Need to balance guides development of limb-body coordination

The need to feel balanced drives the development of coordination between body and limbs as zebrafish larvae learn to swim, a new study finds.

Published online October 8 in eLife, the study found that the developing fish rely on their vestibular organs—the equivalent of the human inner ear—as their sense of balance oversees improvements in coordination needed to remain horizontal. A level posture is preferred across evolution, say the study authors, as it helps animals to move, find food, and evade predators.

Led by researchers from NYU School of Medicine, the work focused on zebrafish larvae, which undergo their development while swimming in the water, venturing into their environment much earlier after fertilization (3-30 days) than a human fetus, which continues to develop in the womb. This external development enabled researchers to watch larvae for changes in movement patterns that depend on brain circuits similar to those that enable human balance.

“The relationship between balance and movement is broken in rare diseases like Developmental Coordination Disorder, and in ataxias, the movement problems that occur in patients with multiple sclerosis and in those who have had a stroke,” says lead study investigator David Schoppik, Ph.D., assistant professor in the Department of Neuroscience and Physiology at NYU School of Medicine.

“Our hope is that the work in fish guides the future development of therapies for disorders caused by the brain’s mishandling of balance cues as it coordinates muscle groups,” says Schoppik.

Balance Basics

Past studies have argued that fins evolved into the forelimbs of land animals, and that zebrafish pectoral fins may provide a useful model for the role of forelimbs in coordinated movement. Maturing humans learn to swing their arms and flex trunk muscles as they walk, which reduces angular momentum (the tendency to pitch forward). However, the sensations that guide the development of this coordination are poorly understood.

One clue observed across evolution is that animals prefer to remain horizontal to satisfy a sense of balance and orientation to the world. On land, animals judge their orientation relative to gravity using many senses, including the feeling of how hard their feet are pressing on the ground, say the authors. The related biomechanics are more complex on land than underwater where, thanks to buoyancy, animals are more dependent on a single factor—their vestibular sense—to guide improvements in coordination, researchers say.

The new study found that zebrafish larvae used upward-orienting body rotations together with lift-producing pectoral fin motions to climb in water. Researchers also observed that fish larvae became better able with age to remain level as they climbed by matching larger fin actions with smaller body movements. Younger fish were more likely to careen upward nose-first like rockets.

The research team also found that zebrafish engineered to lack function in their utricular otoliths—the fish version of the balance system—did not get better with age at coordinating trunk and fin movements to achieve postural stability.

The study results also address the cerebellum, long established as a center for the coordination muscle movements (motor coordination). The new work showed that zebrafish with disabled cerebellar function, instead of using lift-generating pectoral fins only while climbing, also use them as they try to dive. Cerebellar Purkinje cells in particular blocked pro-movement signals to rule out pectoral fin movements when they would clash with body movements.

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What’s your sense of purpose? The answer may affect your health

When you fill out a medical form listing your health history, vital statistics and test results, there probably isn’t a space for “sense of purpose.”

Perhaps there should be. The term may be hard to quantify or define, but it can be a big factor in overall well-being, physical condition and even life expectancy.

“In all phases of life it’s good for your health, and particularly your cardiovascular health, to feel a sense of purpose,” said Dr. Lawson Wulsin, professor of psychiatry at the University of Cincinnati College of Medicine. “We all need a role in life that’s meaningful to us and the people who care about us.”

Lacking a sense of purpose, Wulsin said, can be a factor in depression, which is increasingly linked to physical health problems. Mind-body connections are a longtime theme in wellness discussions – from Norman Cousins’ 1979 landmark book Anatomy of an Illness, which popularized the idea of using humor to foster healing, to current retirement guides that urge seniors to stay active and engaged mentally to promote health and longevity.

A recent study underscored the point. Researchers analyzed data from a survey of nearly 7,000 Americans over 50 who filled out psychological questionnaires that measured how strong their sense of life purpose was. In the years between 2006 and 2010, people with a stronger life purpose were less likely to die of any cause, and even less likely to die of heart, circulatory and blood conditions.

“We were surprised,” said Dr. Leigh Pearce, senior author of the study in the May edition of the journal JAMA Network Open. “There was already a fair amount of literature about life purpose and health outcomes. But this was a big study and these results are so striking.”

So how do you define a sense of purpose?

“There’s no one-size-fits-all,” said Pearce, associate professor of epidemiology at the University of Michigan School of Public Health in Ann Arbor. “I think that what’s unique about life’s purpose is that the way it manifests for each person is different.

“Some may derive purpose from raising kids or helping with grandkids, some from work, some from volunteer activities,” she said. “Anyone can define for themselves what gives them purpose and work toward fulfilling that. It can be achieved and enhanced in so many ways.”

Pearce, who is developing more studies on the subject, said physicians should consider discussing the issue with patients as part of their health assessment and wellness strategy.

Wulsin, whose book Treating the Aching Heart examined the links between depression and heart disease, agreed.

“The popular wisdom is that stress is bad for your heart,” he said. “But because there is no easy way to measure stress and it’s so complicated, it often doesn’t get into the treatment plans of people with heart disease or at high risk of heart disease. That’s something I think we can do better at.”

The physiological connections between purposefulness and longevity are still being studied. But psychological and physical health, Wulsin said, go together.

“I like to say what’s good for your heart is good for your brain,” he said. “And what’s good for your brain is good for your heart.”

People under stress or suffering depression, he said, tend to smoke more, exercise less and sleep less well, all of which can adversely affect health. Beyond that chronic stress and the inability to relax can affect everything from inflammation and metabolism to diabetes and high blood pressure.

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Primary care appointment time impacts prescribing of opioids

(HealthDay)—Even within an individual physician’s schedule, physician behavior for opioid prescribing varies by the appointment timing, according to a study recently published online in JAMA Network Open.

Hannah T. Neprash, Ph.D., from the University of Minnesota in Minneapolis, and Michael L. Barnett, M.D., from Harvard University in Boston, used data from electronic health record systems in primary care offices in the United States to analyze primary care appointments occurring in 2017 for patients with a new painful condition.

The researchers reported that based on 678,319 primary care appointments (642,262 patients; 61.1 percent women) with 5,603 primary care physicians, the likelihood that an appointment resulted in an opioid prescription increased by 33 percent as the workday progressed (from first to third appointment, 4.0 percent; 19th to 21st appointment, 5.3 percent). The likelihood of an opioid prescription further increased by 17 percent as appointments ran behind schedule (zero to nine minutes late, 4.4 percent; ≥60 minutes late, 5.2 percent). The same pattern was not present for a prescription of nonsteroidal anti-inflammatory drugs or referral to physical therapy.

“Appointment timing that contributes to time pressure could be adversely associated with physician decision-making and could have widespread relevance for public health and quality improvement efforts, if similar patterns exist in other clinical scenarios,” the authors write.

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Skin cancer prevention program may have reduced melanoma in Australians

A skin cancer prevention program called SunSmart may have contributed to a recent reduction in melanoma among younger residents of Melbourne, according to a study published October 8 in the open-access journal PLOS Medicine by Suzanne Dobbinson of Cancer Council Victoria in Australia, and colleagues. According to the authors, the findings may have substantial implications for the future delivery of skin cancer prevention programs.

Recently, melanoma rates among younger Australians have dropped, suggesting that prevention programs such as SunSmart may have contributed to this decline. But measures previously used to monitor change over time in preventive behavior for this population focused on just single sun protection behaviors, omitting the effect of extent of use of both individual and combined behaviors that reduce exposure to ultraviolet radiation. This may have led to underestimates of behavior change, given that effective sun protection involves multiple strategies including sun avoidance. To address this issue, Dobbinson and colleagues conducted a population-based survey in Melbourne in the summer before SunSmart commenced (1987-88) and across summers in three subsequent decades (1988-2017). During summer months, residents ranging in age from 14 to 69 years were recruited to participate in weekly telephone interviews assessing their tanning attitudes, sun protection behavior and sunburn incidence on the weekend prior to the interview.

By analyzing trends in sun protection behavior for 13,285 respondents, the researchers found that the use of sun protection increased rapidly in the decade after SunSmart commenced. The likelihood of using one or more sun protection behaviors on summer weekends was three times higher in the 1990s than before SunSmart (AOR: 3.04, 95% CI: 2.52-3.68, p <0.001). There was a smaller increase in the use of maximal sun protection including shade (AOR: 1.68, 95% CI: 1.44-1.97, p <0.001). These improvements were sustained into the 2000s and continued to increase in the 2010s. However, Inferences on program effects are limited by self-reported data, the absence of a control population, the cross-sectional study design and not conducting the survey in all years. Other potential confounders may include increasing educational attainment among respondents over time and exposure to other campaigns such as tobacco and obesity prevention efforts.

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Zantac is pulled from shelves in the UK

Zantac is pulled from shelves in the UK: Health officials recall the common heartburn drug over fears it contains a cancer-causing chemical

  • GlaxoSmithKline said four different types of the medication would be recalled
  • It’s feared pills contain NDMA, considered ‘probably carcinogenic’ to humans
  • All four affected products are only available on prescription in UK, MHRA said 
  • Over-counter Zantac is made by different company and not affected by recall

The manufacturer of common heartburn drug Zantac has recalled several batches over fears they could contain a cancer-causing chemical.

GlaxoSmithKline announced four different types of the medication, all only available on prescription, would be recalled.

Over-the-counter Zantac products, which people can buy without a prescription, are made by a different pharmaceutical firm and are not affected by the recall. 

It is feared some pills may contain traces of NDMA, or N-nitrosodimethylamine – considered to be ‘probably carcinogenic’ to humans.

Health chiefs in the UK today told companies to stop supplying the affected Zantac products immediately and quarantine all remaining stock.

After the FDA discovered trace amounts of a carcinogen in Zantac’s active ingredient, ranitidine, CVS said Saturday it would suspend sales of the popular heartburn drugs (file)

The Medicines and Healthcare products Regulatory Agency (MHRA), which polices the safety of drugs in the UK, issued the alert. 

But it said patients should keep taking their medication unless told otherwise by their doctor. 

Irish health officials recalled 13 products containing ranitidine, the main ingredient in Zantac, at the end of last month.

The Irish equivalent to the MHRA – the Health Products Regulatory Authority – said the fault comes from the manufacturing plant in India.

US retailer CVS also pulled Zantac as well as some generic versions from its shelves after officials found some pills contained traces of NDMA.

WHAT ARE THE ZANTAC PRODUCTS THAT HAVE BEEN RECALLED? 

GlaxoSmithKline has announced a UK-wide recall of four prescription-only types of Zantac, a common heartburn drug. 

It is feared some pills may contain traces of NDMA, or N-nitrosodimethylamine – considered to be ‘probably carcinogenic’ to humans.

The affected products are: 

  • Zantac 150mg/10ml Syrup
  • Zantac 50mg/2ml Injection
  • Zantac 150mg Tablets
  • Zantac 300mg Tablets

Over-the-counter versions of Zantac (75 Relief and 75 Tablets) are not affected by the recall. They are produced by a different company.

The MHRA said that it is still investigating the safety of other medicines containing ranitidine, which is the main ingredient in Zantac. 

Dr Andrew Gray, MHRA’s deputy director of inspections, enforcement and standards, said: ‘Whilst this action is precautionary, the MHRA takes patient safety very seriously.

‘Patients should keep taking their current medicines but should speak to their doctor or pharmacist if they are concerned and should seek their doctor’s advice before stopping any prescribed medicines.

‘We have asked companies to quarantine batches of potentially affected medicines whilst we investigate and we will take action as necessary, including product recalls where appropriate.

‘We have also requested risk assessments from the relevant companies which will include the testing of potentially affected batches.

‘Currently, there is no evidence that medicines containing nitrosamines have caused any harm to patients, but the Agency is closely monitoring the situation, and working with other Regulatory Agencies around world.’ 

NHS figures show almost six million prescriptions were dished out for ranitidine in England last year.

Zantac is not the first medication to be recalled in the UK over fears it could contain NDMA.

The MHRA has pulled a series of heart drugs in the last year after tests revealed some batches contained NDMA or a similar chemical.

Several medical studies have linked NDMA to colorectal, stomach, liver and kidney cancers in animals. Evidence on humans is scarce.  

The Food and Drug Administration (FDA) was the first to discover some batches of ranitidine pills contained trace amounts of NDMA.

Its announcement on September 13 then sparked an investigation into the safety of ranitidine by The European Medicines Agency.

An MHRA spokesperson said at the time it was ‘monitoring the issue’ and would take ‘appropriate action if necessary’. 

When asked by MailOnline last month, the body added it had not yet initiated any product recalls – unlike its Irish counterpart.  

REVEALED, HOW THE ZANTAC SCANDAL UNFOLDED 

SEPTEMBER 13 – The US Food and Drug Administration (FDA) discovers some batches of ranitidine pills, including Zantac, contain trace amounts of NDMA.

The announcement sparks an investigation into the safety of ranitidine by The European Medicines Agency.

An MHRA spokesperson says the body is ‘monitoring the issue’ and will take ‘appropriate action if necessary’.

SEPTEMBER 23 – The Irish equivalent to the MHRA – the Health Products Regulatory Authority – recalls 13 medications containing ranitidine, including seven versions of Zantac. It says the fault comes from the manufacturing plant of the chemical in India

SEPTEMBER 25 – GlaxoSmithKline recalls the drug in India, where it is branded as Zinetac

SEPTEMBER 28 – US retailer CVS removes Zantac and its own generic ranitidine products from 6,200 of its stores over NDMA fears

OCTOBER 1 – Walgreens and Rite Aid announce they are both pausing sales of Zantac and ranitidine over the same fears

OCTOBER 2 – GlaxoSmithKline voluntarily recalls its other two types of ranitidine tablets in Ireland

OCTOBER 8 – The UK Medicines and Healthcare products Regulatory Agency (MHRA) tells companies to stop selling four prescription-only types of Zantac

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Mother contracts a life-threatening blood infection from a TAMPON

Mother gets a rare blood infection from her TAMPON after deadly bacteria entered her bloodstream through microscopic cuts in her vagina

  • Greta Zarate, 32, came down with flu-like symptoms in January as period started 
  • Four days later she was rushed to hospital when her blood pressure plummeted
  • Mother diagnosed with toxic shock syndrome which caused her organs to fail
  • Bacteria festered on tampon and entered blood through tiny cuts in vagina walls 

A mother-of-five contracted a deadly blood infection from a tampon which left her in intensive care for four days. 

Greta Zarate, of Jacksonville, North Carolina, first came down with flu-like symptoms on the first day of her period on January 31.

The 32-year-old was rushed to Onslow Memorial Hospital four days later when her fever spiked and her blood pressure plummeted. 

Mrs Zarate was admitted to intensive care, where X-rays, ultrasounds and CT scans failed to spot the cause of her declining health.

A gynaecologist consultation prompted a vaginal swab, which revealed toxic shock syndrome (TSS), a life-threatening infection caused by bacterial toxins. 

The condition had left the mother with dangerously low blood pressure and a high fever. 

Her immune system went into overdrive to combat the infection, which plunged her body into septic shock, a stage of sepsis which sees the body attack its own organs.  

Medics revealed the potentially-fatal bacteria festered on the build-up of blood on her tampon. It then entered her bloodstream through microscopic cuts on her vaginal wall. 

Greta Zarate (with husband Cas) contracted a life-threatening blood infection from a tampon

She was diagnosed with toxic shock syndrome after suffering from flu-like symptoms on the first day of her period

Mr and Mrs Zarate with their children, from left to right, Ethan, 14, Bree, three, Zoie, six, Nayaly, 10 and Lezley, 12

The stay-at-home mother, from Jacksonville, North Carolina, was rushed to hospital on February 3 when her fever spiked and her blood pressure plummeted

Mrs Zarate said: ‘I had heard of toxic shock syndrome but I never knew the symptoms.

‘On the first day of my period, I was feeling a little crumby. I was in bed for three days.

‘I believed I had the flu and I was treating myself with over the counter medication. I suffered all of the symptoms of TSS but I confused it for the flu – nausea and diarrhoea, dizziness, achey muscles.

‘The only thing I didn’t get was a rash which is often a symptom of it. But I was getting sicker and sicker. My fever was so high, I was shaky and weak.’

Fighting fit: Mrs Zarate is back in the gym and has made a full recovery after her brush with death in February

Her husband Cas, 30, a military logistics chief, rushed to be by her side as she battled her illness

The mother enjoys family life with her children, from left to right, Bree, three, Zoie, six, Nayeli, 10 and Lezley, 12

WHAT IS TOXIC SHOCK SYNDROME?

Toxic shock syndrome is a highly dangerous bacterial infection – but it can be misdiagnosed because the symptoms are similar to other illnesses and because it is so rare.

It occurs when usually harmless staphylococcus aureus or streptococcus bacteria, which live on the skin, invade the bloodstream and release dangerous toxins.

TSS’ prevalance is unclear but doctors have claimed it affects around one or two in every 100,000 women.

It has a mortality rate of between five and 15 per cent. And reoccurs in 30-to-40 per cent of cases.  

Symptoms usually begin with a sudden high fever – a temperature above 38.9°C/102°F.

Within a few hours a sufferer will develop flu-like symptoms including headache, muscle aches, a sore throat and cough.

Nausea and vomiting, diarrhoea, feeling faint, dizziness and confusion are also symptoms.  

Women are most at risk of getting toxic shock syndrome during menstruation and particularly if they are using tampons, have recently given birth or are using an internal barrier contraceptive, such as a diaphragm.

While tampon boxes advise to change them between four to eight hours, it is common for women to forget and leave them in overnight. 

Treatment may involve antibiotics to fight the infection, oxygen to help with breathing, fluids to prevent dehydration and organ damage, and medication to control blood pressure.

Dialysis may also be needed if the kidneys stop functioning. 

In severe cases, surgery may be required to remove dead tissue. In rare incidences, it may be necessary to amputate the affected area. 

To prevent TSS, women should use tampons with the lowest absorbency for their flow, alternate between a tampon and a sanitary towel, and wash their hands before and after insertion.

Tampons should also be changed regularly, as directed on the packaging – usually every four to eight hours. 

She added: ‘My sister is a nurse and she urged me to call someone and get to hospital. I called friends to take care of my kids and I was rushed to the ER in an ambulance.

‘When I got to the hospital they couldn’t figure out what was wrong with me.. My blood pressure was very low. I had X-rays and a CT scan.

‘I was scared and extremely ill. I had a serious pain in my side because my spleen was swollen from trying to fight the infection.

‘The only doctors they hadn’t consulted was gynaecology and it was a blessing that one of the nurses thought that it might be toxic shock because I had my period. She put two and two together.

‘They discovered it was a staph infection in my blood after taking a vaginal swab and it stemmed from microscopic cuts in my vagina from a tampon.’

Mrs Zarate was given antibiotics, fluids and morphine to fight the infection and manage her pain.

The stay-at-home mother underwent a blood transfusion to help restore her body’s red blood cells and to prevent the further spread of the infection.

Her husband Cas, 30, a military logistics chief, rushed to be by her side as she battled her illness.

‘They said if I waited another day it could have had dire consequences,’ said Greta, a stay-at-home mother.

‘People who get toxic shock syndrome can end up losing limbs or even dying so I do feel so lucky.

‘My sister flew in to take care of my kids and my husband was released from his training. He rushed home. In total I spent 11 days in the hospital and four in the ICU.’

Toxic shock syndrome, which affects around one in 100,000 women, occurs when usually harmless Staphylococcus aureus or Streptococcus bacteria, which live on the skin, invade the bloodstream and produce dangerous toxins.

Symptoms include a high fever, low blood pressure, vomiting, confusion and seizures.

It most commonly occurs in women using tampons because the build-up of blood makes the perfect environment for the rapid growth of bacteria.

Tampon boxes come with a warning of the deadly infection after leaving it in for more than eight hours. 

The disease made headlines in the late 1970s and early 1980s after the deaths of several young women who were using a brand of super-absorbent tampon that was later removed from the market.

But Mrs Zarate said she regularly changed her tampons, and medics believed her TSS was caused by tiny cuts in her vagina.

She said: ‘When you pull a dry tampon out of your body, it actually leaves tiny scrapes on your vaginal wall which allow bacteria to enter your bloodstream and that’s what happened to me.

‘I change my tampon every time I use the bathroom, so I knew it wasn’t because I had left it in there for a long, long time.’ 

Mrs Zarate, who is mother to Ethan, 14, Lezley, 12, Nayeli, 10, Zoie, six, and Bree, three, has made a full recovery but can no longer use tampons. 

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Revealing sexual orientation at work improves well-being

Being open about your sexual orientation in the workplace is beneficial to your overall well-being, according to new research from Rice University.

“Opening up about your sexuality at work is a very real fear for many LGBTQ+ Americans, no doubt due to the fact that individuals have been fired for coming out in the workplace,” said Eden King, an associate professor of psychological science at Rice and one of the study authors. “In fact, the U.S. Supreme Court is debating this week whether or not you can be fired for being gay. The topic is very timely and we were interested in how concealing or revealing this information can impact your health and well-being.”

“Affective Antecedents and Consequences of Revealing and Concealing a Lesbian, Gay or Bisexual Identity” will appear in an upcoming edition of the Journal of Applied Psychology. The research, which builds on previous work examining the impact of revealing stigmatized identities in the workplace, specifically focuses on lesbian, gay and bisexual individuals and how the revelation of a person’s sexuality affects their well-being.

The study included 61 lesbian, gay and bisexual participants from varied racial backgrounds who worked full-time in the Washington, D.C., region and had held their jobs for no more than 12 months.

“We focused on new employees because we figured they would have more opportunities to come out to peers than individuals who had been in the organization for a while,” King said.

The people participating in the study answered surveys that included a variety of questions evaluating their level of “outness” and their emotions, such as anxiety, anger and fatigue. Participants responded to surveys about their feelings every morning for three weeks. In addition, they filled out similar surveys every time they made decisions about whether to reveal or conceal their sexual orientation at work.

The researchers found new employees who concealed their sexual orientation felt increased levels of anxiety, anger and fatigue and decreased levels of vigor and self-assurance.

“It is important that lesbian, gay and bisexual people reported the immediate emotional effects of concealing their identity,” King said. “If these negative feelings build up over time, it could have significant implications for lesbian, gay and bisexual workers’ mental health.”

Jonathan Mohr from the University of Maryland was the study’s lead author. Co-authors include Hannah Markell of George Mason University, Kristen Jones of the University of Memphis, Chad Peddie of ECS Federal and Matthew Kendra of Stanford University.

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Electric fish of the catheter against the atrial fibrillation

The number of people suffering from heart rhythm disorders, has become in the past few years, getting bigger and bigger. The reason is the rising life expectancy. Technical innovations, such as in Germany, co-developed electric fish of the catheter, the therapy, therefore, becoming more and more important.

In the case of many diseases, including cardiac rhythm disorders, has procedures, a minimally invasive catheter ablation, in the meantime, in addition to the administration of medications as a treatment option established. The use of the electric fish of the catheter during such an engagement promises additional benefits for the patients.

In the case of the newly developed technology, doctors have taken the skills of the elephant’s trunk fish, for example: The one on the African continent encountered, nocturnal animal in the dark water with the help of electric currents. In a similar way, the electric fish catheter works: the tip of the catheter around the electrodes generate an electric field for detection. "In practice, this is reminiscent of a radar system or a Parking aid – just within the heart, defective heart muscle to track down cells and to veröden", Professor Dr. Reza Wakili, a senior physician explained to the West German heart and vascular centre of the University hospital in Essen.

In 2015, two American engineers had launched the technology in search of a new environment-diagnostics attached. Almost three years later, the electric fish of the catheter received approval in Europe. Using the new method, the movement of the heart can be modeled precisely during the treatment. Thus, it is possible to bring the catheter to the right place. Since the muscle cells have, in comparison to fluids with a high electrical resistance, are used to assess whether the catheter is completely surrounded by tissue and how tightly the tip of the desertification of instruments already on the Site suppressed. Here, in the past, the risk of perforating the heart wall with too much force.

At the Essen University hospital since the introduction of approximately 200 patients have been successfully treated with the electric fish of the catheter.

NK

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Vaping lung injuries resemble chemical burns, expert calls it the 'tip of the iceberg'

As the Centers for Disease Control and Prevention (CDC) continues to investigate a spike in vaping-related injuries, a new breakthrough study from the New England Journal of Medicine is providing evidence that toxic chemicals may be to blame.

The crisis, which began with the hospitalization of eight teenagers in Wisconsin this summer, has now expanded to include 1,080 cases of “severe lung injury” across 48 states. Those suffering from the illness — which has resulted in 18 fatalities thus far — report experiencing an onset of pneumonia-like symptoms, including severe cough, shortness of breath, fever and fatigue. Seventy percent of those affected are male and more than 80 percent are under the age of 35.

Experts from both the CDC and the Food and Drug Administration have been scrambling to find what’s fueling the illnesses — with some suggesting that it’s a build-up of oil — either flavoring or vitamin E oil — in the lungs. Others have implicated THC, the psychoactive ingredient in cannabis, after reports that the majority of those with the illness used a vape containing it. But with others saying they only used nicotine, no single ingredient or product can be cited as the cause.

However, in an October 2 study titled Pathology of Vaping-Associated Lung Injury, researchers from the Mayo Clinic may have gotten one step closer to an answer. In the report, the researchers analyzed the biopsies from 17 patients who developed a severe lung illness related to vaping — two of whom had died as a result. The biopsies showed no signs that a buildup of oil in the lungs was to blame. Instead, the images resembled those of individuals who had been exposed to toxic chemicals — suggesting that there may be other, as-of-now unidentified contaminants at play.

“While we can’t discount the potential role of lipids [oils], we have not seen anything to suggest this is a problem caused by lipid accumulation in the lungs,” Brandon Larsen, MD, PhD, a surgical pathologist at Mayo Clinic in Arizona and one of the lead researchers wrote in the study. “Instead, it seems to be some kind of direct chemical injury, similar to what one might see with exposures to toxic chemical fumes, poisonous gases and toxic agents.”

An image of the damaged lungs circulated this week on social media, with many doctors noting their similarity to chemical burns. In a video put out by the Mayo Clinic explaining the study, Larsen expanded on the shocking findings. “What we see with these vaping cases is a kind of severe chemical injury that I’ve never seen before in a tobacco smoker or a traditional marijuana smoker,” Larsen said. “But I think we’ve only seen the tip of the iceberg.”

Larsen says one of the difficulties of finding the culprit is how many different products are on the market, but that the goal of the analysis was to find “what’s really happening” in the patients’ lungs. “Universally, all of these patients had what appeared to be … a toxic chemical fume injury in the lungs,” said Larsen. “So the injury in the lung looks like a caustic chemical injury that then will injure the lining of the airways — which is not surprising because that’s how the vaping aerosol enters the lungs through the airways and then the lung tissue surrounding those airways will often have the same types of changes.”

Overall, he hopes that those reading about the vaping crisis understand how dangerous it is proving to be. “Everyone should recognize that vaping is not without potential risks, including life-threatening risks, and I think our research supports that,” Larsen said. “It would seem prudent, based on our observations, to explore ways to better regulate the industry and better educate the public, especially our youth, about the risks associated with vaping.”

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How one man lost 135 pounds after doctor said he was morbidly obese: ‘The word morbid shook me to the core’

Wellness Wins is an original Yahoo series that shares the inspiring stories of people who have shed pounds healthfully.

Eric Hunnicutt is 6’4” tall and currently weighs 210 pounds. In 2016, he was inspired to change his lifestyle after a trip to the doctor left him frightened. This is the story of his weight-loss journey, as told to Yahoo Lifestyle.

The Turning Point

I don’t remember a time where weight wasn’t an issue for me. I remember in second grade someone made a comment about my weight that spurred me to go on a diet where I ate nothing but apples for several days.

I went to the doctor in Dec. 2015 with strep. They gave me a printout of my body stats, and after seeing the weight and BMI [body mass index] on that, I was scared. Like really, really frightened. I was classified as morbidly obese. The word ‘morbid’ shook me to the core.

In early 2016, a friend of mine was also looking to lose weight. We started with the Whole30 diet that January — you know, the typical New Year’s resolution sort of thing. I actually started to see results, and just kept at it.

The Changes

It started with Whole30. That diet is pretty restrictive and a lot of those restrictions seemed arbitrary and unnecessary (quinoa, sprouted grains, etc.). I stepped back and analyzed what Whole30 was really doing – essentially just reducing the number of calories I was consuming through eliminating specific categories of food. I work in IT – I’m a pretty number/data-driven guy – and after doing a lot of research, I decided all I really needed to do was burn more calories than what I was consuming. Doing that allowed me to continue to eat all categories of foods. I started tracking my food in MyFitnessPal and incorporated daily cardio into my routine.

As far as exercising, I honestly just started trying to move as much as possible, initially — parking farther away from the building, taking the stairs, walking around the block twice a day at work, etc.

I saw an advertisement for a Zumba class being held at work and decided I’d give it a try. It was really challenging at first. I was pretty nervous, initially — I was the only male in the class, and a 6’4’’, 300-pounds-plus person doesn’t exactly blend into the background. Everyone in that class was so kind and welcoming. Those Zumba sessions really got my heart rate up and they were fun.

At the same time, I joined a gym and started using their cardio equipment for half an hour a day — the Arc Trainer or elliptical at first, as my knees couldn’t take the high impact from running. I don’t remember exactly when, but I moved to the treadmill at some point and started using the Couch to 5K app to try running. After completing that program, I still run almost every day. I try to get the distance of a 5K in – a little over 3 miles. I prefer to run outdoors but sometimes Mother Nature just doesn’t cooperate and I will use the treadmill.

I felt phenomenal. I realized I had more energy, despite working out more. I was sleeping better. I started to notice not only the number on the scale going down but many non-scale victories (favorite clothes being too big, not needing a seatbelt extender on an airplane, going up a flight of stairs without being winded, etc.). Those little things I noticed, feedback from others, and being able to recognize that I felt better were what kept me going.

The After

I think anyone, no matter their shape or size, should be confident in themselves. That being said, that was not the case for me. I was (and still am) conscious of my body all the time. I’m conscious of how I fit into a given space (how I feel in an armchair, for instance), how my clothes are falling on my body. Those things can really have an affect on your confidence. I do feel more confident in myself now — particularly when around other people. People will judge you based on how you look. The phrase “don’t judge a book by it’s cover” is garbage. We innately judge someone on how they look — it’s a survival instinct. Whether you’re aware of it or not, you’re forming thoughts about a person based on the first type of data your brain receives about them.

The Maintenance

I will admit that my relationship with food is still a difficult one. I think about food often. I’m always wondering how any given food I want to consume will impact my body. Thinking things like, “How will this affect my metabolism?” “What will this do to my blood sugar?” “Where does this put me in terms of my caloric needs?”

I do still track foods I eat. I like the data aspect of it. Seeing that quantitative measure gives me peace of mind. That being said, I treat myself every now and then. I’d say I’m at a point where I track loosely and eat somewhat intuitively. I just try to remain conscious of what I’ve consumed.

Most of the foods I eat are not processed. Fruits, vegetables, and meat are what I mainly consume.

I’m at a point now where I feel physically and mentally great. Remembering how I felt before compared to how I feel know is all the motivation I need.

The Struggles

I struggle with guilt associated with either not working out or guilt from consuming something I know is “bad.” My relationship with food is a work in progress. I just try to be rational. I have an incredible support system of friends and family who are there to help me work through my struggles as well.

Advice

I put off changing my diet and exercise regimen for years because I thought I was at the point of no return. Change will be uncomfortable at first. Get your diet down and become familiar with that. After you’ve got diet down, incorporate some exercise into your routine. I’d estimate weight loss is 70 to 80 percent diet-based. The other 30 to 20 percent is done through exercise.

The gym can be intimidating. But nobody there cares about what you’re doing or what you look like. You just have to go in and get your workout in. Don’t worry about others judging you.

Need more inspiration? Read about our other wellness winners!

Wellness Wins is authored by Andie Mitchell, who underwent a transformative, 135-pound weight loss of her own.

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