A Lap At Daytona

What its like driving Daytona, Guy Cosmo shows us how it's done. http://www.youtube.com/watch?v=cdcIsGDQov8

Grand Am Racing

Dr. Chris Prusinski Racing at Daytona International Speedway driving the blue and green Kinetic Racing #79 BMW E92 M3

Daytona Grand Am

Dr. Prusinski leads the way through the chicane at Daytona with the competition in hot pursuit.

Daytona Test Day

NASCAR Grand Am racing test day in frigid weather at Daytona--178 mph before threshold breaking for turn one.

Boost Your Immunity,Look At Sick Pics

Mark Schaller and Will Gervais psychologists at U of BC suggest that just seeing pictures of symptoms of infectious disease, ie. sneezes, lesions, boosts our immunity. Subjects were shown photos associated with infectious illness or of guns (control). Participants white blood cells were then incubated with bacteria. Those exposed to the images of infection demonstrated higher levels of the proinflammatory cytokine interleukin-6 (IL-6) compared with the control (gun picture exposed) subjects.This study is the first evidence that visual perception of other people's illness can boost our immunity. Psychological Science 21(5) pgs. 649-652

Increasing Survival After Major Trauma and Blood Loss

Hasan Alam at Mass General suggests that survival after major trauma associated with major blood loss could be improved by administering valproic acid (Depakote) to the injured. Depakote is used neurologically as an anti-seizure and migraine preventative medicine. Valproic acid aids cells survival on less oxygen by its histone deacetylase inhibitory properties. Found first to be effective on injured rats then on pigs experimentally. More than 500,000 people per year bleed to death as a result of major trauma including motor vehicle accidents and combat wounds.

Surgery, DOI: 10.1016/j.surg.2009.04.007

Amyloid beta has Anti-bacterial Properties

Too much Amyloid beta in the brain has toxic effects, too little may hamper our ability to fight infections in the central nervous system. Will blood testing for amyloid beta levels in our blood be in our future ? Will a best range be preferred as with HDL cholesterol nowadays ?

New Criteria for Preclinical Alzheimer's Disease

Proposed new guidelines are are available online for public feedback at www.alz.org/research.diagnostic_criteria

Neuro-Speed Racing

Dr. Prusinski ( on left ) and co-driver, Chris Hall sign autographs at Barber motorsports park in Alabama at the 2010 Grand-Am race weekend shared with Indycar

Alzheimer's Disease and Abeta Protein

Amyloid beta (Abeta) that accumulates in Alzheimer's disease (AD) plaques resembles LL-37 , a peptide with anti-microbial properties, according to researchers at Harvard Medical School. Abeta has been suggested to be the "brain's protector" against infections, but also appears to be ramped up after traumatic brain injury or stroke in addition to chronic low-grade infections. Interestingly, Abeta is toxic to brain cells. But it is cleared quickly once produced . With too great a response or too many brain insults, Abeta may turns against the body. This suggests a new way of thinking about the pathology of AD in that it may be viewed as an auto-immune disease. Too little Abeta in our brains may lead to increased risk of infections ...too great an accumulation of Abeta carries with it an increased risk of AD. Soscia,SJ Kirby,JE Moir,RD PLoS One 2010 Mar 3;5(3):e9505

HELMINTHS NEEDED FOR BALANCED IMMUNITY ?

Diseases such as inflammatory bowel disease (IBD) were rare before the 1920's, when public health efforts began making strides in cleaning up our water supply,modernizing the treatment of sewage, and improving farming practices.These changes certainly benefited us by reducing or eliminating exposure to many disease-causing pathogens, they also had the unintended consequence of removing exposure to beneficial or even necessary organisms.

People lived closer to the soil in the past, without indoor plumbing and with direct exposure to animals. The result was near universal colonization with helminths, which are complex wormlike animals that inhabit the gastrointestinal tracts of mammals. Like the many bacteria also found in the gut, some helminths can cause disease in a host animal but many are relatively harmless and, in fact, are important regulators of the immune system.

According to Dr. J. Weinstock , a gastroenterologist at Tufts University, " helminths exert a powerful effect on immunity in the host, primarily by inducing the regulatory arm of the immune system, which is important in reigning in the effector ' fight and kill ' arm of the immune system." The regulatory arm hones and shapes the immune response to bacteria, viruses, and parasites, quelling the effects of the effector arm so as to prevent needless tissue damage by turning against the host.

Diseases such as IBD, asthma, rheumatoid arthritis, and multiple sclerosis remain uncommon in less-developed parts of the world where helminthic colonization is still widespread.

Interestingly, petrified human stool many thousands of years old has been found to contain helminth eggs, and autopsies of mummies have found traces of helminths. In fact, the frozen iceman Otzi, found in the northern Alps in 1991 where he had lain in a glacier since 3300 B.C., had T. trichiura in his gut.

Int. J. Parasitol. 2007;37:457-64

Gut 2005;54:87-90

Ann. Rheum. Dis. 2008;67:518-23

Mild Traumatic Brain Injury Detected

Mild Traumatic Brain Injury (mTBI) can be detected using diffusion tensor imaging (DTI) which is an application of MRI that is sensitive

to the direction of the movement of water molecules through tissue.In the intact brain, the primary direction of movement is parallel to axonal bundles, which is caled anisotropy.But when these axons are damaged, the movement becomes less aligned with the bundles.If there is a change in the direction of diffusion of water due to microscopic damage , it is reflected in a decrease in anisotropy.This finding may allow the diagnose of patients with mTBI in whom routine MRI scans are often normal.

Radiology 2009;252 (3) :816-824

BELL'S PALSY RECOVERY

BELL'S PALSY RECOVERY more likely with corticosteroids (higher doses of more than 450 mg ).Adding antiviral drugs (acyclovir is generic and therefore less expensive) may have additional benefit but this was of borderline statistical

significance. JAMA 2009;302(9):985-993

MIGRAINE IN MRS. LINCOLN?

Mary Todd Lincoln suffered from debilitating headaches ( possibly migraine ) throughout her adult life. "Abraham Lincoln Vampire Hunter" by Seth Grahame-Smith

NEW MIGRAINE DRUG CLASS

Telcagepant (MK-0974), the first orally bioavailable neuropeptide calcitonin gene-related peptide (CGRP) receptor antagonist, relieved pain and other migraine symptoms.

Merck is in phase III of the clinical development of this drug and is addressing dose dependent liver toxicity. Neurology2009;73:970-977

END-OF-LIFE ISSUES IN DEMENTIA

Ethical issues are discussed in the management of the demented patient at www.aan.com/go/about/position

The appropriate form of treatment for most patients with advanced dementia is palliative care in which measures that maintain comfort are emphasized and whose goal is to improve quality,not the quantity, of life

ALS-AAN NEW GUIDELINES

The American academy of Neurology has updated its 1999 guidelines to the treatment and managegment of amyotrophic lateral sclerosis (ALS), highlights include:

1.Riluzole should be offered to slow disease progression

2.PEG tube to stabilize weight and prolong survival

3.NIV (non-invasive ventilation) for respiratory insufficiency to slow the decline in FVC (forced vital capacity) and improve quality of life

4.Creatine(5-10 mg) or high-dose vitamin E should not be given

5.Sialorrhea (increased salivation) can be reduced with botox type B

Neurology 2009;73:1218-1226 and 1227-1233

LEPTIN LEVELS IN AD

Leptin (secreted by fat cells to balance body energy and weight) may be a risk factor for AD.

The higher the leptin level the lower the risk for dementia JAMA 2009;302(23):2565-2572

ALZHEIMER's DISEASE

Keep tabs on on all genetic discoveries in AD at www.alzgene.org

As of January, 1,356 studies have lead to the id of 660 genes and 2,822 polymorphisms

Oral Therapies for MS

The Findings:

TRANSFORMS STUDY

Oral fingolimid vs. interferon beta 1A : at one year ,no difference in disability at one year. Fingolimid 0.5 mg/d 52% reduction in relapse rate ; 1.25 mg/d 38% reduction

FREEDOMS STUDY

Fingolimid superior to placebo re: new lesions

CLARITY TRIAL

Cladribine vs placebo, significant reduction in brain lesions on MRI