Day: April 29, 2021

Categories : CancerTags :

Avocado Compound May Be Useful in Leukaemia Therapy

On By ModernMedia

Avocados may be good for more than just an expensive toast topping. According to a new study from the University of Guelph a compound in avocados offers a potential route to improved leukaemia therapy.

The compound in questions targets an enzyme that scientists have identified for the first time as being critical to cancer cell growth, explained Dr Paul Spagnuolo, at the Department of Food Science.

The study focus was on acute myeloid leukaemia (AML), which is the most severe form of leukaemia. Most cases occur in people over age 65, with fewer than 10% of patients surviving five years after diagnosis.

Leukaemia cells have elevated levels of an enzyme called VLCAD involved in their metabolism, said Dr Spagnuolo.

“The cell relies on that pathway to survive,” he said, explaining that the compound is a likely candidate for drug therapy. “This is the first time VLCAD has been identified as a target in any cancer.”

Dr Spagnuolo’s team screened nutraceutical compounds among a variety of compounds, searching for any substance that could inhibit the enzyme. “Lo and behold, the best one was derived from avocado,” said Dr Spagnuolo.

Avocados have already been shown to improve lipid profiles, as well as helping to control weight, likely through increased satiation. His lab previously examined avocatin B, a fat molecule found only in avocados, for potential application in diabetes prevention and obesity management. He’s now keen to see it put to use in leukaemia patients.

“VLCAD can be a good marker to identify patients suitable for this type of therapy. It can also be a marker to measure the activity of the drug,” said Dr Spagnuolo. “That sets the stage for eventual use of this molecule in human clinical trials.”

Around half of patients over 65 diagnosed with AML currently enter palliative care. Some may undergo chemotherapy, but these treatments are often toxic and result in patients dying.

“There’s been a drive to find less toxic drugs that can be used,” he noted.

Referring to earlier work using avocatin B for diabetes, Spagnuolo said, “We completed a human study with this as an oral supplement and have been able to show that appreciable amounts are fairly well tolerated.”
The results of the study were published in the journal Blood.    

Source: Medical Xpress

Journal information: Matthew Tcheng et al, Very long chain fatty acid metabolism is required in acute myeloid leukemia, Blood (2021). DOI: 10.1182/blood.2020008551

Categories : AgeingTags :

Dermal Fillers Can Provide Minor Facelifts

On By ModernMedia

A new study using 3D imaging shows that dermal fillers can also provide some ‘lifting’ effects, as well as their normal ‘volumising’ effects in facial rejuvenation therapy. 

Dermal fillers are ranked second of the top five non-surgical cosmetic procedures, behind botulinum toxin injections. While dermal fillers have been increasing in popularity, plastic surgeons are trying to work out the best application for facial rejuvenation without surgery. Most studies have used subjective rating systems with little generalisability as a result.

The results of a recent study showed that in addition to ‘volumising’ effects, dermal fillers may also have variable ‘lifting’ effects. Sebastian Cotofana, MD, PhD, of the Mayo Clinic,and colleagues came up with a study to measure the true lifting effect of soft tissue fillers.

In this experimental study, the researchers performed standardised dermal filler injections in facial cadaver specimens, in the areas commonly targeted for facial rejuvenation: the forehead and temple; the midface region, including both the medial (central) and the lateral (sides) areas; and around the mouth and jawline.

Dr Cotofana and colleagues performed before-and-after 3D scans of the facial surface to measure the effects of the injections. 

Dermal filler injections showed significant increases in local soft tissue volume in central areas of the face, consistent with the well-established clinical effects of ‘injectable’ treatment in the forehead, midface, and mouth and chin areas.

Local lifting effects were also seen from central facial injections, with up to one millimetre of vertical ‘lift’ in the forehead area, but this was not seen in the other facial areas.

Injections in lateral facial areas such as the jawline also resulted in local volumising and lifting effects. These lateral facial injections also created ‘additional regional lifting effects’ in neighbouring facial areas. Temple injections resulted in a small but significant lifting effect on the lateral midface and jawline, for example.

Combined injection techniques provided even greater benefits. Added to deep filler injection, a superficial temple injection technique produced an additional 17.5% increase in the lifting effect of the temple, plus a 100% increase in the jawline lifting effect.

“These results indicate that lateral face injections co-influence adjacent lateral facial regions and can thus induce regional lifting effects,” wrote Dr Cotofana and coauthors. The results are consistent with previous knowledge of the in-depth anatomy of the face: filler injections may lead to a change in tension of the connective tissue (fascia) under the skin, resulting in “re-positioning” of the upper skin layers.

In this way, filler injections can provide a small but significant lifting effect in a minimally invasive, repeatable procedure, although they are not as effective as plastic surgery. Besides providing confirmation on previous findings on the lifting effects of facial injectables, the study also “broadens their applicability to the total lateral face…to achieve local and regional lifting effects.”

Source: News-Medical.Net
Journal information: Haidar, R., et al. (2021) Quantitative Analysis of the Lifting Effect of Facial Soft-Tissue Filler Injections. Plastic and Reconstructive Surgery. doi.org/10.1097/PRS.0000000000007857.

Categories : Medical Research & TechnologyTags :

A 3D Printed Hydrogel With Self-healing Capacity

On By ModernMedia

Much research has focused on hydrogels, polymer-based materials containing large amounts of water, but hydrogels with both self-healing and complex construction have proved elusive until now. 

Hydrogels need to fulfil two key criteria if they are to be effective replacements for organic tissue: the ability to form extremely complex shapes, and to self-heal after sustaining damage. Previously, hydrogels created in the laboratory had either the capability of being 3D printed into complex shapes, or had the ability to self-heal. This research realises the first time these two capabilities had been combined into one material.

The development of these materials may now be easier, and cheaper, thanks to the use of 3D printing: the researchers in the MP4MNT (Materials and Processing for Micro and Nanotechnologies) team of the Department of Applied Science and Technology of the Politecnico di Torino, coordinated by Professor Fabrizio Pirri. The researchers detailed their work in the prestigious journal Nature Communications.

In addition, the hydrogel was created using both commercially available materials and printer, thus making the approach proposed extremely flexible and potentially applicable anywhere, throwing open the door for development in the fields of both biomedicine and soft robotics.

The research was carried out in the context of the HYDROPRINT3D doctoral project, funded by the Compagnia di San Paolo, in the frame of “Joint Research Projects with Top Universities” initiative, by the PhD student Matteo Caprioli, under the supervision of the DISAT researcher Ignazio Roppolo, in collaboration with Professor Magdassi’s research group of the Hebrew University of Jerusalem (Israel).
The researchers used the digital pulsed light to create a semi-interpenetrated structure of polymer strands that, when severed, could rejoin in 12 hours at room temperature with no outside intervention. The restored section retains 72% of its initial strength.

“[For] many years, in the MP4MNT group, a research unit coordinated by Dr Annalisa Chiappone and I, specifically devoted to development of new materials that can be processed using 3D printing activated by light,” said Ignazio Roppolo, Researcher, DISAT. “3D printing is able to offer a synergistic effect between the design of the object and the intrinsic properties of materials, making [it] possible to obtain manufactured items with unique features.

“From our perspective, we need to take advantage of this synergy to best develop the capabilities of 3D printing, so that this can truly become an element of our everyday life. And this research falls right in line with this philosophy.”

This research represents a first step towards the development of highly complex devices, which can exploit both the complex geometries and the intrinsic self-healing properties in various application fields. Once biocompatibility studies have been refined, it will be possible to use these structures both for cellular mechanism research and for regenerative medicine applications.

Source: News-Medical.Net

Journal reference: Caprioli, M., et al. (2021) 3D-printed self-healing hydrogels via Digital Light Processing. Nature Communications. doi.org/10.1038/s41467-021-22802-z.

Categories : AntibioticsTags :

Holding off on Antibiotics is Safe and Effective for Patients

On By ModernMedia

According to an analysis published in BMJ Today, delayed antibiotic prescribing is a safe and effective strategy for most patients with respiratory tract infections.

Delayed antibiotic prescribing—also known as ‘just in case prescribing’—is when patients agree to see whether symptoms settle before collecting a prescription, in order to help reduce antibiotic use.

Delayed prescribing was shown to be associated with a similar duration of symptoms as no antibiotic prescribing and is not likely to lead to poorer symptom control than immediate antibiotic prescribing. In children with immediate antibiotics a slight benefit was seen but this was not judged important enough to justify immediate antibiotic prescribing.

Respiratory tract infections affect the sinuses, throat, airways or lungs and include conditions such as the common cold, sore throat, cough and ear infection. While most improve without treatment, antibiotics are still widely being prescribed for these conditions.

It has been suggested in various clinical trials that delayed antibiotic prescribing for respiratory tract infections is probably safe and effective for most patients, but they were unable to examine different groups of patients or complications.

To address this, an international research team set out to assess the effect of delayed antibiotic prescribing on symptoms for patients with respiratory tract infections in the community.

They used individual patient data on a total of 55 682 patients from nine randomised controlled trials and four observational studies to compare average symptom severity between delayed versus no antibiotic prescribing, and delayed versus immediate antibiotic prescribing.

Most of the studies took place in primary care settings with the average age of study participants ranging from 2.7 to 51.7 years.

The researchers accounted for factors including age, sex, previous duration of illness, severity of symptoms, smoking status and underlying conditions. Average symptom severity was measured two to four days after initial consultation on a seven point scale (ranging from normal to as bad as could be).

The researchers found no difference in symptom severity for delayed versus immediate antibiotics or delayed versus no antibiotics.

Symptom duration was slightly longer in those given delayed versus immediate antibiotics (11.4 v 10.9 days), but was similar for delayed versus no antibiotics.

Complications resulting in hospital admission or death were lower with delayed versus no antibiotics and delayed versus immediate antibiotics, but neither result was statistically significant.

Re-consultation rates were significantly reduced and an increase in patient satisfaction were found for delayed versus no antibiotics, but not for delayed versus immediate antibiotics.

Children under 5 years of age showed slightly more severe symptoms with delayed antibiotics than with immediate antibiotics, but this was not considered to be clinically meaningful, and this was not seen in older age groups.

 hey concluded that delayed antibiotic prescribing “appears to be a safe and effective strategy for most patients, including those in higher risk subgroups.”

This was a large, detailed analysis accounting for differences in study design and quality to reduce bias. The researchers nevertheless pointed out some limitations, being unable to exclude the possibility that other unmeasured factors may have affected their results.

Source: Medical Xpress

Journal information: Beth Stuart et al, Delayed antibiotic prescribing for respiratory tract infections: individual patient data meta-analysis, BMJ (2021). DOI: 10.1136/bmj.n808

Categories : Pain ManagementTags :

Timing is Key for Psychological Treatment of Chronic Pain

On By ModernMedia

When timed correctly, psychological interventions can reduce the risk of chronic pain, according to a pain expert at the virtual 2021 American Academy of Pain Medicine annual meeting.

“We can look at chronic pain as occurring in a very linear process,” said Ravi Prasad, PhD, of University of California Davis, in a meeting session about multimodal ways to prevent chronic post-surgical pain.

“By definition, pain starts off as something acute,” Dr Prasad explained. The acute phase includes assessments and treatment to try to eliminate pain quickly.

“When the pain condition fails to respond to some of these initial treatments, it starts to enter the subacute category,” Dr Prasad continued. “The patient is still engaged in different medical workups to try to identify the cause of the pain and still participating in treatments, but they haven’t responded to the interventions in the manner expected, meaning the pain continues to persist.” Normally, this comes some 3 to 6 months after the acute phase.

Pain can become chronic when it has plateaued and resists medical treatment for at least 6 months.

“It’s important to recognize these time points exist,” Dr Prasad emphasised. “We can intervene at these different points — and intervene even prior to the experience of acute pain — to try to minimize the likelihood that persistent pain develops.”

There are many factors which contribute to chronic pain. These include environmental stressors, lifestyle factors, unhealthy support systems, limited care access, and patient risk factors such as substance abuse history, adverse childhood experiences, and psychiatric conditions.

Research has shown the most useful predictors of poor pain outcomes after surgery were pre-surgical somatization, depression, anxiety, and poor coping.

“All of these are things that are actually modifiable,” Prasad said. “We can actually do something about these to change the outcomes a person might have.”

Cognitive therapies and relaxation training are two interventions receiving a lot of attention, he noted. Breathing, relaxation exercises, and meditative practices can help patients learn to quiet the nervous system by working on the sympathetic-parasympathetic axis. But cognitive processes also have to be targeted, Prasad observed, and “this is where cognitive behavioral therapy can come in.”

Cognitive behavioural theory is premised on the idea that “by changing the interpretation, we can change the impact of consequences at the emotional, physical, and behavioral level,” Dr Prasad said. “The challenge with this is that our interpretations tend to be automatic.”

“Making changes in our interpretation is difficult because we have to become aware of processes that are occurring in our subconscious and make changes in something that’s been with us for a very long period of time,” he acknowledged. “These thought processes can be very resistant to change. But it’s essential we do this if we want to have sustained change in our outcomes.”

It’s not something as simple as turning negative thoughts into positive ones, Prasad added. “Rather, we look at the accuracy and the degree of helpfulness of the thoughts, and modify the thoughts into something that is more accurate and helpful.”

“We know that when people engage in cognitive behavioral therapy, their outcomes are improved. Affective stress is decreased, pain sensitivity decreases, and this can minimize opioid burden,” he continued. He added that there are many psychological-based tools backed by a strong evidence basem including biofeedback training and mindfulness-based stress reduction.

Dr Prasad emphasised however that timing of these treatments is essential.

“The way to optimize timing is to do presurgical screening to identify what’s the most appropriate intervention for the patient,” he said. Some patients may need help before surgery, others can be targeted at the acute or subacute phase. “Regardless, we want to make sure we address symptoms as early as possible and not wait for pain to be in a chronic state.

Source: MedPage Today

Presentation information: Prasad R “Psychological Interventions to Reduce of Persistent Pain” AAPM 2021.

Categories : Exercise General Interest Mental HealthTags :

Hiking Prescribed for Elderly Man Coping with Lockdown

On By ModernMedia

When Jim Snodgrass, 84, was expecting to receive medication to treat his anxiety, he instead was simply given the phone number for the Ramblers, a UK-based society of nature walkers and hikers.

Dr Victor Jack said that he recognised that Jim needed “social connection” and not medication. Hiking itself also has a number of proven physical and psychological health benefits. Some may be immediate, such as decreased blood pressure, decreased stress levels, enhanced immune system functioning, and restored attention, or else occur over time, such as weight loss, decreased depression, and overall wellness.

During the first COVID lockdown in March 2020, Jim was on his own since his wife Sheila died six years previously, said he suffered a breakdown.

The grandfather-of-two said: “I was not feeling good as I was bothered with my nerves so I called the doctor and that’s when I burst into tears on the phone to the receptionist.

“She was so nice to me and got the doctor to call me. I was surprised when he didn’t give me any pills and instead gave me the number for the Ramblers.”

During lockdown doctors could give exemptions to people who lived on their own to meet one other person outside. Then last summer people were allowed to meet in groups to walk.

Presently in the UK, groups of 15 people are allowed to meet outside.

He said: “The Ramblers saved me during the last year of lockdowns. I don’t know where I would be without them with my nerves. Within two miles of walking I’m a different person. Dr Jack is an amazing man as he has saved me from my nerves in the lockdowns with this idea of his.”

Jim has walked 6.4 to 8 kilometres a day in the last year.

He said: “I even went out when the roads were icy and always stayed within a five mile radius of South Queensferry during the lockdowns. I hope my story helps someone else who is feeling bad so they know to join their local Ramblers group too.”

Dr Jack, of South Queensferry Medical Practice, told BBC Scotland his own experience with stress was used to inform Jim’s treatment.

“When Jim told me he liked walking but that he had been walking on his own I was aware that he was actually quite socially isolated as his wife had died,” Dr Jack explained. “He was benefitting from the physical part of walking but not the social side. A few years ago I joined a running club and found it very helpful for stress. This has made me recognise that any sports club has a benefit particularly through the social connection it provides.”

Dr Jack said he had seen numerous patients experiencing mental health issues during the lockdown, especially in those working from home.

Brendan Paddy, director of Ramblers Scotland, said: “Jim is truly an inspiration to us all. It’s amazing to see how he’s improved his health and happiness by getting active with his local South Queensferry Ramblers group.

“Clearly lockdown has been a hugely challenging time, yet we know that many more people like Jim are discovering the revitalising power of walking – with booming numbers enjoying Scotland’s outdoors. I’d urge anyone who’d like a bit more adventure, friendship and fresh air in their lives, to give the Ramblers a go.”

Source: BBC News