Heather Kahn discusses Kaptchuk’s research and what it might mean for the future of medicine in this “Voices of BIDMC Research” video series.

Ted Kaptchuk on the Placebo Effect The Saturday Evening Post

These common afflictions often have similar symptoms, but require different treatments—antibiotics work for bacterial infections and not viral ones.

Because current diagnostic methods to sort out the two kinds of infection are time-consuming and may not be accurate, investigators Robert Marks, Daria Prilutsky, and their colleagues sought to develop a new test that would enable doctors to rapidly make the right diagnosis.

They found that the immune systems of patients with bacterial infections behaved differently than the immune systems of patients with viral infections, and developed a test based on those differences.

“The method is time-saving, easy-to-perform, and can be commercially available,” say the researchers.

When?

“Just as soon as a manufacturer steps in to provide the funding,” replies Dr. Marks in an email.

The report appears in ACS’ journal Analytical Chemistry.

A New Way to Distinguish Between Bacterial and Viral Infections The Saturday Evening Post

Want some good news?

Foods packaged in a new “killer paper” material developed by an Israeli grad student could keep foods safer—while also extending shelf life.

Scientists are reporting development and successful lab tests of a material intended for use as a new food packaging material that helps preserve foods by fighting the bacteria that cause spoilage.

The paper, described in American Chemical Society journal Langmuir, contains a coating of silver nanoparticles—each 1/50,000 the width of a human hair—that act as powerful antibacterial agents.

Professor Aharon Gedanken and colleagues note that the coated paper showed potent antibacterial activity against E. coli and S. aureus—two causes of bacterial food poisoning—killing all of the bacteria in just three hours.

The new coating used on “killer paper” might someday be added to plastic bags and cartons. Silver is already widely used as a germ-fighter in medicinal ointments, kitchen and bathroom surfaces, and even odor-resistant socks.

Source: The American Chemical Society

Food Safety The Saturday Evening Post

Nutrition experts at Oregon State University Linus Pauling Institute at Oregon State University have essentially “cured” laboratory mice of mild, diet-induced diabetes by boosting production of an enzyme called elongase-5. Liver function and blood sugar levels returned to normal after genetic manipulation, according to study findings published in the Journal of Lipid Research.

In the future, scientists hope to find a drug that will raise elongase-5 levels to help treat people with the form of diabetes related to lifestyle.

Research teams led by Johns Hopkins University in Baltimore and Columbia University in New York City report in the July 23 issue of Cell that bones may control how the rest of the body responds to insulin.

Data from the two studies conducted in mice indicate that bone cells called osteoblasts control release of a hormone that accelerates glucose metabolism elsewhere in the body. The discovery might pave the way to new diabetes drugs that target the key pathway, say researchers.

Research Front: Diabetes Drugs The Saturday Evening Post

Migraines matter, disrupting everyday routines at home and work when sufferers have to disengage from families, friends, or job responsibilities.

“Migraine is an extraordinarily common brain disorder,” says Robert Kaniecki, MD, director of the Headache Center, chief of the Headache Division, and assistant professor of neurology at the University of Pittsburgh. “Approximately 13 percent of American adults are affected by bouts of the disabling headache, robbing them of valuable time from work, family, home, or social activities.”

Fortunately, new and better ways to relieve and even prevent the life-disrupting attacks are on the horizon.

The first major advance in treating migraine hit the U.S. market in 1991 with FDA approval of sumatriptan (Imitrex, GlaxoSmithKline)—a revolutionary prescription drug option that not only eased migraine symptoms, but stopped the attacks.

“Over the ensuing decade, the drug class known as triptans expanded to 7 products, providing relief to millions of migraine sufferers,” explains Dr. Kaniecki. “During that same time period, two anti-epilepsy drugs, Topamax and  Depakote, were also added to the short list of daily drugs with proven benefit in reducing the frequency of migraine attacks.”

Subsequent research, however, had been disappointing—until now.

“It has been nearly 20 years since significant breakthroughs have been made in treating migraine headaches,” Dr. Kaniecki continues. “But we now seem poised for a second wave of new migraine treatments. Many are novel developments while others involve technologically innovative delivery systems for older drugs. For migraineurs who fail to respond to current drug therapies, these new options are reasons for optimism.”

Dr. Sheena Aurora, director of the Swedish Headache Center and assistant professor of neurology at the University of Washington School of Medicine concurs.

“I am excited about new migraine treatments,” Dr. Aurora told the Post. “As a practicing headache specialist, I still find patients who believe that migraine comes from stress. We make them aware that migraine is a biological disorder—they are born with a hypersensitive brain—and stress is one of many triggers. Studies confirm a genetic role in migraine and genomics and proteonomics may yield highly targeted therapies. In addition, we believe that newer trials using topiramate and botulinum toxin A in chronic migraine will pave the path for future research.”

Here are 5 promising new therapies to stop migraines in their tracks that are worth keeping an eye on:

A dissolvable powder form of diclofenac (Cambia). The nonsteroidal anti-inflammatory drug, currently available in tablets, helps reduce migraine-related inflammation and pain.

The Sumavel DosePro (Zogenix). Released in 2010, the innovative device delivers needle-free injections of sumatriptan (Imitrex) by “pushing” the drug into tissue just under the skin. Subcutaneous sumatriptan is easy to use and provides consistent and fast relief, according to Dr. Aurora. Nasal and patch delivery systems for the migraine drug are still in development. Doctors already prescribe sumatriptan tablets, shots, and intranasal solution that relieve migraines by blocking painful nerve signals and restoring swollen blood vessels back to normal size.

LEVADEX, orally inhaled dihydroergotamine (MAP Pharmaceuticals). Migraine sufferers are often unable to digest oral medicines. Now in late stages of clinical testing, LEVADEX is dispensed via an oral inhaler for fast, consistent, and sustained relief of migraine pain and other symptoms. Dihydroergotamine is presently available in nasal and injectable forms.

Calcitonin gene-related peptide (CGRP) antagonist drugs. A novel class of prescription medicines may treat migraines with fewer side effects than conventional therapies by blocking the release of CGRP, a type of protein involved in nerve and blood vessel irritation during a migraine attack. The CGRP antagonist telcagepant (Merck) is in late stages of development.

Transcranial pulse generators. These electronic devices are applied to the skull early in a migraine, sometimes shortening the attack. Surgically implanted devices may generate internal electrical signals to help treat chronic pain, Parkinson’s disease, and migraine headaches.

For a video podcast from the National Headache Foundation that explores some of these options, click here  Video – Dr. Robert Kaniecki, M.D.

Migraines in the News The Saturday Evening Post

After years of research, insulin pills that could make it easier for millions of patients worldwide to manage diabetes are finally moving ahead in clinical trials and a step closer to the medicine cabinet. Investigators are utilizing special coatings for insulin pills that prevent stomach acid from destroying them and additives that make it easier for the intestine to absorb large molecules like insulin. After years of setbacks, several insulin pills are now in various stages of clinical trials, and proof of concept may allow them to move into late-stage and more rigorous clinical testing. Only time will tell, however, whether these much-anticipated pills will make it to the market.

Source: American Chemical Society

Diabetes News The Saturday Evening Post

We’re happy to say that the tradition continues. In the September 2010 issue, Post writer Elizabeth Svoboda profiles eight remarkable discoveries that offer hope for practical solutions to debilitating medical problems such as diabetes, heart disease, arthritis, and more.

Here’s a sneak peak at the upcoming issue, as well as a sampling of diabetes discoveries from the Post archives.

A Look Ahead

Artificial Pancreas (w/image and video of automated insulin delivery system)

When Tyler Wolf was diagnosed with type 1 diabetes as a teenager, his diabetes management routine abruptly became a looming part of his life. Like many of the nearly 24 million diabetes sufferers in the United States, Wolf had to test his blood sugar and give himself insulin injections every day. The grueling routine grated on him. He sometimes rebelled, refusing to check his blood sugar and ending up woozy and delusional as a result.

Dr. Stuart Weinzimer, an endocrinologist at Yale University, is working to ensure that someday patients like Wolf won’t have to wrangle with needles and home test strips anymore. In conjunction with Minneapolis-based Medtronic, Dr. Weinzimer is developing an “artificial pancreas” for diabetics. This automated insulin delivery system, about the size of a small paperback book, includes a continuous glucose monitor (CGM) that channels real-time blood sugar readings to an insulin pump, which then directs the pump to dispense the proper amount of insulin to keep blood sugar levels in equilibrium.

Wolf was among the first patients to evaluate the device, and he was immediately impressed at how it took over the work of managing his disease for him. “The idea of never having to worry about monitoring—that’s close to a cure,” Wolf says. Dr. Weinzimer hopes that it will be commercially available within the next decade.

Here’s a video of the experimental automated insulin deliver system from Medtronic.

A Look Back

Some 70 years before Dr. Weinzimer’s work on an artificial pancreas, research by Dr. F. G. Banting and Dr. Charles Best and colleagues at the University of Toronto led to the remarkable discovery of insulin for treating diabetes, as described in the June 9, 1923, Post article “Clearing the Skies for the Sugar-Poisoned” by Woods Hutchinson, A.M., M.D., who writes:

“Although the processes concerned were extremely complicated and progress correspondingly slow, we are now happily able to announce the first positive step toward the answer of the fateful riddle [why sugar builds up in the bloodstream], one that bids fair to give new hope to all diabetics.

“This is no less than the discovery of the hormone—Greek for stimulator—or spark juice, which enables our bodies to burn sugar and whose absence makes us diabetic.”

By May 15, 1948, the Post reported in “What Your Should Know About Diabetes” by Steven M. Spencer, that Dr. Priscilla White’s “baby-saving program” had dramatically decreased infant deaths by treating diabetic mothers with insulin shots during pregnancy. The US Public Health Service was conducting blood testing of entire communities, and leading expert Dr. Elliott Joslin (founder of today’s renowned Joslin Center in Boston) was described as a zealous archfoe of diabetes who was unmatched “in spreading hope among the known diabetics and urging intensive search for the unknown ones”.

Oral pills for older people with mild diabetes made their American debut in the August 24, 1957, issue of the Post. The article, “Good News for Diabetics” written by Milton Silverman, chronicled the accidental discovery and eventual controversial FDA approval of tolbutamide (Orinase). Early research by French physician Dr. Auguste Loubatieres in sulfa drugs ultimately gave rise to the new pill but was overlooked for more than a decade, wrote Silverman.

“Clearing the Skies for the Sugar-Poisoned” by Woods Hutchinson, published June 9, 1923. “What Your Should Know About Diabetes” by Steven M. Spencer, published May 15, 1948. “Good News for Diabetics” by Milton Silverman, published August 24, 1957.

Medical Breakthroughs: Past and Present The Saturday Evening Post

Unlike other cancers, malignant melanoma develops on the body’s surface. And spotting its distinctive visual clues remains critical to saving lives, according to new research reported online on CA First Look http://caonline.amcancersoc.org/papbyrecent.dtl from the New York University School of Medicine Melanoma Cooperative Group, which recommended in 1985 that attention to asymmetry (A), border irregularity (B), color variegation (C), and diameter more than 6 mm (D) of colored skin lesions could promote earlier recognition of the dangerous disease.

Approaches to detecting melanoma have evolved dramatically in the past 25 years. In the 1990s, dermoscopy revealed new subsurface features to help differentiate between melanoma and ordinary moles. Today, advanced computer-based technologies are helping doctors better identify the lesions that require further inspection.

Examining tumor cells under a microscope remains the gold standard for diagnosing melanoma. But a “good eye” remains key.

“From the development of the ABCDs through current attempts that use complex computer algorithms and genetic markers, a clinician’s ability to detect melanoma in its earliest form has been augmented,” write the authors. “However, a ‘good clinical eye’ is still fundamental to selecting the lesions for evaluation among the sea of those that are prevalent.”

Melanoma grows slowly and may occur anywhere on the skin. Regular and thorough skin checks can discover early signs of trouble. Always report suspicious signs to a dermatologist right away.

Click here http://www.saturdayeveningpost.com/2009/05/30/wellness/medical-update/skin-cancer-melanoma-skin-exams.html for more on how to screen yourself (and your friends and family) for skin cancer and to download the Body Mole Map from the American Academy of Dermatology.

Click here http://www.cancer.gov/aboutnci/servingpeople/snapshots/melanoma.pdf for melanoma research from the National Cancer Institute.

Melanoma Update The Saturday Evening Post

For the nearly 50,000 Americans seeking relief each 
year for debilitating bone-on-bone ankle pain and disability, there’s good news. Recent advances in arguably the 
most intriguing area of orthopedic surgery—total ankle replacement—are making strides in restoring mobility and quality of life to patients.

Today, four total ankle replacements are used in the U.S.: the Agility, the Inbone, the Salto Talaris Anatomic Ankle, and the Scandinavian Total Ankle Replacement (STAR).

“The technology is light years ahead of where it was a decade ago,” says Dr. Robert Anderson, an orthopedic surgeon in Charlotte, North Carolina, who performed more than 40 Inbone procedures in the past two years and is part of a design team working on a second-generation device.

Hi-tech artificial ankles provide a new alternative to surgery, which permanently fuses worn-out joints. That procedure reduces ankle pain but often limits mobility, causes a limp, and can lead to arthritis in nearby foot joints. An estimated 25,000 Americans underwent ankle fusions in 2009; others considered even more drastic measures.

Reasons for needing an ankle replacement include wear-and-tear over time, accidents, sports injuries, and bone diseases that lead to severe and life-limiting arthritis.

Four years ago, Jeanne St. John’s ankle problems led her to the brink of a difficult decision.

“I was born with deformed ankles and, eventually, was 
so immobilized by arthritis that I considered a double amputation,” recalls St. John, who lives in Oregon. “Then a friend heard about the Inbone. It’s been life-changing for me.”

As with hip and knee replacements, the history of total ankles dates back to the 1970s. Healthy ankles can withstand 1.5 times one’s body weight while walking, but early devices didn’t hold up. Then, Dr. Mark Reiley—who performed St. John’s surgeries in the San Francisco Bay Area—devised a new way to replace the complex joint.

“Dr. Reiley took the proven technology of knee replacements and basically flipped it upside down to be used in the ankle,” Dr. Anderson describes. “The device, now called the Inbone, has very good mechanical advantages and can be used for primary replacements, as well as revisions of failed or previously placed devices. We believe it will be successful 
for a long time.”

Orthopedic surgeons select the specific ankle replacements depending on patient age, anatomy, bone quality, and goals. Long-term success rates on Inbone are not yet available; European data show that 85 percent of modified Salto and STAR devices are functioning well after 10 years.

But Jeanne St. John, now age 67, prefers to focus on how far her new ankles take her.

“I think in terms of steps rather than years,” she says. “I save my steps for selected activities and for travel. Some of my friends are slowing down, but I have this ‘reverse aging’ thing going on, and I’m so thankful.”

Good News for Bad Ankles The Saturday Evening Post

Mark McEwen, former TV weatherman for The Early Show on CBS, found out during a flight to Orlando in 2005. He had been dozing, then woke up, feeling odd. “It was like being underwater and trying to swim to the surface,” says McEwen, now 55. “You’re just trying to survive, to make sense of something that is senseless.” He had no clue it was a stroke. Nor apparently did the attendant who helped him off the plane—or the skycap who left McEwen sitting curbside in a wheelchair. McEwen could barely talk, but he did manage to ring his wife’s cell phone and convey a basic message. “Help me. Not good.”

If someone near you, like McEwen, were having a stroke, would you recognize it? Would you know what to do? Stroke is the third leading cause of death in this country—and every 40 seconds on average, someone in the United States suffers one. About 30 percent of strokes 
are mild, resulting in no disability. But the 20 percent that are severe, yet survivable, can be crippling.

“A major stroke can change everything—the ability to speak, to move, to work,” says Dr. Walter Kernan, professor of medicine at Yale University School of Medicine. “It may seem to rob a person of his life without actually taking it.” Fortunately, new therapies are in the works that may help improve outcomes.

Striking Out Against Stroke

The most significant advance is the clot-busting drug, known as tissue plasminogen activator, or tPA, which can help the 85 percent of patients whose strokes are caused by clots in the brain. “Sadly,” says Dr. Ralph Sacco, a neurologist and president-elect of the American Heart Association (of which the American Stroke Association is a division), “only about 5 percent of patients actually get it because they don’t reach the hospital in time or they don’t go to a [hospital certified as a] primary stroke center, which can give it rapidly.” Administered intravenously, it takes time to dissolve a clot, particularly a large one and as neurologists say, “time is brain.” Last year, the AHA revised its guidelines, saying that tPA could be given up to four hours and 30 minutes after the onset of stroke—a significant increase over the previous three-hour window. But sooner remains better.

“The best outcomes are still in patients with small clots who receive tPA in less than 90 minutes,” says Dr. Rishi Gupta of Vanderbilt University Medical Center.

Other technologies are already available at comprehensive stroke centers (a notch above primary stroke centers, which are mainly geared to giving tPA). At the Cleveland Clinic, doctors are using stents to prop open blocked blood vessels during a stroke, as well as two FDA-approved devices to help remove clots. One, the Merci Retriever, works like a miniature corkscrew to pull the clot out. The other, the Penumbra, breaks up a clot with microjets of water, then suctions out the pieces. Both devices require highly skilled specialists, and not every patient is a candidate. “You have to image the brain first to see if functional tissue remains that could benefit from restored blood flow,” says Dr. Irene Katzan, medical director of the stroke program at the Cleveland Clinic.

Refining Recovery

Acute treatment is only the first step in stroke recovery. Fortunately, therapists are getting better results with post-stroke rehabilitation than ever. “We used to say to patients, ‘you have three to six months to improve, and after that you can’t expect a whole lot,’ ” says Dr. Richard Zorowitz, chair of physical medicine and rehabilitation at Johns Hopkins Bayview Medical Center. Now, knowledge about the brain’s ability to rewire itself—a concept called neuroplasticity—has encouraged therapists (and patients) to try longer and harder.

“Thanks to the neuroplasticity of the brain—the ability of the brain cells to rearrange their connections, our brain has more capacity than we ever imagined to rewire itself for greater levels of recovery,” says researcher and stroke survivor Dr. Jill Bolte Taylor (read “Life After Stroke”).

Dr. Steven C. Cramer at the University of California, Irvine, is working with robotic therapy to help restore function as well as investigating two hormones that may encourage stem cells to develop into new neurons, key cells that transmit nerve signals to and from the brain. So far, early results look promising. Meanwhile, Dr. David Simpson at Mount Sinai School of Medicine in New York is using botulinum toxin (Botox) to help reduce the spasms that lead to twisted limbs and abnormal gaits, a frequent result of stroke.

For the most part, rehab consists of hard work—and lots of it. Three hours a day is the rule of thumb. But technologies like Nintendo’s Wii video game console keeps exercises interesting—engaging stroke patients in games such as bowling or tennis to improve balance and shifting of weight.

As for McEwen, he’s back on his feet after 14 months of rehab. Today the former weatherman, who described his experiences in his 2008 book Change in the Weather, is a motivational speaker and spokesperson for the American Stroke Association. The organization’s latest campaign (PowerToEndStroke.org) is directed at people with risk factors for stroke—high blood pressure, diabetes, excess weight, and a history of heart disease. “There are lots of things you can do to lower your risk for stroke,” says McEwen. “Knowledge
 is power.” And it could just save your life.

The Post Investigates: Stroke Advances The Saturday Evening Post

Without hard data from large clinical trials, it’s hard to make conclusions on the benefits of herbs for allergies. But European studies suggest these widely-available remedies may be worth considering:

Butterbur (Petasites hybridus) blocks the formation of compounds called leukotrienes that promote inflammation. Swiss researchers found that the flowering herb is less sedating but as effective as the OTC antihistamine cetirizine (brand name: Zyrtec). To reduce the risk of liver damage, it’s recommended that butterbur be taken for only six weeks a year.

Rosmarinic acid, a chemical derived from rosemary leaves, reduced seasonal allergy symptoms in a preliminary Japanese study.  The compound seems to have anti-inflammatory properties and also suppress immune cell activity.

Stinging nettle (Urtica dioica) is a popular allergy remedy in Europe.  In one study, 58 percent of 69 volunteers reported that a daily 600 mg dose of freeze-dried nettle leaf relieved allergy symptoms—and 48 percent said its anti-inflammatory effect was more effective than standard OTC allergy medicines.

For research-based information on conditions and treatments, including diet supplements and herbs, visit The National Center for Complementary and Alternative Medicine http://nccam.nih.gov/.

Herbs for Seasonal Allergies The Saturday Evening Post

AF occurs when the heart’s two upper chambers (the atria) quiver instead of beating effectively. In paroxysmal AF, the abnormal heart rhythm starts and stops on its own.

When drugs to control erratic heartbeats don’t work, doctors may use electric shock or thread catheters through blood vessels to zap cardiac cells with heat, a therapy called radiofrequency ablation.

The innovative therapy reported at the American College of Cardiology (ACC) 2010 Scientific Sessions utilizes freezing technology, or cryoablation, instead.

“Cryoablation could offer a straightforward and significantly simplified treatment for patients with very symptomatic and obnoxious atrial fibrillation,” says Dr. Douglas Packer, professor of Medicine at the Mayo Clinic in Rochester, Minnesota, and principal investigator of the Stop AF (Sustained Treatment of Paroxysmal Atrial Fibrillation) study.

In the pivotal trial, the Arctic Front Cardiac CryoAblation Catheter System from Medtronic kept nearly 70 percent of AF sufferers symptom-free for one year, compared to 7.3 percent of those given the usual drug therapy.

“There are 150,000 to 200,000 new cases of AF in the U.S. every year, Dr. Packer explained to Post editors. “Some will be asymptomatic and treated with blood thinners to prevent strokes. Others might be treated with anti-arrhythmic drugs. But the target population for ablation is people who don’t respond to drug therapy—and there are a lot of them.”

To date, more than 9,000 patients have been treated worldwide with the Arctic Front Cryocatheter. The treatment is not yet approved in the U.S., however.

“Seeking FDA approval for the system is the next step,” says Dr. Packer. “Data from Europe support the approach, but the FDA requires a large U.S. trial to demonstrate the device’s effectiveness and safety,” he explains. “This is the hallmark clinical trial in the U.S.”

Other ACC News on Atrial Fibrillation

Ablation therapy: Dr. Packer also reports that the CABANA pilot study of 60 patients with persistent or long-standing AF and underlying cardiovascular disease found that catheter ablation more effectively prevented recurrent AF than drug therapy. But the NIH-funded study is just getting started.

“The 4 to 5 year Cabana trial will consider longer-term issues of ablation: Does it reduce mortality, does it prevent strokes, and how much does it cost,” notes Packer.

Drug therapy: Analysis of pooled data from the EURIDIS and ADONIS trials suggest that it’s safe for doctors to prescribe dronedarone (brand name: Multaq) for their patients with atrial fibrillation within two days after discontinuing treatment with the drug amiodarone (brand name: Cordarone).

“Many doctors want to switch their AF patients from amiodarone to dronedarone,” says Dr. Peter Kowey, lead investigator and chief of the division of cardiovascular diseases at the Main Line Health System in Wynnewood, Pennsylvania. “These data will give some guidance until a randomized trial is completed.”

Atrial Fibrillation The Saturday Evening Post

The new data are consistent with previous research showing that people with migraines also tend to suffer from conditions that are risky to their hearts—diabetes, high blood pressure, obesity, and high cholesterol.

“Our results provide another reason for people with migraines to reduce other risk factors for heart disease,” said study investigator Marcelo E. Bigal, M.D., Ph.D., with Merck Research Laboratories and the Albert Einstein College of Medicine in Bronx, New York.

In the study, researchers surveyed 6,102 migraine sufferers and 5,243 healthy volunteers about headaches, treatment, general health, and any diagnosed heart problems. Findings show that 4.1 percent of those with migraines reported having a heart attack, compared to 1.9 percent of the control group.

Yet to be discovered is the precise role of migraines in the development of cardiovascular disease, and whether drug therapy to prevent migraines or blood clots might help protect the health of migraineurs.

Dr. Bigal’s study is published in the February 23, 2010, print issue of Neurology® <http://www.neurology.org/>.

Heading Off Heart Disease The Saturday Evening Post

Inflammation of a thick band of tissue (called the plantar fascia) often causes persistent heel pain. In a preliminary study of 44 patients not helped by conventional therapies for plantar fasciitis, doctors report that all but two were pain-free within two or three weeks of a procedure called dry-needling followed by a steroid shot. During the procedure, doctors insert a needle into the area where the fascia connects to the heel bone. This creates a small amount of bleeding and activates blood platelets to help the tissue heal. The needle is then pulled back into soft tissue surrounding the fascia and used to inject a steroid. The promising data was presented by an Italian research team at the 2008 annual meeting of the Radiological Society of North America held in Chicago.

Dry-needling Helps Constant Heel Pain The Saturday Evening Post

Two studies published in November 2008 offer hope to people who experience balance and hearing loss related to Ménière’s disease. Researchers in Valencia, Spain, report that the number of debilitating episodes tends to decrease as time goes by. When they don’t, Dr. Stephen Wetmore of West Virginia University School of Medicine in Morgantown found that surgery to drain fluid from the inner ear’s endolymphatic sac improved the problem in 77 percent of 51 cases. A second sac surgery was beneficial in 65 percent of 14 people who experienced recurrent symptoms five months or longer after the original procedure.

New Research Offers Hope for Patients with Meneire’s Disease The Saturday Evening Post