinforces our memories made while we are awake.”
Not sure if you’re getting enough Zzz’s? Here are six signs you should probably hit the hay earlier.
1. You have an insatiable appetite:  Too little sleep is linked to higher levels of ghrelin, a hormone that also triggers hunger.
2. ::Tear:: You’re an emotional basket case: In 2007, researchers found that sleep-deprived noggins were 60% more reactive to negative and disturbing images. Experts likened the change to the brain reverting back to a primitive state in which people are unable to put emotional experiences into the proper context or produce the appropriate response.
3. Just when you need to . . . Wait, what was I going to say? Oh, that’s right, just when you need to remember something important, your sleepy brain will likely forget it or lack the concentration necessary to focus. A lack of sleep has been consistently linked to difficulty focusing, a poor attention span, confusion, a decrease in alertness and concentration, forgetfulness and trouble learning.
4. You can’t seem to shake that cold: A 2009 study suggested that people who sleep fewer than seven hours per night were about three times more likely to catch a cold than people who got eight or more hours.
sleep 25. Your cat-like reflexes have disappeared: It seems sleep deprivation also affects our motor skills, leading to slowed reactions and questionable balance.
6. You think Marvin Gaye is talking about napping in his tune “Let’s Get It On:” Turns out a lack of sleep can also lead to a decreased sex drive and an increase in the stress hormone cortisol.
Copyright © SIU School of Medicine, Springfield, Illinois

Relief for Raynaud’s Syndrome

Written by Rebecca Budde, SIU School of Medicine
snow glovesAfter some amazingly mild days in December, the winter weather has really set in – it’s COLD outside! For some, the cold means the welcome possibility of a dusting of snow on the lawn; for others, the cold can exacerbate an already painful incurable condition.
Raynaud’s Syndrome is a disorder that can affect the blood vessels in the fingers, toes, ears and nose. This disorder is characterized by episodic attacks that cause ischemia (constricted blood vessels) and pain in the areas affected. “For those with Raynaud’s Syndrome, in the hands, the limited blood flow can cause the fingers to turn cold, white and/or blue and be very painful, possibly even cause sores or ulcers to form,” according to plastic surgeon Dr. Michael W. Neumeister.
In January 2004, Dr. Neumeister injected his first patient suffering from Raynauds with BOTOX® in an attempt to help his pain. “His fingers were white with no blood supply and he had some ulcers and exposed bone,” Dr. Neumeister says. “The first time he came to me, he said, ‘Doc, cut my fingers off!’ This man had been admitted to the hospital, had intravenous morphine and even surgeries to attempt to cure the pain in his hands.” The BOTOX® worked.
Since that first injection, BOTOX® has started to become a more widely known option. The FDA has Raynaudsnot given on-label approval for using BOTOX® for Raynaud’s, but Dr. Neumeister is conducting a stage 2 clinical trial to determine the effectiveness of BOTOX® for Raynaud’s.
The side effects are minimal, and the reduction of the patient’s pain is swift. Patients may experience temporary (a couple of months) weakness in the muscles that control the spreading of the fingers. Seventy percent of patients have pain relief, according to Dr. Neumeister.
In addition to patients with Raynaud’s, Dr. Neumeister has used BOTOX® to treat neuromas, painful scars, chronic back pain, carpal tunnel, tennis elbow, diabetic foot pain and reflex sympathetic dystrophy syndrome.
Read more about The Hidden Talents of BOTOX®.
Read more about Raynaud’s Syndrome.
Copyright © SIU School of Medicine, Springfield, Illinois

Resolution #1: quit smoking!

written by Rebecca Budde, SIU School of Medicine
If one of your top New Year’s resolutions is to quit smoking, Simmons Cancer Institute at SIU School of Medicine might be able to help you. “Freedom From Smoking” a smoking cessation program that focuses on HOW to quit to help you hold to that resolution.
If you didn’t make the resolution, maybe you should reconsider; it’s never too late to quit. No matter what your age, quitting will add years to your life, not to mention money in your pocket. Also consider that you are helping those around you since second-hand smoke is also known to have negative health effects, especially on children. Don’t let cigarettes take control of the health of you and your loved ones.cdc smokingFreedom From Smoking class:
Dates:
January 13, 20, 27, February 3, 5, 10, 17 & 24.
Time:  Noon-1:00
All sessions must be attended
Quit day is February 3, with an additional session that week on the February 5.
Location:  Simmons Cancer Institute, 315 West Carpenter Street, Springfield, Room 2004
Registration fee:  $50/person, covers program materials
Register online or call 545-7493
Class is limited to 10 participants, so register NOW!!

Infographic from CDC.
Copyright © SIU School of Medicine, Springfield, Illinois.