Listening to other people chew

Misophonia terrorist.

For people with a condition that some scientists call misophonia, mealtime can be torture. The sounds of other people eating — chewing, chomping, slurping, gurgling — can send them into an instantaneous, blood-boiling rage, Joyce Cohen writes.

Many people can be driven to distraction by certain small sounds that do not seem to bother others — gum chewing, footsteps, humming. But sufferers of misophonia, a newly recognized condition that remains little studied and poorly understood, take the problem to a higher level.

They also follow a strikingly consistent pattern, experts say. The condition almost always begins in late childhood or early adolescence and worsens over time, often expanding to include more trigger sounds, usually those of eating and breathing.

Aage R. Moller, a neuroscientist at the University of Texas at Dallas who specializes in the auditory nervous system, believes the condition is hard-wired, like right- or left-handedness, and is probably not an auditory disorder but a “physiological abnormality” that resides in brain structures activated by processed sound. 

Misophonia (“dislike of sound”) is sometimes confused with hyperacusis, in which sound is perceived as abnormally loud or physically painful. But Dr. Johnson says they are not the same. “These people like sound, the louder the better,” she said of misophonia patients. “The sounds they object to are soft, hardly audible sounds.” One patient is driven crazy by her beloved dog licking its paws. Another can’t bear the pop of the plosive “p” in ordinary conversation.

Yeah, that one gets me, too.

How to think about cancer screening tests

I wrote the other day of a new recommendation that men not undergo the PSA test for prostate cancer. It's still a choice, and some men, and doctors, might want the test. National statistics are not the same as your particular body.

The decision to screen for breast cancer is somewhat similar -- there are questions about whether it actually saves lives.

Dr. H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice, has written an excellent article for The New York Times explaining the difficulty of deciding, and I recommend that you read all of it.

I'll just grab a few of the highlights.

Both breast and prostate cancer screening are really difficult calls, and the statistical differences between them are only of degrees. Reasonable individuals, in the same situation, could make different decisions based on their valuation of the benefits and harms of screening.

Screening is like gambling: there are winners and there are losers. And while the few winners win big, there are a lot more losers.

False positives are really common in both breast and prostate cancer screening. Approximately 15 to 20 percent of women and men who are screened annually over a 10-year period will have to undergo at least one biopsy because of a false-positive mammogram or PSA — prostate-specific antigen — test.

Patients who are overdiagnosed are the big losers here. They undergo surgery, radiation and chemotherapy unnecessarily. And then there are the associated complications: chemotherapy can cause nausea and radiation can burn normal tissue; breast surgery can be disfiguring, and prostate surgery can lead to bladder and sexual dysfunction.

Now let’s consider the winners — those who have avoided dying from breast or prostate cancer by getting screened. While there is some debate about whether they really exist, my reading of the data is that they do, but they are few and far between — on the order of less than 1 breast or prostate cancer death averted per 1,000 people screened over 10 years. That’s less than 0.1 percent.

"The truth is that neither test works that well," he concludes. "Even with screening, most people destined to develop deadly, untreatable cancers will still do so. When it comes to breast and prostate cancer screening, there are no right answers, just trade-offs."

It's worth your time to read the whole thing.

If you're a man, read this

Healthy men should no longer receive a PSA blood test to screen for prostate cancer because the test does not save lives over all and often leads to more tests and treatments that needlessly cause pain, impotence and incontinence in many, a key government health panel has decided.

This issue is not new. I have played the PSA game for more than a decade, and I no longer care to play. My number goes up, I'm off to the urologist. Then it goes down. Then it goes up again, and I'm off to the urologist, who now wants to biopsy. Over and over.

The recommendation:

is based on the results of five well-controlled clinical trials and could substantially change the care given to men 50 and older. There are 44 million such men in the United States, and 33 million of them have already had a PSA test — sometimes without their knowledge — during routine physicals.

“Unfortunately, the evidence now shows that this test does not save men’s lives,” said Dr. Virginia Moyer, a professor of pediatrics at Baylor College of Medicine and chairwoman of the task force. “This test cannot tell the difference between cancers that will and will not affect a man during his natural lifetime. We need to find one that does.”

Moreover, there is no evidence that a digital rectal exam or ultrasound are effective, either. “There are no reliable signs or symptoms of prostate cancer,” said Dr. Timothy J. Wilt, a member of the task force and a professor of medicine at the University of Minnesota. Frequency and urgency of urinating are poor indicators of disease, since the cause is often benign.

From 1986 through 2005, one million men received surgery, radiation therapy or both who would not have been treated without a P.S.A. test, according to the task force. Among them, at least 5,000 died soon after surgery and 10,000 to 70,000 suffered serious complications. Half had persistent blood in their semen, and 200,000 to 300,000 suffered impotence, incontinence or both. As a result of these complications, the man who developed the test, Dr. Richard J. Ablin, has called its widespread use a “public health disaster.”

Plenty of reputable people are opposed to this new recommendation. What should you do? Talk to your doctor, and ask a lot of questions about everything you hear. Remember, there's a difference between public health statistics and your own body. Read everything you can. Get a second opinion, and a third. Ultimately, the decision is yours.

You can read a lot more about this here.

How to talk to your doctor

You go in, and he's rushed, and you're confused, and you forget to ask the question you came in with. I've finished an exam without knowing the diagnosis and had to ask.

The federal Agency for Healthcare Research and Quality has created a website to help.

Patients talking to the doctor about a proposed surgery, for example, are prompted to ask how long it will take to recover. The site offers tips on what to do before, during and after medical visits, such as calling the doctor if there are any side effects. The site includes an interactive "Question Builder."

Here are some typical questions to ask at a checkup.

• What is my diagnosis?
• What are my treatment options? What are the benefits of each option? What are the side effects?
• Will I need a test? What is the test for? What will the results tell me?
• What will the medicine you are prescribing do? How do I take it? Are there any side effects?
• Why do I need surgery? Are there other ways to treat my condition? How often do you perform this surgery?
• Do I need to change my daily routine?

Read more in The Wall Street Journal here.

Let the games begin

Online gamers have deciphered the structure of an enzyme of an AIDS-like virus that had thwarted scientists for a decade.

Their target was a monomeric protease enzyme, a cutting agent in the complex molecular tailoring of retroviruses, a family that includes HIV. Figuring out the structure of proteins is vital for understanding the causes of many diseases and developing drugs to block them.

Foldit, developed in 2008 by the University of Washington, is a video game in which gamers, divided into competing groups, compete to unfold chains of amino acids -- the building blocks of proteins -- using a set of online tools.

To the astonishment of the scientists, the gamers produced an accurate model of the enzyme in just three weeks. Cracking the enzyme "provides new insights for the design of antiretroviral drugs," says the study, referring to the lifeline medication against the human immunodeficiency virus (HIV). 

"We wanted to see if human intuition could succeed where automated methods had failed," Firas Khatib of the university's biochemistry lab said in a press release. "The ingenuity of game players is a formidable force that, if properly directed, can be used to solve a wide range of scientific problems."

Hey kids, next time your parents get crazy about you playing video games ...

Have a bowl of cereal for dinner

Dinner's ready!

Bill Phillips, the editor of MensHealth.com, likes a bowl of cereal with bananas for dinner. It wouldn't be bad for the rest of us either. Here's why.

Eat a bowl of 100 percent B12-boosted cereal and milk every morning and you'll be covered for B12, he writes, and that vitamin is essential if you don't want to lose brain matter as you age. Acid-blocking drugs may be depriving you of as much B12 as you need.

The banana offers potassium -- without this essential mineral, your heart couldn't beat, your muscles wouldn't contract, and your brain couldn't comprehend this sentence. Why? Potassium helps your cells use glucose for energy. A banana offers 400 mg of the 4,700 mgs a young man needs each day.

The milk offers iodine, and you probably don't get what you need from salt. However, iodine can also be found in a nearly sodium-free source: milk. Animal feed is fortified with the element, meaning it travels from cows to your cereal bowl. Not a milk lover? Eat at least one serving of eggs or yogurt a day; both are good sources of iodine.

Good news for your mice

Will live longer than you.

Keep them on that little treadmill.

Researchers have found one more reason to exercise: working out triggers influential stem cells to become bone instead of fat, improving overall health by boosting the body's capacity to make blood. The body's mesenchymal stem cells are most likely to become fat or bone, depending on which path they follow. Aerobic exercise triggers those cells to become bone more often than fat. In sedentary mice, the same stem cells were more likely to become fat, impairing blood production in the marrow cavities of bones.

I didn't know I had mesenchymal stem cells. Maybe that explains that annoying itch.

"The interesting thing was that a modest exercise program was able to significantly increase blood cells in the marrow and in circulation," says one of the researchers. "What we're suggesting is that exercise is a potent stimulus -- enough of a stimulus to actually trigger a switch in these mesenchymal stem cells."

Can someone hand me the remote?