Take A Deep Breath: How To Cope With Panic Attacks

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Submitted by The Baylor College of Medicine….

BaylorCollegeWith symptoms that often mimic heart attacks, panic attacks can be extremely scary for people who experience them. To help, Baylor College of Medicine’s Dr. Asim Shah gives his recommendations on recognizing the signs of a panic attack and relaxation strategies you can use if you are having one.

“Panic attacks are a mental health disorder that fall under the category of a panic disorder. Panic attacks can occur when a person becomes uncontrollably anxious, nervous or fearful,” said Shah, professor and executive vice chair in the Menninger Department of Psychiatry and Behavioral Sciences at Baylor.

There can be numerous causes of panic disorders, Shah said. They can have a genetic cause or a person may be more sensitive and react negatively to stress or anxiety. Common reasons why people have panic attacks include the death of a loved one, a divorce or loss of a job, but any stressful situation can cause panic attacks.

The symptoms of a panic attack can include:

  • Feeling impending doom
  • Feeling detached from reality
  • Feeling like your heart is sinking
  • Feeling like you are losing control or even dying
  • An increased heart rate
  • Shaking, trembling or having chills
  • Sweating or cramps
  • Tightness in your chest or throat

“In some ways, having a panic attack can resemble having a heart attack. Some people end up going to the emergency room thinking they are having a heart attack but come to find out they are having a panic attack,” Shah said.

yogaposeIf you realize that you are having a panic attack, there are few strategies that Shah recommends for you to use to help relax. The first step is to try to divert your thoughts to positive thinking. You also can do breathing and mindfulness exercises. For example, you can close your eyes, picture yourself somewhere you feel safe, and deeply and slowly breathe in and out. These exercises also can help with any muscle tension you might be experiencing because of the panic attack.

Shah added that is important to differentiate between panic and anxiety. Panic happens immediately. It can be unpredictable and unprovoked but the feeling lasts no more than 30 minutes. With anxiety, people can be fearful and have a feeling of doom, but it is less intense and can last for months.

“Panic attacks are easily treatable so please seek help if you are experiencing them,” Shah said. “Untreated panic attacks can cause complications with your medical and mental health and impact your social life. For example, you may avoid going to work or school or social engagements, which can lead to depression and then possibly to having suicidal thoughts. Some people may even develop alcohol and substance addictions. Given this, it is very important to be treated before any of these complications can arise.

SRC-1 Gene Variants Linked To Human Obesity

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From The Baylor College of Medicine…..

BaylorCollegeMaintaining a healthy body weight is no simple matter. A better understanding of how the body regulates appetite could help tip the scale toward the healthy side. Contributing toward this goal, a team led by researchers at Baylor College of Medicine and the University of Cambridge reports in the journal Nature Communications that the gene SRC-1 affects body weight control by regulating the function of neurons in the hypothalamus – the appetite center of the brain.

Mice lacking the SRC-1 gene eat more and become obese. SRC-1 also seems to be involved in regulating human body weight. The researchers identified in severely obese children 15 rare SRC-1 genetic variants that disrupt its function. When mice were genetically engineered to express one of these variants, the animals ate more and gained weight.

“The protein called steroid receptor coactivator-1 (SRC-1) is known to participate in the regulation of body weight, but its precise role is not clear,” said co-corresponding author Dr. Yong Xu, associate professor of pediatrics and of molecular and cellular biology and a researcher at the USDA/ARS Children’s Nutrition Research Center at Baylor College of Medicine and Texas Children’s Hospital. “Here we explored the role of SRC-1 in the hypothalamus, a brain area that regulates appetite.”

The researchers discovered that SRC-1 is highly expressed in the hypothalamus of mice, specifically in neurons that express the Pomc gene. Pomc neurons are known to regulate appetite and body weight.

Further experiments showed that SRC-1 is involved in regulating the expression of Pomc gene in these cells. When Xu and his colleagues deleted the SRC-1 gene in Pomc neurons, the cells expressed less Pomc and the mice ate more and became obese.

The researchers also explored whether SRC-1 also would play a role in regulating human body weight.

“We had identified a group of severely obese children carrying rare genetic variants in the SRC-1 gene,” said co-corresponding author Dr. I. Sadaf Farooqi, professor of metabolism and medicine in the Department of Clinical Biochemistry at the University of Cambridge and Wellcome Trust Principal Research Fellow.

Working together, Xu, Sadaf Farooqi and their colleagues found that many of the SRC-1 variants in the obese children produced dysfunctional proteins that disrupted the normal function of SRC-1. On the other hand, SRC-1 variants in healthy individuals did not disrupt SRC-1 function.

saladheartsmallFurthermore, mice genetically engineered to express one of the human SRC-1 genetic variants found in obese children ate more and gained weight. This is the first report of SRC-1 playing a role in the hypothalamus in the context of body weight control.

“By providing evidence that bridges basic and genetic animal studies and human genetic data, we have made the case that SRC-1 is an important regulator of body weight,” Xu said.

Other contributors to this work include Yongjie Yang, Agatha A. van der Klaauw, Liangru Zhu, Tessa M. Cacciottolo, Yanlin He, Lukas K.J. Stadler, Chunmei Wang, Pingwen Xu, Kenji Saito, Antentor Hinton Jr, Xiaofeng Yan, Julia M. Keogh, Elana Henning, Matthew C. Banton, Audrey E. Hendricks, Elena G. Bochukova, Vanisha Mistry, Katherine L. Lawler, Lan Liao, Jianming Xu, Stephen O’Rahilly, Qingchun Tong, UK10K consortium, Inês Barroso and Bert W. O’Malley. The authors are affiliated with one or more of the following institutions: Baylor College of Medicine; University of Cambridge Metabolic Research Laboratories; Wellcome Trust-MRC Institute of Metabolic Science; Huazhong University of Sciences & Technology, China; Wellcome Sanger Institute, Cambridge; University of Colorado – Denver and University of Texas Health Science Center at Houston.

For a complete list of the sources of financial support for this project, visit this link.

 

Study Reports Emerging Triggers Of Rare Food Allergy In Infants

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News from the Baylor College of Medicine…..

BaylorCollegeA study led by the section of immunology, allergy and rheumatology in the Department of Pediatrics at Baylor College of Medicine researches an uncommon food allergy known as ‘food protein-induced enterocolitis syndrome’ (FPIES) that occurs mostly in infants. The findings of the study determine the responsible foods triggers, as well as the characteristics and management of FPIES. 

“One of the main problems with FPIES is that it can be challenging to diagnose,” said Dr. Aikaterini Anagnostou, associate professor of pediatric allergy at Baylor, director of the food immunotherapy program at Texas Children’s Hospital and the lead researcher in the study. She stressed that FPIES symptoms can mimic other illnesses, such as viral gastroenteritis or sepsis in infants.

“I often find that this condition is misdiagnosed and that many people are not aware of it,” Anagnostou said. “There is also a significant delay in the diagnosis, and I have heard many stories from patients coming into my clinic and raising all of these concerns. The aim of our study is to further investigate FPIES, and to raise awareness of this uncommon food allergic disorder.”

The main symptoms of FPIES include vomiting, lethargy, pallor and diarrhea, which are triggered by typical weaning foods such as cow’s milk, soy, rice and oats. Anagnostou explains that weaning foods are introduced to infants when they are being weaned off breast milk or formula and onto solid foods. In contrast to other food allergies, FPIES presents with a delayed reaction two to four hours after ingesting the food.

The study took place over a three-year period from 2015 to 2017 and included 74 infant cases of FPIES in the area. The findings reveal that rice is the most common trigger amongst children affected by FPIES in Houston (cow milk is the most common cause in other U.S. geographic locations). Rarer triggers such as banana and avocado also were identified as more common for this population. Anagnostou also reported that a significant percentage of children had multiple food triggers, an unusual observation for FPIES-related studies.

“It is difficult to ascertain why we see different triggers in this area,” Anagnostou said. “We suspect that this observation is related to different dietary and weaning habits, with certain foods preferred as weaning foods in our area compared to other areas in the United States.”

Additionally, Anagnostou reported a six-month delay in the diagnosis of FPIES in the Houston population. “This finding highlights once more how challenging FPIES can be to recognize and diagnose,” she said. “For instance, we found that 22 percent of infants in our study received a sepsis work-up because it is often difficult to differentiate between FPIES and sepsis in young infants, especially at initial presentation.”

Due to the profuse vomiting caused by FPIES, infants can experience dehydration or in more severe cases, go into shock during the acute phase of the disease. In more chronic cases, Anagnostou said failure to thrive and malnutrition may occur if parents do not seek medical help.

“Another new finding of our study was the significant percentage of infants at risk for malnutrition because the parents become worried about introducing other foods,” Anagnostou said. “As a result of this, infants may suffer from a very limited and restricted diet.”

Anagnostou said that consulting a dietitian is one of the crucial parts of managing the disease so that families can receive education on proper food introduction. Also key to managing the condition is fluid resuscitation for severe dehydration and oral rehydration for mild cases. Anagnostou notes that giving epinephrine will not work for this type of allergy.

After a diagnosis of FPIES is made, Anagnostou recommends avoiding the triggering food. Subsequently, the food may be tried in the hospital setting under medical supervision, every 12 to 18 months to assess whether FPIES is outgrown.

“Different people outgrow FPIES at different time points,” Anagnostou said. “The food can be tried in a controlled environment and if there is a reaction, it will be treated appropriately. If the food is tolerated and there is no reaction during the observation period, then it can be reintroduced into the diet.”

mombabyAnagnostou advises parents who notice repeat reactions (usually profuse vomiting) after introducing a new food into their child’s diet to seek medical help and potentially consider this diagnosis. “I am not suggesting that for every child that vomits after a food introduction the diagnosis will be FPIES,” she said. “Of course, there are several factors at play here and many other diseases to consider, but this is something to keep in mind if the reaction is consistent with certain food triggers.”

One of the reassuring facts about FPIES is that most children outgrow the disease once they are older and that it rarely carries into adulthood. Anagnostou said there have been a few recorded cases of adult FPIES, with the main triggers being nuts and shellfish.

“There is a lot of information that is still missing,” Anagnostou said. “We don’t know much yet about the disease’s mechanism or any specific risk factors that could predispose an infant to having FPIES. What is clear is that we need to raise awareness about FPIES so that we minimize the delay in the diagnosis, which can be a significant source of anxiety for families.”

The full study was published this month in the Annals of Allergy, Asthma and Immunology journal.