Antibiotic resistent bacteria

In the taxonomy of bad bugs, acinetobacter is classified as an opportunistic pathogen. Healthy people can carry the bacteria on their skin with no ill effects - a process known as colonization. But in newborns, the elderly, burn victims, patients with depressed immune systems, and those on ventilators, acinetobacter infections can kill. When a team of geneticists unlocked the secret of the bug's rapid evolution in 2005, they found that one strain of multidrug-resistant Acinetobacter baumannii carries the largest collection of genetic upgrades ever discovered in a single organism. Out of its 52 genes dedicated to defeating antibiotics, radiation, and other weapons of mass bacterial destruction, nearly all have been bootlegged from other bad bugs like Salmonella, Pseudomonas, and Escherichia coli.

Acinetobacter is only one of many bacterial nemeses prowling around in ICUs and neonatal units in hospitals all over the world. A particularly fierce organism known as MRSA - methicillin-resistant Staphylococcus aureus - infects healthy people, spreads easily, and accounts for many of the 90,000 fatal infections picked up in US hospitals each year. Another drug-resistant germ on the rise in health care facilities, Clostridium difficile, moves in for the kill when long courses of antibiotics have wiped out normal intestinal flora.

Nevertheless, the bug makes an unlikely candidate for the next mass plague. It preys exclusively on the weakest of the weak and the sickest of the sick, slipping into the body through open wounds, catheters, and breathing tubes. Colonization poses no threat to people who aren't already ill, but colonized health care workers and hospital visitors can carry the bacteria into neighboring wards and other medical facilities. Epidemiologist Roberta Carey at the Centers for Disease Control and Prevention calls acinetobacter the Rodney Dangerfield of microorganisms: "It doesn't get a lot of respect because it's not out there bumping off normal, healthy people." But lately the bacteria has been getting its due, because it is rapidly evolving resistance to all of the antibiotics that used to keep it in check.

Until a few years ago, most strains could be dispatched with a wide variety of drugs. For the most tenacious infections, doctors could rely on a family of ultrabroad spectrum antibiotics called carbapenems. But strains of acinetobacter are emerging now that are immune to every known remedy. Multidrug - resistant pathogens are an epidemiologist's nightmare - reminders of the dark ages when millions of people died every year of runaway infections.

By creating the most heroic and efficient means of saving lives in the history of warfare, the Pentagon had accidentally invented a machine for accelerating bacterial evolution and was airlifting the pathogens halfway around the world.

Anti-oxidant foods listed

High: Wild blueberries, blackberries, pecans
Low: Red meat

Brain "insula" region controls addiction

New York Times
In Clue to Addiction, a Brain Injury Halts Smoking

By BENEDICT CAREY
Published: January 26, 2007
Scientists studying stroke patients are reporting today that an injury to a specific part of the brain, near the ear, can instantly and permanently break a smoking habit. People with the injury who stopped smoking found that their bodies, as one man put it, "forgot the urge to smoke." The finding, which appears in the journal Science, is based on a small study. But experts say it is likely to alter the course of addiction research, pointing researchers toward new ideas for treatment.

While no one is suggesting brain injury as a solution for addiction, the finding suggests that therapies might focus on the insula, a prune-size region under the frontal lobes that is thought to register gut feelings and is apparently a critical part of the network that sustains addictive behavior.

Previous research on addicts focused on regions of the cortex involved in thinking and decision making. But while those regions are involved in maintaining habits, the new study suggests that they are not as central as the insula is.

The study did not examine dependence on alcohol, cocaine or other substances. Yet smoking is at least as hard to quit as any other habit, and it probably involves the same brain circuits, experts said. Most smokers who manage to quit do so only after repeated attempts, and the craving for cigarettes usually lasts for years, if not a lifetime.

"This is the first time we've shown anything like this, that damage to a specific brain area could remove the problem of addiction entirely," said Dr. Nora Volkow, director of the National Institute on Drug Abuse, which financed the study, along with the National Institute of Neurological Disorders and Stroke. "It's absolutely mind-boggling."

Others cautioned that scientists still knew little about the widely distributed neural networks involved in sustaining habits.

"One has to be careful not to extrapolate too much based on brain injuries to what's going on in all addictive behavior, in healthy brains," said Dr. Martin Paulus, a psychiatric researcher at the University of California, San Diego, and the San Diego V.A. Medical Center. Still, Dr. Paulus said, the study "opens up a whole new way to think about addiction."

The researchers, from the University of Iowa and the University of Southern California, examined 32 former smokers, all of whom had suffered a brain injury. The men and women were lucid enough to answer a battery of questions about their habits, and to rate how hard it was to quit and the strength of their subsequent urges to smoke.

They all had smoked at least five cigarettes a day for two years or more, and 16 of them said they had quit with ease, losing their cravings entirely.

The researchers performed M.R.I. scans on all of the patients' brains to specify the location and extent of each injury.

They found that the 16 who had quit easily were far more likely to have an injury to their insula than to any other area. The researchers found no association between a diminished urge to smoke and injuries to other regions of the brain, including tissue surrounding the insula.

"There's a whole neural circuit critical to maintaining addiction, but if you knock out this one area, it appears to wipe out the behavior," said Dr. Antoine Bechara, a senior author of the new paper, who is a neuroscientist at the Brain and Creativity Institute at U.S.C. His co-authors were Dr. Hanna Damasio, also of U.S.C., and Nasir Naqvi and David Rudrauf of the University of Iowa.

The patients' desire to eat, by contrast, was intact. This suggests, the authors wrote, that the insula is critical for behaviors whose bodily effects become pleasurable because they are learned, like cigarette smoking.

The insula, for years a wallflower of brain anatomy, has emerged as a region of interest based in part on recent work by Dr. Antonio Damasio, a neurologist and director of the Brain and Creativity Institute. The insula has widely distributed connections, both in the thinking cortex above, and down below in subcortical areas, like the brain stem, that maintain heart rate, blood pressure and body temperature, the body's primal survival systems.

Based on his studies and others', Dr. Damasio argues that the insula, in effect, maps these signals from the body's physical plant, and integrates them so the conscious brain can interpret them as a coherent emotion.

The system works from the bottom up. First, the body senses cues in the outside world, and responds. The heart rate might elevate at the sight of a stranger's angry face, for example; other muscles might relax in response to a pleasant whiff of smoke.

All of this happens instantaneously and unconsciously, Dr. Damasio said — until the insula integrates the information and makes it readable to the conscious regions of the brain.

"In a sense it's not surprising that the insula is an important part of this circuit maintaining addiction, because we realized some years ago that it was going to be a critical platform for emotions," Dr. Damasio said in a telephone interview. "It is on this platform that we irst anticipate pain and pleasure, not just smoking but eating chocolate, drinking a glass of wine, all of it."

This explains why cravings are so physical, and so hard to shake, he said: they have taken hold in the visceral reaches of the body well before they are even conscious.

Other researchers have found that the insula is activated in
unpleasant circumstances, like a bad smell or the anticipation of a painful shock, or even in shoppers when they see a price that seems too high. Damage to the insula is associated with slight impairment of some social function.

While antismoking treatments based on the new findings are still a long way off, the authors suggest that therapies that replicate some of the physical sensations of the habit, like inhalers, could be useful.

And at least two previous studies suggest that people can reduce the sensation of pain by learning to modulate the activity in an area of their brain.

In experiments, healthy volunteers watched real-time M.R.I. images of a cortical region linked strongly to pain sensation and learned to moderate that neural activity, reducing the pain they felt from a heated instrument pressed to their palms. The same kind of technique could be tried with addicts watching images of their insulas.

"The question is, Can you learn to deactivate the insula?" Dr. Volkow said. "Now, everybody's going to be looking at the insula."

Latest Weight-Loss Advice: Slow Down and Pay Attention

Which organic foods are worth buying (or not)

Should: Peppers,

Compartment syndrome surgery described

Compartment syndrome feels like shin-splints but is different in that it is consistently present when the person engages in any strenuous activity that uses the legs. It is most common in long-distance runners. The pain is caused by poor circulation to the lower legs and this poor circulation is in turn caused by the casement surrounding the lower leg muscles being too tight. This tightness is likely caused by overuse of the lower legs by such activities as running. Compartment surgery makes small cuts in the casement and this allows the muscle to expand and allows blood flow to return to the lower leg in normal volumes. The surgery is 100% successful.

Antioxidant foods: Vitamins don't deliver

Blackberries, walnuts, blueberries, etc. Vitamins don't work.

America is fat because of A/C and sleep deprivation

What if the "fat epidemic" is caused by factors besides carbo-loading and couch-cruising?

How to maintain a happy marriage; train your spouse

http://www.nytimes.com/2006/06/25/fashion/25love.html?
ei=5087%0A&en=144468fd91d40925&ex=1151467200&pagewanted=all

Modern Love
What Shamu Taught Me About a Happy Marriage
By AMY SUTHERLAND
Published: June 25, 2006

AS I wash dishes at the kitchen sink, my husband paces behind me, irritated. "Have you seen my keys?" he snarls, then huffs out a loud sigh and stomps from the room with our dog, Dixie, at his heels, anxious over her favorite human's upset.

In the past I would have been right behind Dixie. I would have turned off the faucet and joined the hunt while trying to soothe my husband with bromides like, "Don't worry, they'll turn up." But that only made him angrier, and a simple case of missing keys soon would become a full-blown angst-ridden drama starring the two of us and our poor nervous dog.

Now, I focus on the wet dish in my hands. I don't turn around. I don't say a word. I'm using a technique I learned from a dolphin trainer.

I love my husband. He's well read, adventurous and does a hysterical rendition of a northern Vermont accent that still cracks me up after 12 years of marriage.

But he also tends to be forgetful, and is often tardy and mercurial. He hovers around me in the kitchen asking if I read this or that piece in The New Yorker when I'm trying to concentrate on the simmering pans. He leaves wadded tissues in his wake. He suffers from serious bouts of spousal deafness but never fails to hear me when I mutter to myself on the other side of the house. "What did you say?" he'll shout.

These minor annoyances are not the stuff of separation and divorce, but in sum they began to dull my love for Scott. I wanted — needed — to nudge him a little closer to perfect, to make him into a mate who might annoy me a little less, who wouldn't keep me waiting at restaurants, a mate who would be easier to love.

So, like many wives before me, I ignored a library of advice books and set about improving him. By nagging, of course, which only made his behavior worse: he'd drive faster instead of slower; shave less frequently, not more; and leave his reeking bike garb on the bedroom floor longer than ever.

We went to a counselor to smooth the edges off our marriage. She didn't understand what we were doing there and complimented us repeatedly on how well we communicated. I gave up. I guessed she was right — our union was better than most — and resigned myself to stretches of slow-boil resentment and occasional sarcasm.

Then something magical happened. For a book I was writing about a school for exotic animal trainers, I started commuting from Maine to California, where I spent my days watching students do the seemingly impossible: teaching hyenas to pirouette on command, cougars to offer their paws for a nail clipping, and baboons to skateboard.

I listened, rapt, as professional trainers explained how they taught dolphins to flip and elephants to paint. Eventually it hit me that the same techniques might work on that stubborn but lovable species, the American husband.

The central lesson I learned from exotic animal trainers is that I should reward behavior I like and ignore behavior I don't. After all, you don't get a sea lion to balance a ball on the end of its nose by nagging. The same goes for the American husband.

Back in Maine, I began thanking Scott if he threw one dirty shirt into the hamper. If he threw in two, I'd kiss him. Meanwhile, I would step over any soiled clothes on the floor without one sharp word, though I did sometimes kick them under the bed. But as he basked in my appreciation, the piles became smaller.

I was using what trainers call "approximations," rewarding the small steps toward learning a whole new behavior. You can't expect a baboon to learn to flip on command in one session, just as you can't expect an American husband to begin regularly picking up his dirty socks by praising him once for picking up a single sock. With the baboon you first reward a hop, then a bigger hop, then an even bigger hop. With Scott the husband, I began to praise every small act every time: if he drove just a mile an hour slower, tossed one pair of shorts into the hamper, or was on time for anything.

I also began to analyze my husband the way a trainer considers an exotic animal. Enlightened trainers learn all they can about a species, from anatomy to social structure, to understand how it thinks, what it likes and dislikes, what comes easily to it and what doesn't. For example, an elephant is a herd animal, so it responds to hierarchy. It cannot jump, but can stand on its head. It is a vegetarian.

The exotic animal known as Scott is a loner, but an alpha male. So hierarchy matters, but being in a group doesn't so much. He has the balance of a gymnast, but moves slowly, especially when getting dressed. Skiing comes naturally, but being on time does not. He's an omnivore, and what a trainer would call food-driven.

Once I started thinking this way, I couldn't stop. At the school in California, I'd be scribbling notes on how to walk an emu or have a wolf accept you as a pack member, but I'd be thinking, "I can't wait to try this on Scott."

On a field trip with the students, I listened to a professional trainer describe how he had taught African crested cranes to stop landing on his head and shoulders. He did this by training the leggy birds to land on mats on the ground. This, he explained, is what is called an "incompatible behavior," a simple but brilliant concept.

Rather than teach the cranes to stop landing on him, the trainer taught the birds something else, a behavior that would make the undesirable behavior impossible. The birds couldn't alight on the mats and his head simultaneously.

At home, I came up with incompatible behaviors for Scott to keep him from crowding me while I cooked. To lure him away from the stove, I piled up parsley for him to chop or cheese for him to grate at the other end of the kitchen island. Or I'd set out a bowl of chips and salsa across the room. Soon I'd done it: no more Scott hovering around me while I cooked.

I followed the students to SeaWorld San Diego, where a dolphin trainer introduced me to least reinforcing syndrome (L. R. S.). When a dolphin does something wrong, the trainer doesn't respond in any way. He stands still for a few beats, careful not to look at the dolphin, and then returns to work. The idea is that any response, positive or negative, fuels a behavior. If a behavior provokes no response, it typically dies away.

In the margins of my notes I wrote, "Try on Scott!"

It was only a matter of time before he was again tearing around the house searching for his keys, at which point I said nothing and kept at what I was doing. It took a lot of discipline to maintain my calm, but results were immediate and stunning. His temper fell far shy of its usual pitch and then waned like a fast-moving storm. I felt as if I should throw him a mackerel.

Now he's at it again; I hear him banging a closet door shut, rustling through papers on a chest in the front hall and thumping upstairs. At the sink, I hold steady. Then, sure enough, all goes quiet. A moment later, he walks into the kitchen, keys in hand, and says calmly, "Found them."

Without turning, I call out, "Great, see you later."

Off he goes with our much-calmed pup.

After two years of exotic animal training, my marriage is far smoother, my husband much easier to love. I used to take his faults personally; his dirty clothes on the floor were an affront, a symbol of how he didn't care enough about me. But thinking of my husband as an exotic species gave me the distance I needed to consider our differences more objectively.

I adopted the trainers' motto: "It's never the animal's fault." When my training attempts failed, I didn't blame Scott. Rather, I brainstormed new strategies, thought up more incompatible behaviors and used smaller approximations. I dissected my own behavior, considered how my actions might inadvertently fuel his. I also accepted that some behaviors were too entrenched, too instinctive to train away. You can't stop a badger from digging, and you can't stop my husband from losing his wallet and keys.

PROFESSIONALS talk of animals that understand training so well they eventually use it back on the trainer. My animal did the same. When the training techniques worked so beautifully, I couldn't resist telling my husband what I was up to. He wasn't offended, just amused. As I explained the techniques and terminology, he soaked it up. Far more than I realized.

Last fall, firmly in middle age, I learned that I needed braces. They were not only humiliating, but also excruciating. For weeks my gums, teeth, jaw and sinuses throbbed. I complained frequently and loudly. Scott assured me that I would become used to all the metal in my mouth. I did not.

One morning, as I launched into yet another tirade about how uncomfortable I was, Scott just looked at me blankly. He didn't say a word or acknowledge my rant in any way, not even with a nod.

I quickly ran out of steam and started to walk away. Then I realized what was happening, and I turned and asked, "Are you giving me an L. R. S.?" Silence. "You are, aren't you?"

He finally smiled, but his L. R. S. has already done the trick. He'd begun to train me, the American wife.

Amy Sutherland is the author of "Kicked, Bitten and Scratched: Life and Lessons at the Premier School for Exotic Animal Trainers" (Viking, June 2006). She lives in Boston and in Portland, Me.