Scorpion Protein and Brain Tumours

Apparently the protein that can be extracted from the scorpions venom can be useful for Brain Tumour Surgeons. This substance make’s the tumour glow and that can help the surgeon to see exactly what’s the tumour and can extract it more exactly decreasing the risks of affecting other parts of the brain.

This video explains better the process and how this protein can be used.

Bringing Light | Bert Klasey, Chris Baron & James Allen Smith from Focus Forward Films on Vimeo.

Pharmacological treatment for Anxiety

Medications are a common treatment for anxiety disorders in adults, and research supports their efficiency. Anxiolytic drugs have been shown to reverse specific abnormalities in the neurotransmitter system of anxious people. Benzodiazepines (BZs) have been shown to be effective in treating adults with panic disorders, agoraphobia with panic, social phobia, and generalized anxiety disorder. Required dosage varies considerably across individuals and recommended practice is to start with a low dose and build up until a therapeutic effect is achieved, thus avoiding unnecessary toxicity and side effects. Physical dependence on BZs is concern, and discontinuation of BZ treatment can be associated with a rebound in symptoms, so a gradual fading and augmentation of the medication with psychological treatments is recommended. Tricyclic antidepressants (TCAs, especially imipramine  and clomipramine) adn especially monomine oxidase inhibitors have been shown effective with panic disorder and social phobia. The advantage of these medications are that they can also produce an improvement in comorbid depressive symptoms. However, both of these antidepressants have significant side effects. Thus they are rarely a first choice for the treatment of primary anxiety. The selective serotonin reuptake inhibitors are widely used as antidepressants and have been shown to have potential for the treatment of panic disorder, social phobia, obsessive compulsive disorder, and post-traumatic stress disorder. However, little information is available about the long-term efficacy of these agents and the side effects, which can include agitation, insomnia, gastrointestinal problems, and sexual dysfunctions.

A number of important clinical issues have been identified regarding medication treatments for anxiety disorders. The long-term outcomes and effects of medication are not clear and the therapeutic benefits once medication has been discontinued remain dubious.  Most clinicians, therefore, consider a combination of drug and cognitive behavioural treatment to be optimal for handling anxiety disorders.

With regard to children, there is a lack of well controlled and well conducted research studies into psychopharmacological interventions, and there is little support for their use as sole treatments for anxiety disorders with younger people. BZs, which have received the most empirical support and are most commonly prescribed for children and adolescents with anxiety disorders, they are tolerated by most children with minimal side effects, although these can include unsteady gait, blurred/double vision, reduced mental acuity , sedation, slurred speech, tremor, drowsiness, and irritability . BZs are comparatively safe in overdose, but the risks associated with tolerance and dependence in children are unknown. Studies of the efficacy of TCAs with anxious children have focused on separation anxiety and school refusal and have produced conflicting results. Only one of four published studies has provided support for the efficacy of TCAs in the treatment of separation anxiety. However, one of the three negative studies used an arguably sub-therapeutic medication dosage while the remaining two had small sample sizes. The most frequent side effects of TCAs include blurred vision, sedation, lightheadedness, dry mouth, urinary retention, and constipation.  Overdosage can result in severe medical complications. There is some evidence that buspirone may be effective in the treatment of generalized anxiety, and further controlled trials are merited, especially given it’s lack of major side effects, its limited potential for abuse, and its low probability of producing withdrawal symptoms following cessation. Fluoxentine (prozac) has shown promise in the treatment of childhood obsessive compulsive disorder and generalized anxiety in children. In one study,81% of the children given fluoxetine showed moderate to marked improvement in their anxiety symptoms with few side effects.

Psychological Treatment for Anxiety

When considering the success of any particular treatment, it is useful to discriminate between efficacy and effectiveness. The former refers to the outcomes associated with a treatment when it is delivered in its optimal form. The latter refers to the outcomes associated with the treatment in the real world, and thus includes consideration  of many factors such as resources needed, skills of the clinicians in the community, and acceptability of the treatment to consumers, as well as the efficacy of the treatment. While psychodynamics and family therapies have been used in the treatment of childhood anxiety disorder, the lack of controlled studies prohibits conclusions about their efficacy or effectiveness. In contrast, a wealth of evidence is available about the efficiency and, to a lesser extent, the effectiveness of cognitive-behavioral and pharmacological interventions.

Cognitive-behavioral treatments incorporate a range of treatment strategies, and most clinicians recommend a combination of procedures based on conditioning/exposure, reinforcement, physiology, and cognition. Common to all learning-based treatments in the premise that anxious patients can, through learning, minimize the threat value of the things they fear  and learn to regulate their emotions and psychological reactions more comfortably as they explore life. Exposure techniques involve having the patient, under the support and guidance of a therapist, face the fear in order to learn that the feared stimulus is not in fact so threatening,thereby breaking the cycle of avoidance. Often, some exposure is undertaken in imagination prior to exposure in the real world. The underlying mechanism that account for the success of exposure based procedures are still controversial. Originally Joseph Wolpe explained it as the inhibition of anxiety through relaxation learned as part of the exposure treatment. More recent views emphasize changes in thinking processes that occur during exposure. David Clark and his colleagues  use exposure treatments that help the sufferer to rethink and devalue the threat associated with the things they fear as they face them.

Psychological strategies for dealing with anxiety include muscle relaxation skills and breathing techniques to help patients manage uncontrollable arousal, especially during exposure exercises. Most of this techniques were developed with anxious adults but can be used with children and adolescents. A number of other strategies have been developed more specifically for children.  Modelling procedures often include the use of films, whereby the child learns to devalue the threat of the fear after watching other people confidently handle the feared situations. Modelling is an important procedure with children who may be manifesting a fear that is shared by other family members. The child is prompted to imitate the performance of the model who is demonstrating nonfearful behaviours and is reinforced for coping behaviour. The efficacy of modelling procedures is both the treatment of childhood phobias and in the preparation of children for stressful events has been supported.

Treatments for anxious children often incorporate reward-base programs, especially in the treatment of school refusal, socially avoidant children, and specific phobias. In general, therapeutic success is enhanced when these programs are combined with other techniques  such as exposure  and cognitive reappraisal.

Some evidence has emerged to indicate that the provisions of learning programs (scheduled as part of the school curriculum) for anxious children can assist in preventing the development of anxiety disorders in a significant proportion of children.

Anxiety Disorders

The experience of fear and anxiety are common, typically temporary, and have survival value in that they motivate “flight-flight” responses to danger. Normal anxiety and anxiety disorders vary along a continuum, with the degree of distress and interference with daily life distinguishing between what is normal and adaptive and what is dysfunctional. For some people, anxiety can become so problematic that they can be said to have an anxiety disorder. Disorders of this type are among the most common mental health problems, and a large proportion of health resources are spent on dealing with anxiety and its associated problems.

The most common diagnostic system in use are the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association and the International Classification of Diseases of the World Health Organization. In determining whether a problem warrants a formal diagnosis as an anxiety disorder, the clinician using these systems will consider the specific symptoms, the duration of the problem, the interference caused by the problem, and whether the anxiety can be better explained by another problem such as drug abuse or a medical condition. The DSM-IV discriminates between anxiety disorders that typically begin in childhood or adolescence and those usually diagnosed in adulthood. However, children can be diagnosed with any of the adult categories, and only one disorder is specific to children and adolescents: separation anxiety disorder. This disorder results from undue anxiety regarding separation from significant figures in the child’s life. The child’s reaction to such separation is beyond that expected for his or her development level.

This anxiety disorder of adulthood include: agoraphobia, panic disorder, specific phobias, social phobias, and generalized anxiety disorder. Agoraphobia is a morbid fear and avoidance of public places such as shopping centres and public transportation. Although the problem may be based on a previous experience of having suffered a panic attack in such places, panic is no longer a feature; a long standing pattern of avoidance is the primary manifestation. Panic disorder is the repeated experience of uncontrollable panic attacks not associated with specific phobic stimuli characterized by heard palpitations, sweating, breathing problems, nausea, and shaking, as well as thoughts of losing control, having a heart attack or stroke, and dying. Those individuals who exhibit panic disorder without agoraphobia show no secondary avoidance of particular places associated with the phobia avoid certain places because they fear the onset of a panic attack, which they associate with those places. Sufferers develop a sensitivity to internal arousal that signal the possibility of a panic attack. Thus, any signs of  bodily changes due to exertion, loss of breath, excitement, anger, and so on can come to elicit panic; often described as “fear of fear”. Specific or simple phobias result from specific stimuli. These phobias tend to parallel the fears people normally have throughout the life span, except the phobias lead to a greater degree of fear and significant impairment. The most common stimuli for specific phobias include medical procedures, needles, blood , injury, heights, water, small spaces such as elevators, insects, and animals. Social phobia results from the morbid anxiety associated with being scrutinized by others. Sufferers show high levels of self consciousness and exaggerate other people’s negative reaction to them  on the basis of their own state of anxiety, Thus, sufferers find it difficult to attend social gatherings and perform tasks in front of people, which often makes them unable lead normal social and work lives. Generalized anxiety disorder involves undue anxiety or worry about a range of areas that may include well-being  of family members, self-consciousness, future or past events, performance and competence. The worry is experienced as uncontrollable and is therefore ineffective as the worry is a narrowing of attentional focus that screens out all non-worry related events. Others argue that the worry may function to protect the worrier from other more distressing forms of cognitive activity, such as mental images of scenes that elicit unpleasant emotional states.

There are a number of other disorders in the psychological and psychiatric literature, but more controversy exists about whether their categorization is correct. Three such disorders are obsessive-compulsive disorder, post-traumatic stress disorder, and hypochondriasis. An individual who suffers from obsessive-compulsive disorder feels compelled to perform rituals over and over to prevent tragedy from occurring. The most common forms of obsessive-compulsive disorder involve repeated checking to make sure mistakes have not been made and repeated washing to avoid contamination. The rituals rarely bring any relief, so normal life is often  sacrificed to a cycle of never ending ritualization. Post-traumatic stress disorder involves a range of symptoms that are directly attributable to the previous experience of a traumatic event. Hypochondriasis, or health anxiety, is a preoccupation with the belief or fear that one has a serious illness, even in the absence of organic pathology and despite medical reassurance. As in panic disorder, some who suffers from hypochondriasis becomes sensitized to and fearful of bodily sensations that are incorrectly taken as evidence of serious illness. Such worries are also common in depression, so assessment must try to disentangle the primacy of the various symptoms. The validity of the above categories of anxiety disorders is still controversial. As new research and clinical practice evolves, so do the way scientists categorize disorders, and it is reasonable to predict that the diagnostic system may look markedly different in the future. The American Psychiatric Association has placed increasing emphasis on research and resulting evidence is used in further developing the diagnostic system. For example, the childhood category of avoidant disorder was omitted from DSM-IV after research indicated that it did not differ sufficiently from social phobia.

Most sufferers of anxiety disorders have more than one type of anxiety disorder, and thus it is difficult to argue that the subtype of anxiety disorder are really discrete entities. Further, anxiety disorders also tend to overlap with other emotional and behavioural problems, in particular depression and substance abuse. The latter may simply be due to people using drugs to anxiety and depression is more complex, and the similarity of the two problems had led a number of researchers to argue they are one and the same. A consensual view holds that anxiety and depression are distinct yet overlapping events that share the common experience of negative affect but show distinctions in patterns of symptoms and respond to treatment.