In this video, I share what I mean when I say “I want you on the MOST EFFECTIVE drug that you’re COMFORTABLE taking.”
5 Common Symptoms of MS That I Have and Tips to Help Manage Them
When we live with MS, there can be dozens of symptoms, and they can interfere with our lives, our ability to work, and our quality of life. In this video, I am going to go over five common MS symptoms that I have and some tips and evidence-based ways to help us manage symptoms and improve our quality of life. These symptoms include fatigue, Uhthoff’s phenomenon, cog fog, spasms, and weakness.
How Your Body Clock Shapes Inflammation
New research from RCSI University of Medicine and Health Sciences has uncovered how the body’s internal clock, or circadian rhythm, regulates inflammation in the immune system. The findings reveal that immune cells called macrophages behave differently depending on the time of day, paving the way for treatments that work harmoniously with the body’s natural rhythms.
Macrophages are immune cells that act as first responders, detecting harmful substances and triggering inflammation when needed. They assemble large protein complexes called inflammasomes, which function like “smoke detectors” to alert the immune system to potential danger.
The study, published in The FASEB Journal, showed that activating a specific inflammasome called NLRP3 fluctuates based on the 24-hour circadian clock. This rhythm determines when macrophages are most effective at detecting threats and have the energy to respond. A critical driver of this process is the mitochondria, often referred to as the cell’s “powerhouses,” which fuel these immune responses.
Inflammation and the Time of Day
“When macrophages ‘think’ it’s morning, their inflammasome activation is faster and stronger,” explained Professor Annie Curtis, the study’s principal investigator from RCSI’s School of Pharmacy and Biomolecular Sciences. “This heightened immune response aligns with the early part of the day, when we are awake and more likely to face injuries or infections.”
This discovery helps explain why symptoms of inflammatory conditions, such as arthritis, tend to worsen in the morning.
“Overactive inflammasomes are a key factor in diseases like arthritis,” said Dr. James O’Siorain, lead author of the study. “Our findings suggest that therapies targeting these inflammasomes could be more effective when timed to the body’s natural immune rhythms.”
Implications for Treatment
The research opens up possibilities for tailoring treatments for inflammatory diseases based on the time of day. For example, medications designed to regulate inflammasome activity might be most effective when administered during peak macrophage activity in the morning.
The study highlights how an improved understanding of the connection between circadian rhythms and immune function could lead to more precise and effective therapies for inflammation-induced conditions.
Supported by funding from Taighde Éireann – Research Ireland, this study underscores the importance of timing in medicine, offering a new perspective on managing diseases where inflammation plays a central role.
How AI Could Transform ADHD Care Through Medical Chart Review
In a groundbreaking study, Stanford Medicine researchers have harnessed artificial intelligence (AI) to comb through thousands of doctors’ notes in electronic medical records (EMRs), revealing trends that could improve care for children with attention deficit hyperactivity disorder (ADHD). This innovative use of AI promises to relieve researchers and clinicians of tedious medical chart reviews, enabling them to focus on improving patient outcomes.
The study, published on December 19 in Pediatrics, demonstrates how large language models (LLMs) can efficiently detect gaps in ADHD management and suggest improvements. “This model enables us to identify some gaps in ADHD management,” said lead author Yair Bannett, MD, assistant professor of pediatrics at Stanford Medicine. Senior author Heidi Feldman, MD, added that the insights gained could be applied broadly across healthcare.
AI Revolutionizing ADHD Follow-Up Care
Medical records often contain critical information buried in freeform notes, making it challenging for researchers to identify patterns. For children with ADHD, proper follow-up care after starting medication is essential to monitor side effects and adjust dosages. However, manually reviewing thousands of notes is time-consuming and prone to human error.
The Stanford team trained an AI tool to analyze 15,628 notes from the medical records of 1,201 children aged 6 to 11. These children, treated across 11 pediatric practices, had been prescribed ADHD medications that can cause side effects like appetite suppression. The AI was tasked with identifying whether follow-up inquiries about side effects occurred within the first three months of medication use.
By training the model on 501 human-reviewed notes, researchers achieved 90% accuracy in classifying follow-up mentions. This AI-driven approach allowed them to analyze a task that would have otherwise taken more than seven months of full-time work.
Key Findings: Insights Beyond Human Reach
The AI model uncovered patterns that manual reviews could not. For instance, it revealed that some pediatric practices frequently conducted follow-ups via phone calls, while others did not. It also showed that doctors were less likely to ask about side effects for non-stimulant ADHD medications compared to stimulants.
“These are insights you wouldn’t detect without deploying AI across thousands of notes,” Bannett said. However, the model also highlighted its own limitations. While it identified patterns, it couldn’t explain the reasons behind them — a task that required input from pediatricians.
Challenges and Ethical Considerations
The researchers noted some limitations. The AI might have missed follow-ups recorded outside the EMRs or misclassified notes on medications unrelated to ADHD. Despite these challenges, the study highlights the importance of guiding AI tools with human expertise.
“AI is ideal for sorting through vast amounts of medical data, but ethical considerations and disparities in healthcare must remain front and center,” Bannett said. In a recent editorial, he and his colleagues emphasized the need to address biases in AI models trained on existing healthcare data.
A Vision for Personalized ADHD Care
Looking ahead, AI could help doctors make more personalized decisions for ADHD management. By analyzing large populations, AI might predict which patients are at risk of specific side effects based on age, race, genetic profile, and other factors. This capability could transform ADHD care, making it more precise and patient-centered.
“Each patient has their own experience, and with AI, we can complement that with the knowledge of large populations,” Bannett said. While the potential is immense, ensuring responsible AI deployment will be key to unlocking its full benefits for ADHD care and beyond.
This study marks a significant step toward integrating AI into routine medical care, offering a glimpse of a future where technology enhances clinicians’ ability to provide better, more tailored care.
Could Overactive Cells Be Driving Type 2 Diabetes?
Scientists at the University of Missouri-Columbia are zeroing in on a surprising culprit behind type 2 diabetes and cardiovascular issues: overactive chemoreceptor cells in the neck. These tiny sensors, located near the carotid artery, monitor oxygen levels in the body, but when they go into overdrive, they may signal trouble for your heart and metabolism.
Why These Cells Matter
When chemoreceptors become overactive, they’re linked to high blood pressure, high blood sugar, and even a greater risk of cardiovascular-related death. In experiments with rats, removing these overactive cells showed promise in reducing blood pressure and improving blood sugar control. Inspired by these results, the researchers explored a less invasive approach: Could high doses of oxygen, known as hyperoxia, calm these overactive cells and improve human health outcomes?
Testing the Theory
The study involved two groups of participants — 17 with type 2 diabetes and 20 without it. The researchers found that chemoreceptors were noticeably more active in people with diabetes, especially in those with the highest blood sugar levels.
When participants were exposed to hyperoxia, the chemoreceptor activity dropped. Heart rate, blood pressure, and breathing rate also decreased. But here’s the catch: This calming effect on chemoreceptors didn’t translate into improved blood sugar control or insulin sensitivity for people with diabetes.
What This Means for Diabetes Research
While the study confirmed that overactive chemoreceptors play a role in type 2 diabetes, it also showed that simply reducing their activity with oxygen isn’t enough to fix the problem.
“The goal was to understand how these chemoreceptors influence cardiovascular and metabolic outcomes in diabetes,” explained Dr. Camila Manrique-Acevedo, one of the study’s authors. “Now we know that hyperoxia alone doesn’t improve metabolic function, so we can shift our focus to other promising therapies.”
The Road Ahead
This research adds another piece to the puzzle of type 2 diabetes and cardiovascular health. By pinpointing the role of chemoreceptors, scientists are one step closer to developing targeted treatments that could help patients manage their conditions more effectively.
For now, the hunt continues for new ways to tackle the overactive cells that may be driving diabetes and its complications.
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