The cranberry is proven to be loaded with a plethora and exuberant overabundance of helpful chemicals. It carries three classes of flavonoids (flavenols, anthocyanins and proanthocyanidins), as well as catechins and triterpenoids. We are still trying to work out what these chemicals can do for us. So far, laboratory bench studies show that they might be able to help with some cancers, some vascular and heart diseases, the bacteria that cause stomach ulcers and a reovirus that infects monkeys—but, to be sure, we need more and bigger studies in people.
Urinary Tract Infections
A Urinary Tract Infection (UTI) is a bacterial infection that affects any part of the urinary tract, and unfortunately they are very common in women.
The male and female urinary tracts are relatively the same except for the length of the urethra. (Female shown)
The symptoms of UTIs are unpleasant—they include frequency (a desire to urinate far too frequently, and usually producing only a small volume), urgency (the sudden desire to urinate), and dysuria (pain on passing urine). It now seems that cranberry juice helps in the prevention of a recurrent UTI—but only in women.
Cranberry 101
The cranberry is a small trailing (or creeping) plant, belonging to the genus Vaccinium. It can creep up to 2 m in length and sprout up to 20 cm in height. It grows in the colder, wetter parts of the world, with most of the 110,000 tonne annual crop originating from the USA and Canada. The peoples of the icy far northern climes inside the Arctic Circle have made it part of their diet for thousands of years.
In the USA and Canada, it has long been consumed in pies, sauces and relishes, as a dried fruit, and as a drink.
It’s called ‘cranberry’ in the USA because the early settlers thought it looked a little like the neck, head and beak of a crane (the bird). However, it’s called ‘fenberry’ in the UK (a ‘fen’ is a marsh, its natural home).
These chemicals have a very neat mechanism of interfering with some of the many bacteria that can cause a UTI. They don’t kill the bacteria. Instead, they seem to stop the nasty E. coli bacteria from adhering to the lining of the urinary bladder and urethra. This means that any E. coli bacteria that do make it into the lower urinary tract are very easily washed out by the regular emptying of the bladder.
A typical study looked at 150 women, all of whom had previously had a UTI. Some were given 50 ml of a cranberry-lingonberry juice concentrate to drink each day, while others (the control group) were not. Over the next six months, 39% of those in the control group suffered a UTI, while only 16% of those drinking the cranberry juice did.
It now seems that cranberry juice helps in the prevention of a recurrent UTI—but only in women. It does nothing to treat a UTI while it’s flaring up—and it does nothing to help men with a UTI.
So now young lovers, wherever you are, you might think of mixing cranberry juice into your early evening cocktails…But how many prophylactics can you have in one evening?
How Much, How Often?
How much and how often should a woman take cranberry juice to reduce recurrences of a UTI? We don’t really know yet.
Typically, 50–150 ml per day of pure cranberry juice seems to help. However, 100% cranberry juice is very acidic. For this reason, it is usually diluted in a cocktail of other juices to reduce the quantity to about 25%. Some studies suggest that it might be helpful to take it in two doses per day.
Paracelsus said, ‘All drugs are poisons, what matters is the dose’. And even natural cranberry juice can have side effects. It can react with some regular medications—and cause kidney stones. And if you drink more than 3 litres per day (!!), you could get diarrhoea.
References
Howell, Amy B., ‘Bioactive compounds in cranberries and their role in prevention of urinary tract infections’, Molecular Nutrition and Food Research, 2007, Vol 51, Issue 6, pp 732–737.
Jepson, Ruth G., et al., ‘A systematic review of the evidence for cranberries and blueberries in UTI prevention’, Molecular Nutrition and Food Research, 2007, Vol 51, Issue 6, pp 738–745.
Kontiokari, Tero, et al., ‘Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women’, British Medical Journal, 30 June 2001, pp 1571–1573.
Neto, Catherine C., ‘Cranberry and blueberry: Evidence for protective effects against cancer and vascular disease’, Molecular Nutrition and Food Research, 2007, Vol 51, Issue 6, pp 652–664.
They Swore it Was Tourette’s
Most of us know very little about neuropsychiatric diseases. But if somebody asks us what disease makes you swear all the time, most of us will say Tourette’s. And yes, there is a disease called Tourette’s, but swearing is its least common presentation.
History of Tourette’s Syndrome
The disease goes under many names, e.g. Tourette’s, Tourette’s Syndrome and Gilles de la Tourette Syndrome.
It was first noted in 1825 when the French physician Jean Marc Gaspard Itard (1775–1838) described the symptoms of ten of his patients. They found themselves performing repetitive behaviours that were not under their conscious control, including involuntary movements and verbal utterances (e.g. continually clearing their throats or saying inappropriate words).
Tourette’s Syndrome is named after George Gilles de la Tourette (1859–1904), a French neurologist who wrote a paper in 1885 called ‘Study of a nervous affliction’. It was based on his observations of nine patients afflicted with strange involuntary movements. At the time, Tourette was a medical resident for the famous French neurologist and physician Jean-Martin Charcot (1825–1893). It was Charcot who generously proposed that this illness be named after Tourette.
For the next century, the disease was poorly understood, and most of the treatments for it didn’t really work. A major change occurred around 1970, when Drs Arthur and Elaine Shapiro described their limited successes with certain medications. They proposed that Tourette’s Syndrome should henceforth be regarded as a neurological disease, not an emotional one.
Tourette’s Syndrome
Tourette’s Syndrome is known as a ‘spectrum disease’. This means that it has a whole range of symptoms—from short-lived and mild, to chronic and severe.
Fancy Words
Medical vocabulary is really just a shorthand way of describing something more complex.
Some of these medical words are often used to describe Tourette’s Syndrome behaviour. ‘Echolalia’ means ‘to repeat another person’s words’, while ‘pallalia’ means ‘to repeat the same words over and over’. ‘Echopraxia’ means ‘to imitate another person’s movements’. ‘Coprolalia’ means ‘to use rude words’, while ‘copropraxia’ means ‘to make rude gestures’.
Obsessive-Compulsive Disorder has two parts. The word ‘obsessive’ refers to unwanted and repetitive thoughts, mental images and fears that are not related to activities of daily living. ‘Compulsive’ refers to the actions, which are performed to reduce the obsessive worries. Although seen as voluntary these actions are actually irresistible.
Definition of Tourette’s Syndrome
Over the years, the definition of Tourette’s Syndrome (TS) has changed a few times. The current definition has four parts.
First, the patient has to have several motor tics and at least one vocal tic. A ‘tic’ is a rapid, repeated identical movement. It can range from simple to complex—from eye-blinking or shouldershrugging right up to gymnastic movements such as deep knee squats and somersaults. A tic can also be vocal, involving the muscles of speech (which, of course, are controlled by the brain). Vocal tics can be as simple as a grunt or a repeated cough or clearing of the throat, or as complex as inappropriate language.
In one case, a woman, as part of her TS, uttered rude words. She became deaf from a completely separate disease and when she learnt sign language, she found herself making rude gestures when signing.
The tics are often described as a ‘semi-voluntary response to an irresistible force’. It’s
similar to having a tickle in your throat at a symphony performance or a church service. You can refrain from having to noisily clear your throat for a while, but the longer you wait, the greater the pressure builds up, and when you do finally clear your throat, it’s loud and long. Some high school students with TS say that they can suppress the tics all day at school, but once they get home, they get enormous relief from letting the tics run their course.
The second part of the definition relates to timing. The tics can happen many times per day (usually in bouts), nearly every day, or intermittently over a period greater than a year. Either way, to suit the definition, there cannot be a tic-free period longer than three months.
Third, the tics first appear at an age less than 18 years. Indeed, about half of TS sufferers have their first tic by the age of seven.
And finally, the tics are not caused by another medical condition (such as Huntington’s Disease, Wilson’s Disease, infectious encephalitis or Primary Dystonia) or by substance abuse.
The Numbers
At first, it was thought that TS was rare and severe. In fact, back in 1972 the US National Institute of Health estimated that there were fewer than 100 people with TS in the USA. We now know that it is relatively common and often mild.
TS occurs worldwide, in all cultures. The current estimate is that it affects 0.1–1% of the population. Males are 2–10 times more likely to be affected than females.
Depending on the study, about 40–70% of TS sufferers appear to have Attention Deficit Hyperactivity Disorder (ADHD), while 20–60% have Obsessive-Compulsive Disorder (OCD). In many cases, these conditions cause more distress to the person than the TS. The so-called Pure TS, or TS Only, the syndrome without the OCD, ADHD or other disorders, accounts for about 40% of those with TS.
In general, TS starts with simple motor tics presenting first (say, at 5–10 years of age) and the more complex motor tics later, with vocal tics developing at 8–15 years of age. TS is usually at its worst during adolescence. On average, in about two-thirds of TS sufferers, the symptoms lessen as they get older—unfortunately, in one-third, they do not.
There can be unexpected side effects. For example, if the motor tics include head-jerking, the head involvement can cause muscle strain to the neck, and even make reading very difficult.
One strange characteristic of TS is that the symptoms wax and wane, with no obvious pattern. The symptoms are unpredictable, being very different from day to day and week to week.
In general, TS does not affect life expectancy.
Other Symptoms of TS
One occasional symptom of TS is sensory hypersensitivity, e.g. a person cannot bear to wear wrinkled socks because of the extreme discomfort. Another is ‘insistence on sameness’—usually associated with OCD.
Rage attacks, lasting 5–30 minutes, occasionally occur in children and teenagers.
The complex and socially inappropriate behaviour (rude words and gestures) is usually associated with ADHD.
TS in the Media
In the USA in 2001, the talkback radio doctor, Dr Laura Schlessinger, was asked about inviting a person with TS to a wedding. At the time, Dr Schlessinger was under the false impression that people with TS spent all day swearing. As part of her answer she replied: ‘Well, I’m going to come to your party and just scream F-You, F-You, F-You every five seconds and see if you want to invite me back…it is outrageous to call that a disability that should be tolerated at a wedding.’ She did not realise that swearing is the least typical symptom, that only 10–15% of people exhibit it, and then for only a small fraction of the time.
TS appeared in South Park, in the episode called ‘Le Petit Tourette’. It first went to air on 3 October 2007. In this episode, Cartman sees a little boy with Tourette’s Syndrome swearing. Cartman pretends that he has TS, and enjoys being able to be as rude as he likes without getting into trouble. Things get messy when he is booked to appear on a nationwide current affairs TV show. He has a change of heart and wants to get out of it, but is threatened with murder by the host if he does. The Tourette Syndrome Association conceded that ‘the episode was surprisingly well researched…there was a surprising amount of accurate information conveyed…providing accurate facts to the public’. South Park being South Park, they just had to use more rude words than usual and, as a result, this was their first episode to be rated at the more restrictive MA LV (i.e. mature audience, adult themes, coarse language and violence).
The Cause
At this stage, we do know that there is a very strong genetic component to the disease. It might be related to a site on Chromosome 8 (and possibly Chromosomes 5 and/or 11). There might also be a non-genetic component to TS, possibly as a reaction to being infected by a Streptococcus bacterium. (But, on the other hand, most people get a streptococcal infection at some stage in their early life.)
It seems that TS is a disorder of the synaptic neurotransmitter chemicals that transmit information in the nervous system. Scanning studies of the brains of TS sufferers show extra activity in those parts of the brain dealing with sensation, movement and language.
To summarise, we don’t really know the cause(s) of TS. This is partly because the brain is fiendishly complex. Another reason is that we have very few animal models to compare and study, apart from some stallions with inherited repetitive grooming rituals and some Labrador dogs that will lick their paws until they are abraded.
But we know that the risk factors include having a family history of TS, being male and under the age of 20 years.
Famous TS Sufferers
TS is known as a ‘spectrum disease’. This means that it has a whole range of symptoms—from short-lived and mild to chronic and severe (fortunately, this is relatively uncommon). Therefore, some people with milder symptoms can disguise it in their daily lives.
Unfortunately, some cannot. Dr Samuel Johnson (1709–1784), the writer, critic and poet, who wrote the first modern dictionary of the English Language, had TS. His biographer, James Boswell, wrote that Dr Johnson had ‘nervous movements’ and would often continually repeat fragments of words or other sounds. He would suppress these tics with a great effort of his will, as he was much embarrassed by them.
In recent times, the actor Dan Aykroyd claimed in a radio interview that he had mild TS. Athletes and musicians have also claimed that they have tamed the restless energy and spontaneity of TS to their own advantage.
A few studies have shown that people with TS can have a higher IQ and quicker motor activity than expected. The famed neurologist and author, Dr Oliver Sacks, writes that while ‘one must not romanticise Tourette’s…one may have the rather rare situation of a biological condition becoming creative or becoming an integral part of the identity and creativity of an individual’.
Rarely Rude
The florid symptoms that most people believe to be typical of Tourette’s Syndrome are actually the least typical. This is probably because they get all the attention. The majority of people diagnosed with TS will never do anything rude. The obscene words and rude gestures appear in only 10–15% of people with TS, and then only for a very small fraction of the day.
The rest of the time, people with TS are just like anybody else—I swear.
References
Kushner, Howard I., A Cursing Brain? The Histories of Tourette Syndrome,
Cambridge, Massachusetts: Harvard University Press, 1999. Pearce, J.M.S., ‘Doctor Samuel Johnson: “the great convulsionary” a victim of
Gilles de la Tourette’s syndrome’, Journal of The Royal Society of Medicine, 1994, Vol 87, No 7, pp 396, 397.
Sacks, Oliver, ‘Tourette’s syndrome and creativity: Exploiting the ticcy witticisms and witty ticcicisms’, British Medical Journal, 19–26 December 1992, pp 1515–1516.
Moth to a Flame (Let Bogongs be Bogongs)
You hear the phrase all the time, ‘…drawn like a moth to the flame’. And you’ve probably witnessed it. It’s a hot summer evening, you’re on the verandah when you sudd
enly notice a moth zooming towards the light. But although the moth appears to be attracted to the light, it’s actually just confused by it.
Moth Facts
The wingspans of moths range in size from a tiny 4 mm to a terrifying 300 mm. Moths are closely related to butterflies. They have a similar life cycle—egg, larva (caterpillar), pupa (chrysalis) and, finally, the imago (adult). Moths tend to be nocturnal, but there are a few species that are active at dawn and dusk and others that are active during the day.
Beneficial or a Menace?
Moths and people certainly have a love-hate relationship.
The silkworm (the larva of some moth species) makes raw silk to build its cocoon. Farming silkworms for their silk has been occurring for hundreds of years. And we use about 130,000 tonnes of this raw silk each year to make beautiful soft fabrics.
Eating the larva or caterpillar of the Mopane Moth (Gonimbrasia belina) is popular in southern Africa, as was eating the larva of the Bogong Moth (Agrotis infusa) in the Australian Alps. Indigenous Australians would roast the bodies in hot ashes to burn off the legs and wings. What remained would then be mashed into a meal that has a nutty taste, like walnuts.
On the other hand, various species of moths attack and destroy crops and trees around the world. However, many moths provide a beneficial service by pollinating some wild plants that might otherwise not survive.
Science is Golden Page 14
