Categories : Expert Opinion Metabolic DisordersTags : Leave a comment

South Africa’s Weight-loss Revolution is Testing Medical Discipline

On By ModernMedia
Photo by I Yunmai on Unsplash

One in every two South African adults is considered overweight or obese. It is not surprising, then, that potentially lifesaving prescription-based metabolic medicines are surging in popularity. The challenge: demand is rising faster than the clinical structure needed to support it, leaving many patients unsure what responsible, medically supervised care should look like.

It is a concern Dr Gerhard Vosloo, a prominent sports, exercise, and lifestyle physician, says he is encountering more frequently in clinical practice. “Expectations are becoming unreasonably high, while few understanding the level of medical oversight required to manage these therapies responsibly. It’s just not as simple as prescribing an aggressive regime and standing back.”

To address issues in today’s weight management sector, Dr Vosloo established Dr GL Vosloo Medical Practice, managed by BioWell, as a formal online medical practice built around sound clinical judgment, structured care, and meaningful patient oversight. He says, “We’re building a model – one that could serve as a stable structure for the wider industry, where sound medical judgment is consistently prioritised over the public’s growing appetite for weight loss drugs.”

The danger of normalising prescription therapy

Dr Vosloo cautions that the rapid rise of these medicines in the mainstream is oversimplifying a highly complex subject and making pharmaceutical use seem routine, when it should remain a final option after disciplined nutrition- and exercise-led approaches have been fully explored.

“Misinformation spreads like wildfire online. People are starting to view prescribed medicines as a routine diet option, when they should be a last resort. Pharmaceuticals are powerful tools for people who struggle to lose weight, but they should be introduced only when medically appropriate, and only after nutrition, exercise, and appropriate supplementation have been fully explored.”

He maintains that prescribed medicines should form part of a structured metabolic management programme that, when used correctly, will reduce cardiometabolic risk, improve insulin sensitivity, regulate appetite, and support meaningful body composition change. The goal is to improve metabolic health under disciplined supervision, and when treatment is not medically necessary, doctors must refuse to prescribe.

“Clinical eligibility must be determined by medical rationale,” he says. “A patient’s preference for medication, emotional pressure to start treatment, or the ability to pay cannot override clinical judgement. Where medical need is absent, a BioWell doctor will decline to prescribe and direct the patient to a non-pharmaceutical, doctor-supported metabolic management pathway.”

Dosing with discipline

Beyond unnecessary prescribing practices, Dr Vosloo stresses that the industry is undermined by over lenient dosing habits. As practiced on the BioWell platform, dosing decisions should instead follow a conservative model guided by clinical responses and tolerability rather than speed of weight loss. The objective is to protect overall health while supporting steady progress that the body can sustain.

“An unfortunate consequence of aggressive dosing is the loss of muscle mass. It’s easier for the body to draw from muscle than it is to mobilise fat, particularly when calories and protein are low – a hallmark of aggressive dosing protocols. The nutritional and training commitment needed to offset muscle loss under more radical regimens are difficult to manage for most people. It’s far safer and more sustainable to take low doses over a longer period.”

“BioWell doctors are more measured in our approach. Conservative dosing and escalation protocols help keep muscle loss to a minimum, while structured nutrition and exercise support plans strengthen the muscular system. This also reduces the risk of nutritional deficiency and limits the physiological stress that often accompanies poorly managed treatments.”

The end goal, Dr Vosloo explains, is to safely and gradually bring South Africa’s obesity crisis under control without creating any additional harm. “Prescription-based metabolic medicine is an undeniably powerful tool in the fight against obesity – one we cannot afford to lose. It’s a lifeline for people battling weight-related illness, but it’s also become a dangerous crutch for those willing to gamble with their health just to lose a few kilograms quickly. If we want to change the health trajectory of millions, we need to rein in aggressive dosing practices and establish a common-sense structure across the sector.”

Categories : Ageing Environmental EffectsTags : Leave a comment

HEPA Air Purifiers May Boost Brain Power in Adults Over 40 – New Research

On By ModernMedia
Photo by Mari Lezhava on Unsplash

Nicholas Pellegrino, University of Connecticut; Doug Brugge, University of Connecticut, and Misha Eliasziw, Tufts University

Using an in-home HEPA purifier for one month spurs a small but significant improvement in brain function in adults age 40 and older. That’s the result of a new study we co-authored in the journal Scientific Reports.

HEPA purifiers – HEPA stands for high efficiency particulate air – remove particulate matter from the air. Exposure to particulate matter has been connected to respiratory and cardiovascular illnesses as well as neurological diseases such as Alzheimer’s and Parkinson’s. Environmental health researchers increasingly recommend that people use HEPA air purifiers in their homes to lower their exposure to particulate matter, but few studies have examined whether using them boosts mental function.

We analysed data from a study of 119 people ages 30 to 74 living in Somerville, Massachusetts. Somerville sits along Interstate 93 and Route 28, two major highways, resulting in relatively high levels of traffic-related air pollution. This makes it an especially good location for testing the health effects of air purifiers.

We randomly assigned participants to one of two groups. One used a HEPA air purifier for one month and then a sham air purifier – which looked and acted like the real thing but did not contain the air-cleaning filter – for one month, with a monthlong break in between. The second group used the real and sham purifiers in reverse order.

After each month, participants took a test that measured different aspects of their mental capacity. The test probed people’s visual memory and motor speed skills by measuring how quickly they could draw lines between sequential numbers, and it tested executive function and mental flexibility by asking them to draw lines between alternating sequential numbers and letters.

We found that participants 40 years and older – about 42% of our sample – on average completed the section testing for mental flexibility and executive function 12% faster after using the HEPA purifier than after using the sham purifier. That was true even when we accounted for factors like differences in the amount of time participants spent indoors, with either filter, as well as how stressful they found the test.

This improvement may seem small, but it is similar to the cognitive benefits that people experience from increasing their daily exercise. While you may not experience a sudden increase in clarity from a 12% boost, preventing cognitive decline is vital for long-term well-being. Even small decreases in cognitive functioning may be associated with a higher risk of death.

Studies increasingly show that air pollution can be detrimental to brain health.

Why it matters

Air pollution can negatively affect mental function after just a few hours of exposure. Studies show that air purifiers are effective at reducing particulates, but it’s unclear whether these reductions can prevent cognitive harm from ongoing pollution sources like traffic. Research has been especially lacking in people living near major sources of air pollution, such as highways.

People living near highways or major roadways are exposed to more air pollution and also experience higher rates of air pollution-related diseases. These risks aren’t encountered by all Americans equally: People of color and low-income people are more likely to live near highways or areas with heavy traffic.

Our study shows that HEPA air purifiers may offer meaningful health benefits under these circumstances.

What still isn’t known

Research shows that air pollution begins to affect cognitive function especially strongly around age 40. These effects may become increasingly prominent as people age.

HEPA air purifiers may therefore be especially beneficial for older adults. Our study did not explore this possibility, as fewer than 10 of our 119 participants were over the age of 60.

Also, our participants only used a HEPA air purifier for one month. It’s possible that longer durations of air purification may sustain or even increase the improvement in cognitive function we observed in our study.

Finally, it is unclear exactly how air purifiers improve cognition. Some studies suggest that exposure to particulate matter reduces the amount of the brain’s white matter, which helps brain cells conduct electrical signals and maintains connections between brain regions. The brain regions most harmed by air pollution are the ones that control mental flexibility and executive function, the same domains in which we saw improvements in our study.

We plan to study whether reducing particulate matter by using air purifiers is indeed protecting the brain’s white matter, and whether it could reverse some cognitive decline. We will explore that possibility by studying how levels of molecules called metabolites, which cells produce as they do their jobs, change in response to breathing polluted air and air cleaned by a HEPA filter.

The Research Brief is a short take on interesting academic work.

Nicholas Pellegrino, Research Associate in Public Health Sciences, University of Connecticut; Doug Brugge, Professor of Public Health Science and Community Medicine, University of Connecticut, and Misha Eliasziw, Associate Professor of Biostatistics, Public Health and Community Medicine, Tufts University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Categories : AgeingTags : Leave a comment

Alzheimer’s Risk Gene APOE4 Silently Undermines Bone Quality in Women

On By ModernMedia

Buck Institute researchers discover a surprising connection between a major risk factor for Alzheimer’s

Photo by Karolina Grabowska on Pexels

Scientists at the Buck Institute for Research on Aging, along with collaborators at UC San Francisco, have discovered that APOE4, the most common genetic risk factor for Alzheimer’s disease, causes bone quality deficits specifically in female mice, through a mechanism that is invisible to standard imaging and can emerge as early as midlife.

The findings, published in Advanced Science, reveal an unexpected biological link between Alzheimer’s risk and skeletal health, and identify a new molecular pathway that could one day inform earlier diagnosis of cognitive decline or guide treatment for bone quality loss in women who carry the APOE4 gene.

“What makes this finding so striking is that bone quality is being compromised at a molecular level that a standard bone scan simply will not catch,” says Buck professor Birgit Schilling, PhD, a senior author of the study. “APOE4 is quietly disrupting the very cells responsible for keeping bone strong, and it is doing this specifically in females, which mirrors what we see with Alzheimer’s disease risk.”

Physicians have long observed that people with Alzheimer’s disease suffer bone fractures at higher rates, and that a diagnosis of osteoporosis in women is actually the earliest known predictor for Alzheimer’s. But the underlying mechanism connecting brain and bone health has remained elusive.

To investigate this connection, researchers, led by research scientist and co-first author of the paper Charles Schurman, PhD, first performed a proteomic analysis of aged mouse bone, a comprehensive survey of all the proteins present in the tissue. “The team discovered that bone, and particularly osteocytes, the long-lived cells embedded within it, is unusually rich in proteins associated with neurological disease, including apolipoprotein E [APOE] and amyloid precursor protein,” says Schurman. “Notably, APOE expression in osteocytes was twice as high in aged female mice as in young or male mice.”

The team then turned to a humanised mouse model carrying either APOE2 (associated with reduced Alzheimer’s risk), APOE3 (considered neutral), or APOE4 (the risk variant), and analysed bone and hippocampal tissue from the same animals. APOE4 produced strong, sex-specific effects on both the bone transcriptome and proteome; researchers found the protein-level disruption in bone was actually more pronounced than the corresponding changes in the hippocampus.

Despite the protein level disruption, cortical bone structure appeared normal under imaging. Researchers found that bone quality deficits arose not from changes in bone shape or density, but from APOE4’s suppression of perilacunar/canalicular remodelling, the process by which osteocytes actively maintain the microscopic channels that keep bone mechanically resilient. When this maintenance breaks down, bone quality deteriorates even when it looks intact.

“These results suggest that osteocytes could serve as early biological sentinels for age-related cognitive decline in women carrying APOE4,” says professor Lisa Ellerby, PhD, also a senior author of the paper. The Ellerby lab studies genetic risk factors for Alzheimer’s.  “We think that targeting osteocyte function may open a new front in preserving bone quality in this population.”

Researchers say there is a larger takeaway from this research that links brain and bone science.  “While we think this work is relevant for human patients with Alzheimer’s disease or with osteoporosis, this study also highlights the need for researchers to consider the human body as an entire system without isolating organs and diseases from each other,” says Ellerby.

Source: Buck Institute for Research on Aging

Categories : Infection ControlTags : Leave a comment

Searching for the Weak Spots in C. Diff’s Defences

On By ModernMedia

New studies reveal how Clostridioides difficile behaves inside the body

Clostridioides difficile. Credit: CDC

Bacterial infections caused by Clostridioides difficile are a serious and persistent problem for patients and hospitals alike. The bacterium can cause severe diarrhoea, life-threatening inflammation of the colon, and recurring illness that dramatically reduces quality of life – especially for older adults, who face the highest risk of complications and death.  

C. diff remains difficult to control for a combination of factors. The bacterium survives many disinfectants, allowing it to easily spread in health care settings, where it is the most common cause of infectious diarrhoea. After entering the body through the mouth, the bacterium travels to the colon, where it colonises and starts releasing toxins that damage tissues. About one in nine patients treated for C. diff will develop another infection within weeks or months, often unpredictably, with the risk of a repeat infection increasing from there. And some strains of the bacterium have become resistant to the first-line antibiotics used to treat it.

Researchers at Tufts University School of Medicine are tackling these challenges by studying C. diff at multiple levels, from how individual bacterial cells behave inside the gut to the molecular switches that help them survive and spread. Together, these approaches are revealing hidden vulnerabilities that could lead to better ways to prevent new or recurrent infections, predict severe disease, or stop the bacterium before it causes harm. 

Watching Infections Unfold, Cell by Cell

“C. diff is everywhere,” said Aimee Shen, an associate professor of molecular biology and microbiology at Tufts School of Medicine. “But infections can look very different from one patient to the next.”  

Some people carry the bacterium without ever getting sick. Others develop severe, life-disrupting illness – typically after being treated for another illness with antibiotics that wipe out beneficial gut bacteria that may have otherwise warded off an infection.  

“A bad C. diff infection is reportedly incredibly painful, like glass shards moving through your intestine,” said Shen. “And there’s some research that shows that C. diff toxins actually act on neurons in the gut.” 

To better understand why the spectrum of disease severity varies so widely, Shen, Tufts’ School of Medicine professor Carol Kumamoto, and their collaborators developed a new imaging approach that lets them track what individual C. diff cells were doing inside the body. They applied fluorescent “reporters” – microscopic glowing tags that mark gene activity – to track which genes are turned on in individual C. diff cells in tissue samples from infected mice. This allowed them to see where the bacteria hide in the gut, which cells switched on toxin genes, and how activity differed from cell to cell during infection.

Their study, recently published in Nature Communications, showed that C. diff spread throughout the entire gut, including closer to the gut’s vulnerable lining than previously thought.  

However, toxin production didn’t depend on the bacteria’s location and only some cells made toxins at any given time. Shen said this suggests that disease may be driven by a small, hard-to-detect subpopulation rather than simply how many bacteria are present.

The imaging study also revealed other unexpected findings, including that a strain of toxin-overproducing bacteria formed unusually long, filament-like shapes in the gut during the acute phase of infection. “These were not observed in later stages of an infection,” said Shen. “This suggests that bacteria producing the most destructive amounts of toxins may be particularly susceptible to certain stresses encountered during infection.”

By illuminating how infections unfold cell by cell in this way, the new imaging method may provide information that could someday help doctors predict which patients are likely to develop severe or recurrent disease. It also may help researchers develop new treatments that better target harmful subpopulations of C. diff bacteria while sparing beneficial gut microbes.

Finding a Potential Weak Spot  

One reason C. diff spreads so effectively is its ability to form tough, dormant spores that act like microscopic seeds sealed in armour. Transmitted via trace amounts of faecal matter, these spores can survive for long periods, stubbornly resisting heat and many common disinfectants, including hand sanitisers. Once ingested, C. diff spores germinate – springing back to life and thus able to spawn toxins.  

This is a pivotal moment scientists hope to block.

Shen’s lab has long studied how the bacterium recognises it has reached the right place to reawaken. Most spore-forming bacteria rely on the same standard molecular sensors, but C. diff uses a different system. Its spores respond to bile acids found in digestive fluids, along with other signals that together flip the bacterium’s switch from dormancy to active growth.

In a study recently published in PLOS Biology, Shen, Tufts’ School of Medicine professor Ekaterina Heldwein, and their collaborators identified a key part of that switch. They found that two proteins, CspC and CspA, lock together to form a signalling hub that helps spores interpret environmental cues. By mapping the structure of this protein pair and testing how it functions, the team showed the combined complex controls how sensitive spores are to germination signals.

“It’s like we’ve identified a central control panel for deciding when the spore comes back to life,” Shen says. “If we understand how that panel works, scientists someday may be able to design new drugs to keep it switched off.”

Searching for More Precise Targets

Together, the studies offer a clearer picture of both how C. diff causes disease and when it becomes dangerous.

Now, in addition to continuing their work on single-cell imaging and spore germination, Shen’s lab is working to uncover other hidden rules that govern C. diff’s behaviour. This includes how it reproduces using a division mechanism unlike those seen in other well-studied bacteria – the focus of a 2023 study published by Shen and collaborators in Nature Communications.  

“The hope is the aspects that make C. diff unique – how it spreads, reproduces, and damages tissue – will allow researchers to design ways to target it much more specifically, while keeping the rest of the gut microbiome healthy and intact,” she said.

Original written by Genevieve Rajewski

Source: Tufts University

Categories : CancerTags : Leave a comment

Age, Sex, and Cancer Type Influence Risk of Subsequent Cancers Among Survivors

On By ModernMedia

Findings may have implications for long-term cancer survivorship surveillance

Researchers assess the risk of developing a subsequent primary cancer based on demographic factors and cancer characteristics. Tara Winstead, Pexels (CC0, https://creativecommons.org/publicdomain/zero/1.0/)

Risk of developing a subsequent primary cancer varied significantly by age at initial diagnosis, sex, and type of first cancer, according to a study by Oxana Palesh and Susan Hong and colleagues at Virginia Commonwealth University, U.S., published April 28th in the open-access journal PLOS Medicine.

Advances in cancer detection and treatment have led to a growing population of cancer survivors. In the U.S., the number of cancer survivors is expected to grow by 22% over the next decade – from 18 million in 2025 to more than 22 million by 2035. Survivors remain at higher risk for developing new primary cancers distinct from their original diagnosis. This risk may be influenced by factors such as older age, exposure to radiation and/or chemotherapy and ongoing lifestyle factors like smoking, obesity and poor diet. Understanding who is at greater risk and how this risk changes over time can help to inform prevention and monitoring strategies.

Using retrospective data from more than 3 million cancer survivors in the U.S., researchers examined how demographic factors and cancer characteristics correlate with subsequent cancer risk. Several factors were associated with developing a subsequent cancer, including older age at initial diagnosis and male sex. In addition, survivors of lung, bladder, and skin melanoma were at higher risk of developing new cancer.

These findings reinforce the importance of long‑term survivorship care and risk‑based monitoring. By identifying survivor groups at heightened risk, studies like this can help to inform tailored prevention strategies, surveillance guidelines, and survivorship care planning as the cancer survivor population continues to grow.

First author Hui Cheng adds, “By examining nearly five decades of national data, we found population-level shifts in subsequent primary cancer risk, with several survivor groups experiencing rising risks. These findings can help design more tailored surveillance and prevention strategies.”

Provided by PLOS

Categories : Expert OpinionTags : Leave a comment

Beware the Salt Trap: Why South Africa’s Heart Health Depends on More Than Regulation

On By ModernMedia
Credit: Pixabay CC0

While South Africa was among the first countries to introduce mandatory salt reduction targets in processed foods, health experts warn that hypertension remains a major public health concern. The reason is increasingly clear, the problem is no longer only what is manufactured, but how people eat every day.

As World Salt and Hypertension Awareness Week (4–29 May) approaches, the focus should shift from reformulated products to daily behaviour change. High salt intake causes the body to retain excess fluid, which increases the volume of blood in the system and places greater pressure on the artery walls, directly leading to the development of hypertension.

“While the policy has successfully reduced hidden salt in many staple foods, it has not yet shifted South African taste preferences.,” says Lizeth Kruger, Clinic Executive at Dis-Chem. “We are still reaching for the shaker out of habit, and that’s where the real danger lies.”

Hypertension remains one of South Africa’s leading risk factors for heart disease and stroke, often progressing silently until complications arise. According to the Heart and Stroke Foundation South Africa, more than one in three adults lives with high blood pressure, a ‘silent killer’ that accounts for roughly half of all strokes and 40% of heart attacks in the country.

Kruger says a shift in everyday eating habits could reduce excess salt intake

1. Automatic salt shake

Many people add salt before tasting their food, even when meals have already been seasoned during cooking or processing.

2. Hidden salt in everyday staples

Stock cubes, processed meats, margarine and sauces remain significant sodium sources, especially when used frequently in daily cooking.

3. Convenience meals and takeaways

Ultra-processed foods and fast meals are often high in sodium, with a single serving sometimes approaching or exceeding the recommended daily limit.

4. A conditioned taste for salt

Long-term high-salt diets have shaped taste preferences, making fresh, whole foods seem bland and reinforcing reliance on added seasoning.

5. Unnoticed snack intake

Savoury snacks, biltong and crackers contribute meaningful sodium but are often not counted in daily intake.

Small changes, meaningful impact

Kruger says reducing salt intake is less about strict diets and more about changing repeat behaviours.

“Small, consistent adjustments can make a real difference over time,” she explains.

  • Tasting food before adding salt is a simple first step, as many meals are already seasoned. Rinsing canned foods such as beans or corn can also reduce sodium content.
  • Flavour can be enhanced using alternatives such as garlic, lemon juice, herbs and black pepper, while checking labels for lower-sodium options helps guide better choices.

A shared responsibility

“Regulation has laid the foundation, but the final step is ours,” Kruger advises. “By becoming more aware of everyday habits, we can reduce the risk of hypertension, stroke and heart disease in our homes.”

Categories : Cardiovascular DiseaseTags : Leave a comment

Ablation Superior to Drugs in Treating Persistent AFib

On By ModernMedia

Large international clinical trials show an innovative procedure outperforms drugs for advanced atrial fibrillation

Pexels Photo by Freestocksorg

A minimally invasive heart procedure may be a better first-line treatment than medication for people living with advanced forms of atrial fibrillation (AFib), according to a major international clinical trial led by researchers at the UBC Faculty of Medicine.

For decades, most patients with AFib have been treated with medications first. Procedures like catheter ablation – a minimally invasive technique used to correct faulty electrical signalling in the heart – have typically been reserved for patients whose symptoms persist despite drug therapy. While recent research has suggested ablation may be a more effective initial treatment for early-stage disease, it has also been unclear whether this is true for patients with more advanced disease, who tend to be older, have more underlying health conditions and face higher risks overall.

Published in The New England Journal of Medicine, the new study shows starting with ablation can lead to better outcomes for patients with advanced forms of AFib.

“Traditionally, we’ve taken a stepwise approach, starting with medications and moving to procedures later,” said Dr Jason Andrade, clinical professor at UBC’s faculty of medicine and investigator at the Centre for Cardiovascular Innovation. “What this trial shows is that, even in patients with more advanced AFib, earlier intervention with ablation can provide substantial benefits and better control of the disease.”

A different way to treat the heart

The study focused on patients with persistent AFib, a more serious form in which the abnormal rhythm lasts longer and is more difficult to treat.

Researchers randomly assigned patients to receive either catheter ablation as their initial treatment or standard anti-arrhythmic drug therapy.

During catheter ablation, physicians guide thin, flexible tubes through blood vessels into the heart. Once in place, they eliminate the areas of heart tissue responsible for triggering and sustaining the abnormal electrical signals.

In this study, researchers used a newer technique called pulsed field ablation, which delivers short bursts of electrical energy to precisely target heart tissue.

“You can think of it as resetting the heart’s electrical system,” said Dr. Andrade. “Instead of using heat or freezing, this approach uses carefully controlled pulses to interrupt abnormal signals while minimising damage to surrounding tissue.”

After one year, patients who underwent ablation were significantly more likely to remain free of abnormal heart rhythms than those who started with medication. The overall risk of serious adverse events was similar between the two groups.

“Patients with more advanced atrial fibrillation are inherently more complex,” said Dr Andrade. “Even in this higher-risk group, starting with ablation can offer better control of the condition.”

A decade of reshaping global care

The findings build on more than a decade of research led by Dr Andrade and his team that has helped transform how AFib is treated worldwide.

Earlier landmark trials from this group demonstrated that catheter ablation could be used as a first-line treatment in patients with early-stage AFib. In addition, these studies were the first to demonstrate that catheter ablation was a disease-modifying therapy, significantly slowing the progression of the disease.

Those discoveries helped shift clinical practice globally, with physicians increasingly offering ablation earlier in a patient’s care.

Together, the program of research has redefined how AFib can be treated across its full course, from early to more advanced stages, giving patients and clinicians clearer guidance on when to consider ablation.

“Our goal is to give patients and clinicians the evidence they need to make the best decision for each individual,” said Dr Andrade. “This study fills an important gap for a group of patients where the answer hasn’t been clear.”

Source: The University of British Columbia

Categories : NeurologyTags : Leave a comment

Hydraulic Brain: Body Motion Linked to Fluid Movement in the Brain

On By ModernMedia

Abdominal contractions are tightly linked to gentle brain movements that help circulate CSF

Using microCT scanning, which allows for high-resolution imaging of an organism’s internal structures, and other imaging techniques, researchers found that a network of veins serve as a mechanical connection between the abdominal cavity and the brain. Here, the veins in red run through the interior of a vertebrae and around the spine.  Credit: Provided by Patrick Drew and team/Penn State. All Rights Reserved.

The brain is more mechanically connected to the body than previously appreciated, scientists reported in Nature Neuroscience. Through a study using mice and simulations, the team found a potential biological mechanism underlying why exercise is thought to benefit brain health: abdominal contractions compress blood vessels connected to the spinal cord and the brain, enabling the organ to gently move within the skull. This swaying facilitates the surrounding cerebrospinal fluid to flow over the brain, potentially washing away neural waste that could cause problems for brain function.

According to Patrick Drew, professor of engineering science and mechanics, of neurosurgery, of biology and of biomedical engineering at Penn State, the work builds on previous studies detailing how sleep and neuron loss can influence how and when cerebrospinal fluid flushes through the brain.

“Our research explains how just moving around might serve as an important physiological mechanism promoting brain health,” said Drew, corresponding author on the paper. “In this study, we found that when the abdominal muscles contract, they push blood from the abdomen into the spinal cord, just like in a hydraulic system, applying pressure to the brain and making it move. Simulations show that this gentle brain movement will drive fluid flow in and around the brain. It is thought the movement of fluid in the brain is important for removing waste and preventing neurodegenerative disorders. Our research shows that a little bit of motion is good, and it could be another reason why exercise is good for our brain health.”

Drew, who also holds the title of associate director of the Huck Institutes of the Life Sciences, explained how in a hydraulic system, a pump creates pressure that drives fluid flow. In this case, the pump is the abdominal contraction – which can be as light as the tensing prior to sitting up or taking a step. The contraction puts pressure on the vertebral venous plexus, a network of veins that connect the abdominal cavity to the spinal cavity, causing the brain to move.

The researchers used two-photon microscopy — which allows for high-definition imaging of living tissue — to observe the brain shifting in the moments before the mouse moved, but right after the tightening of the abdominal muscles needed to spur the body into further movement. On the left, the brain, in green, sits during a stationary moment, while the image on the right shows the brain during movement.  Credit: Provided by Patrick Drew and team/Penn State. All Rights Reserved.

The researchers visualised the process in moving mice with two advanced imaging technologies: two-photon microscopy, which allows for high-definition imaging of living tissue, and microcomputed tomography, which enables high-resolution 3D examination of whole organs. They observed the brain shifting in the moments before the mouse moved, but right after the tightening of the abdominal muscles needed to spur the body into further movement.

To confirm that it was abdominal contractions rather than other movement that acted as the pump, the researchers applied gentle and controlled pressure to the abdomens of lightly anaesthetised mice. With no other movement other than a localised mechanical pressure less than a human would experience with a blood pressure cuff, the mice’s brains shifted.

“Importantly, the brain began moving back to its baseline position immediately upon relief of the abdominal pressure,” Drew said. “This suggests that abdominal pressure can rapidly and significantly alter the position of the brain within the skull.”

With the abdominal contraction-brain movement link confirmed, Drew said the next step was to understand the fluid’s movement in the brain and if the brain’s movement could induce fluid flow. However, there previously were no existing imaging techniques to visualize the rapid, nuanced dynamics of such fluid flows.

“Luckily, our interdisciplinary team at Penn State was able to develop these techniques, including conducting the imaging experiments of living mice and creating computer simulations of fluid motion,” Drew said. “That combination of expertise is so important for understanding these types of complicated systems and how they impact health.”

Francesco Costanzo, professor of engineering science and mechanics, of biomedical engineering, of mechanical engineering and of mathematics, led the computational modelling.

“Modelling fluid flow in and around the brain offers unique challenges because there are simultaneous, independent movements, as well as time-dependent, coupled movements. Accounting for all of them requires accounting for the special physics that happens every time a fluid particle crosses one of the many membranes in the brain,” Costanzo said. “So, we simplified it. The brain has a structure similar to a sponge, in the sense that you have a soft skeleton and fluid can move through it.”

By simplifying the geometry of the brain to that of a sponge, Costanzo explained that the team could model how fluid flows through a structure with varied spaces, like wrinkles in the brain, or pores in the sponge.

“Keeping with the idea of the brain as a sponge, we also thought of it as a dirty sponge – how do you clean a dirty sponge?” Costanzo asked. “You run it under a tap and squeeze it out. In our simulations, we were able to get a sense of how the brain moving from an abdominal contraction can help induce fluid flow over the brain to help clear waste products.”

Drew emphasised that while more work is needed to understand the full implications in humans, this study suggests that body movement may help to cycle cerebrospinal fluid around and in the brain, removing waste and helping to protect against neurodegenerative disorders associated with waste buildup.

“This kind of motion is so small. It’s what’s generated when you walk or just contract your abdominal muscles, which you do when you engage in any physical behaviour. It could make such a difference for your brain health,” Drew said.

By Ashley WennersHerron

Source: Pennsylvania State University

Categories : Expert OpinionTags : Leave a comment

Joint Effort is Key to Sustainable Healthcare Reform

On By ModernMedia

By Gale Shabangu, Chairperson, Hospital Association of South Africa (HASA)

Recently, President Cyril Ramaphosa made an important decision: to pause the promulgation of the National Health Insurance (NHI) Act until the Constitutional Court has ruled on the pending challenges to Parliament’s role in passing the Act. In doing so, he affirmed that due process must guide reform.

It is a reminder that healthcare reform is not a race to the finish line, but a journey that requires careful pacing, broad consultation and respect for the voices of South Africans. Reform at this scale is like tending a vast garden: every seed must be planted with foresight, every path cleared with care, so that the harvest nourishes all.

Families already feel the strain of rising costs – electricity, food, borrowing – and medical contributions that climb steadily. Yet even in this pressure, there is resilience. South Africans have always found ways to adapt, to share, to build together. Healthcare reform must honour that spirit, ensuring affordability is not a privilege but a shared foundation.

The private healthcare system is a necessary and valuable part of the scaffolding of our healthcare system, sustaining capacity that millions rely on. Unfinished reforms, such as risk equalisation, mandatory membership, and base benefit packages, remain like bridges half‑built. Completing them would stabilise participation and strengthen the entire ecosystem.

If private participation declines, demand does not vanish – it shifts. Public hospitals, already carrying immense responsibility, would feel the weight. Yet here lies the opportunity: to recognise that public and private healthcare are not adversaries but allies. The public sector anchors universal access; the private sector provides funded capacity that absorbs demand and sustains innovation. Together, they form a single ecosystem, each part vital to the whole.

Healthcare reform is about weaving our systems together into a fabric strong enough to carry us all.

As the President recently noted, readiness is central to bringing legislation into effect. Readiness is not bureaucracy – it is the heartbeat of reform. It signals that change must be feasible, not forced; sustainable, not symbolic. That is a hopeful message, because it means reform will be paced by practicality, not politics.

The path forward is clear and promising: complete outstanding reforms in medical schemes, strengthen risk pooling, invest in primary care and prevention, and sequence structural changes responsibly. These steps are not obstacles – they are stepping stones toward a healthier, more equitable South Africa.

Healthcare reform is a national undertaking and a shared responsibility. Government, funders, providers, employers and civil society are all custodians of this commitment. What matters now is how we act, with realism, collaboration and a clear focus on strengthening what already works.

Equitable access to quality healthcare is our shared goal. Achieving it requires evidence, readiness, and respect for complementarity. With stability, sustainability and collaboration as our compass, South Africa can build a healthcare system that is workable and inspiring – a system that reflects the resilience, dignity and hope of its people.

Healthcare requires stewardship. With stability, sustainability, and collaboration guiding reform, South Africa can build a system that works for everyone. And with optimism guiding reform, I believe we can build a system that works for everyone – today, tomorrow and for generations to come.

Categories : Cancer Surgeries & ProceduresTags : Leave a comment

Innovative Surgery Cuts Ovarian Cancer Risk by Nearly 80% 

On By ModernMedia

New research shows that Canadian-developed surgical procedure dramatically reduces rates of the most lethal gynaecological cancer

Fallopian Tubes. Credit: Scientific Animations CC4.0 BY-SA

A prevention strategy developed by Canadian researchers reduces the risk of the most common and deadly form of ovarian cancer by nearly 80%, according to a new study published today in JAMA Network Open.

The strategy, known as opportunistic salpingectomy (OS), involves proactively removing a person’s fallopian tubes when they are already undergoing a routine gynaecological surgery such as hysterectomy or tubal ligation, commonly called “having one’s tubes tied”.

British Columbia in Canada became the first jurisdiction in the world to offer OS in 2010, after a team of researchers from UBC, BC Cancer and Vancouver Coastal Health designed the approach when it was discovered that most ovarian cancers originate in the fallopian tubes rather than the ovaries. OS leaves a person’s ovaries intact, preserving important hormone production so there are minimal side effects from the added procedure.

The new study, led by a B.C.-based international collaboration called the Ovarian Cancer Observatory, provides the clearest evidence yet that the Canadian innovation saves lives.

“This study clearly demonstrates that removing the fallopian tubes as an add-on during routine surgery can help prevent the most lethal type of ovarian cancer,” said co-senior author Dr Gillian Hanley, an associate professor of obstetrics and gynaecology at UBC. “It shows how this relatively simple change in surgical practice can have a profound and life-saving impact.”

New hope against a deadly cancer

Ovarian cancer is the most lethal gynaecological cancer. Approximately 3100 Canadians are diagnosed with the disease each year and about 2000 will die from it.

There is currently no reliable screening test for ovarian cancer, meaning that most cases are diagnosed at advanced stages when treatment options are limited and survival rates are low.

The OS approach was initially developed and named by Dr Dianne Miller, an associate professor emerita at UBC and gynaecologic oncologist with Vancouver Coastal Health and BC Cancer. She co-founded B.C.’s multidisciplinary ovarian cancer research team, OVCARE.

“If there is one thing better than curing cancer it’s never getting the cancer in the first place,” said Dr. Miller.

The new study is the first to quantify how much OS reduces the risk of serous ovarian cancer – the most common and deadly subtype of the disease. It builds on previous research demonstrating that OS is safe, does not reduce the age of menopause onset, and is cost-effective for health systems.

The study analysed population-based health data for more than 85 000 people who underwent gynaecological surgeries in B.C. between 2008 and 2020. The researchers compared rates of serous ovarian cancer between those who had OS and those who had similar surgeries but did not undergo the procedure.

Overall, people who had OS were 78% less likely to develop serous ovarian cancer. In the rare cases where ovarian cancer occurred after OS, those cancers were found to be less biologically aggressive. The findings were validated by data collected from pathology laboratories from around the world, which suggested a similar effect.

From B.C. innovation to global impact

Since its introduction in B.C. in 2010, OS has been widely adopted, with approximately 80 per cent of hysterectomies and tubal ligation procedures in the province now including fallopian tube removal.

Globally, professional medical organizations in 24 countries now recommended OS as an ovarian cancer prevention strategy, including the Society of Obstetrics and Gynaecology of Canada, which issued guidance in 2015.

“This is the culmination of more than a decade of work that started here in B.C.,” said co- senior author Dr. David Huntsman, professor of pathology and laboratory medicine and obstetrics and gynaecology at UBC and a distinguished scientist at BC Cancer. “The impact of OS that we report is even greater than we expected.”

The researchers say expanding global adoption of OS could prevent thousands of ovarian cancer cases worldwide each year.

“This is a powerful example of how UBC research is changing clinical practice worldwide and saving lives,” said Dr Sharmila Anandasabapathy, dean of the faculty of medicine and vice-president, health, at UBC. “It speaks to the strength of our researchers and clinicians working together to translate discovery into real-world impact for patients here at home and around the world.”

Extending OS to other abdominal and pelvic surgeries where appropriate could further increase the number of people who could benefit from the prevention strategy. B.C. recently became the first province to expand OS to routine surgeries performed by general and urologic surgeons through a project supported by the Government of B.C. and Doctors of BC.

“Our hope is that more clinicians will adopt this proven approach, which has the potential to save countless lives,” said Dr Huntsman. “Not offering this surgical add-on may leave patients unnecessarily vulnerable to this cancer.”

Brett Goldhawk

Source: University of British Columbia