‘Where does it hurt?’ is the first question asked to any person in pain.
A new UCL study defines for the first time how our ability to identify where it hurts, called ‘spatial acuity’, varies across the body, being most sensitive at the forehead and fingertips.

Using lasers to cause pain to 26 healthy volunteers without any touch, the researchers produced the first systematic map of how acuity for pain is distributed across the body.

With the exception of the hairless skin on the hands, spatial acuity improves towards the centre of the body whereas the acuity for touch is best at the extremities. This spatial pattern was highly consistent across all participants.

The experiment was also conducted on a rare patient lacking a sense of touch, but who normally feels pain. The results for this patient were consistent with those for healthy volunteers, proving that acuity for pain does not require a functioning sense of touch.

‘Acuity for touch has been known for more than a century, and tested daily in neurology to assess the state of sensory nerves on the body. It is striking that until now nobody had done the same for pain,’ says lead author Dr Flavia Mancini of the UCL Institute of Cognitive Neuroscience. ‘If you try to test pain with a physical object like a needle, you are also stimulating touch. This clouds the results, like taking an eye test wearing sunglasses. Using a specially-calibrated laser, we stimulate only the pain nerves in the upper layer of skin and not the deeper cells that sense touch.’

Volunteers were blindfolded and had specially-calibrated pairs of lasers targeted at various parts of their body. These lasers cause a brief sensation of pinprick pain. Sometimes only one laser would be activated, and sometimes both would be, unknown to participants. They were asked whether they felt one

The artificial pancreas promises to dramatically improve the quality of life for people with type 1 diabetes, which typically develops in childhood. All previous artificial pancreas trials, in hospitals and in home environments, have seen researchers strictly monitor patients. The latest trial, funded by JDRF, has shown for the first time that unsupervised use of the artificial pancreas overnight can be safe.

Type 1 diabetes is an autoimmune condition in which the pancreas is unable to produce insulin, a hormone which regulates blood glucose levels. High levels of glucose can seriously damage the body’s organs. People with type 1 diabetes currently rely on multiple insulin injections or pump infusions every day; a child diagnosed at the age of five faces up to 19,000 injections and 50,000 finger prick blood tests by the time they are 18.

Participants in the trial, all aged between 12 and 18, saw improved blood glucose control during the trial, experiencing fewer nights with hypoglycaemic episodes, generally known as

A new study in animals shows that using a compound to block the body

Probiotics are effective in preventing hepatic encephalopathy in patients with cirrhosis of the liver, according to a new study. Hepatic encephalopathy is a deterioration of brain function that is a serious complication of liver disease.

‘This rigorous new research finds that probiotics modify the gut microbiota to prevent hepatic encephalopathy in patients with cirrhosis of the liver,’ said David W. Victor III, MD. ‘These results offer a safe, well-tolerated and perhaps cheaper alternative to current treatments.’

Investigators from Govind Ballabh Pant Hospital, New Delhi, India, conducted a single-centre, prospective, open-label, randomised trial with cirrhosis patients who showed risk factors for hepatic encephalopathy, but had yet to experience an obvious episode. When comparing treatment with probiotics versus placebo, the researchers found that the incidence of hepatic encephalopathy was lower in patients treated with probiotics.

Probiotic supplementation was not associated with any side effects and none of the patients required discontinuation of therapy. These results suggest that probiotics are similar in effectiveness to the current standard of care, lactulose, in the prevention of hepatic encephalopathy, yet they appear to be much better tolerated. The effectiveness of lactulose, a non-absorbable disaccharide, is limited by side effects (diarrhoea, bloating and gas) and a narrow therapeutic window.

‘By virtue of its size, study duration and design, as well as the thorough nature of the baseline and follow-up assessments, this study represents an important contribution to the hepatic encephalopathy literature,’ added Dr. Victor, a practicing hepatologist in the Methodist J.C. Walter Jr. Transplant Center at Houston Methodist Hospital, TX. AGA Institute