Medical News Today: Is pediatric surgery a gateway to opioid misuse?

The United States is in the grips of what some have dubbed an opioid epidemic. New research explores how pediatric surgical patients fit into this bleak picture.
Child taking pills in bed
A new study investigates opioid use in a young population.

Across all age groups, opioid prescriptions have been steadily rising since the 1990s. This has, in turn, led to an increase in opioid addiction and, consequently, opioid-related deaths and heroin use.

Between 1997 and 2012, adolescent opioid use rose by 176 percent and heroin use rose by 161 percent.

Following surgical procedures, opioids are very useful for treating pain. For many people, this is their first contact with opioids. In fact, research has shown that postoperative pain management is a significant risk factor for prolonged opioid use in adults.

Opioids in adolescents and young adults

Postoperative opioid prescribing varies widely for both adults and children. In some instances, large doses are prescribed, even after more minor procedures.

Although children seem to be more vulnerable to drug addiction than adults, very little is known about prescription opioid use following surgery in adolescents and young people.

A new study, published in the journal Pediatrics, set out to address this gap in our knowledge. As the study authors explain, “Our study is the first in which researchers evaluated persistent opioid use after surgical care in the adolescent and young adult age group.”

The researchers carried out a retrospective study that included 88,637 surgical patients who were aged 13–21, none of whom had taken opioids before their surgery, and none had any further surgery in the 6 months following the original procedure.

This group was compared with a control sample of almost 3 million 13–21-year-olds, who had not had surgery.

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Persistent opioid use

The team investigated the percentage of surgical patients who continued to use opioids for longer than would normally be deemed necessary. In this case, persistent opioid use is defined as filling one or more opioid prescriptions between 90 and 180 days after surgery.

In the surgical group, persistent opioid use was found in 4.8 percent of patients, compared with just 0.1 percent of the control group.

It was also noted that many of these filled prescriptions of “substantial quantity […] equivalent to refills of 40 tablets of hydrocodone (5-milligram tablets) or 26 tablets of oxycodone (5-milligram tablets) at 6 months after surgery.”

The percentage of people who continued to use opioids depended on surgery type. The lowest usage rates were seen following orchiopexy, a procedure to move an undescended testicle (2.7 percent), and the highest were observed following colectomy, which is the removal of part of the bowel (15.2 percent).

Further research is needed to understand why there is such a large difference between surgical procedures.

Other factors that increased the likelihood of continued opioid use included age (older children were more at risk) and sex (females were more at risk). As the authors explain:

These findings raise concern that acute exposure to opioids for postoperative pain management may be associated with a risk of long-term use for a significant number of adolescents and young adults.”

They continue, “[P]rolonged perioperative opioid refills may be placing vulnerable adolescent and young adult patients and their local communities at a higher risk than previously appreciated.”

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Worrying links and future work

Even more concerning is the fact that associations have already been found between opioid use during adolescence and substance use disorders at the age of 35. Similarly, the majority of U.S. high school seniors using opioids non-medically report first coming into contact with them in a medical context.

Overall, the findings garnered from this group of adolescents and young adults mirror those seen in adult populations. As the study authors write, regardless of age, there is an “increase in long-term opioid use after new opioid prescriptions in both the general population and postoperative settings.”

That being said, due to the young age of this group, there is a relatively larger overall, lifetime risk for chronic opioid use. The findings will add fuel to the already complicated debate regarding pain management guidelines for children.

The scientists suggest that it might be useful to prescreen people in order to identify those who are at most risk of persistent opioid use. They also advise minimizing opioid exposure wherever alternative methods of analgesia are available.

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Medical News Today: Is Parkinson’s disease passed on through genetics?

While the exact cause of Parkinson’s disease is unknown, the development of the condition is influenced by many genetic and environmental factors. Doctors have identified how mutations in some genes can be passed down through generations and may lead to an increased risk of Parkinson’s disease.

Parkinson’s disease is a condition that affects the brain, particularly the areas that control movement and balance. It can cause worsening neurological changes that often start with tremors and muscle rigidity. It also increases a person’s risk of depression and dementia.

In this article, learn about how genetics affect the development of Parkinson’s disease, and when to talk to a doctor about family history and genetic testing.

Genetics and Parkinson’s disease

DNA strand.
Certain genes that increase the risk of Parkinson’s developing may be passed down through family members.

An estimated 15 percent of people with Parkinson’s disease have a family history of the condition.

Doctors have identified genes that are passed down from family members that seem to increase a person’s likelihood of developing Parkinson’s. They have also identified genes where damage or a mutation in the gene increases the risk for a particular condition.

Parkinson’s disease causes a lack of dopamine in the brain, which affects movement. Some genes appear to influence the ability of the brain to break down proteins that are present in neurons where dopamine is produced.

Genes associated with Parkinson’s disease

Researchers have identified several genes that are thought to be dominant and run in families with a history of Parkinson’s disease.

A dominant gene is one that is almost always passed down from parent to child and influences the likelihood that a person will inherit a particular trait or condition.

According to the National Human Genome Research Institute, genes that are associated with Parkinson’s disease include:

  • SNCA (PARK1)
  • UCHL1 (PARK5)
  • LRRK2 (PARK8)
  • PARK3

There are also recessive genes linked to Parkinson’s disease. If a gene is recessive, it means that a parent may carry the gene but not have the characteristic or condition linked to it. Parkinson’s disease is one such condition.

When a child inherits a recessive gene from both parents, they may have an increased risk of Parkinson’s disease. Examples of these genes include:

  • PARK2 (PARK2)
  • PARK7 (PARK7)
  • PINK1 (PARK6)
  • DJ-1
  • Parkin

Inheriting any of the genes doctors have identified as being related to Parkinson’s disease does not necessarily mean a person will develop the condition.

There are other, undiscovered genes and environmental factors that affect the development of Parkinson’s.

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When should a person get genetic testing?

Lab technician looking at sample in petri dish through microscope.
Genetic testing may not always help to determine whether someone is at risk of developing Parkinson’s or not.

While researchers know some of the genes associated with an increased risk of Parkinson’s disease, this is not enough to provide meaningful results for most people with a family history of the condition.

One exception is for people diagnosed with Parkinson’s disease before 30 years of age.

Researchers have identified the presence of a mutation in the PINK1 gene in about 2 percent of people with early-onset Parkinson’s disease.

Genetic testing exists for the PINK1, PARK7, SNCA, and LRRK genes, which may influence Parkinson’s disease. A person can talk to their doctor or a genetic counselor to determine if genetic testing may be a good choice for them.

Risk factors

There are several risk factors for Parkinson’s disease, including:

  • Advancing age. Doctors usually diagnose the disease when a person is 50 years of age or older. While exceptions exist, being older is a risk factor.
  • Being male. Doctors diagnose men in greater numbers than women. This does support the theory that Parkinson’s has a genetic link.
  • Family history. A person is more likely to develop Parkinson’s disease if they have a parent or sibling with the disease.
  • History of exposure to toxins. People who are exposed to environmental pesticides and herbicides, such as farmers, seem to have an increased risk of Parkinson’s disease.
  • History of head trauma. An injury to the brain, neck, or upper spine has been associated with greater risk for the disease.

Having one or more of these risk factors does not mean a person will develop Parkinson’s, only that they have a higher risk than others in the general population.

Early signs of Parkinson’s

Parkinson’s disease is a progressive disorder. Symptoms may start with minor changes to movement or thinking and worsen with time.

Early symptoms may include a small tremor or movement in one hand only. Other early symptoms can include:

  • problems with balance
  • lack of arm swing when walking
  • problems creating facial expressions
  • speech problems, such as slurring words
  • unexplained muscle stiffness

Parkinson’s disease often starts to affect one side of the body first. As the disease progresses, it will begin to show on both sides.

A person should always talk to their doctor if they are concerned their symptoms could be related to Parkinson’s disease or another condition.

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Can Parkinson’s disease be prevented?

Young couples learning ballroom dancing.
Sports and exercises that involve balance, including dancing or tai chi, may help to reduce the risk of Parkinson’s.

Doctors and researchers have not yet identified a way to prevent Parkinson’s disease from developing.

However, some studies have linked exercise with a reduction in Parkinson’s disease risk. According to one review, exercises associated with balance have been shown to be particularly effective.

Examples of exercise that involves balance include walking, tai chi, and dancing.


Although researchers have come a long way in terms of knowledge about the causes of Parkinson’s disease, there are still many discoveries to be made.

According to one study, the presence of one of the six known gene mutations is detected in only 3 to 5 percent of people who develop Parkinson’s disease without a family history. This means there are many other factors that may influence the development of the disease.

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Medical News Today: The sleep diet: Could this work?

It’s January. Many of us have noticed that our pants are slightly tighter than they were last year. How might we shift that extra weight without suffering the gym? Try an extra hour in bed, a new study suggests.
Man sleeping
Could we lose weight just by getting more sleep?

Scientists based at King’s College London in the United Kingdom have recently conducted a pilot study investigating sleep and diet. Their findings might be good news for those of us who feel tired and chubby at the moment.

Sleep is a strange beast. Most of us know that we feel awful if we don’t get enough, yet hardly any of us manage the recommended 7-ish hours that we need.

In actual fact, according to the Centers for Disease Control and Prevention (CDC), 1 in 3 Americans don’t get the right amount of shut-eye.

This is quite a worrying statistic, as sleep — or a lack thereof — is now considered to be a risk factor for obesity and cardiometabolic conditions, such as impaired glucose tolerance and high blood pressure.

If lack of sleep can have such a major impact, it seems sensible to search for ways of extending sleep in individuals who might be at risk.

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Extending sleep

Dr. Wendy Hall, from the Department of Nutritional Sciences at King’s College London, and team recently completed a pilot study in which they tested whether or not a simple intervention could increase sleep duration in a group of adults.

Their results are published today in the American Journal of Clinical Nutrition.

In all, 21 healthy short-sleepers undertook a 45-minute sleep consultation. During this session, the sleep extension group were given at least four helpful hints to lengthen their sleep time, including information about reducing caffeine intake — having a coffee just before bedtime makes it harder to drop off (who knew?) — and setting up relaxing routines, such as a warm bath and some Kenny G.

For the next 7 days, the participants kept sleep diaries. They also wore a motion sensor that could detect exactly how long participants slept, and how long they spent in bed before falling asleep.

Alongside the researchers’ efforts to extend sleep duration, they also monitored nutritional intake throughout the study period.

Overall, 86 percent of the sleep extension group increased their time spent in bed, and around half increased their sleep duration (by 52–90 minutes). Three members of the group hit the weekly recommended average of 7–9 hours of sleep per night.

However, the researchers believe that the extra sleep that the participants got might not have been of particularly great quality. They conclude that it might take a little more time to get into a new sleep routine; Kenny G can only do so much.

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Intriguing dietary changes

OK, so I know you’re desperate to read about the dietary aspect of the study, and the diet diaries threw out some interesting findings. For example, the individuals who did manage to attain an extended sleep pattern reported eating 10 fewer grams of free sugars, as well as fewer carbohydrates, per day.

The fact that extending sleep led to a reduction in intake of free sugars, by which we mean the sugars that are added to foods by manufacturers or in cooking at home as well as sugars in honey, syrups, and fruit juice, suggests that a simple change in lifestyle may really help people to consume healthier diets.”

Dr. Wendy Hall

But before we all get too excited and rush out to buy new mattresses, it’s important to note that the study is just a pilot. It involved 21 people, only 18 of whom extended their time in bed, and it took just over 1 week to complete.

Having said that, because sleep is a known risk factor for many diseases, it’s important to build on these limited foundations. Further research needs to identify whether or not it is possible to make meaningful changes to sleep habits in this way.

As lead researcher Haya Al Khatib says, “We have shown that sleep habits can be changed with relative ease in healthy adults using a personalized approach.”

“Our results,” she continues, “also suggest that increasing time in bed for an hour or so longer may lead to healthier food choices. This further strengthens the link between short sleep and poorer-quality diets that has already been observed by previous studies.”

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They plan to extend their foray into sleep modification and diet. Al Khatib continues, “We hope to investigate this finding further with longer-term studies examining nutrient intake and continued adherence to sleep extension behaviors in more detail […].”

So, for now, we should take the findings with a pinch of salt; a lot more work will be needed to firm up the conclusions. That being said, it’s now well-established that as a nation, we need more sleep — so you may as well give it a try.

Just to throw one final cat among the sleep-deprived pigeons, there is also some evidence that sleeping for too long increases mortality risk. As ever, moderation is key. Not too much, not too little.

On a personal note, I have 1-year-old twins, so the chances of me ever getting enough sleep are incredibly slim — unlike my waistline.

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Medical News Today: What is tendinosis?

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    Abate, M., Salini, V., Schiavone, C., & Andia, I. (2016, December 22). Clinical benefits and drawbacks of local corticosteroids injections in tendinopathies [Abstract]. Expert Opinion on Drug Safety16(3), 341–349. Retrieved from

    Bass, E. (2012, March 31). Tendinopathy: Why the difference between tendinitis and tendinosis matters. International Journal of Therapeutic Massage & Bodywork5(1), 14–17. Retrieved from

    Fusini, F., Bisicchia, S., Bottegoni, C., Gigante, A., Zanchini, F., & Busilacchi, A. (2016, May 19). Nutraceutical supplement in the management of tendinopathies: A systematic review. Muscles, Ligaments and Tendons Journal6(1), 48. Retrieved from

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    Miller, L. E., Parrish, W. R., Roides, B., & Bhattacharyya, S. (2017, November 6). Efficacy of platelet-rich plasma injections for symptomatic tendinopathy: Systematic review and meta-analysis of randomised injection-controlled trials. BMJ Open Sport & Exercise Medicine3(1), e000237. Retrieved from

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Medical News Today: What causes pericoronitis?

Pericoronitis occurs when the wisdom teeth do not have enough room to erupt through the gums. As a result, they may only partially come through the gum, which may lead to inflammation and infection of the soft tissue around the wisdom tooth.

If wisdom teeth only partially erupt, gum flaps may develop. These flaps are areas where food can become trapped, and bacteria can build up, causing infection.


Woman with pericoronitis rubbing cheek ache from wisdom tooth.
Pericoronitis is when the wisdom teeth do not emerge from the gums fully. It may cause pain and discomfort.

The symptoms can vary between individuals depending on the severity of the infection.

Chronic symptoms include:

  • dull pain
  • mild discomfort
  • bad taste in the mouth
  • swollen gum in the affected area

Chronic symptoms often only last for 1 to 2 days but keep recurring over a period of months.

Acute symptoms usually last 3 to 4 days and can include:

  • severe pain that can cause loss of sleep
  • swelling on the affected side of the face
  • discharge of pus
  • pain when swallowing
  • swollen lymph nodes under the chin
  • fever

What are the causes?

Pericoronitis commonly occurs in people in their 20s, with around 81 percent of those affected being aged between 20 and 29 years old.

Men and women develop pericoronitis in equal numbers.

There are also some common causes and conditions associated with pericoronitis:

  • poor oral hygiene — this more commonly causes acute pericoronitis
  • stress
  • pregnancy
  • upper respiratory tract infection — this is caused by a virus — often a cold — or bacteria, and affects the nose, sinuses, and throat

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Woman at the dentists looking at an x-ray of her teeth.
A dentist can diagnose pericoronitis, and may take an X-ray in some cases.

Dentists often diagnose pericoronitis during a clinical evaluation. The dentist will diagnose the condition by examining the wisdom teeth and checking for signs and the appearance of pericoronitis.

The dentist will look to see if the gums are inflamed, red, swollen, or draining pus. They will also look to see if there is a gum flap in the affected area.

The dentist might also take an X-ray to look at the alignment of the wisdom teeth and to rule out other possible causes for the pain, such as dental decay.

If a doctor diagnoses pericoronitis, they will refer the individual to a dentist for further treatment.

What are the treatment options?

Once the dentist has diagnosed pericoronitis, they will design a treatment plan according to the specific needs of the individual.

The condition can be difficult to treat because if there is a gum flap, then the problem will not go away completely until the tooth fully erupts, or the tooth or tissue is removed.

If the person has symptoms that are localized to the area around the tooth then the dentist may try the following treatment options:

  • thoroughly cleaning the area
  • removing any food debris
  • draining any pus

If there is an infection, then the dentist will prescribe antibiotics, and an individual can take other medication to manage the pain and reduce swelling. A person should consult their dentist before using any over-the-counter medications or mouth rinses.

In many cases, the dentist may recommend removing the tooth, especially if it is a recurring problem.

It is vitally important that symptoms of pericoronitis are treated swiftly to keep the infection from spreading and to lessen the risks of complications.

Anyone experiencing symptoms of pericoronitis should contact their dentist as soon as possible. Those who realize their wisdom teeth are coming through but have no symptoms of pericoronitis should still tell their dentist so that they can monitor the progress.

Home remedies

For minor cases of pericoronitis, some home remedies can help alleviate and treat symptoms.

A warm saltwater rinse can help, as can cleaning the affected area carefully with a toothbrush to remove plaque and food debris.

However, if a person sees no improvement after 5 days, then they should consult a dentist.

It is not recommended to use home remedies if a person is experiencing severe symptoms.

Possible complications

Complications associated with pericoronitis can occur. Problems are more likely to happen if the symptoms are not treated promptly.

Sometimes, the infection can spread from the affected area, which can lead to swelling and pain in other parts of the head and neck.

Trismus, where a person finds it difficult to open their mouth or bite down, can also be a complication.

In rare cases, complications of pericoronitis can even be life-threatening. Untreated pericoronitis can lead to Ludwig’s angina, which is an infection that spreads under the jaw and tongue. This condition can also cause other deep infections within the head, neck, or throat.

There is also the possibility that the infection can spread into the bloodstream, in a condition known as sepsis, which can also be life-threatening.

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Mouthwash, toothbrush, toothpaste, dental floss, and other oral hygiene products.
Practicing good oral hygiene may help to prevent pericoronitis from occurring.

Steps that people can take to try and reduce the chance of pericoronitis developing include:

  • Good oral hygiene: Extra cleaning around the affected tooth to remove food debris and bacteria will help.
  • Regular visits to the dentist: Regular check ups will help the dentist identify any signs or problems associated with pericoronitis, increasing the chance of treating them early.
  • Taking pre-emptive action: Contacting the dentist whenever a person has any concerns about pericoronitis developing is recommended.


Typically, pericoronitis causes no long-term effects. If the wisdom tooth fully erupts or is removed then pericoronitis will not reoccur in that area.

If a tooth is removed, then a person can usually expect to make a full recovery after about 2 weeks. During recovery, a person can expect to experience:

  • jaw stiffness
  • a mildly bad taste in the mouth
  • swelling
  • pain
  • tingling or numbness of the mouth and face (less common)

Following all aftercare instructions is essential. A person should contact their dentist or oral surgeon if they experience intense or throbbing pain, fever, or bleeding.

The most important thing about treating pericoronitis is ensuring that individuals receive the right treatment so that this painful condition can be corrected as soon as possible.

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Medical News Today: ADHD: Could maternal depression be the cause?

In this article, we discuss new evidence in support of a significant link between depression during pregnancy and an increased risk of attention deficit hyperactivity disorder in the child.
Depression during pregnancy
A new study uncovers links between maternal depression and ADHD.

Attention deficit hyperactivity disorder (ADHD) is primarily characterized by two categories of behavioral problems: inattentiveness and hyperactivity or impulsiveness.

ADHD is now one of the most common pediatric neurodevelopmental disorders, affecting up to 7.2 percent of all children.

The condition raises the likelihood that the child will face difficulty at school and later in life. Also, some evidence suggests that ADHD increases mortality rates.

And worryingly, according to some reports, the incidence rate of ADHD is steadily rising. Although better detection rates certainly play a part in the increase, this cannot explain the size of growth.

Therefore, the race is on to understand what causes ADHD and, importantly, whether or not it can be prevented.

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Maternal depression and ADHD

A group of researchers recently investigated the role of depression during pregnancy in ADHD risk. Although scientists have explored a range of potential causes of ADHD, maternal depression has received relatively little attention.

The sparse literature on this interaction has been inconclusive. However, the authors of the current study believe that this lack of clarity might be due to methodological flaws.

Such flaws include the fact that earlier studies only quantified depression at one or two points in time during pregnancy, rather than throughout. Also, the effects of depression after pregnancy were not taken into account.

Another potential issue in previous work is explained by the authors. “The studies failed to account for maternal pre-pregnancy obesity and common pregnancy disorders,” they explain, “which in addition to increasing the child’s ADHD risk, may often also accompany maternal depression.”

The team designed a study to reopen the question and address the issues outlined above. So, in this experiment, depressive symptoms were measured biweekly from 12 weeks pregnant until delivery.

Children were followed until the age of 3–6. At this point, the scientists registered details about the mother’s depressive symptoms following pregnancy. Data regarding pre-pregnancy obesity, hypertension disorders during pregnancy, and gestational diabetes were also collated.

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Study sheds light on depression-ADHD link

In all, 1,779 Finnish mothers and their one child, born 2006–2010, were included in the study. Their assessment began at the 12th week of gestation, and the final assessment took place when the child was an average of 3.8 years old. The researchers’ findings were recently published in the journal PLOS One.

Following analysis, the authors found that the proportion of “children with clinically significant ADHD symptoms were higher in the group of women who had consistently high depressive symptoms throughout pregnancy.”

In short, ADHD was more commonly found in the offspring of depressed mothers, and their symptoms were significantly worse.

If the mother experienced depressive symptoms after birth, this added to the effects of depressive symptoms during pregnancy: there was a further increased risk of ADHD and more pronounced symptoms.

Contrary to expectations, maternal obesity and pregnancy disorders — such as maternal diabetes — did not influence ADHD outcomes in the offspring. Similarly, when depressive symptoms were split into trimesters, there were no time-specific effects. This was because, in general, those mothers who were depressed during pregnancy were depressed throughout.

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What might cause this interaction?

The study’s findings are clear cut, but as the authors write, “An obvious study limitation is that we are not able to specify the brain structural or functional nor biological or behavioral underlying mechanisms.”

This will be the next step, and a number of potential mechanisms have already been proposed. For example, earlier studies showed that maternal depressive symptoms, salivary cortisol levels, or both might alter a baby’s brain structure and the way that it is connected.

Depression during pregnancy has also been linked with an increase in placental glucocorticoid sensitivity, which could have a wide array of effects on fetal development.

Inflammation could also play a role; studies have found that inflammatory cytokines correlate with maternal depressive symptoms.

It will take time to unravel how and why maternal depression is linked to ADHD, and it is likely to be a complex picture involving all of the processes above and more. However, for now, the current findings can still be clinically useful.

As the authors write in their conclusion, “[P]reventive interventions focusing on maternal depressive symptoms may benefit not only maternal but offspring well-being.”

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Medical News Today: What emotion does this image evoke? Fear or disgust?

According to the latest study on trypophobia — a fear of irregular patterns or clusters of small holes — it may not be a phobia after all. The negative response seems to be driven by disgust rather than fear.
Lotus seed heads
How do you feel about this image?

Trypophobia is not currently recognized by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders as a mental disorder.

However, within forum discussions and social media threads, thousands of people admit to feeling distinct discomfort when they see clusters of holes.

These people might be disturbed by the sight of honeycomb or lotus seed heads (such as those in the image). Some of us even feel queasy in the presence of aerated chocolate.

Researchers led by Stella Lourenco, a psychologist at Emory University in Atlanta, GA, decided to dig deeper into trypophobia and asked why it might occur.

Specifically, the team wanted to get to grips with the physiological and psychological drivers of this rather odd — and currently unofficial — phobia. Their results are published this week in the journal PeerJ.

Though the word “trypophobia” may not be particularly familiar, Lourenco says, “The phenomenon, which likely has an evolutionary basis, may be more common than we realize.”

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Fear and disgust

Both fear and disgust impart an evolutionary advantage — fear helps us to avoid peckish predators, while disgust steers us away from eating perished plums. These negative emotions are certainly psychological bedfellows, but they’re also distinct entities.

Over the years, since Darwin’s time, the similarities and differences between fear and disgust have been debated. It is now established that the physiological responses are different: fear activates the sympathetic nervous system, and disgust triggers the parasympathetic nervous system.

The sympathetic nervous system prepares the body for threat or injury by increasing heart rate and contracting muscles. The parasympathetic nervous system controls general body functions at rest, making muscles relax and heart rate decrease.

Repeating patterns and primal fears

The first question to ask is why groups of holes and irregular repeating patterns are frightening to our primal, caveman brains.

Some psychologists believe that the high contrast seen in trypophobia-inducing images is similar to patterns found on some dangerous animals, such as snakes. It has been argued that this similarity could be the driving force behind the negative response.

We’re an incredibly visual species. Low-level visual properties can convey a lot of meaningful information. These visual cues allow us to make immediate inferences — whether we see part of a snake in the grass or a whole snake — and react quickly to potential danger.”

Lead study author Vladislav Ayzenberg, graduate student in Lourenco’s laboratory

If we spot a snake (or snake-like object) in the grass, it triggers our so-called “fight or flight” response, which is mediated by the sympathetic nervous system and readies our body for imminent danger.

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Measuring pupils

The study was designed to identify whether a trypophobic reaction is triggered by the sympathetic or parasympathetic nervous system. The team wanted to know whether this odd reaction is based on disgust or fear.

Pupillometry — which is an eye-tracking technique that measures pupil size and reactivity — let the scientists glimpse the physiology behind the emotion. Earlier work had shown that a fear response induces an increase in pupil size while, conversely, disgust causes pupil size to decrease.

Aerated chocolate
Delicious or disgusting?

Using this knowledge, the researchers showed participants three sets of images:

  • 20 showing threatening animals (spiders and snakes)
  • 20 known to trigger a trypophobic reaction
  • 20 controls that included pictures of cups, butterflies, and other inoffensive subject matter

The theory goes that if trypophobia is a fear response, a person’s pupils should respond in a similar way to both the images of dangerous beasts and lotus seed pods.

If, however, trypophobia is a disgust-based response, the pupils would behave differently between the two experimental image types.

After analysis, it was clear that both the images of dangerous animals and trypophobic patterns triggered a response. However, they were not the same: pictures of snakes and spiders caused an increase in pupil size, whereas images of holes caused the pupils to constrict.

“On the surface,” states Ayzenberg, “images of threatening animals and clusters of holes both elicit an aversive reaction. Our findings, however, suggest that the physiological underpinnings for these reactions are different, even though the general aversion may be rooted in shared visual-spectral properties.”

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The researchers conclude that rather than the trypophobia-inducing images mimicking dangerous animals, they might remind our primal brains of rotten or moldy food. This, rather sensibly, triggers a disgusted reaction and an aversion to the images.

Interestingly, the study was carried out on students, none of whom reported having trypophobia. As Lourenco explains, “The fact that we found effects in this population suggests a quite primitive and pervasive visual mechanism underlying an aversion to holes.”

More studies will be needed to firm up these findings, but they do add extra weight to the theory that fear and disgust are separate but related emotions. So, if you have trypophobia, remember: you are not afraid of holes, you are disgusted by them.

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Medical News Today: Oophorectomy: Everything you need to know

An oophorectomy is a surgical procedure to remove one or both of a woman’s ovaries. The surgery is usually performed to prevent or treat certain conditions, such as ovarian cancer or endometriosis.

An oophorectomy comes with its own risks and complications, so a person should always discuss their options with a doctor prior to surgery.

The surgery only lasts a few hours, but recovery times can vary. Self-care is an important part of recovery, and it is crucial to discuss recovery with a doctor beforehand to avoid unwanted complications.

What is an oophorectomy?

womans reproductive system oophorectomy
The removal of a woman’s ovaries is known as an oophorectomy.

The term oophorectomy is used to describe the surgical removal of one or both of the ovaries. It is also called ovariectomy.

The surgery may just remove the ovaries, or it may be a part of a hysterectomy, which is the removal of the uterus and possibly some surrounding structures.

There are different reasons for an oophorectomy, including:

Women who carry the BRCA1 or BRCA2 genes may be more likely to experience certain types of cancer and may choose to have an oophorectomy, as a preventive measure.

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Types of oophorectomy

Oophorectomy is a broad term for a medical procedure that removes one or both ovaries, but there are different types of oophorectomies that can be done.

  • Unilateral oophorectomy: Removal of one ovary, usually done when a woman still wants to become pregnant.
  • Bilateral oophorectomy: Removal of both ovaries, done to prevent disorders or spread of cancer cells.
  • Salpingo-oophorectomy: Removal of the fallopian tube along with the ovary, often to treat cancers or other disorders.
  • Prophylactic oophorectomy: Also called a preventative oophorectomy, this procedure is done to reduce the risk of future diseases.

What to expect

woman having blood drawn for test
Before an operation is scheduled, a doctor may perform tests such as urine tests, physical tests, and blood tests.

A person should always discuss what to expect during and after the surgery with their doctor.

Several tests may be used before scheduling the operation, including:

  • physical exams
  • blood tests
  • urine tests
  • computed tomography (CT) scan
  • ultrasound

An oophorectomy is performed using either open abdominal surgery or laparoscopic surgery. Both operations should take no more than a few hours to complete but may require staying one or several nights in the hospital.

Open abdominal surgery

In an open abdominal surgery, a surgeon will make an incision in the abdomen and then carefully separate the abdominal muscles.

Blood vessels will be temporarily tied off to prevent bleeding. The surgeon will remove the ovary or ovaries and then seal up the incision.

Laparoscopic surgery

During laparoscopic surgery, a thin, cord-like instrument is inserted into a small cut near the navel. A tiny camera allows the surgeon to see and remove the ovary or ovaries.

The process may leave less noticeable scars and have a shorter recovery time than open abdominal surgery.

After the surgery

It is helpful for someone else to drive the woman home and care for her in the first few days after her surgery.

Most surgeries will require at least 2–3 weeks away from work. Regular check-ups allow doctors to monitor and alter the recovery process, as needed.

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How long does recovery take?

Recovering from an oophorectomy will vary based on a few different factors, including the type of surgery. Laparoscopic surgery may require only 1 day in the hospital, but open abdominal surgery will typically need 2 or more days in the hospital.

Recovery recommendations will vary, depending on the individual, but some general recovery tips include:

  • resting before surgery and during recovery
  • taking relaxed, deep breaths
  • avoiding heavy lifting or exercise
  • refraining from sexual intercourse
  • avoiding using tampons during recovery
  • making dietary changes and taking medications for constipation as needed
  • avoiding infection risks, such as taking baths and wearing tight or synthetic clothing

Doctors will also instruct their patients on how to take care of their incision site, including regular cleaning, keeping the area dry, and monitoring it for signs of infection.

Risks and complications

woman on sofa with blanket suffering from fever sweating and chills
Signs and symptoms of complications may include depression, nausea and vomiting for more than a few days, and fever.

Although an oophorectomy is often performed to help treat or prevent diseases, it may put women at risk of other issues.

Serious complications are rare, but people who smoke, are obese, or have diabetes may be more at risk for surgical complications.

Women who have had pelvic surgery or serious infections in the past may also be more vulnerable to complications.

Women who have both ovaries removed will no longer be able to become pregnant. A woman who wishes to become pregnant or is considering pregnancy in the future should discuss alternative options to oophorectomy with a doctor.

Signs of complications

It is vital to report any signs of a complication to a doctor, as soon as possible. These signs and symptoms include:

  • fever
  • abnormal amount of blood or discharge
  • redness and swelling near the incision
  • skin near the incision feeling very warm
  • nausea and vomiting for more than a few days
  • difficulty urinating
  • chronic abdominal pain
  • shortness of breath or chest pain
  • mood swings
  • depression

Surgical risks

The surgery itself also involves some risks, including:

  • excessive bleeding or blood clots
  • infection
  • scar tissue
  • nerve damage
  • tumor rupture
  • injury to the urinary tract or other organs
  • hernia due to weakened abdominal muscles

In rare cases, people may experience respiratory or cardiac problems after anesthesia.

Hormonal changes

Women who have both of their ovaries removed before they have reached menopause usually take hormones to reduce the risk of menopause symptoms or other disorders. Hormone therapy, comes with side effects, however, including mood swings, nausea, and headaches.

A woman may choose to let the body go through menopause without taking replacement hormones. It is best to discuss any potential hormonal changes with a doctor before an oophorectomy. Some women will be treated with hormones, but not all are good candidates.


A bilateral oophorectomy may also increase the risk of a woman developing osteoporosis, which causes weak and brittle bones. This is because the body will no longer produce much estrogen.

Osteoporosis can increase the risk of breaking bones, particularly from falls or other injuries.

Life expectancy

Women who keep their ovaries until at least the age of 50 may live longer than women who have a bilateral oophorectomy before then.

One study noted that while a bilateral oophorectomy does reduce the risk of death from ovarian cancer and breast cancer in some cases, it may increase the risks of death from all other causes.

However, surgery may still be the best option for women who are BRCA1 or BRCA2 carriers.

A review in the Journal of Clinical Oncology noted that women with these genes who have their ovaries removed have an 80 percent reduction in the risk of death from specific cancers and a 77 percent reduction in risk of death from all causes.

It is essential for a person to discuss their personal history and all their options with a doctor before choosing an oophorectomy.

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An oophorectomy can be a lifesaving procedure in many cases. However, women with an otherwise healthy uterus and ovaries should thoroughly discuss their options with a doctor, as the surgery comes with some risks.

Women should give themselves plenty of time to recover from surgery, as the recovery time can vary. A woman may want to consider having help at home for the first few days to assist her getting up and preparing meals.

Women who have had one ovary removed but still have their uterus may notice very little change, as their hormones and menstruation will stay relatively the same. Women who have had both ovaries removed will notice the biggest change.

Doctors can help people to explore recovery options and give them more information about what symptoms to expect after an oophorectomy.

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Medical News Today: What causes muscle soreness and stiffness?

Muscle stiffness is when the muscles feel tight and difficult to move, particularly after resting.

Muscles stiffness can also be accompanied by pain, cramping, and discomfort.

It is usually not a cause for concern and can be treated with home remedies and stretching.

In this article, we look at some causes of muscle stiffness, as well as home remedies and when to see a doctor.


There are a variety of things that can cause muscle stiffness, including:


Woman in exercise and sports wear with muscle stiffness in back.
Alongside sprains and strains, exercise or physical stress may cause muscle stiffness.

A common cause of muscle stiffness is exercise or hard physical labor of some kind.

Often, stiffness can occur when someone starts a new exercise routine or program or has increased the intensity and duration of their routine.

When this happens, the muscles are required to work harder, and this causes microscopic damage to the muscle fibers, resulting in stiffness or soreness. This type of injury is sometimes referred to as delayed onset muscle soreness (DOMS).

Any movement can cause DOMS, but it is commonly caused by:

  • jogging or running downhill
  • using weights
  • doing squats
  • doing push-ups

Sprains and strains

The most common cause of muscle stiffness is a sprain or strain, which can affect both the muscles and ligaments.

A strain is when the muscle fibers are stretched or torn. Strains are particularly common in the legs and lower back.

A sprain is when the ligaments have been stretched, twisted, or torn. The ligaments are the bands of tissue around the joints that connect the bones together.

Common areas prone to sprains include:

  • knees
  • ankles
  • wrists
  • thumbs

Other symptoms associated with sprains and strains include:

  • pain
  • swelling
  • bruising
  • tenderness
  • redness

Polymyalgia rheumatica

Polymyalgia rheumatica causes muscle pain and stiffness. It usually affects the upper body, including the shoulders, neck, and arms. It also commonly affects the hips.

The average age of a person with polymyalgia rheumatica is 70, and some people do not develop it until they reach their 80s. What causes the condition is unknown.

Additional symptoms of polymyalgia rheumatica include:

  • trouble sleeping
  • difficulty putting on clothing
  • problems changing position, such as getting out of a chair or a car

Bites or stings

Infected mosquito bite on forearm.
Insect bites or stings may cause muscle stiffness, especially if they become infected.

Insect bites and stings can sometimes cause muscle stiffness. Bites or stings may also cause a red, swollen lump on the skin, which can be itchy and painful.

Bugs that commonly bite or sting and may cause muscle stiffness include:

  • wasps
  • hornets
  • bees
  • horseflies
  • ticks
  • mosquitoes
  • fleas
  • spiders
  • midges

Symptoms of a bite or sting will usually improve within a few days, but some people have allergic reactions that may require medical attention.

Stiffness after an insect bite can also be associated with more serious conditions, such as Lyme disease, malaria, or Rocky Mountain spotted fever. These conditions will also cause other symptoms, such as fever and malaise.


Some infections cause muscle stiffness in addition to other symptoms. These infections include:

  • tetanus, a bacterial infection usually associated with dirt or soil
  • meningitis, an infection of the brain and spinal cord
  • HIV
  • Legionnaires’ disease
  • polio
  • mononucleosis or mono
  • lupus
  • influenza or the flu


Some medications can cause muscle stiffness. Muscle stiffness is a common side effect of statins, or drugs prescribed to lower cholesterol.

Anesthetics used before surgery can also cause a person to experience muscle stiffness during the hours and days that follow.

Additional causes

Other things that may lead to occasional muscle stiffness include:

  • a lack of daily physical activity
  • being overweight
  • having a poor diet
  • not sleeping properly
  • being in a cold or damp environment

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When to see a doctor

Most cases of muscle stiffness will go away on their own or with the aid of home remedies, but prolonged or frequent stiffness can sometimes be a sign of an underlying condition.

If someone is experiencing muscle stiffness along with additional symptoms, such as fever, pain, dark urine, or swelling, they should speak to a doctor.

If a person is experiencing stiffness after an insect bite or sting, they should speak to a medical professional, especially if they have allergy symptoms.

People should always speak to a doctor about any bothersome side effects of medications they are taking, including muscle stiffness.

It is important for a person to tell the doctor about all the symptoms they have, not just muscle stiffness, in order to get an accurate diagnosis.

Treatment and home remedies

If muscle stiffness is a symptom of an underlying condition, a person will work with their doctor to make a treatment plan. A doctor may also prescribe anti-inflammatory medication to reduce pain and discomfort.

Over-the-counter painkillers usually work for pain relief, although stronger medications may be prescribed if necessary.

If a medication is causing stiffness, a doctor may be able to adjust the dose or prescribe an alternative.

For most cases of muscle stiffness, there are some simple home remedies for relief. These include:

  • resting until the body repairs
  • using heat or ice packs, or alternating between each
  • stretching to improve flexibility and circulation
  • taking a warm bath or shower to promote blood circulation
  • massaging the affected areas

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Man sitting down stretching his legs and hamstrings before exercising.
Regular exercise, alongside stretching and warming up before exercise, may help to prevent muscle stiffness.

There are also some simple changes people can make to their lifestyle to prevent getting muscle stiffness. These include:

  • exercising regularly
  • warming up and down before and after exercise
  • stretching the muscles
  • wearing the correct footwear during exercise
  • wearing warm clothing in cold weather
  • practicing good posture
  • ensuring furniture at home and work gives comfort and support
  • avoiding long periods of inactivity


Staying hydrated and eating a varied, nutritious diet is an important part of a healthy lifestyle and can also help reduce the chance of muscle stiffness.

To stay hydrated, a person should drink plain water every day, try herbal teas, or add fruit slices to sparkling water.

Research has shown a link between muscle stiffness and dehydration, so a person should take breaks and stay hydrated while exercising.


Muscle stiffness will usually go away on its own in a few days. In chronic or recurrent cases, making simple lifestyle changes may help treat and prevent muscle stiffness.

If muscle stiffness is a symptom of a more serious underlying condition, the outlook will vary depending on the cause. A person should speak to their doctor if they are concerned about unexplainable or long-term muscle stiffness.

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Medical News Today: Does green tea help weight loss?

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