Conservatory Garden (Spring) 2
Photo: Sara Cedar Miller/Central Park Conservancy, The New York Times, April 14, 2010, by Donald G. McNeil Jr.  –  One of the difficulties of diagnosing tuberculosis is that there is no simple blood or urine test. Instead, a laboratory technician must take a sample of sputum coughed up from the lungs, stain it and inspect it under a microscope for the telltale bacteria, which resemble long-grain rice. It takes expertise that is often rare in poor countries.

Guardian Technologies, a Virginia company that was started to help airport X-ray scanners distinguish explosives in luggage from innocuous plastics and liquids, has developed a system that automatically scans microscope slides for the bacillus.

The company’s software algorithms can spot distinctive shapes, colors and densities that untrained eyes may miss. In a recent test in South Africa, which has some of the highest TB rates in the world, the technology was 93 percent accurate in detecting the bacillus on microscope slides and had a false positive rate of less than 2 percent, the company said.

The original Guardian system fit a digital camera to a standard microscope. Now, it is making an automated version that can hold 50 slides and work all night while no one is in the lab.

New technologies like Guardian’s hold great promise for poor countries with inadequate laboratories, said Dr. Neil Schluger, the chief scientific officer of the World Lung Foundation. “The question is,” he said, “can you make it work in the middle of nowhere? And what do you do when it breaks?”

Dr. Schluger said that a recent survey of 114 laboratories in Ghana found that most of their microscopes did not work.

By JOHN TIERNEY, April 14, 2010, by John Tierney  –  As a retired clinical psychologist, Clark Martin was well acquainted with traditional treatments for depression, but his own case seemed untreatable as he struggled through chemotherapy and other grueling regimens for kidney cancer. Counseling seemed futile to him. So did the antidepressant pills he tried.

Nothing had any lasting effect until, at the age of 65, he had his first psychedelic experience. He left his home in Vancouver, Wash., to take part in an experiment at Johns Hopkins medical school involving psilocybin, the psychoactive ingredient found in certain mushrooms.

Scientists are taking a new look at hallucinogens, which became taboo among regulators after enthusiasts like Timothy Leary promoted them in the 1960s with the slogan “Turn on, tune in, drop out.” Now, using rigorous protocols and safeguards, scientists have won permission to study once again the drugs’ potential for treating mental problems and illuminating the nature of consciousness.

After taking the hallucinogen, Dr. Martin put on an eye mask and headphones, and lay on a couch listening to classical music as he contemplated the universe.

“All of a sudden, everything familiar started evaporating,” he recalled. “Imagine you fall off a boat out in the open ocean, and you turn around, and the boat is gone. And then the water’s gone. And then you’re gone.”

Today, more than a year later, Dr. Martin credits that six-hour experience with helping him overcome his depression and profoundly transforming his relationships with his daughter and friends. He ranks it among the most meaningful events of his life, which makes him a fairly typical member of a growing club of experimental subjects.

Researchers from around the world are gathering this week in San Jose, Calif., for the largest conference on psychedelic science held in the United States in four decades. They plan to discuss studies of psilocybin and other psychedelics for treating depression in cancer patients, obsessive-compulsive disorder, end-of-life anxiety, post-traumatic stress disorder and addiction to drugs or alcohol.

The results so far are encouraging but also preliminary, and researchers caution against reading too much into these small-scale studies. They do not want to repeat the mistakes of the 1960s, when some scientists-turned-evangelists exaggerated their understanding of the drugs’ risks and benefits.

Because reactions to hallucinogens can vary so much depending on the setting, experimenters and review boards have developed guidelines to set up a comfortable environment with expert monitors in the room to deal with adverse reactions. They have established standard protocols so that the drugs’ effects can be gauged more accurately, and they have also directly observed the drugs’ effects by scanning the brains of people under the influence of hallucinogens.

Scientists are especially intrigued by the similarities between hallucinogenic experiences and the life-changing revelations reported throughout history by religious mystics and those who meditate. These similarities have been identified in neural imaging studies conducted by Swiss researchers and in experiments led by Roland Griffiths, a professor of behavioral biology at Johns Hopkins.

In one of Dr. Griffiths’s first studies, involving 36 people with no serious physical or emotional problems, he and colleagues found that psilocybin could induce what the experimental subjects described as a profound spiritual experience with lasting positive effects for most of them. None had had any previous experience with hallucinogens, and none were even sure what drug was being administered.

To make the experiment double-blind, neither the subjects nor the two experts monitoring them knew whether the subjects were receiving a placebo, psilocybin or another drug like Ritalin, nicotine, caffeine or an amphetamine. Although veterans of the ’60s psychedelic culture may have a hard time believing it, Dr. Griffiths said that even the monitors sometimes could not tell from the reactions whether the person had taken psilocybin or Ritalin.

The monitors sometimes had to console people through periods of anxiety, Dr. Griffiths said, but these were generally short-lived, and none of the people reported any serious negative effects. In a survey conducted two months later, the people who received psilocybin reported significantly more improvements in their general feelings and behavior than did the members of the control group.

The findings were repeated in another follow-up survey, taken 14 months after the experiment. At that point most of the psilocybin subjects once again expressed more satisfaction with their lives and rated the experience as one of the five most meaningful events of their lives.

Since that study, which was published in 2008, Dr. Griffiths and his colleagues have gone on to give psilocybin to people dealing with cancer and depression, like Dr. Martin, the retired psychologist from Vancouver. Dr. Martin’s experience is fairly typical, Dr. Griffiths said: an improved outlook on life after an experience in which the boundaries between the self and others disappear.

In interviews, Dr. Martin and other subjects described their egos and bodies vanishing as they felt part of some larger state of consciousness in which their personal worries and insecurities vanished. They found themselves reviewing past relationships with lovers and relatives with a new sense of empathy.

“It was a whole personality shift for me,” Dr. Martin said. “I wasn’t any longer attached to my performance and trying to control things. I could see that the really good things in life will happen if you just show up and share your natural enthusiasms with people. You have a feeling of attunement with other people.”

The subjects’ reports mirrored so closely the accounts of religious mystical experiences, Dr. Griffiths said, that it seems likely the human brain is wired to undergo these “unitive” experiences, perhaps because of some evolutionary advantage.

“This feeling that we’re all in it together may have benefited communities by encouraging reciprocal generosity,” Dr. Griffiths said. “On the other hand, universal love isn’t always adaptive, either.”

Although federal regulators have resumed granting approval for controlled experiments with psychedelics, there has been little public money granted for the research, which is being conducted at Hopkins, the University of Arizona; Harvard; New York University; the University of California, Los Angeles; and other places.

The work has been supported by nonprofit groups like the Heffter Research Institute and MAPS, the Multidisciplinary Association for Psychedelic Studies.

“There’s this coming together of science and spirituality,” said Rick Doblin, the executive director of MAPS. “We’re hoping that the mainstream and the psychedelic community can meet in the middle and avoid another culture war. Thanks to changes over the last 40 years in the social acceptance of the hospice movement and yoga and meditation, our culture is much more receptive now, and we’re showing that these drugs can provide benefits that current treatments can’t.”

Researchers are reporting preliminary success in using psilocybin to ease the anxiety of patients with terminal illnesses. Dr. Charles S. Grob, a psychiatrist who is involved in an experiment at U.C.L.A., describes it as “existential medicine” that helps dying people overcome fear, panic and depression.

“Under the influences of hallucinogens,” Dr. Grob writes, “individuals transcend their primary identification with their bodies and experience ego-free states before the time of their actual physical demise, and return with a new perspective and profound acceptance of the life constant: change.”, April 14, 2010, by Roni Caryn Rabin  –  People with diabetes are at increased risk for developing some cancers and are more likely than nondiabetics to die of cancer. Now a study reports that they also have a higher risk of dying in the weeks just after cancer surgery.

The analysis of 15 earlier studies encompassed about 60,000 patients, both with and without diabetes, who underwent surgery for cancers of the colon, esophagus, liver, lung, stomach, pancreas and prostate. It found that the patients with pre-existing diabetes were 50 percent more likely than nondiabetic patients to die within a month of surgery, regardless of the type of cancer.

The patients in the studies had both types of diabetes, though Type 2 is more common.

Their higher death rate may have resulted from problems associated with the chronic illness, like a greater risk of infections and heart disease, said Hsin-Chieh Yeh, assistant professor of medicine and epidemiology at Johns Hopkins School of Medicine and an author of the paper, published in the April issue of Diabetes Care.

“The implication of this is that diabetes care is important on top of the cancer care,” Dr. Yeh said. “When patients are diagnosed with cancer, the patient and the family and the physician think, ‘This is serious — we have to take care of the cancer part first.’ And sometimes they forget about the diabetes they have.”

Librado Romero/The New York Times, April 14, 2010, by Karen Barrow  –   Is kosher food safer and healthier food?

An ancient diet has become one of the hottest new food trends.

A growing number of supermarket shoppers are going kosher — not for religious reasons, but because they are convinced the foods are safer and better for health.

Kosher foods, which must meet a number of dietary and processing rules to comply with traditional Jewish law, are the fastest growing ethnic cuisine, reports the market research firm Mintel. Sales of kosher foods reached $12.5 billion in 2008, an increase of 64 percent since 2003.

Reflecting the growing interest, Manischewitz, a major kosher food company, held a kosher cook off last month in Manhattan. It featured five chefs from around the country who prepared dishes with the most traditional of kosher-recipe ingredients: chicken broth.

Four of the chefs do not keep kosher but look for certain kosher products in the supermarket. One of those is Julie DeMatteo, a 68-year-old grandmother from Clementon, N.J., who is not Jewish but regularly shops for kosher foods. She believes they are more closely monitored during their processing and “more consistent in taste,” she said.

According to the market research survey, 62 percent of people who buy kosher foods do so for quality reasons, while 51 percent say they buy kosher for its “general healthfulness.” About one-third say they buy kosher because they think food safety standards are better than with traditional supermarket foods. Only 15 percent of respondents say they buy kosher food because of religious rules.

“We see consumers looking for a convergence of ethics, supervision and quality to general health and wellness,” said David Yale, chief executive of Manischewitz.

Joe Regenstein, a professor of food science at Cornell University who specializes in kosher laws, notes that kosher food restrictions were created for religious reasons, not to produce healthier or safer food. Although some of the kosher laws related to ingredients and preparation may have potential health advantages, there’s no evidence to show that kosher food products are healthier or safer than those from traditional food companies, he said.

But the strict rules for producing and certifying kosher food products may result in closer scrutiny of food safety issues. For instance, independent organizations such as the Orthodox Union are paid by food companies to send trained personnel to factories to ensure that all of the restrictions of kosher laws are met. The extra monitoring typically means that kosher products are produced more slowly than other foods.

In general, kosher food has to be carefully watched throughout its processing and preparation. Grains, packaged vegetables, fruits and similar products are thoroughly inspected for any trace of non-kosher substances like insects. Because kosher laws prohibit the mixing of meat and dairy, all kosher dairy products are processed separately from any meat product. No shellfish is allowed, and all fish, like anything that is kosher, must be processed with utensils that have not been in contact with anything non-kosher.

“The extra eyes and slower speeds probably allow the government inspectors to do a better job,” Dr. Regenstein said. “The fact that a kosher company is meeting a lot of rules and subjected to random inspections is something of real value. Although most consumers don’t really understand it in that detail.”

Certifying a meat as kosher is even more complicated. First, only certain animals are allowed to be eaten: no pigs, rodents or birds of prey, for example. Additionally, every cow, chicken or other animal that is certified as kosher has to be killed and butchered in a particular way.

During this process, called “shechting,” each animal is killed quickly by a trained individual. Some believe this form of butchering is more humane and less painful than traditional slaughterhouse practices. Every butchered animal is closely inspected for signs of disease, and any animal that may have been sick is not used.

Certain non-kosher animal parts, like the tail, the sciatic nerve and some fats generally found in the hindquarters, are separated and sold to non-kosher meat-processing companies. And because all kosher meats are thoroughly salted, they may be less likely to carry E. coli and salmonella, experts say, though no studies have been done to confirm this speculation.

A kosher symbol on a food can also be particularly helpful for those with strict dietary requirements or allergies to a certain food. Kosher foods are a good option for consumers with allergies to shellfish, for example. A strict vegan can buy a kosher product labeled “pareve” and be certain that it contains no trace of milk or meat. Muslims and Seventh Day Adventists, who also follow strict diets, also are regular buyers of kosher foods.

Ultimately, the best part of buying kosher products is that it may help you know what is — and more importantly, what’s not — in your food.

All-Nighters is an exploration of insomnia, sleep and the nocturnal life



The New York Times, April 14, 2010, by Terry Sejnowski MD  –  Is there anything good about insomnia? Could there possibly be any upside to a long, torturous sleepless night?

To answer the question, let’s look at another condition entirely.

Postpartum depression affects between 5 percent and 25 percent of new mothers.  Symptoms — including sadness, fatigue, appetite changes, crying, anxiety and irritability — usually occur in the first few months after child birth.  There is a simple way to alleviate postpartum depression in just a few hours: sleep deprivation.

If a depressed mother stays up all night, or even the last half of the night, it is likely that by morning the depression will lift.  Although this sounds too good to be true, it has been well documented in over 1,700 patients in more than 75 published papers during the last 40 years.[1]  Sleep deprivation used as a treatment for depression is efficacious and robust: it works quickly, is relatively easy to administer, inexpensive, relatively safe and it also alleviates other types of clinical depression. Sleep deprivation can elevate your mood even if you are not depressed, and can induce euphoria. This throws a new light on insomnia.

This remarkable result is not well known outside a small circle of sleep researchers for three good reasons.  First, sleep deprivation is not as convenient as taking a pill.  Second, prolonged sleep deprivation is not exactly a desirable state; it leads to cognitive defects, such as reduced working memory and impaired decision making.  Finally, depression recurs after the mother, inevitably, succumbs to sleep, even for a short nap.  Nonetheless this is an incredibly important observation; it shows that depression can be rapidly reversed and suggests that something is happening in the sleeping brain to bring on episodes of depression.  All this offers hope that studying sleep deprivation may lead to new, unique and rapid treatments for depression.

Scans suggest that something happening in the sleeping brain can bring on episodes of depression.

Neuroscientists have been trying to solve this puzzle.  The first hint of what may be happening during sleep came from J. Christian Gillin, a former colleague of mine at the University of California at San Diego and the San Diego Veterans Affairs Medical Center. Using imaging, he found that a small area of the cerebral cortex in the front of the brain  — the anterior cingulate cortex — which was consistently overactive in depressed patients, quieted to normal levels of activity after the patients were deprived of sleep. And when the patients were allowed to sleep, the activity in this area returned to the elevated levels.

Helen Mayberg at Emory University has shown that electrical stimulation of the anterior cingulate cortex, which disrupts normal activity, also reduces depression.  Some patients reported feeling immediate relief and calm after the procedure.

This tells us where in the cortex to look, but we also need to understand the changes that occur in the cortex during sleep. As you fall asleep, neurons in the brain stem that project throughout the cortex and keep it activated stop firing. The reduced stimulation from the brain stem disconnects the cortex from sensory input and there is a major shift in the pattern of electrical activity in the cortex. During the early part of the night the cortex is in a state of slow-wave sleep punctuated by brief periods of rapid-eye movement sleep (REM), which become more frequent and longer lasting toward early morning.

One major class of antidepressants, tricyclics, blocks REM sleep, which suggests that sleep deprivation may work against depression the same way. This is consistent with the tendency for depressed individuals to sleep longer than they do when they feel normal. Additional support for this hypothesis comes from genetic studies of families with short REM latency — the tendency to enter REM early in the sleep cycle. This condition disrupts slow wave sleep and extends REM sleep. The risk of depression is much greater if you come from a family with this genetic background. While this is a rare genetic defect that can only account for a small fraction of all depressed patients, these special cases give us valuable clues to conditions that predispose some people to clinical depression.

Despite all we have learned about the brain and sleep states, we still do not have a smoking gun to pinpoint what goes wrong when a mother suffers from postpartum depression, or why sleep deprivation lifts her mood. But what we do know is intriguing and this is driving research that could lead someday to rapid and effective ways to treat depression.

This is exciting news for researchers, and for the millions who suffer from debilitating mood disorders. Insomniacs, though, are unlikely to welcome yet another lost night of sleep, or to be cheered by the notion that a good slumber the night before could have made them feel even worse.

Footnote: [1] J. Christian Gillin, Monte Buchsbaum, Joseph Wu, Camellia Clark, William Bunney Jr., Sleep deprivation as a model experimental antidepressant treatment: Findings from functional brain imaging, Depression and Anxiety 14 (1), 37-49, 2001

Terry Sejnowski is the Francis Crick Professor at the Salk Institute for Biological Studies where he directs the Computational Neurobiology Laboratory; an investigator with the Howard Hughes Medical Institute; a professor of biological sciences at University of California at San Diego and a member of the Institute of Medicine of the National Academies. He is the co-author of “The Computational Brain,” with Patricia Churchland.