Why does training in mindfulness meditation help patients manage chronic pain and depression? In a newly published neurophysiological review, Brown University scientists propose that mindfulness practitioners gain enhanced control over sensory cortical alpha rhythms that help regulate how the brain processes and filters sensations, including pain, and memories such as depressive cognitions.
The proposal, based on published experimental results and a validated computer simulation of neural networks, derives its mechanistic framework from the intimate connection in mindfulness between mind and body, since standardised mindfulness meditation training begins with a highly localised focus on body and breath sensations. This repeated localised sensory focus, the scientists write, enhances control over localised alpha rhythms in the primary somatosensory cortex where sensations from different body are ‘mapped’ by the brain.
In effect, what the researchers propose in their paper, is that by learning to control their focus on the present somatic moment, mindfulness meditators develop a more sensitive ‘volume knob’ for controlling spatially specific, localised sensory cortical alpha rhythms. Efficient modulation of cortical alpha rhythms in turn enables optimal filtering of sensory information. Meditators learn not only to control what specific body sensations they pay attention to, but also how to regulate attention so that it does not become biased toward negative physical sensations such as chronic pain. The localised attentional control of somatosensory alpha rhythms becomes generalised to better regulate bias toward internally focused negative thoughts, as in depression.
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For women with abdominal pain or vaginal bleeding during early pregnancy, patient history and clinical examination alone are insufficient to indicate or eliminate the possibility of ectopic pregnancy, while transvaginal sonography appears to be the single best diagnostic method for evaluating suspected ectopic pregnancy, according to an analysis of previous studies.
The rapid identification and accurate diagnosis of women who may have an ectopic pregnancy is critically important for reducing the maternal illness and death associated with this condition. Ectopic pregnancy is the leading cause of first-trimester pregnancy-related death, responsible for up to 6 percent of maternal mortality during early gestation, according to background information in the article. ‘Fewer than half of the women with an ectopic pregnancy have the classically described symptoms of abdominal pain and vaginal bleeding. In fact, these symptoms are more likely to indicate miscarriage.’
John R. Crochet, M.D., of the Center of Reproductive Medicine, Webster, Texas and colleagues conducted a study to systematically review the accuracy and precision of the patient history, clinical examination, readily available laboratory values, and sonography in the diagnosis of ectopic pregnancy in women with abdominal pain or vaginal bleeding during early pregnancy. The researchers conducted a search of the medical literature and identified 14 studies with 12,101 patients the met the criteria for inclusion in the analysis.
The authors found that presence of an adnexal (structures near the uterus, such as the ovaries and the Fallopian tubes) mass in the absence of an intrauterine pregnancy on transvaginal sonography, and the physical examination findings of cervical motion tenderness, an adnexal mass, and adnexal tenderness all increase the likelihood of ectopic pregnancy. ‘A lack of adnexal abnormalities on transvaginal sonography decreases the likelihood of ectopic pregnancy. Existing studies do not establish a single serum human chorionic gonadotropin [hCG; a hormone] level that is diagnostic of ectopic pregnancy.’
‘Women with abdominal pain or vaginal bleeding during early pregnancy may have an ectopic pregnancy. This systematic review of the literature and meta-analysis confirms that the patient history and clinical examination alone are insufficient to indicate or eliminate the possibility of ectopic pregnancy. In a hemodynamically stable patient, the appropriate evaluation includes transvaginal sonography and quantitative (serial) serum hCG testing. Patients with signs and symptoms of excessive blood loss or hemodynamic collapse should immediately have gynecological evaluation.’ EurekAlert

Replacing the combination of brand-name, antiretroviral drugs currently recommended for control of HIV infection with soon-to-be-available generic medications could save the U.S. health care system almost $1 billion a year but may diminish the effectiveness of HIV treatment.  A study led by Massachusetts General Hospital (MGH) investigators examines the potential impact of such a change.

"The switch from branded to generic antiretrovirals would place us in the uncomfortable position of trading some losses of both quality and quantity of life for a large potential dollar savings," says Rochelle Walensky, MD, MPH, of the MGH Medical Practice Evaluation Center, lead author of the study.  "By estimating the likely magnitude of these offsetting effects now

Researchers at UCLA report that they have refined a method they previously developed for capturing and analysing cancer cells that break away from patients’ tumours and circulate in the blood. With the improvements to their device, which uses a Velcro-like nanoscale technology, they can now detect and isolate single cancer cells from patient blood samples for analysis.
Circulating tumour cells, or CTCs, play a crucial role in cancer metastasis, spreading from tumours to other parts of the body, where they form new tumours. When these cells are isolated from the blood early on, they can provide doctors with critical information about the type of cancer a patient has, the characteristics of the individual cancer and the potential progression of the disease. Doctors can also tell from these cells how to tailor a personalised treatment to a specific patient.
In recent years, a UCLA research team led by Hsian-Rong Tseng, an associate professor of molecular and medical pharmacology at the Crump Institute for Molecular Imaging and a member of both the California NanoSystems Institute at UCLA and UCLA’s Jonsson Comprehensive Cancer Center, has developed a ‘NanoVelcro’ chip. When blood is passed through the chip, extremely small ‘hairs’