Blast up the nose to ease migraine agony fast

A device that uses gas to blast medicine up the nose could help treat migraine.

The hand-held gadget contains a propellant, a liquid that turns into a gas, to fire tiny molecules of a pain-killing drug deep into the upper nasal cavity. This area is packed with tiny blood vessels, called capillaries, that are able to absorb medicine rapidly, providing quick relief for migraine sufferers.

Tests show that within 20 minutes of using the nose blaster, which is about twice the size of a standard nasal spray, patients get the same relief as they would if the same pain-killing medicine was injected.

Migraines affect around one in ten people. An attack can last up to 72 hours and might be preceded or accompanied by flashes of light or aura, tingling, nausea and increased sensitivity to light and sound.

The hand-held gadget contains a propellant, a liquid that turns into a gas, to fire tiny molecules of a pain-killing drug deep into the upper nasal cavity

Patients are usually prescribed triptans, that can be pills, injected or sprayed up the nose. These can’t prevent attacks but help alleviate symptoms. The issue with pills is that they are broken down in the stomach and gradually absorbed into the bloodstream. This can prolong the time it takes to get relief.

Injections are rarely popular because of discomfort, and existing nasal sprays deposit much of the drug in the nostrils, where there is much less absorption because of fewer blood vessels.

Conventional nasal sprays rely on a manual pump to squirt liquid medicine up the nose. This limits the effectiveness, so only about 5 to 10 per cent of the medicine reaches the upper nasal cavity, where it is more likely to be quickly absorbed.

Patients are usually prescribed triptans, that can be pills, injected or sprayed up the nose

Patients are usually prescribed triptans, that can be pills, injected or sprayed up the nose

The new device, developed by U.S. firm Impel Neuropharma, not only acts as a powerful propellant, but it also contains a more powerful painkiller that until now has only been available in injection form. The device contains three chambers — one holds liquid dihydroergotamine, a powerful painkiller sometimes used to treat severe migraine.

Another chamber contains a liquid called hydrofluoroalkane, the same propellant used in modern asthma inhalers to propel droplets of medicine deep into the lungs. The patient places the gadget’s nozzle into either nostril at the first sign of a migraine.

At the press of a button on the device, a small dose of the drug is released from its storage chamber into a third ‘mixing’ chamber; at the same time, a tiny amount of hydrofluoroalkane is pumped from its chamber into this mixing chamber, where it instantly gets turned into a pressurised gas.

Injections are rarely popular because of discomfort, and existing nasal sprays deposit much of the drug in the nostrils, where there is much less absorption because of fewer blood vessels

Injections are rarely popular because of discomfort, and existing nasal sprays deposit much of the drug in the nostrils, where there is much less absorption because of fewer blood vessels

Pressing a second button blasts the pain-killing medicine in a fine aerosol stream through the nostril into the upper nasal cavity. The whole process takes a couple of seconds. Testing the gas-powered gadget is still at an early stage. But the results of a small trial on 36 migraine patients by the company (but not yet peer reviewed and published in a journal), showed those using the device had similar levels of pain relief within 20 minutes to those who had the drug injected.

The company now plans to investigate whether it could also be used to improve delivery of drugs for Parkinson’s and other diseases that affect the brain.

Dr Andy Dowson, director of headache services at King’s College Hospital in London, said inhaling the drug with the device could in principle bring rapid pain relief if larger trials show it works. He said: ‘The question is, how good is the delivery system?’

Meanwhile, a new injection can also reduce migraine attacks. In a trial, around 1,100 patients were given monthly or quarterly injections of fremanezumab or placebo, and monitored for three months. Fremanezumab is thought to work by blocking a chemical called CGRP (calcitonin gene-related peptide) to prevent blood vessels on the surface of the brain dilating during a migraine attack, triggering pain.

Results showed those who were given the drug had significantly fewer days with headaches, according to the New England Journal of Medicine. Further studies are planned.

 CAN A PLACENTA JAB SOOTHE SORE HEELS?

Powdered placenta could be an unlikely new treatment for painful feet.

Scientists at the Five Cities Foot Clinic in California, in the U.S., are testing dried amniotic membrane, the innermost layer of the placenta, on 164 patients suffering from plantar fasciitis.

This is where the band of tissue that runs from the heel along the length of the sole of the foot becomes inflamed and swollen.

Plantar fasciitis is the most common cause of heel pain.

The donated placenta is mixed with saline to make it injectable.

One theory is that the anti-inflammatories in placenta — identified in previous studies — will work to reduce pain.

PLASTER TO TELL IF STROKE TREATMENT IS WORKING

Sensors that are stuck to the neck and resemble a simple plaster are being tested as a way to monitor the recovery of stroke patients. The device can detect muscle movement and vocal cord vibrations and so can monitor how well patients are responding to treatment, for speech or difficulties swallowing, for example.

The devices have a 12-hour rechargeable battery and send their information wirelessly to a smartphone. The developer, from Northwestern University in Illinois, U.S., says the technology, which could be available in two years, will give doctors an accurate idea if a treatment is working.

SKIN CELLS THAT MAY HELP MS PATIENTS

Scientists believe they may be able to use a patient’s own skin cells to help repair the damage caused by multiple sclerosis (MS).

The disease occurs when immune cells mistakenly attack the protective fatty sheaths that surround nerves, causing inflammation and damage. 

However, in work on mice, researchers at the University of Cambridge have found they can re-programme skin cells into the type of stem cells found in the brain and when these cells are transplanted into the nervous system, they reduce inflammation — the hope is that they may also help repair damage, too. 

Unlike stem cells from donors — already used to help with MS — using a patient’s own stem cells brings no risk of rejection. More research is now planned.

HEART ATTACK SYMPTOMS IN WOMEN THAT DOCTORS MISS

Women aged 55 or under complaining of heart attack symptoms are more likely to be told they aren’t heart-related.

In a study by the Yale School of Public Health in the U.S. researchers analysed data from 2,009 women and 976 men who’d been hospitalised for acute myocardial infarction, the medical name for heart attack.

Although most patients reported chest pain as their main symptom, the women were more likely to complain of other signs, such as indigestion, arm and jaw pain and shortness of breath. Other studies found older women had similar problems. 

 THE NEW WAY TO BEAT PAIN? CONFUSING IT!

 Zapping nerves with electrical signals that retrain the brain could be a new way to treat chronic pain.

The treatment is being tested on 20 patients with pain from pancreatic cancer at Johns Hopkins University in the U.S.

They will undergo ten 45-minute sessions when the painful area will be treated with mild electrical impulses that the patient will not feel. The electrical impulses come in different frequencies and stimulate different types of nerve fibre at the same time.

This is thought to ‘scramble’ the pain signals travelling to the brain so that it no longer associates them with pain. This is unlike standard nerve stimulation which blocks the signals.

SENSE AND SENSIBILITY 

How to boost the power of your senses. This week: Hearing

Our hearing deteriorates when the tiny hairs that conduct sound through the ears become damaged or die as a result of age or exposure to loud noise. It’s not yet possible to restore these, but scientists at Harvard University recently found you can train your brain to pick up sound more effectively.

For three-and-a half hours a week, a group of 24 people around the age of 70 used a brain-training game that taught them to focus on a specific sound through background noise. After eight weeks, they picked up 25 per cent more words in noisy surroundings, according to the journal Current Biology.

In a 2013 trial by Northwestern University in the U.S., people using the game Brain Fitness (available at brainhq.com) also found it improved their ability to distinguish words spoken in a crowded room.

RUDE HEALTH

Four out of five of adults will at some point experience debilitating lower back pain, which can affect their sex lives. 

Research published in the journal Spine in 2017 found that depending on the type of back pain, certain sexual positions could help. 

For instance, women with lower back pain reported reduced pain in the missionary position. 

TECHNO DOC 

How technology is changing our health. This week: Self-cleaning stickers

A U.S. company has created self-cleaning crystals that are being trialled in a U.S. airport to make security checkpoints more hygienic.

The so-called NanoSeptic device has tiny crystals and, through a process called photocatalysis, when light hits the crystals they react with oxygen to break down contaminants on our luggage.

This reaction is continuous so creates a self-cleaning product that’s said to be stronger than bleach. The product is available as a large sticker and can be attached to handles and inside security trays.

The continuously self-cleaning linings should prevent contamination between items placed in the tray.



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