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Low-Dose Ketamine Eases Fentanyl Withdrawal Symptoms

The AHA! Team — Thu, 17 Oct 2024 08:22:08 +0000

University of Washington School of Medicine via News-Medical – Drug overdose is the leading cause of injury deaths in young adults in the United States, with fentanyl causing over 70,000 deaths annually. Many people who use fentanyl become trapped in their addiction out of fear and a low tolerance for the withdrawal symptoms, which include muscle cramps, nausea, chills, sweats and intense cravings. They can’t stop using fentanyl, and they also have trouble starting either of the two medications, methadone and buprenorphine, that can dramatically reduce their risk of overdose death. Research findings published Aug. 29 in Addiction Science & Clinical Practice may offer hope. A pilot study showed that a small amount of ketamine can reduce or eliminate the withdrawal symptoms associated with quitting fentanyl. “The main takeaway is that we have found an easier way for people trapped in the grip of fentanyl addiction to get started in treatment.” Dr. Lucinda Grande, clinical assistant professor of family medicine, University of Washington School of Medicine She was the study’s lead author. “Methadone can be difficult to access due to strict federal regulations, and starting buprenorphine can cause severe withdrawal symptoms before those who start it become stabilized,” added study co-author Dr. Tom Hutch. He is the medical director of the opioid treatment program at We Care Daily Clinics in Auburn, Wash. “Ketamine, at an imperceptibly low dose, helps bridge that gap.” Over 14 months, Grande and colleagues in Auburn and Olympia prescribed ketamine to 37 fentanyl-addicted patients whose fear of withdrawal symptoms had deterred them from trying buprenorphine. Twenty-four patients actually tried the drug, and 16 completed the transition to buprenorphine. Most patients reported a reduction or elimination of withdrawal symptoms after each ketamine dose, the effect of which lasted for hours. Of the last 12 who completed the transition, 92% remained in treatment for at least 30 days. Patients placed a ketamine lozenge or syrup under the tongue. The 16 mg dose is a small fraction of that typically used for anesthesia, the main clinical role of ketamine for 50 years, according to Grande. That dosage also is less than half of the smallest ketamine dose prescribed for depression treatment, an increasingly common use of this medication. Researchers monitored patients daily or almost daily, and refined the treatment strategy based on patient response and prescriber experience. Grande developed the concept after she learned that emergency-medicine physician and coauthor Dr. Andrew Herring of Oakland, California, used a higher, sedating dose of ketamine successfully in his emergency department to resolve a patient’s severe case of withdrawal from fentanyl addiction. Grande is a primary-care and addiction doctor in practice near Olympia who, in the past dozen years, has used low-dose ketamine to treat more than 600 patients for chronic pain and depression. Ketamine has gained prominence in the news since actor Matthew Perry of the sitcom “Friends” overdosed on the drug and drowned. Perry had undergone high-dose ketamine treatment for depression, news reports have suggested. “Our study underscores the enormous potential of this medication for addressing important health problems such as depression, chronic pain and now fentanyl-use disorder,” said Grande. Ketamine’s positive attributes have been overshadowed by Perry’s death, she said. Grande hopes this pilot study’s results will be confirmed by larger studies. “I am excited about these results,” she said. “This is a wonderful opportunity to save lives.” Source: University of Washington School of Medicine Journal reference: Grande, L., et al. (2024) Ketamine-assisted buprenorphine initiation: a pilot case series. Addiction Science & Clinical Practice. doi.org/10.1186/s13722-024-00494-2. To read the original article click here.

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Soft, Stretchy ‘Jelly Batteries’ Inspired by Electric Eels

The AHA! Team — Thu, 25 Jul 2024 08:12:50 +0000

University of Cambridge via EurekAlert! – Researchers have developed soft, stretchable ‘jelly batteries’ that could be used for wearable devices or soft robotics, or even implanted in the brain to deliver drugs or treat conditions such as epilepsy. The researchers, from the University of Cambridge, took their inspiration from electric eels, which stun their prey with modified muscle cells called electrocytes. Like electrocytes, the jelly-like materials developed by the Cambridge researchers have a layered structure, like sticky Lego, that makes them capable of delivering an electric current. The self-healing jelly batteries can stretch to over ten times their original length without affecting their conductivity The first time that such stretchability and conductivity has been combined in a single material. The results are reported in the journal Science Advances. The jelly batteries are made from hydrogels: 3D networks of polymers that contain over 60% water. The polymers are held together by reversible on/off interactions that control the jelly’s mechanical properties. The ability to precisely control mechanical properties and mimic the characteristics of human tissue makes hydrogels ideal candidates for soft robotics and bioelectronics; however, they need to be both conductive and stretchy for such applications. “It’s difficult to design a material that is both highly stretchable and highly conductive, since those two properties are normally at odds with one another,” said first author Stephen O’Neill, from Cambridge’s Yusuf Hamied Department of Chemistry. “Typically, conductivity decreases when a material is stretched.” “Normally, hydrogels are made of polymers that have a neutral charge, but if we charge them, they can become conductive,” said co-author Dr Jade McCune, also from the Department of Chemistry. “And by changing the salt component of each gel, we can make them sticky and squish them together in multiple layers, so we can build up a larger energy potential.” Conventional electronics use rigid metallic materials with electrons as charge carriers, while the jelly batteries use ions to carry charge, like electric eels. Jelly batteries use ions to carry charge, like electric eels The hydrogels stick strongly to each other because of reversible bonds that can form between the different layers, using barrel-shaped molecules called cucurbiturils that are like molecular handcuffs. The strong adhesion between layers provided by the molecular handcuffs allows for the jelly batteries to be stretched, without the layers coming apart and crucially, without any loss of conductivity. The properties of the jelly batteries make them promising for future use in biomedical implants, since they are soft and mould to human tissue. “We can customise the mechanical properties of the hydrogels so they match human tissue,” said Professor Oren Scherman, Director of the Melville Laboratory for Polymer Synthesis, who led the research in collaboration with Professor George Malliaras from the Department of Engineering. “Since they contain no rigid components such as metal, a hydrogel implant would be much less likely to be rejected by the body or cause the build-up of scar tissue.” In addition to their softness, the hydrogels are also surprisingly tough. They can withstand being squashed without permanently losing their original shape, and can self-heal when damaged. The researchers are planning future experiments to test the hydrogels in living organisms to assess their suitability for a range of medical applications. The research was funded by the European Research Council and the Engineering and Physical Sciences Research Council (EPSRC), part of UK Research and Innovation (UKRI). Oren Scherman is a Fellow of Jesus College, Cambridge. To read the original article click here.

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Microrobots Show Promise for Treating Tumors

The AHA! Team — Mon, 19 Aug 2019 07:00:00 +0000

California Institute of Technology via News Wise – “These micromotors can penetrate the mucus of the digestive tract and stay there for a long time. This improves medicine delivery,” Gao says. “But because they’re made of magnesium, they’re biocompatible and biodegradable.” Targeting medical treatment to an ailing body part is a practice as old as medicine itself. A Band-Aid is placed on a skinned knee. Drops go into itchy eyes. A broken arm goes into a cast. But often what ails us is inside the body and is not so easy to reach. In such cases, a treatment like surgery or chemotherapy might be called for. A pair of researchers in Caltech’s Division of Engineering and Applied Science are working on an entirely new form of treatment–microrobots that can deliver drugs to specific spots inside the body while being monitored and controlled from outside the body. “The microrobot concept is really cool because you can get micromachinery right to where you need it,” says Lihong Wang, Caltech’s Bren Professor of Medical Engineering and Electrical Engineering. “It could be drug delivery, or a predesigned microsurgery.” The microrobots are a joint research project of Wang and Wei Gao, assistant professor of medical engineering, and are intended for treating tumors in the digestive tract. The microrobots consist of microscopic spheres of magnesium metal coated with thin layers of gold and parylene, a polymer that resists digestion. The layers leave a circular portion of the sphere uncovered, kind of like a porthole. The uncovered portion of the magnesium reacts with the fluids in the digestive tract, generating small bubbles. The stream of bubbles acts like a jet and propels the sphere forward until it collides with nearby tissue. On their own, magnesium spherical microrobots that can zoom around might be interesting, but they are not especially useful. To turn them from a novelty into a vehicle for delivering medication, Wang and Gao made some modifications to them. VIDEO: https://www.youtube.com/watch?v=YWK3gg6J8ng First, a layer of medication is sandwiched between an individual microsphere and its parylene coat. Then, to protect the microrobots from the harsh environment of the stomach, they are enveloped in microcapsules made of paraffin wax. At this stage, the spheres are capable of carrying drugs, but still lack the crucial ability to deliver them to a desired location. For that, Wang and Gao use photoacoustic computed tomography (PACT), a technique developed by Wang that uses pulses of infrared laser light. The infrared laser light diffuses through tissues and is absorbed by oxygen-carrying hemoglobin molecules in red blood cells, causing the molecules to vibrate ultrasonically. Those ultrasonic vibrations are picked up by sensors pressed against the skin. The data from those sensors is used to create images of the internal structures of the body. Previously, Wang has shown that variations of PACT can be used to identify breast tumors, or even individual cancer cells. With respect to the microrobots, the technique has two jobs. The first is imaging. By using PACT, the researchers can find tumors in the digestive tract and also track the location of the microrobots, which show up strongly in the PACT images. Once the microrobots arrive in the vicinity of the tumor, a high-power continuous-wave near-infrared laser beam is used to activate them. Because the microrobots absorb the infrared light so strongly, they briefly heat up, melting the wax capsule surrounding them, and exposing them to digestive fluids. At that point, the microrobots’ bubble jets activate, and the microrobots begin swarming. The jets are not steerable, so the technique is sort of a shotgun approach–the microrobots will not all hit the targeted area, but many will. When they do, they stick to the surface and begin releasing their medication payload. “These micromotors can penetrate the mucus of the digestive tract and stay there for a long time. This improves medicine delivery,” Gao says. “But because they’re made of magnesium, they’re biocompatible and biodegradable.” Tests in animal models show that the microrobots perform as intended, but Gao and Wang say they are planning to continue pushing the research forward. “We demonstrated the concept that you can reach the diseased area and activate the microrobots,” Gao says. “The next step is evaluating the therapeutic effect of them.” Gao also says he would like to develop variations of the microrobots that can operate in other parts of the body, and with different types of propulsion systems. Wang says his goal is to improve how his PACT system interacts with the microrobots. The infrared laser light it uses has some difficulty reaching into deeper parts of the body, but he says it should be possible to develop a system that can penetrate further. To read the original article click here.

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Concussion Symptoms Reversed by Magnetic Therapy

The AHA! Team — Sun, 18 Aug 2019 07:00:00 +0000

University of Saskatchewan via EurekAlert – Taghibiglou also found that certain proteins, which are important to protect the brain from various neurological conditions, were restored to their normal level by the low-frequency magnetic stimulation. The proteins protect neurons and halt the progression of post-concussion inflammation and neurodegeneration. Concussion symptoms – such as loss of balance, hazy comprehension, sleep disturbance and ability to walk straight – can be reversed by a new type of magnetic stimulation, research at the University of Saskatchewan (USask) shows. Magnetic stimulation using a laptop-style device for 20 minutes per day improved the ability of rodents with concussion to walk in a straight line, navigate a maze, run on a wheel, and perform cognitive tests, according to research published in the Journal of Neurotrauma. “Concussion is a major health concern affecting all sections of society from children whose brain is still developing to older people suffering falls,” said Professor Changiz Taghibiglou, who led the research. “The beauty of this therapy is not only that it is effective, but that it is non-invasive, easy to use and cost-effective.” The USask team also found evidence that Low Frequency Magnetic Simulation could potentially protect the brain from future degeneration, a risk following serious concussions. Concussion or mild traumatic brain injury (mTBI) is a major public health concern and can be caused by sports injuries, motor-vehicle accidents, falls and other head trauma. The World Health Organization (WHO) estimates that more than 10 million people per year are affected by a traumatic brain injury (TBI). In Canada, 160,000 people suffer from brain injuries annually, with over 1.5 million Canadians living with the consequences. Income lost from disabilities related to brain injuries in Canada is predicted to rise from $7.3billion to $8.2 billion between 2011 and 2031. Concussion can also cause severe headaches and hamper a person’s ability to think straight and perform day-to-day tasks. Within four days of treatment, rodents with repeated concussion had their ability to perform a variety of cognition and motor tests restored to almost normal levels. Their bodyclocks, governing sleep patterns, which can be thrown out of sync by concussion, were also restored to their normal function. In the next stages of the research program, the USask team plans to conduct longer-term tests on rodents, followed by human trials. The mice were exposed to low levels of magnetic stimulation, which mimic the way brain waves oscillate. Mice with concussion that had not been treated were unable to perform the behavioral and neurological tasks, which included running on a wheel without falling off. Taghibiglou also found that certain proteins, which are important to protect the brain from various neurological conditions, were restored to their normal level by the low-frequency magnetic stimulation. The proteins protect neurons and halt the progression of post-concussion inflammation and neurodegeneration. Children and adolescents are particularly vulnerable to adverse effects of brain injuries as their brains are still developing into their early 20s. “Traumatic brain injury is a clinical condition that poses significant challenges to patients, families and health professionals,” said Dr. Yanbo Zhang (M.D), professor of psychiatry in USask’s College of Medicine, and co-author of the paper. “Patients can suffer long- lasting cognitive impairments, emotional and behavioural changes. Currently, we do not have effective treatment to improve the cognitive impairment. Low frequency magnetic stimulation provides a novel option for concussion treatment. It is portable, non-invasive and affordable.” To read the original article click here.

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