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He developed a wide variety of procedures and devices to reattach or replace vital body parts, including the first inflatable prosthetic penis.Berish Strauch, a plastic surgeon whose pioneering procedures and devices to reattach or replace vital body parts included one of the first toe-to-thumb transplants, a device to reverse vasectomies and, perhaps most notably, the first inflatable prosthetic penis, died on Dec. 24 in Greenwich, Conn. He was 90.His daughter, Laurie Strauch Weiss, said the cause of his death, in a hospital, was respiratory failure.Beginning in the late 1960s, Dr. Strauch was at the forefront of a revolution in plastic surgery, in particular microsurgery, in which doctors use microscopes and precision instruments to sew together minuscule blood vessels, nerves and ligaments, some thinner than a human hair, said Dr. June K. Wu, an associate professor of surgery at Columbia University who completed her residency under Dr. Strauch.As the longtime chief of reconstructive surgery at Montefiore Medical Center in the Bronx, Dr. Strauch devised many of the surgical procedures and technologies that are now considered commonplace. Among other achievements, he pioneered techniques to remove excess skin from patients who had lost significant amounts of weight from bariatric surgery — a sort of extreme tummy tuck.After a New York City firefighter lost his thumb in 1976, Dr. Strauch tried to reattach it. When that proved impossible, he suggested something more radical: taking one of the man’s big toes and sewing it in place of the severed digit.Not only did the surgery work, but within a few months, the firefighter was back on the job.Dr. Strauch, far left, at a workshop and symposium on microvascular surgery in New York City in 1974.via Laurie Strauch Weiss“I don’t recommend a transplant for a person who has lost a finger,” he told the newspaper Midnight in 1976. “A thumb, yes, because the opposable thumb is what differentiates us from beasts.”Dr. Strauch was among the first modern surgeons to use leeches to help control blood flow after surgery and remove necrotic tissue — a seemingly medieval technique that, he said, could not be improved upon by human innovation.“If you had to go out and design an instrument to remove blood,” he told The New York Times in 1987, “you couldn’t design one that was more suited than the biblical leech.”He left an especially deep mark on the field of urology. He created the so-called Strauch clamp, a device used to assist in reversing vasectomies. And in perhaps his most remarkable but no less important innovation, he invented the first inflatable penile prosthesis.Artificial penises had been in use for centuries, either as replacements for detached members, as treatment for erectile dysfunction or for use in sex reassignment surgery. But in most cases they were either permanently flaccid or permanently erect — neither of which was an especially satisfying arrangement for anyone involved.Dr. Strauch devised a prosthetic penis attached by a tube to a reservoir of fluid implanted inside the body. When the patient wanted an erection, he could activate a pump to fill the prosthesis (though to reverse it, he would need to work the fluid back into the reservoir manually).He received a patent for his invention in 1973, after which he sold it to a company called American Medical Systems. One of the company’s founders, F. Brantley Scott, then further developed the product — and in the annals of medical history has since received most of the credit.Berish Strauch was born on Sept. 19, 1933, in the Bronx, the son of Herman and Anna (Weiss) Strauch. His father cut men’s suits in Manhattan’s garment district; his mother was a milliner.As a child, Berish, who went by Bob in informal situations, accompanied his parents to their work. He later said that watching them wield scissors and knives for hours inspired his interest in surgery.He attended the Bronx High School of Science and graduated from Columbia, where he studied pre-med, in 1955 and from its medical school in 1959. After fellowships at Roosevelt Hospital in New York and Stanford Hospital in Palo Alto, Calif., he returned to the Bronx to join the staff at Montefiore. He became chief of plastic surgery there in 1978.Dr. Strauch married Rena Feuerstein in 1955. She died just eight weeks before he did. Along with their daughter, he is survived by their son, Robert, himself a noted hand surgeon; seven grandchildren; and his sister, Renee Freed. The Strauchs lived in Rye, N.Y.Though he never sought attention, Dr. Strauch played a minor but important role in one of the biggest tabloid stories of the 1990s.Mary Jo Buttafuoco, third from right, with her husband, Joey, at a news conference in Mineola, N.Y., in 1992. When she suffered massive facial damage after being shot in the head, Dr. Strauch performed extensive surgery and returned most of her face to normal.Michael Alexander/Associated PressIn 1992 Amy Fisher, a teenager from Long Island, shot a woman named Mary Jo Buttafuoco in the side of the head after confronting her over Ms. Fisher’s affair with Mrs. Buttafuoco’s husband, Joey.Mrs. Buttafuoco survived, but she suffered massive facial damage, including partial paralysis. Hearing about her case, Dr. Strauch reached out to her lawyer and offered to help.“This is one of the most fruitful areas of medicine,” he told Newsday in 1992. “In the past 20 years there has been a whole new level of knowledge.”He performed extensive surgery on Mrs. Buttafuoco in early 1993, returning most of her face to normal — though it was too late to reverse extensive nerve damage.“She will still have some elements of the paralysis primarily of the lower lip,” he told Newsday after the surgery. “But she’s a beautiful lady, and she’s going to look great.”

Published22 minutes agoShareclose panelShare pageCopy linkAbout sharingImage source, Getty ImagesBy Vicky WongBBC NewsThe Duchess of York has been diagnosed with malignant melanoma following the removal of a cancerous mole during treatment for breast cancer.Sarah Ferguson had several moles removed and analysed while having reconstructive surgery following a mastectomy, her spokesman said.The duchess “remains in good spirits”, despite it being “distressing” to have another cancer diagnosis.She is the third royal to announce a medical procedure this week.Her spokesperson said: “Her dermatologist asked that several moles were removed and analysed at the same time as the duchess was undergoing reconstructive surgery following her mastectomy, and one of these has been identified as cancerous.”She is undergoing further investigations to ensure that this has been caught in the early stages.”Clearly, another diagnosis so soon after treatment for breast cancer has been distressing but the duchess remains in good spirits.”The duchess wants to thank the entire medical team which has supported her, particularly her dermatologist whose vigilance ensured the illness was detected when it was.”She believes her experience underlines the importance of checking the size, shape, colour and texture and emergence of new moles that can be a sign of melanoma.”The statement also thanked the private medical team that supported the royal during her treatment.The duchess confirmed a diagnosis for breast cancer last June, following a routine mammogram screening.She went on to have a single mastectomy at King Edward VII hospital in London, a private clinic used by senior royals.The 64-year-old was married to the Duke of York, Prince Andrew, for 10 years before they divorced in 1996.They continue to share a home at Royal Lodge – a property owned by the Crown Estate at Windsor Great Park.They have two daughters – Princess Beatrice, 35, and Princess Eugenie, 33 – and three grandchildren.The duchess was last seen in public on Christmas Day attending a Christmas Day church service in Sandringham with the King and Queen and other senior members of the Royal Family.She has not accompanied the family on the walk to the Christmas morning church service for more than 30 years.It was confirmed on Wednesday that the Princess of Wales would remain in hospital for up to two weeks after planned surgery, and that the King would soon be treated for an enlarged prostate.On Wednesday, Kensington Palace confirmed that Catherine would stay in hospital for up to two weeks after undergoing abdominal surgery.Kensington Palace said the procedure was successful but that the princess is not expected to resume royal duties for months.The palace did not disclose further details about her condition but said it is not cancer-related.Shortly after that announcement, Buckingham Palace said the King would receive treatment for a benign prostate condition and will visit an undisclosed hospital in the coming days.It is thought the King wanted to share his diagnosis with the public to encourage other men who may be experiencing symptoms to get checked.More on this storyDuchess of York recovering after breast cancer opPublished26 June 2023Duchess of York names reconstructed breast DerekPublished3 August 2023Princess of Wales in hospital after abdominal surgeryPublished4 days agoKing Charles to be treated for benign prostate conditionPublished4 days ago

Published38 minutes agoShareclose panelShare pageCopy linkAbout sharingImage source, Niall McCanBy Smitha MundasadInside Health Presenter, BBC Radio 4It’s not often you meet someone who gets a round of applause for farting on stage. “I was giving a talk in London and I had mentioned earlier about my flatulence,” Niall McCann says. He’d explained to the audience that a speed flying accident in 2016 – in which he smashed into the Brecon Beacons mountains at 50mph – had left him with bladder, bowel and sexual dysfunction.”And then it happened very prominently and everyone started clapping,” he says.We met for an episode of BBC Radio 4’s Inside Health. In the programme he spoke very candidly – and with surprising humour and positivity – about his accident, the surgery to reconstruct his spine and his remarkable recovery.One of the things we spoke about was what it’s been like for him living with bladder and bowel and sexual problems – the intimate challenges that don’t often get talked about.He says he’s happy to talk because “there’s stigma and there shouldn’t be”, and he hopes that by being open maybe he will help others.And while he recognises many others are less fortunate, as spinal injuries can often cause lasting paralysis, he wants to shine light on things people often deal with silently.’Trying to be a hero when I was a beginner’On that day eight years ago, Niall decided the conditions were perfect to go speed-flying.He says it is a bit like paragliding, except that instead of gliding, you run off a cliff and plummet to the ground, but on that day he was “trying to be a hero when I was really a beginner”. Niall accidentally turned a few degrees too far, smashing into the Brecon Beacons mountainside. Listen to Inside Health podcast: Bowels, bladders and sex: learning to live after my mountain accidentNiall spent 38 days at the University of Wales Hospital in Cardiff, having operations on his spine and learning how to use his legs again. The major concern was how much damage had been done to his spinal cord, which is a bundle of nerves that transmits information between the brain and the body. If damaged, there can be a range of problems, including paralysis. But because Niall had bruised his, rather than cut it, the chance of recovery – although often incomplete – was greater. Image source, Niall McCannThere were many considerable challenges in hospital but once home, there were even more adjustments to be made – not least to his relationship and how he saw himself. “At first I had the overwhelming sense of being utterly dependant. I couldn’t reach around my backside – so I couldn’t take myself to the toilet,” he says.His wife, mother and brother all helped out. “This wasn’t part of the marriage vows,” he reflects, “But they did it without complaining.”There was one particular incident that he credits for giving him motivation to regain his independence in the bathroom.His mother-in-law, who was a nurse, was due to come round just weeks after the accident.”So she had wiped many bottoms of course, but I didn’t want one of them to be mine,” he says. First disabled team crosses Europe’s largest ice cap in just 11 daysNiall McCann joins mountain rescue team who saved himHumour aside, learning to live with a loss of control of his bowels was not easy. “What many spinal cord injury patients do is manually evacuate their bowels – using their hands to pull out whatever is in their rectum at the time,” he explains. “It took a bit of time for me to learn to do this.” One of the funniest moments, he recalls, was a few weeks after the accident when he attempted a pull-up at his mum’s house.”My brother had a pull-up bar on the door-frame. “Of course I wanted to see if I could do it. So I did very cautiously.”This put pressure on Niall’s core so he checked his incontinence pad – and it was empty. “But my brother was stood right behind me and he watched as I curled out a very large stool on the dining-room floor,” he recalls.’Minor imposition’Over time, accidents like this became less frequent. And Niall says while it did not feel good to have a “poo in his pants”, he needed to manage this “by-product” of his accident as best he could. Now it is just “a minor imposition” that he is mindful of at certain moments.”For example, when my daughter wants me to throw her in the air, I need to think about when I last opened my bowels.”Another consequence of the damage to the nerves in this area is that he cannot relax his bladder to pee, something he has in common with many people with spinal cord injuries. Niall now uses an intermittent catheter – a tube that allows him to empty his bladder.Image source, Niall McCannBut he thinks many people do not realise that spinal cord injuries often cause lasting problems with your bladder and bowels. And even less frequently spoken about is sex. ‘Stepping into the unknown’For every spinal cord patient the situation is unique – but for some it is an inability to get aroused and there can be ejaculation issues, he explains.This has been one of the most challenging aspects of his recovery. “So much starts afresh in terms of your married life when you come home with a life-changing injury.”You are learning a lot of new things about each other. It is almost like being teenagers.”At the beginning Niall slept downstairs, because the stairs were a challenge. But when he was able to climb them, he had mixed emotions, Downstairs, it turned out, had become a bit of a sanctuary.”It almost felt like a pressure to go back into cohabiting after having had my own space. That almost felt like stepping into something new and unknown again.” But if you really want to pursue an intimate relationship with your partner – then just trying things and finding out what works is so important, he says. “And this will probably take some experimentation and some frustration and some embarrassment. But the other person is learning at the same time – you are both learning together.”I am very lucky at how patient, accommodating and accepting my wife has been,” he adds.In Niall’s case, he was warned very early on that having children might be difficult. So the couple immediately registered for IVF. Niall says he knows how lucky it is that Phoebe was born three years after his accident.Image source, Niall McCann”If I hadn’t had my accident we wouldn’t have Phoebe – we would have had another child probably – but we wouldn’t have had her, and she is the best thing to come out of this.”Niall acknowledges his recovery has had ups and downs, but he says talking about it has been so important.”A lot of people don’t feel like they can, and I am in the fortunate position of being able to. I hope my openness allows other people to share with their loved ones too.” More on this storyFirst disabled team crosses Europe’s largest ice capPublished29 April 2023Rescued man joins team who saved himPublished13 May 2017Drug ‘repairs spinal cord injuries’Published4 December 2014’The cough that paralysed me’Published26 May 2013

Last Thanksgiving, Cynthia Mosson had been on her feet all day in her kitchen in Frankfort, Ind., preparing dinner for nine. She was nearly finished — the ham in the oven, the dressing made — when she suddenly felt the need to sit down.“I started hurting in my left shoulder,” said Ms. Mosson, 61. “It got really intense, and it started to go down my left arm.” She grew sweaty and pale and told her family, “I think I’m having a heart attack.”An ambulance sped her to a hospital where doctors confirmed that she had suffered a mild heart attack. They said testing revealed serious blockages in all her coronary arteries and told her, “You’re going to need open-heart surgery,” Ms. Mosson recalled.When such patients head into an operating room, what happens next has a lot to do with their sex, a recent study in JAMA Surgery reported. The study reinforced years of research showing that male and female patients can have very different outcomes following an operation called coronary artery bypass grafting.C.A.B.G. (pronounced like the vegetable) restores blood flow by taking arteries from patients’ arms or chests, and veins from their legs, and using them to bypass the blocked blood vessels.“It’s the most common cardiac operation in the United States,” taking place 200,000 to 300,000 times a year, said Dr. Mario Gaudino, a cardiothoracic surgeon at Weill Cornell Medicine and lead author of the study.Twenty-five to 30 percent of C.A.B.G. patients are women. How do they fare? The mortality rate for C.A.B.G., though low, is much higher for women (2.8 percent) than men (1.7 percent), Dr. Gaudino and his colleagues found.Analyzing results from about 1.3 million patients (average age: 66) from 2011 to 2020, the researchers also determined that after C.A.B.G., about 20 percent of men had complications that included strokes, kidney failure, repeat surgeries, infections of the sternum and prolonged respirator use and hospital stays. Among women, more than 28 percent did.Cardiac and pulmonary rehabilitation respiratory therapist Abbey Smit, right, took Ms. Mosson’s blood pressure at a rehabilitation appointment at IU Health Frankfort Hospital.Kaiti Sullivan for The New York TimesOf those complications, “many are relatively minor and self-resolving,” Dr. Gaudino said. But recovering from sternal wound infections can take months, he noted, and “if you have a stroke, that can affect you for a long time.” Though outcomes improved for both sexes over the decade, the gender gap remained.The study “should be regarded as an exploding flare in the sky for all clinicians who care for women,” an accompanying editorial said. Yet to cardiac researchers, the results sounded familiar.“This has been something we’ve known since the 1980s,” said Dr. C. Noel Bairey Merz, a cardiologist and researcher at Cedars-Sinai Medical Center. Heart disease, she pointed out, remains the leading cause of death for American women.With C.A.B.G., “the general assumption was that it was getting better because the technology, the knowledge, the skills and training were all improving,” she said. To see the gender disparity persist “is very disappointing.”Several factors help explain those differences. Women are three to five years older than men when they undergo bypass surgery, in part because “we recognize coronary artery disease more easily and earlier in men,” Dr. Gaudino said. “Men have the classic presentation we study in medical school. Women have different symptoms.” These may include fatigue, shortness of breath and pain in the back or stomach.Fewer than 20 percent of patients enrolled in clinical trials have been female, so “what we’ve been taught is essentially based on research in men,” he added.Partly because they’re older — about 40 percent are over 70 — women are more apt than men to have developed health problems like diabetes, high blood pressure and vascular conditions, “all factors that increase risk in cardiac surgery,” Dr. Gaudino said. They also have smaller, more fragile blood vessels, which can make surgery more complex.The disparities affect other forms of cardiac treatment and surgery, too. Women have worse outcomes than men five years after receiving a stent, a 2020 review of randomized trials reported.Ms. Mosson’s daily medications.Kaiti Sullivan for The New York TimesThey’re “less likely to be prescribed and to take statins, and particularly less likely to take the high-intensity statins, which are the most lifesaving,” Dr. Bairey Merz said. “The list goes on and on.”When C.A.B.G. works well, the results can feel miraculous. Rhonda Skaggs, 68, had a quadruple bypass in July 2022 and spent 12 days in intensive care before going home to Brooksville, Fla. Six months passed before she returned to work at a Home Shopping Network outlet store.“Now, you’d never know I had open-heart surgery,” she said. “I walk 10,000 steps a day. I teach line dance classes twice a week. I have my life back.”But Susan Leary, 71, a retired New York City teacher now living in Fuquay-Varina, N.C., is facing a second procedure after bypass surgery at Duke University last month.“Women are less likely to get all the vessels that need to be bypassed bypassed,” said her cardiothoracic surgeon, Dr. Brittany Zwischenberger, co-author of the call-to-arms editorial in JAMA Surgery.A few years before, Ms. Leary had sought a procedure to shrink away the “ugly-looking” varicose veins in her legs; now, she lacked viable blood vessels for grafting. “How did I know I was going to need some of those veins for my heart?” she said.She had a double bypass, instead of the triple bypass she needed, which represents “incomplete revascularization.”“It can contribute to worse outcomes and future interventions,” Dr. Zwischenberger said. “Fortunately, she’s a candidate for a stent” for the third blocked artery, which involves inserting a mesh tube into the vessel to widen it. The procedure is scheduled for next month.Advocates of improved care for women argue that their surgical risks can be reduced.Dr. Lamia Harik, a cardiothoracic surgery researcher at Weill Cornell Medicine, and her colleagues have found that nearly 40 percent of women’s mortality during C.A.B.G. stems from interoperative anemia. (Their study is in press.)On the treadmill during her rehabilitation appointment. Ms. Mosson has begun a three-times-weekly cardiac rehab program, recommended for patients who’ve undergone bypass surgery. She finds that her stamina is improving.Kaiti Sullivan for The New York TimesThat occurs when operating teams administer fluids to dilute patients’ blood during the procedure, allowing them to use the large cardiopulmonary bypass machine (“the pump”) that keeps blood oxygenated and flowing while surgeons do the grafting.“This is something modifiable,” Dr. Harik said. For women, surgeons might use smaller pumps or reduce the volume of added fluid, or both.To learn more, Dr. Gaudino and other researchers have begun enrolling women, and only women, in two new clinical trials. The international ROMA study, the first all-female surgical trial, will investigate two C.A.B.G. techniques to see which produces better outcomes; the federally funded Recharge trial will compare stenting with C.A.B.G.“In the past, a lot of surgeons thought this was inevitable,” Dr. Gaudino said of the differences between the sexes. “Maybe they will not disappear, but they can be minimized.”Ms. Mosson said her surgeons were pleased with the results of her quadruple bypass, though she was readmitted to the hospital briefly for fluid in her lungs. She has begun a three-times-weekly cardiac rehab program, recommended for patients who’ve undergone bypass surgery, and finds that her stamina is improving.She still contends with the psychological aftermath of her heart attack and surgery, as Ms. Skaggs did and Ms. Leary still does. They describe shock — none had a history of heart disease — depression and anxiety. “I’m still struggling with the fear it will happen again,” Ms. Mosson said.One antidote, for Ms. Leary, was being recruited for ROMA; Duke is among the clinical trial sites. She jumped at the chance to enroll.“Let me be a part of it,” she said. “Maybe my daughter will need this information someday.”

Published11 minutes agoShareclose panelShare pageCopy linkAbout sharingImage source, Getty ImagesBy Dominic HughesHealth correspondent, BBC NewsSexual health services in England are at breaking point, according to local councils who are responsible for running the clinics. They say that soaring rates of gonorrhoea and syphilis infections are threatening to overwhelm services. More than two-thirds of council areas have seen infection rates climb since 2017. They are calling on the government to provide extra funding to meet rising demand. Data gathered by the government’s Office for Health Improvement and Disparities shows that in almost every council area in England, diagnosis rates of gonorrhoea have increased in recent years. Gonorrhoea and syphilis at record highThe Local Government Association (LGA) – representing the councils that provide sexual health clinics – is warning that demand is soaring and services are struggling to keep up. It is calling on the government to provide extra funding, as well as to publish a long-term plan to help prevent and treat sexually transmitted infections. Nearly three-quarters of councils have seen a rise in rates of syphilis cases, and chlamydia infections are up in more than a third of areas. Many of the new cases are younger people, and involve gay, bisexual and other men who have sex with men, but rates have also increased in heterosexual people. Experts believe there has been a rebound effect after the restrictions connected to Covid, but infections were rising well before the pandemic hit. There has also been a greater effort to test more people and improve access to services which may have led to more cases being identified. Councillor David Fothergill, chairman of the LGA’s Community Wellbeing Board, says the statistics show that local sexual health services are grappling with unprecedented increases in demand. “Councils have been working hard to encourage more people to access sexual health services and get tested more regularly to help improve detection rates and catch infections early. “Investment in sexual health services helps to prevent longer-term illness and unwanted pregnancies, reducing pressure on our NHS and improving the health of people across our communities.” A report by the UK Health Security Agency last year revealed that in 2022 gonorrhoea cases were at their highest level since records began in 1918 – and syphilis cases were the highest since 1948. Dr Claire Dewsnap, president of the British Association for Sexual Health and HIV, says the quality and accessibility of services is under threat. “Without sufficient investment, sexual health service users will face severe challenges in their ability to access expert, timely care. “This data not only demonstrates the deeply concerning trajectory of STI [sexually transmitted infection] growth, but also the need for a robust national strategy, backed up by adequate funding. “As demand for care increases, without imminent action, we compromise our ability to safeguard the sexual health of our nation.” More on this storyGonorrhoea and syphilis at record high in EnglandPublished6 June 2023Related Internet LinksSTI annual data tables – UKHSAThe BBC is not responsible for the content of external sites.

Published2 hours agoShareclose panelShare pageCopy linkAbout sharingBy Angie BrownBBC Scotland, Edinburgh and East reporterFor 17 years, Daren Frankish has been suffering from headaches so agonising they leave him screaming and banging his head off walls. The 53-year-old from Edinburgh says they feel like he is being hit full-force with a baseball bat, while being stabbed in the eye with a knife. Officially known as cluster headaches, they are thought to be one of the most painful conditions to affect a human being. “During lockdown I had to walk to the hospital and I remember thinking if a bus came along I would jump in front of it – so I know why they are called suicide headaches,” the horticultural engineer told BBC Scotland News.”I live in fear of the next attack, it frightens the life out of me. It’s a psychological torture knowing it can come at any time, I’m so scared of them.”Cluster headaches: Like someone is grabbing your face’I could rip my eye out at times’Attacks normally last between 15 minutes and three hours and can happen in clusters of seven or eight in a day.But Daren has also endured episodes which have lasted 12 hours. He says they begin with shooting pains on the left side of his head, above his eye. “My left eye starts to go red, starts to droop and waters profusely. My nose blocks up and a severe pain starts in my head,” he said. “I can only describe the attack as awful. It is like someone has hit you full swing with a baseball bat. It also feels like a knife has gone through above my left eye and then been levered down.”I get very restless and sometimes physically sick, I scream into a pillow, bang my head on the wall or anything hard, I usually pace around my living room in pitch darkness as I cannot tolerate any light.”Daren sometimes goes for a walk holding a cloth over his left eye as it waters severely.He walks in empty places and carries a card in case someone tries to talk to him.”I am unable to communicate with anyone when I am going through an attack,” he said. Daren said that recently his attacks were becoming more frequent and lasting longer. Last May he spent two nights in the A&E department at the Royal Infirmary in Edinburgh after two attacks, each lasting 12 hours.”These attacks where excruciating and the worst attacks I have ever experienced,” he said.What are cluster headaches? Image source, Doug Armand/ Getty ImagesCluster headaches are rare, affecting about one in 1,000 people – an estimated 65,000 people in the UK. But it’s a misnomer for a condition that is “so much more than a headache”, according to Katie Martin, Brain Research UK research manager. “As Daren has described, the excruciating pain of a cluster attack is unbearable, leaving people screaming in pain, and banging their heads off walls to try to end the agony.”We’re funding desperately-needed research to accelerate our understanding of the condition, towards the development of new treatments that will provide effective relief for all those affected.”Sufferers are normally over the age of 30, and the headaches are more common in men than woman. The frequency of attacks may vary from one attack every few days to multiple attacks per day. Each attack may range from 15 minutes to several hours.They cause multiple admissions to hospital, restricting people’s lifestyles and often leading to unemployment. They are also associated with a threefold increase in risk of depression and suicidal tendencies are often reported.There is no cure. Daren had his first episode in 2007 when he was 37. “I was on holiday with my family in Prague when I got a got a headache that was so severe I thought there was something seriously wrong with me like a brain tumour,” the father-of-two said.He has since been prescribed medication including steroids, lithium, heart medication and epilepsy tablets.”I don’t have epilepsy but they are trying everything on me but nothing works.”I also have an injection which I can use as soon as an attack comes on, which sometimes works.”Daren has oxygen canisters in his house, which he uses to try to stabilise an attack.He has tried different diets and cutting out smoking and alcohol but continues to have the crippling headaches.Read more stories from Edinburgh, Fife and East ScotlandDo you have a story from Edinburgh, Fife and east Scotland to share with BBC News?”The next step is I’m going to have a nerve block injected into my head,” he said. The local anaesthetic numbs the nerves in the short term. The steroid reduces inflammation. It can reduce attacks for up to a year.”I’m willing to take the risks of having this because these suicide headaches severely affect my life,” he said. “They destroy everything and I can’t do anything when the attacks happen.”It put pressure on my marriage and was part of the reason for my divorce and I feel awful for my kids growing up hearing my screams.”Daren has read some evidence to suggest cluster headaches can be caused by meningitis – which he had when he was two and again when he was 12 years old.For now he has to live with them.”It does it when it wants, I have no control over it. When it comes for you, it gets you,” he said.Find more information and support about suicide and feelings of despair at BBC Action Line. Around the BBCBBC Radio 4 – Inside Health, Braintraining and dementia; Cluster headaches; Cancer rehab; #hellomynameisRelated Internet LinksCluster headaches – NHSNational Library of MedicineBrain Research UKThe BBC is not responsible for the content of external sites.

Scientists have created the world’s first working nanoscale electromotor, according to research published in the journal Nature Nanotechnology. The science team designed a turbine engineered from DNA that is powered by hydrodynamic flow inside a nanopore, a nanometer-sized hole in a membrane of solid-state silicon nitride.
The tiny motor could help spark research into future applications such as building molecular factories for useful chemicals or medical probes of molecules inside the bloodstream to detect diseases such as cancer.
“Common macroscopic machines become inefficient at the nanoscale,” said study co-author professor Aleksei Aksimentiev, a professor of physics at the University of Illinois at Urbana-Champagne. “We have to develop new principles and physical mechanisms to realize electromotors at the very, very small scales.”
The experimental work on the tiny motor was conducted by Cees Dekker of the Delft University of Technology and Hendrik Dietz of the Technical University of Munich.
Dietz is a world expert in DNA origami. His lab manipulated DNA molecules to make the tiny motor’s turbine, which consisted of 30 double-stranded DNA helices engineered into an axle and three blades of about 72 base pair length. Decker’s lab work demonstrated that the turbine can indeed rotate by applying an electric field. Aksimentiev’s lab carried out all-atom molecular dynamics simulations on a system of five million atoms to characterize the physical phenomena of how the motor works.
The system was the smallest representation that could yield meaningful results about the experiment; however, “it was one of the largest ever simulated from the DNA origami perspective,” Aksimentiev said.
Mission Impossible to Mission Possible
The Texas Advanced Computing Center (TACC) awarded Aksimentiev a Leadership Resource Allocation to aid his study of mesoscale biological systems on the National Science Foundation (NSF)-funded Frontera, the top academic supercomputer in the U.S.

“Frontera was instrumental in this DNA nanoturbine work,” Aksimentiev said. “We obtained microsecond simulation trajectories in two to three weeks instead of waiting for a year or more on smaller computing systems. The big simulations were done on Frontera using about a quarter of the machine — over 2,000 nodes,” Aksimentiev said. “However, it’s not just the hardware, but also the interaction with TACC staff. It’s extremely important to make the best use of the resources once we have the opportunity.”
Aksimentiev was also awarded supercomputer allocations for this work by the NSF-funded Advanced Cyberinfrastructure Coordination Ecosystem: Services & Support (ACCESS) on Expanse of the San Diego Supercomputer Center and Anvil of Purdue University.
“We had up to 100 different nanomotor systems to simulate. We had to run them for different conditions and in a speedy manner, which the ACCESS supercomputers assisted with perfectly,” Aksimentiev said. “Many thanks to the NSF for their support — we would not be able to do the science that we do without these systems.”
DNA as a Building Block
The success with the working DNA nanoturbine builds on a previous study that also used Frontera and ACCESS supercomputers. The study showed that a single DNA helix is the tiniest electromotor that one can build — it can rotate up to a billion revolutions per minute.
DNA has emerged as a building material at the nanoscale, according to Aksimentiev.

“The way DNA base pair is a very powerful programming tool. We can program geometrical, three-dimensional objects from DNA using the Cadnano software just by programming the sequence of letters that make up the rungs of the double helix,” he explained.
Another reason for using DNA as the building block is that it carries a negative charge, an essential characteristic to make the electromotor.
“We wanted to reproduce one of the most spectacular biological machines — ATP synthase, which is driven by electric field. We chose to do our motor with DNA,” Aksimentiev said.
“This new work is the first nanoscale motor where we can control the rotational speed and direction,” he added. It’s done by adjusting the electric field across the solid state nanopore membrane and the salt concentrations of the fluid that surrounds the rotor.
“In the future, we might be able to synthetize a molecule using the new nanoscale electromotor, or we can use it to as an element of a bigger molecular factory, where things are moved around. Or we could imagine it as a vehicle for soft propulsion, where synthetic systems can go into a blood stream and probe molecules or cells one at a time,” Aksimentiev said.
If you think this sounds like something out of a 1960’s sci-fi movie, you are right. In the movie Fantastic Voyage, a team of Americans in a nuclear submarine is shrunk and injected into a scientist’s body to fix a blood clot and need to work quickly before the miniaturization wears off.
As far-fetched as this might sound, Aksimentiev says that the concept and the elements of the machines we are developing today could enable something like this to happen.
“We were able to accomplish this because of supercomputers,” Aksimentiev said. “Supercomputers are becoming more and more indispensable as the complexity of the systems that we build increases. They’re the computational microscopes, which at ultimate resolutions can see the motion of individual atoms and how that is coupled to a bigger system.”
Funding came from ERC Advanced Grant no. 883684 and the NanoFront and BaSyC programmes; ERC Consolidator Grant to H.D. (GA no. 724261), the Deutsche Forschungsgemeinschaft via the Gottfried-Wilhelm-Leibniz Programme (to H.D.) and the SFB863 Project ID 111166240 TPA9; National Science Foundation grant DMR-1827346; the Max Planck School Matter to Life and the MaxSynBio Consortium. Supercomputer time was provided through TACC Leadership Resource Allocation MCB20012 on Frontera and through ACCESS allocation MCA05S028.

One in three children who suffer from bacterial meningitis live with permanent neurological disabilities due to the infection. This is according to a new epidemiological study led by Karolinska Institutet and published in leading medical journal JAMA Network Open.
For the first time, researchers have identified the long-term health burden of bacterial meningitis. The bacterial infection can currently be cured with antibiotics, but it often leads to permanent neurological impairment. And since children are often affected, the consequences are significant.
“When children are affected, the whole family is affected. If a three-year-old child has impaired cognition, a motor disability, impaired or lost vision or hearing, it has a major impact. These are lifelong disabilities that become a major burden for both the individual and society, as those affected need health care support for the rest of their lives,” says Federico Iovino, associate professor in Medical Microbiology at the Department of Neuroscience, Karolinska Institutet, and one of the authors of the current study.
By analyzing data from the Swedish quality register on bacterial meningitis between 1987 and 2021, the researchers have been able to compare just over 3,500 people who contracted bacterial meningitis as children with just over 32,000 matched controls from the general population. The average follow-up time is over 23 years.
The results show that those diagnosed with bacterial meningitis consistently have a higher prevalence of neurological disabilities such as cognitive impairment, seizures, visual or hearing impairment, motor impairment, behavioral disorders, or structural damage to the head.
The risk was highest for structural head injuries — 26 times the risk, hearing impairment — almost eight times the risk, and motor impairment — almost five times the risk.
About one in three people affected by bacterial meningitis had at least one neurological impairment compared to one in ten among controls.

“This shows that even if the bacterial infection is cured, many people suffer from neurological impairment afterwards,” says Federico Iovino.
With the long-term effects of bacterial meningitis identified, Federico Iovino and his colleagues will now move forward with their research.
“We are trying to develop treatments that can protect neurons in the brain during the window of a few days it takes for antibiotics to take full effect. We now have very promising data from human neurons and are just entering a preclinical phase with animal models. Eventually, we hope to present this in the clinic within the next few years,” says Federico Iovino.
The research was funded by Merck & Co (in Sweden MSD).
Facts:
Bacterial meningitis is a rare but very serious infection that can affect people of all ages, but is most common in newborns, children and adolescents, and the elderly. It is often caused by pneumococcus (Streptococcus pneumoniae) which is also a major cause of bacterial respiratory infections such as pneumonia, otitis and sinusitis, which also mainly affect the youngest and oldest members of society.
Untreated, bacterial meningitis is fatal, but the infection can now be cured with antibiotics. However, antibiotics have difficulty penetrating the blood-brain barrier, which means that it takes time to fight the infection. During this time, nerve cells can be damaged and result in various permanent neurological damage. Furthermore, there is the constant threat of antibiotic-resistance to face in the clinics.
Source: Federico Iovino, Public Health Agency and Centers for Disease Control and Prevention.

Diabetes often remains undetected until it has already damaged organs or nerves. This is partly due to the fact that diagnosis at an early stage is time-consuming and difficult. An international team of researchers headed by Associate Professor Dr. Johannes Dietrich from the Department of Medicine I of Ruhr University Bochum at St. Josef Hospital in Bochum, Germany, has shown that a mathematical calculation based on just two values taken from a blood sample enables the reliable and inexpensive diagnosis of diabetes at an early stage. The researchers published their findings in the Journal of Diabetes on January, 2, 2024.
Diabetes often remains long undetected
“Thirty percent of all people who suffer from diabetes haven’t yet been diagnosed and, consequently, don’t receive any treatment,” points out Johannes Dietrich. This is partly due to the fact that it’s not easy to detect the disease at an early stage. “Diabetes sets in gradually, and our diagnostic options are not sensitive enough to detect it; moreover, they aren’t specific enough, meaning that false positive results can also occur,” stresses Dietrich.
Together with his colleagues from Germany, India, Singapore and the UK, he has researched a new method for the early detection of diabetes. The method, called SPINA Carb, is based on mathematical modeling. All that is required is a blood sample, which is taken in the morning before the patient’s had their breakfast. Two values measured in the sample are relevant: the insulin value and the glucose value. “We enter these values into an equation that describes the body’s control loop for sugar metabolism and break it down according to a certain variable,” explains Johannes Dietrich. The result is a so-called static disposition index (SPINA-DI).
More reliable than other markers
In computer simulations, the research team proved that the new parameter confirms the theory of dynamical compensation, which predicts that Insulin resistance in people with metabolic syndrome is compensated for by the pancreatic beta cells increasing their activity. A subsequent study of three groups of volunteers from the USA, Germany and India supported this assumption. “In all three groups, we found that the calculated SPINA-DI correlated with relevant indicators of metabolic function, such as the response to an oral glucose tolerance test,” outlines Johannes Dietrich. On top of that, SPINA-DI proved more reliable than other calculated markers of glucose metabolism and allowed a more accurate diagnosis.
“The new method is not only cost-effective, but also precise and reliable,” conclude the authors. “It could complement and, in many cases, even replace more complex established methods.”

Patients with Guillain-​Barré syndrome (GBS) face a rare and heterogeneous disorder of the peripheral nervous system that is often triggered by preceding infections and causes severe muscle weakness. In Europe and the USA, around 1 to 2 cases per 100,000 people occur every year.
GBS usually begins with weakness and tingling in the legs, which can then spread to the arms and upper body, making it difficult to walk or move. In severe cases, paralysis can affect the breathing muscles. Although GBS is considered an autoimmune disease, the underlying mechanisms remain largely unknown, making an accurate diagnosis and effective treatment a challenge.
A recent study led by Daniela Latorre, an SNSF PRIMA group leader at the Institute of Microbiology at ETH Zurich, and published in the journal Nature, now uncovers a pivotal aspect of GBS pathophysiology. The work investigated autoimmune factors that are potentially responsible for this illness in close collaboration with clinical scientists at the University Hospital Zurich and the Neurocenter of Southern Switzerland (EOC) in Lugano.
Autoreactive T cells target peripheral nerves
By employing sensitive experimental approaches, Latorre’ s group was able to reveal that in GBS patients, specific cells of the immune system known as T lymphocytes invade the nerve tissue and target the insulating covering of nerve fibres called myelin.
Normally, T lymphocytes play a vital role in our immune system by identifying and eliminating threats like infections and abnormal cells. However, in rare cases, they can mistakenly attack the body’s own tissues, leading to autoimmune diseases.
“We found that these autoreactive T lymphocytes were exclusive to patients with a type of GBS characterised by nerve demyelination and showed a specific disease-associated signature, distinguishing them from healthy individuals,” Latorre explains. These findings mark the first evidence of the contribution of autoreactive T lymphocytes to the disease in humans.
Furthermore, the researchers identified T lymphocytes reactive to both self-antigens of peripheral nerves (myelin) and viral antigens in a subset of post-viral GBS patients, supporting a direct link between disease development and triggers of a preceding infection.
Current treatments are effective for many GBS patients, but they lack specificity, and around 20% of patients remain severely disabled or die. Overall, the work of the research team offers novel insights into our understanding of GBS, opening avenues for further investigations on larger patient groups to decipher immune mechanisms in different GBS variants. This new knowledge could lead to targeted therapies for specific GBS subtypes, potentially improving patient care.