Dr. Michael Schlitt, Neurosurgeon, Neurosurgery, Seattle

Rise in Depression

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According to data gathered by San Diego State University Dr. Michael Schlitt depressionprofessor Jean Twenge from 6.9 million adolescents and adults, Americans are now more depressed than they’d previously been in decades.  Twenge discovered that Americans now report more psychosomatic symptoms of depression, such as trouble with sleeping or concentrating, than people did back in the 1980s.  Previously, studies found that more people have been treated for depression in recent years, although it wasn’t clear if this was due to a rise in depression or just increased awareness and less stigma.  However, Twenge claims that this study shows an increase in symptoms that most people don’t even know are connected with depression, suggesting that adolescents and adults are actually suffering a lot more.

In comparison to people from the 1980s, teens in the 2010 are 38 percent more likely to have trouble remembering, 74 percent more likely to have trouble sleeping and twice as likely to have seen a professional for issues with mental health.  College students in the survey were 50 percent more likely to say that they felt overwhelmed, and adults were more likely to say that their sleep was restless, they had little appetite and everything was an effort.  These are all typical psychosomatic symptoms of depression.  In spite of all these symptoms, people are no more likely to say that they’re depressed when asked the question directly.  Twenge says this suggests that this rise in depression isn’t based on people being more willing to admit depression.

This study also found that the suicide rates among teens have decreased, even though this decline was at best insignificant when compared to the increase in symptoms of depression.  Due to the use of anti-depressant medications doubling over this time period, Twenge believes that while medication has helped those with the most severe depression problems, it hasn’t reduced the increases in other symptoms that can still cause significant issues.

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Dr. Michael Schlitt, Neurosurgeon, Neurosurgery, Seattle

Studying Ebola

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An international research team has rapidly sequenced 99 Ebola virus genomes collected in the 2014 outbreak.  The team, which includes members from the Broad Institute, Harvard University and the Sierra Leone Ministry of Health and Sanitation, holds out hope that the findings will help multidisciplinary, international efforts to understand and contain the epidemic that is currently exploding in West Africa.  Before their research was published, five of the team members died of Ebola.  The 99 genomes that they studied came from a total of 78 patients diagnosed with Ebola in Sierra Leone during the first 24 days of the outbreak.  Since some patients gave more than one sample, the team was able to see how the virus changed over the course of a single infection.

Through deep sequencing techniques, the team increased the amount of data available on the Ebola by four-fold.  The results revealed that the 2014 Ebola virus genomes contain over 300 mutations that distinguish them from previous outbreaks.  They also found clues that suggest that the 2014 outbreak started from a single introduction into humans before spreading among them over many months.  Fruit bats are thought to be the natural host of Ebola, which first appeared among humans in the 1970s.  The 2014 outbreak is unprecedented in both its size and the fact that it emerged in highly populated parts of West Africa, as opposed to sparsely populated areas in Central Africa as before.  Previously, the largest outbreak was in 1976 and reported 318 cases.  The current outbreak, however, has reported over 2,000 cases and over 1,000 deaths.  According to the World Health Organization (WHO), the current outbreak has infected more than 240 health care workers in West Africa, more than half of whom have died.

Dr. Michael Schlitt ebola

The Ebola virus as seen under a microscope.

According to the study, the 2014 Ebola strains most likely have a common ancestor back in the 1976 outbreak, and suggests that the strains in the current West African outbreak separated from the Central African version in the past 10 years.  The mutations in the 2014 Ebola strains are mostly in genes that code for proteins, which is important for researchers looking to keep track of how the virus is changing.  With this is in mind, the researchers released the genome sequences to the international scientific community before finally publishing their study.  By making the data immediately available to the community, the researchers hope to accelerate response efforts.  The study presents a catalog of 395 mutations, over 340 of which distinguish the current outbreak from previous ones, and over 50 of which have exclusively occurred during the current outbreak.

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Dr. Michael Schlitt, Neurosurgeon, Neurosurgery, Seattle

Virtual Reality and Surgery

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August saw the first ever “virtual reality (VR) operation” being conducted as part of research into how the Oculus Rift headset could benefit surgical training.  I recently came across an article that discusses the merging of surgery and gaming technology.  This March, Facebook acquired the startup Oculus VR, the developers of the Oculus Rift virtual reality headset, for $2 billion.  The gaming world had mixed feelings about this purchase, as they were suspicious as to what a tech giant like Facebook was planning on doing with what many people consider to be the next major evolution in gaming.

Dr. Michael Schlitt Oculus Rift

The Rift, shown here, could be used to train surgeons.

Immediately after the takeover was announced, Markus Persson, known for creating Minecraft, cancelled a deal that would have brought Minecraft to the Rift.  With Mark Zuckerberg acquiring the Rift, it seemed like the focus of the device was no longer going to be gaming, as Zuckerberg planned on using for other purposes.  However, those who were angry that the Rift was being used for purposes other than gaming didn’t realize that such a device could be used for a variety of purposes, possibly even health care.  Groups have already started experimenting with the technology in the medical field.  Last month, scientists, videographers and surgeons collaborated on the first “Oculus Rift operation”.  The project was originally conceived by French engineer and VR enthusiast Rémi Rousseau.  Rousseau partnered with the medical research fundraising body MOVEO Foundation to demonstrate what role the Oculus Rift could play as a training aid for surgeons.

According to Rousseau, using VR for training purposes is nothing new, as the military has been using virtual reality-simulated environments in training for over 35 years.  The advantages that come from being able to train novice personnel in a low-to-no-risk simulated environment is undeniable.  The technology has yet to catch on due to money, but with such tech giants as Apple, Android, Windows and Linux backing it, VR could soon be available to consumers.  The Rift, however, wouldn’t be a medical device, but if it’s widely adopted, it could be a valuable tool for physicians.  In Rousseau’s experiment, two synchronized GoPro cameras were mounted onto the head of surgeon Dr. Thomas Gregory as he was performing a total hip replacement.  The idea here was to capture hi-res 3D footage of the operation from the perspective of the surgeon.  When this was viewed back through the headset of the Rift, the viewer has the feeling of being in the surgeon’s body, watching the procedure through their eyes.

When you’re a training surgeon, you always have a task to do during the surgery, and therefore it becomes difficult to see what the main surgeon is actually doing.  Being able to witness a surgery through the perspective of the surgeon is extremely useful, and the Rift would allow the user to replay the surgery in detail, pause, fast forward or rewind.  It can also be a great way to share and learn new technologies among surgeons.  Since the current iteration of the Rift costs $350, while radiology screens cost over $15,000, Rousseau suggests that if the resolution of the Rift is improved, then it could even be a viable radiological interpretation tool.

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Dr. Michael Schlitt, Neurosurgeon, Neurosurgery, Seattle

Glasses Obsolete?

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There’s a joke by the comedian Brian Regan about people who only wear glasses when they’re driving.  “Why don’t you just get a car window with lenses in it?”, he says.  While this sounds goofy, something like it may soon become reality.  Scientists at UC Berkeley are currently developing computer algorithms that compensate for an individual’s visual impairment, creating vision-correcting displays that allow users to see text and images clearly on a computer screen without the need of eyeglasses or contact lenses.  This technology could help hundred of millions of people who currently need glasses to use their smartphones, tablets and computers.  For example, one common problem is presbyopia, a type of farsightedness in which the ability to focus on nearby objects is gradually diminished as the aging eyes’ lenses lose elasticity.

Glasses

Glasses like these may soon become obsolete

More importantly, these displays being developed could eventually aid people with more complex visual problems, known as high order aberrations, which cannot be corrected by eyeglasses.  In a world where screens such as computers and smartphones are a daily fact of life, many of us could take for granted the ability to use such devices without any sort of visual aid.  A lot of people with high order aberrations have irregularities in the shape of the cornea, which makes it very difficult to have a contact lens that will fit them.  In some instances, this can be a barrier to holding certain jobs or functioning in society, since many workers need to look at a screen as part of their work.  Such research, if successful, could transform the lives of such people.

UC Berkeley researchers teamed up with Gordon Wetzstein and Ramesh Raskar, colleagues at MIT, to develop their latest prototype of this vision-correcting display.  The setup adds a printed pinhole screen sandwiched between two layers of clear plastic to an iPod display to enhance image sharpness.  The research team will present this computational light field display in August at the International Conference and Exhibition on Computer Graphics and Interactive Techniques (SIGGRAPH) in Vancouver.  According to the study’s lead author, Fu-Chung Huang, this project is so significant because, instead of relying on optics to correct vision, this is one of the first attempts at using computation.  It’s a very different, non-intrusive, class of correction.  The algorithm works by adjusting the intensity of each direction of light that emanates from a single pixel in an image based on a user’s specific visual impairment.  In a process known as deconvolution, the light then passes through the pinhole array in such a way that the user will perceive a sharp image.

In the experiment, researchers displayed images that appeared blurred to a camera, which was set to simulate a farsighted person.  When using the new prototype display, the blurred images appeared sharp through the camera lens.  This latest approach improves upon earlier versions of vision-correcting displays that resulted in low-contrast images.  This new display combines light field display optics with a new algorithm.  This research prototype could easily be developed into a thin screen protector, and continued improvements in eye-tracking technology would help make it easier for the displays to adapt to the position of the user’s head position.

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Dr. Michael Schlitt, Neurosurgeon, Neurosurgery, Seattle

Weight Loss Pill

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I recently came across an article about a new pill, Gelesis100, which is apparently supposed to be both a safe and effective weight loss aid.  However, this isn’t a new treatment; the pill, by manufacturer Gelesis, was previously known as Attiva, and was piquing the media’s interest back in 2010 after passing a clinical trial of 95 people.  Reportedly in development for 15 years, Attiva was a new way of thinking about weight loss treatment.  The capsule contains a “hydrogel”, which is comprised of two food ingredients that have a unique reaction when cross-linked with each other.

Gelesis

Gelesis, the company who created Gelesis100.

While the hydrogel is only around the size of a sugar grain, when it’s consumed with water, it expands into gel-form in the stomach, which stretches the stomach walls.  The stomach’s nerve fibers are then stimulated, which tells the brain that the stomach is full and unable to receive more food.  Attiva was found to be safe and well-tolerated, and with few side effects, mostly focused around nausea, constipation or diarrhea.  After this pill was created, Gelesis neded to demonstrate to the FDA that their pill can help people lose weight over a year-long period.  However, after that, there wasn’t a whole lot heard about Attiva.

At ICE/ENDO 2014, Gelesis revealed their new “proof of concept” trial on Attiva, which they rebranded as Gelesis100.  A group of 43 people were randomly assigned to receive 2.25g of Gelesis100 before lunch and dinner, a group of 42 received 3.75g and a control group of 43 received a placebo that contained cellulose.  All participants were then instructed to eat 600 fewer calories a day.  Participants were weighed at the start and end of the 12-week study.  The people in the 2.25g group had lost 6.1% of their body weight after treatment, the 3.75g group lost 4.5% and the placebo group lost 4.1%.  The researchers believe that the higher dose group lost less weight due to “lower tolerability” to the hydrogel.

In the 2.25g group, subjects with initial high-fasting blood sugar lost more weight than other participants in the group, with an average reduction in body weight of 8.2%.  However, the people who lost the most weight were prediabetic subjects, who lost on average 10.9% of their body weight.  Once again, the trial found only minor side effects from hydrogel, mostly bloating, flatulence, abdominal pain and diarrhea, which occurred significantly less in the smaller dose group.  If Gelesis100 is approved by the FDA, then Gelesis will be regulated as a medical device.

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Dr. Michael Schlitt, Neurosurgeon, Neurosurgery, Seattle

Marijuana and Schizophrenia

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Scientists have been studying the connection between schizophrenia and marijuana use for some time now.  According to a new study done by King’s College in London, increased marijuana use and schizophrenia may have some genes in common.  While still outlawed in most of the world, the legalization of medicinal and recreational marijuana has been a hotly debated topic, which makes research to investigate the health risks from its use that much more important.

Handful of Ganja

A handful of marijuana, which could be directly linked to schizophrenia.

The most common symptoms of schizophrenia include delusions and auditory hallucinations.  It’s still not yet clear what causes the disorder, but scientists believe that a combination of physical, genetic, psychological and environmental factors play a role in its development.  So far, researchers have identified a number of genes linked to schizophrenia, variants of which each slightly increase the risk of development.  For their study, lead author Robert Power and his colleagues analyzed a sample of just over 2,000 healthy individuals, roughly half of whom admitted to using marijuana.  From the number of gene variants linked to schizophrenia that each participant carried, the team assigned each participant a “genetic risk profile” and compared it to marijuana use.

The results of the study revealed that participants whose genetic risk profile predisposed them to schizophrenia were more likely to smoke marijuana, and use it more frequently, than those who didn’t carry schizophrenia risk genes.  Power notes that the findings do not necessarily rule out that marijuana use could directly increase the risk of schizophrenia, but rather suggest that there is most likely an association in the other direction, namely, that a predisposition to schizophrenia most likely increases use of marijuana.  The study, according to him, highlights the complexities of gene-environment interaction in the context of marijuana use and schizophrenia.  Back in December, Medical News Today reported that the use of marijuana is linked to schizophrenia-related brain changes in the thalamus.  This study found that the brain abnormalities persisted long after people stopped smoking.

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Dr. Michael Schlitt, Neurosurgeon, Neurosurgery, Seattle

Lacrosse in Seattle

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I recently came across an article about Drew Snider, one of the most talented lacrosse players to come out of Seattle.  A two-time prep All-American, a key player in two Maryland runs at a national championship and a current finalist for a spot on the US men’s national team, he’s got quite an impressive track record.

Drew Snider

Drew Snider, shown here playing lacrosse.

However, Snider has admitted that he almost didn’t make it through his first year of lacrosse at Maryland.  While he could play the game naturally, he didn’t understand any of the terms, and as a result his lacrosse IQ was very low.  This is one of the main reasons that Snider has taken a head-coaching position of the O’Dea lacrosse program in its first year of existence.  Snider wants to give young lacrosse players the opportunities that he never had growing up.  O’Dea’s program is one of 14 new teams that has joined the varsity level in Washington in the past two years; there are now a total of 93 squads in the state.  In the past fifteen years or so, lacrosse has exploded in popularity.  Previously restricted to the Northeast and Mid-Atlantic, it’s been gaining quite a following in the west.  While the Washington Interscholastic Activities Association hasn’t officially sanctioned lacrosse yet, O’Dea is one of the few schools to name its lacrosse team a varsity-level sport, instead of just a club.

Back when Snider was in high school, O’Dea had flirted with adding lacrosse to their sports, and really started considering it about three years ago.  O’Dea wanted to offer the sport before last season, but several things didn’t work out.  Now, however, they have opportunities for kids to play this rapidly growing sport.  The number of participants at O’Dea is rising, and Snider also created City Side LAX, a program aimed to teach kids the fundamentals of lacrosse.  The idea is to instill an understanding of the game, so that kids’ lacrosse IQs are higher.  Back when he was a kid, Snider used to walk around with his lacrosse stick and people had no idea what it was.  Now, however, you can drive around the Seattle area and see kids playing lacrosse at fields.

 

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