In Other Journals

Numbers by colour

What would you think someone would say to you if you told them that you saw numbers as colours? For example, that you see the number three as purple? On being told she was weird because she said her “numbers were colours”, one teenager didn’t mention it again, to anyone, for the next 25 years.1 However, in an editorial in the BMJ, US expert Eagleman says that synaesthesia — where stimulation of one area of the brain triggers an anomalous perceptual experience in another (usually separated) area of the brain — is a harmless neurological condition experienced by about 1% of the population.2 He describes synaesthesia as a fusion of different sensory perceptions: “the feel of sandpaper might evoke an F sharp, a symphony might be experienced in blues and golds, or the concept of February might be experienced above the right shoulder”. Synaesthetic experiences are not hallucinations; and synaesthetic perceptions are involuntary, automatic, and consistent over time, he said. The condition may have a genetic basis.

1. BMJ 2009; 339: b3191

2. BMJ 2010; 340: b4616

Defeating deformity

What may the Roman emperor Claudius, the English poet Lord Byron and the international entertainer Dudley Moore have had in common with each other? Congenital talipes equinovarus or, in other words, a clubfoot. In the past, infants born with a clubfoot may have been subjected to various, often multiple, surgical procedures. Today, they are much more likely to be managed with the more successful Ponseti method, which consists of sequential plasters and prolonged bracing, with one or two minor surgical procedures included as required. In a review article, Bridgens and Kiely say that the earlier this treatment is started — ideally at around one or two weeks of age — the easier the correction will be. Detailed information about the Ponseti method is available online at www.ponseti.info and www.global-help.org

The question of whether there is a role for antibiotics in the treatment of Buruli ulcer disease (Mycobacterium ulcerans infection) has now been answered with a resounding “yes”, according to an Australian expert. Johnson was commenting on a randomised controlled trial, conducted in Ghana and published in The Lancet, which found that antimycobacterial treatment with agents such as streptomycin, rifampicin and clarithromycin was effective in treating early, limited infection — without surgical debridement. For many years, surgical debridement alone was the standard treatment for Buruli ulcer disease; the addition of antimicrobial drugs to surgical treatment has only been recommended relatively recently. The researchers observed that healing of lesions continued long after antibiotic treatment had stopped. Johnson said that this slow response could have led earlier investigators to abandon antibiotics in favour of wide surgical excision. Further, paradoxical reactions during antibiotic treatment (where things look worse before they get much better) could also have contributed to the view that antibiotics were ineffective. (Lastly, “yes”, for those Australians who are wondering, — we have known Buruli ulcer as Bairnsdale ulcer.)

Treatment with a natural substance may prevent, or at least delay, the onset of psychotic disorder in at-risk adolescents and young adults, say a team of Austrian and Australian researchers (including Australian of the Year, Professor Patrick McGorry). In a randomised, placebo-controlled trial, Amminger and colleagues found that daily capsules of concentrated marine fish oil taken for a period of 12 weeks significantly reduced the risk of progression to psychosis in subjects at ultra-high risk of psychotic disorder. Further, the effect was sustained at one year — well after the intervention had ceased. Long-chain omega-3 polyunsaturated fatty acids (PUFAs) are key components of the oil, and are thought to have neuroprotective effects. The researchers say taking the fish oil could present an appealing alternative to using antipsychotic medications in the prodromal phase of psychotic illness. The adverse effects of using antipsychotics can include metabolic changes, sexual dysfunction and weight gain, whereas omega-3 PUFAs are thought to be very safe, with few clinically relevant adverse effects, except for some gastrointestinal symptoms that may occur, like nausea, loose stools and fishy eructation.