Aug 15th, 2014
Two APK faculty members are being recognized for performing with distinction. Read more here […]
Aug 15th, 2014
Dr. Ashley Smuder, a NIH post-doctoral fellow in the Department of Applied Physiology and Kinesiology, has been promoted to Research Assistant Professor. She will continue her work in Dr. Scott […]
Nov 3rd, 2014
We are excited to announce that Dr. Beth Barton, currently in the Department of Anatomy and Cell Biology at the University of Pennsylvania, has been hired by APK as part […]
August 15, 2016
A new, non-invasive way to track the progression of Parkinson’s disease could help evaluate experimental treatments to slow or stop the disease’s progression. University of Florida researchers used functional magnetic resonance imaging to reveal areas where Parkinson’s disease and related conditions cause progressive decline in brain activity. The study, funded by the National Institutes of Health, was published in the journal Neurology. While current treatments focus on controlling symptoms, biomarkers provide a quantifiable way to measure how medications address not just symptoms, but the neurological changes behind them. Previous studies have used imaging techniques that require the injection of a drug that crosses the blood-brain barrier. “Our technique does not rely upon the injection of a drug. Not only is it non-invasive, it’s much less expensive,” said David Vaillancourt, Ph.D., a professor in UF’s Department of Applied Physiology and Kinesiology and the study’s senior author. The study’s authors – which included researchers from UF’s College of Health and Human Performance and College of Medicine as well as the Medical University of South Carolina – used functional magnetic resonance imaging to evaluate five areas of the brain that are key to movement and balance. A year after the baseline study, the 46 Parkinson’s patients in the study showed declining function in two areas: the primary motor cortex and putamen. Parkinson’s-related disorders evaluated in the study also showed declines: The 13 subjects with multiple system atrophy had reduced activity in three of the five areas, while the 19 with progressive supranuclear palsy showed declines in all five areas. The brain activity of the 34 healthy control subjects did not change. “For decades, the field has been searching for an effective biomarker for Parkinson’s disease,” said Debra Babcock, M.D., Ph.D., program director at the NIH’s National Institute of Neurological Disorders and Stroke. “This study is an example of how brain imaging biomarkers can be used to monitor the progression of Parkinson’s disease and other neurological disorders.” The finding builds on a 2015 UF study that was the first to document progressive deterioration from Parkinson’s via MRI, showing an increase in unconstrained fluid in an area of the brain called the substania nigra. An NIH-funded study beginning in November will use both biomarkers to test if a drug approved for symptom relief can slow or stop progressive degeneration. Katrina Gwinn, M.D., also a program director at the NIH’s National Institute of Neurological Disorders and Stroke, described the effort to identify biomarkers as “an essential part of moving towards the development of treatments that impact the causes, and not just the symptoms, of Parkinson’s disease.”
August 11, 2016
With more than 20 cases of non-travel related Zika reported in South Florida, tourists express more concern with travel to the state but still plan to come, a new study shows. Findings from a recent study, conducted by the University of Florida’s Tourism Crisis Management Initiative, or TCMI, shows more than 70 percent of potential visitors are concerned with the mosquito-borne Zika virus in Florida. Of those who expressed concern, less than 10 percent have changed their travel plans. Of the 10 percent who changed their plans, the majority postponed their travel plans (60 percent), while 25 percent went somewhere else. Interestingly, of those who changed their plans, about 15 percent asked a medical professional for their opinion before making a decision. The study also shows that 45 percent had medium to high levels of knowledge of the Zika virus as a result of coverage on social media (36 percent) and television news coverage (27 percent). Researchers surveyed 828 potential domestic visitors who planned to travel to Florida within the next six months. The survey was conducted three days after 15 non-travel-related cases were discovered in Miami-Dade County. The study found that most respondents were aware that the outbreak was confined to a portion of the Miami-Dade area of Florida. Interestingly, 82 percent say they were aware that the recommended use of insect repellants are a good protective behavior, as well as staying indoors with air conditioning or using screened windows and doors to avoid contact with mosquitoes. "Making insect repellent available for guests in public areas of hotels and other public accommodations as well as directing them to information such as the Centers for Disease Control and Prevention website would help to build protective behaviors," said Ignatius Cahyanto of Black Hills State University, lead study researcher and affiliate researcher TCMI. When turning to sources for information, once again the CDC was seen as the primary source for information (85 percent), followed by the destination itself (58 percent). "Ensuring that timely, accurate and up-to-date information is available for visitors on the tourist bureau's website as well as partner websites is critical. Directing visitors to the destination's site and the CDC will keep visitors informed when they book their trips," said Lori Pennington-Gray, director of the TCMI.
August 11, 2016
In the past two decades, the devastation associated with opioid addiction has escaped the relative confines of the inner city and extended to suburban and rural America. Due in large part to the proliferation of prescription pain relievers, rates of opioid abuse, addiction, overdose and related deaths have increased dramatically. This has affected families and communities that once felt immune to this crisis. On Aug. 1, an analysis of health care claims for treatment of opioid dependence showed a 3,000 percent increase from 2007 to 2014. The knowledge that many are afflicted or affected has helped people understand the powerful psychological and physiological grip of addiction. As a result, stigma has decreased. What was once relegated to the back burner of public concern has become a top public health priority. We addiction experts also have gained better understanding of the illness, and we see reasons for hope. Shifts in public policy The Affordable Care Act and the Mental Health Parity and Addiction Equity Act combined to finally require insurance companies to cover treatment for patients suffering from addiction. Insurance companies can no longer deny treatment or significantly limit treatment for psychiatric disorders, including addiction, as they had in the past. President Obama recently proposed US$1.1 billion in funding to expand access to treatment for opioid addiction and overdose prevention. In July, the House passed a bill that would further expand access to care for addiction and other mental health conditions. Then, on July 22, the president signed into law the Comprehensive Addiction and Recovery Act of 2016. If adequately funded by Congress, the law will help to strengthen prevention, treatment and recovery efforts. This improves treatment options for individuals in the criminal justice system, which may decrease rates of return to crime and prison. It also expands access to naloxone, a lifesaving drug that emergency medical workers and even family and friends, in certain cases, can administer to someone who has overdosed. This stepped-up policy response is giving doctors the means to better treat people with opioid addiction. When combined with improvements in public understanding that addiction is a disease requiring treatment, we as a society are creating an environment that supports treatment. We believe this will save many thousands of lives. A societal effort Physicians are re-examining their own prescribing practices to decrease the likelihood of medication diversion or misuse and to minimize the development of iatrogenic addiction, or addiction that stems from medical treatment. Law enforcement officials have worked to close down hundreds of “pill mills,” or clinics purporting to serve patients with chronic pain disorders. In reality, they serve as primary access points for dealers selling prescription drugs on the black market. In all states except Missouri, prescription drug monitoring programs have also helped to identify patients in need of intervention. More patients have access to treatment than ever before, including many in the criminal justice system who participate in drug court diversionary programs. Such programs save taxpayer money and decrease recidivism. Greater understanding and knowledge The field of addiction medicine has matured and expanded, recently acquiring recognition as a dedicated medical specialty. According to the American Society of Addiction Medicine, the disease of addiction is best understood as a single condition. There is no distinction made depending on the preferred drug(s) of abuse. Addiction specialists conceptualize addiction as a bio-psycho-social-spiritual disease. They understand that continued use of psychoactive substances interferes with active participation in psychosocial treatment. Such usage prevents development of a personal program of recovery. Therefore, successful treatment of opioid addiction begins with abstinence from all substances of abuse. Patients should not expect to quit using oxycodone, fentanyl or heroin but continue to drink alcohol or to smoke marijuana. The same holds true for treatment of addiction to alcohol, marijuana, cocaine or any other drug. Some patients require medically supervised detoxification to abstain. Accessing the right treatment is crucial to success. Some will need a more intensive treatment setting. Even individuals who were unsuccessful maintaining abstinence with outpatient treatment may achieve recovery in a more intensive treatment setting. Addiction, like other medical conditions with significant behavioral components, is a chronic condition. Relapse may occur. Thus, most patients need to learn skills that help them cope adaptively with stressors in their daily lives. Often, they need to address issues from their past that relate to substance abuse. People with addiction may have other psychiatric conditions. They need to be treated for those, too. In many areas, publicly funded treatment programs are available for individuals lacking insurance or who cannot afford private treatment. Support from family and 12-step programs helpful Family members should encourage patients suffering from addiction to seek a professional evaluation. This will help determine the appropriate level of care, which could range from outpatient management to long-term residential treatment. In addition, physicians and other treatment specialists highly encourage participation in a 12-step recovery program, such as Alcoholics Anonymous or Narcotics Anonymous. Such programs are free, and they offer many benefits. Research has documented significantly reduced risk of relapse with increased likelihood of successful outcome among patients treated for opioid addiction in this way. Family members often benefit from 12-step programs, too. Al-Anon or Alateen can help them learn how best to support their loved one without enabling the addiction. Medications also helpful Patients with opioid use disorders may also benefit from medication assistance. Currently, four types of prescription medication are approved to assist with treatment of opioid addiction. The opioid antagonist medication, naltrexone, is available as a daily oral pill or as a monthly intramuscular injection. It helps patients by decreasing cravings. It also blocks patients' ability to “get high,” even if they use an opioid drug. Naltrexone has no abuse potential, and can be safely used by most patients. Second, the opioid partial agonist medication buprenorphine is available as an oral pill, dissolving tablet or filmstrip. It also reduces cravings and reduces and prevents withdrawal symptoms. It, too, blocks the ability to “get high.” Buprenorphine has some abuse potential, however. It should be used only under guidance and careful monitoring by a physician with sufficient expertise. In fact, doctors must receive a waiver to be allowed to prescribe buprenorphine. Third, the opioid agonist medication methadone prevents withdrawal symptoms, reduces cravings and interferes with the ability to “get high” from other opioids. Methadone also has abuse potential and risk of overdose if used inappropriately, however. As a result, methadone is typically dispensed in liquid form on a daily basis, and only from specialized methadone maintenance treatment clinics. Finally, for individuals at high risk of relapse, new measures are in place to help prevent death in the event of accidental overdose. The opioid antagonist medication naloxone is now available in an automatic injector formulation for use by police, EMTs and other first responders. Naloxone has long been used by medical professionals in emergency rooms to reverse opioid overdose. Naloxone is also available by prescription for patients with opioid addiction and their families to keep on hand as a safety precaution. In some states it is also available over the counter at certain pharmacies. It can be viewed much like an Epi-pen, which patients with severe allergies keep on hand for emergencies. A naloxone nasal spray is newly available, which may further facilitate access to this lifesaving medication. These changes to public policy and advances in opioid treatment have greatly improved the prognosis for patients suffering from opioid addiction. Research and clinical evidence have demonstrated that long-term recovery is not only possible, but expected, following adequate treatment with appropriate follow-up care. Now, more than ever, there is hope for healing from addiction. This article originally appeared in The Conversation on Aug. 9, 2016.