Month: January 2022

Categories : Cancer COVIDTags :

Many Young People with Cancer Experiencing Distress in the Pandemic

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A new study has reported that many adolescents and young adults with cancer are suffering high psychological distress during the COVID pandemic. During the pandemic, adolescents and young adults with cancer had an 85% higher odds of experiencing psychological distress compared with a similar group surveyed in 2018.

For the study, which was published in Psycho-Oncology, 805 individuals in Canada who were diagnosed with cancer between 15 and 39 years of age completed an online survey.  

More than two‐thirds of the group (68.0%) experienced high psychological distress. Additionally, those whose employment had been disrupted during the pandemic and those with blood cancer were more likely to experience high psychological distress, while those who were older and those with a personal income in 2020 that was less than $40 000 tended to have lower distress.  

The survey revealed overarching themes of pandemic experiences that included inferior quality of life, impairment of cancer care, COVID–related concerns, and extreme social isolation.  

“The pandemic has adversely impacted the mental health of adolescents and young adults with cancer,” said senior author Sapna Oberoi, MBBS, MD, DM, of the University of Manitoba. “The findings of this study underscore the importance of providing enhanced and tailored interventions to combat psychological distress among these patients. Cancer organisations and policymakers must prioritise mental health supports for adolescents and young adults with cancer to optimise their health outcomes and quality of life.”

Source: Wiley

Categories : NeurologyTags :

Prompts During Sleep Boosts Recall of Names and Faces

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Hearing names repeated during deep sleep may help bolster recall of names and faces, according to new research from Northwestern University.

The researchers found that people’s name recall improved significantly when memories of newly learned face-name associations were reactivated while they were napping. Uninterrupted deep sleep was key in this improvement.

“It’s a new and exciting finding about sleep, because it tells us that the way information is reactivated during sleep to improve memory storage is linked with high-quality sleep,” said lead author Nathan Whitmore, a PhD candidate in the Interdepartmental Neuroscience Program at Northwestern University.

The research is reported in the Nature partner journal npj Science of Learning.

The three main stages of the experiment of Whitmore et al. (2022). First, participants learned 80 face-name associations. Next, they slept while EEG was monitored to determine sleep stage, and 20 of the spoken names were presented softly over background music during slow-wave sleep. Finally, memory testing showed superior memory due to memory reactivation during sleep, but only when sleep was undisturbed by sound presentations. Credit: Nathan Whitmore, a Ph.D. candidate in the Interdepartmental Neuroscience Program at Northwestern University.

The results also highlighted the importance of adequate sleep: for study participants with EEG measurements that indicated disrupted sleep, the memory reactivation had no effect and may even be detrimental. But in those with uninterrupted sleep during the specific times of sound presentations, the reactivation helped participants recall just over 1.5 more names.

The study recruited 24 participants, aged 18-31 years old, who were asked to memorise the faces and names of 40 pupils from a hypothetical Latin American history class and another 40 from a Japanese history class. When each face was presented again, they were asked to recall the associated name. After the learning exercise, participants took a nap while the researchers carefully monitored brain activity using EEG measurements. When participants reached the N3 “deep sleep” state, some of the names were softly played on a speaker with music that was associated with one of the classes.

When participants awoke, they were again tested on recognising faces and recalling their names.

According to the researchers, the finding on the relationship between sleep disruption and memory accuracy is noteworthy for several reasons.

“We already know that some sleep disorders like apnoea can impair memory,” said Whitmore. “Our research suggests a potential explanation for this—frequent sleep interruptions at night might be degrading memory.”

The lab is currently exploring the reactivation of memories and deliberately disrupting sleep in order to learn more about the relevant brain mechanisms.

Source: EurekAlert!

Categories : UncategorizedTags :

COVID Misinformation Less Prevalent than Believed

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Contrary to what might be expected, misinformation about COVID was less prevalent than for other health topics, researchers found.

Before the COVID pandemic, health misinformation was already widely spread. While all types of information about COVID (including misinformation) were popular between March and May 2020, posts about COVID were more likely to come from governments and academic institutions. Often, these posts were more likely to go viral than posts from sources that routinely spread misinformation.

“At the start of the pandemic, governments and organisations around the world started paying attention to the problem of health misinformation online,” said David Broniatowski, an associate professor at the George Washington University. “But when you compare it to what was going on before the pandemic, you start to see that health misinformation was already widespread. What changed is that, when  COVID-19 hit, governments and social media platforms started paying attention and taking action.”

The researchers collected public posts on Twitter and Facebook at the outset of the pandemic, between March and May 2020, when content about COVID was growing rapidly. They compared those to posts on other health topics from the same time period in 2019, and looked at the credibility of the websites that each post shared. More credible sources included government and academic sources as well as the traditional news media. Sources deemed “not credible” comprised conspiracy-oriented sites and state-sponsored sites known for spreading  propaganda, which were 3.67 times more likely to spread misinformation than credible sites.

“Misinformation has always been present, even at higher proportions before COVID started. Many people knew this, which makes the ensuing misinformation spread during COVID entirely predictable,” said study co-author Mark Dredze, an associate professor at Johns Hopkins University. “Had we been more proactive in fighting misinformation, we may not have been in an anti-vaccination crisis today.”

“These findings suggest that the ‘infodemic’ of misinformation is a general feature of health information online, not one restricted to COVID-19,” Broniatowski said. “Clearly there is a lot of misinformation about COVID, but attempts to combat it might be better informed by comparison to the broader health misformation ecosystem.”

Source: George Washington University

Categories : Cardiovascular DiseaseTags :

Long-term Use of RAS Inhibitor Drugs Could Damage Kidneys

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New research is raising concerns that long-term use of renin-angiotensin system (RAS) inhibitor drugs such as ACE inhibitors could be contributing to kidney damage.

The researchers stress that patients should continue taking the medications. But the scientists are urging studies to better understand the drugs’ long-term effects.

“Our studies show that renin-producing cells are responsible for the damage. We are now focusing on understanding how these cells, which are so important to defend us from drops in blood pressure and maintain our well-being, undergo such transformation and induce kidney damage,” said UVA’s Dr Maria Luisa Sequeira Lopez. “What is needed is to identify what substances these cells make that lead to uncontrolled vessel growth.”

A billion people around the world are affected by chronic hypertension. In a study published in JCI Insight, University of Virginia (UVA) researchers were seeking to better understand why severe forms of the condition are often accompanied by atherosclerosis in the kidney, leading to organ damage.

They found that renin cells, which help regulate blood pressure through renin production, play an important role. Harmful changes in the renin cells can cause the cells to invade the walls of the kidney’s blood vessels. The renin cells then trigger a buildup of another cell type, smooth muscle cells, that cause the vessels to thicken and stiffen, resulting in impeded kidney blood flow.

Long-term use of RAS inhibitor drugs, such as ACE inhibitors, or angiotensin receptor blockers, have a similar effect. But the study found that long-term use of the drugs was associated with hardened kidney vessels in both lab mice and humans

The researchers note that the medications can be lifesaving for patients, so they stress the importance of continuing to take them. But they say additional studies are needed to better understand the drugs’ long-term effects on the kidneys.

“It would be important to conduct prospective, randomised controlled studies to determine the extent of functional and tissue damage in patients taking medications for blood pressure control,” said UVA’s Dr Ariel Gomez. “It is imperative to find out what molecules these cells make so that we can counteract them to prevent the damage while the hypertension is treated with the current drugs available today.”

Source: University of Virginia

Categories : Ethics and LawTags :

UK Surgeon Who Branded Initials on Livers Struck Off

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A liver surgeon in the UK who branded his initials on the livers of two patients has been struck off the medical register.

The incidents, which occurred in 2013, involved the surgeon using an argon beam machine to write his initials “SB” on the livers of two anaesthetised patients while working at Birmingham’s Queen Elizabeth Hospital. In liver transplants, the argon beams are normally used for cauterisation and to highlight areas to work on.

His actions came to light when 4cm initials were discovered by another surgeonon an organ that had been transplanted by Bramhall and failed about a week after the operation. Pictures of the branding were taken with a mobile phone.

Bramhall tendered his resignation at the Birmingham hospital in 2014.

In a review of the case, the UK’s Medical Practitioners Tribunal Service (MPTS) said it was an “act borne out of a degree of professional arrogance”, adding that his actions “undermined” public trust in the medical profession.

In December 2017, Simon Bramhall, admitted two counts of assault by beating at Birmingham Crown Court and was fined £10 000 (R210 000). In December 2020 , he was suspended from the profession for at least five months, but a report from the latest tribunal on Monday said a review hearing on 4 June found his fitness to practise was no longer impaired by reason of his criminal convictions and his suspension lifted.

After an appeal from the General Medical Council (GMC), the sanction was quashed and then the case resubmitted to MPTS for its consideration.

On Monday, MPTS found Bramhall’s actions “breached” the trust between patient and doctor, and he was struck off.

The MPTS tribunal concluded that a suspension order would be “insufficient to protect the wider public interest” and said erasure from the medical register would be an “appropriate and proportionate sanction”.

Source: The Guardian

Categories : Obstetrics & GynaecologyTags :

Assisted Reproductive Technology Doubled Birth Rates in Middle-aged Women

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A study found birth rates among middle-aged women in Northern European increased thanks to assisted reproductive technologies.

The study examined the total population of women aged 40–49 years between 2008–2018 in Denmark, Norway, and Sweden, birth rates increased in Denmark and Sweden, and births resulting from assisted reproductive technology doubled in all three countries. The findings were published in Acta Obstetricia et Gynecologica Scandinavica.

The study found that use of hormonal contraception increased among women aged 40–44 years in Denmark from 24% to 31%, in Sweden from 27% to 30%, and in Norway from 22% to 24%. Additionally, birth rates among women 40–44 years increased from 9.5 to 12 per 1000 women in Denmark and from 11.7 to 14.3 per 1,00 in Sweden, while they remained stable in Norway at approximately 11 per 1000 women.

In women aged 40–49 years, there was a doubling of assisted conceptions in Denmark from 0.71 to 1.71 per 1000 women; in Sweden from 0.43 to 0.81 per 1000; and in Norway from 0.25 to 0.53 per 1000. The study also found that Sweden had the highest induced abortion rate (7.7 to 8.1 per 1000 women) in women aged 40–49 years during the study period.

“This study confirms the trend of postponing childbirth observed for most of Europe and demonstrates the important role of assisted reproductive technology on birth rates in this age group,” said lead author Ingela Lindh, MD, of Sahlgrenska University Hospital. “The study provides valuable information to improve women’s knowledge about their fertility.”

Source: Wiley

Categories : Cardiovascular DiseaseTags : 1 Comment

Patient Doing Well after World-first Pig Heart Transplant

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David Bennett, a 57 year old US man, is doing well after being the world’s first human transplant of a pig heart, according to the man’s son, David Bennett Jr.

When his father first told him of the pig heart option, his son was incredulous, telling the BBC: “I didn’t believe him, I thought he was suffering from delirium at first.”

However, when he did some research on the work done, he realised it was a reality and that they were “walking into the unknown”.

He added that according to Dr Bartley Griffith, who performed the surgery, his father has a good prognosis of 6–9 months. The experimental seven-hour procedure at the University of Maryland Medical Center in Baltimore was considered the last hope of saving Mr Bennett’s life, though it is currently unclear what his long-term chances of survival are. 

“It was either die or do this transplant,” Mr Bennett explained a day before the surgery, adding that it was his “last choice”.

Dr Griffith said heart failure and an irregular heartbeat made him ineligible for a human heart transplant or a heart pump.

Xenotransplantation, as these inter-species transplants are called, have failed, largely because patients’ bodies quickly rejected the animal organ. Notably, in 1984, Baby Fae, a dying infant, lived 21 days with a baboon heart. 

What makes this attempt different is that the Maryland surgeons used a heart from a pig that had been genetically modified to remove a sugar in its cells that’s responsible for that hyper-fast organ rejection. Many biotech companies are working on adapting pig organs for xenotransplantation.

“I think you can characterise it as a watershed event,” Dr David Klassen, chief medical officer at the United Network for Organ Sharing (UNOS), which oversees the US transplant system.

Dr Klassen nevertheless cautioned that it’s only a first tentative step into exploring whether xenotransplantation might finally work this time.

The Food and Drug Administration, which oversees such experiments, allowed the surgery under what’s called a “compassionate use” emergency authorisation, available when a patient with a life-threatening condition has no other options.

Surgeon Bartley Griffith said the surgery would bring the world “one step closer to solving the organ shortage crisis”. At present, 17 people die every day in the US waiting for a transplant, with more than 100 000 reportedly on the waiting list. A record 3800 heart transplants were done last year, according to the UNOS.

Source: BBC News

Categories : Pain ManagementTags :

Duloxetine Flops for Osteoarthritis Pain Relief

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A new study found that duloxetine, a medication that is prescribed to treat depression and may also reduce chronic pain, did not benefit patients with hip or knee osteoarthritis.

Off-label uses for duloxetine include chemotherapy-induced peripheral neuropathy and stress urinary incontinence. It is in the Serotonin and norepinephrine reuptake inhibitors (SNRIs) class of medications. 

An open label, cluster randomised trial was conducted in patients experiencing chronic osteoarthritis-related pain in the hip or knee that did not go away with paracetamol and NSAIDs. Of 133 patients, 66 were assigned to duloxetine 60mg/day plus usual care and 66 were assigned to only usual care. 

The findings, published in Arthritis & Rheumatology howed that duloxetine did not lessen WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) pain at 3 months or 12 months. For the subgroup of patients with symptoms of centralised pain no effect of duloxetine was found either.

“There was no clinically relevant effect of duloxetine added to usual care compared to usual care alone for chronic osteoarthritis pain, and it should not be implemented,” the authors concluded.

Source: Wiley

Categories : COVIDTags :

Quebec to Impose Health Tax on The Unvaccinated

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The Canadian province of Quebec will impose a health tax on residents not vaccinated against COVID. The province is experiencing a surge in cases, and its 12 028 deaths as of Tuesday are the highest in Canada.

The province’s Premier Francois Legault announced on Tuesday that it would be the first in the nation to financially penalise the unvaccinated.

Around 12.8% of Quebec residents are unvaccinated, yet make up nearly half of all hospital cases.

At a news conference, the premier said that people who have not had a first vaccine dose will have to pay a “contribution”, which will be “significant”.

“I think right now it’s a question of fairness for the 90% of the population who made some sacrifices,” Mr Legault said. “I think we owe them this kind of measure.”

The province also announced last week that proof of vaccination would be required to shop in government cannabis and liquor stores.

Death rates are similar to January 2021, before widespread vaccinations had begun in the province. Unvaccinated patients make up 45% of COVID ICU cases.

Hospitals in Montreal, the province’s largest city, are nearing 100% capacity and have already started limiting non-Covid related care. Quebec’s positivity rate stands at 20%.

Though such approaches are rare, some unvaccinated individuals in other parts of the world face penalties from their governments.

Greece is set to require those over 60 to pay a €100 (R1750) fine for each month that they remain unvaccinated. Austria is considering an even stiffer €7200 (R126 000) fine for unvaccinated individuals. Unvaccinated COVID patients in Singapore will also have to pay their own medical bills: with ICU stays, this has been estimated at a median of S$25 000 (R287 500).

Source: BBC News

Categories : Neurology Substance UseTags :

A Brain ‘Breathalyser’ for THC Intoxication

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Scientists have developed a noninvasive brain imaging procedure to identify individuals whose performance has been impaired by THC, the psychoactive ingredient of cannabis. As reported in Neuropsychopharmacology, the technique uses functional near-infrared spectroscopy (fNIRS) to measure brain activation patterns linked to THC intoxication. The technology could have a great impact on road and workplace safety. 

The increasing legalisation of cannabis has driven the need for a portable brain imaging procedure that can distinguish between THC-caused impairment and mild intoxication. “Our research represents a novel direction for impairment testing in the field,” explained lead author Jodi Gilman, PhD. “Our goal was to determine if cannabis impairment could be detected from activity of the brain on an individual level. This is a critical issue because a ‘breathalyser’ type of approach will not work for detecting cannabis impairment, which makes it very difficult to objectively assess impairment from THC during a traffic stop.”

In previous studies, THC has been shown to impair cognitive and psychomotor performance essential to safe driving, a factor thought to at least double the risk of fatal motor vehicle accidents. However, concentration of THC in the body does not correspond well to functional impairment. Regular cannabis users often can have high levels of THC in the body and not be impaired. Metabolites of THC can remain in the bloodstream for weeks after the last cannabis use, well beyond the period of intoxication. Thus, there is a need for a different method to determine impairment from cannabis intoxication.

In the study, 169 cannabis users underwent fNIRS brain imaging before and after receiving either oral THC or a placebo. Participants who reported intoxication after being given oral THC showed an increased oxygenated haemoglobin concentration (HbO) – a type of neural activity signature from the prefrontal cortex region of the brain – compared to those who reported low or no intoxication.

“Identification of acute impairment from THC intoxication through portable brain imaging could be a vital tool in the hands of police officers in the field,” said senior author and principal investigator A. Eden Evins, MD, MPH, founding director of the Center for Addiction Medicine. “The accuracy of this method was confirmed by the fact impairment determined by machine learning models using only information from fNIRS matched self-report and clinical assessment of impairment 76% of the time.”

The study suggested the feasibility of inexpensive, lightweight, battery-powered fNIRS devices that could be incorporated into a headband or cap, and thus require minimal set-up time.

“Companies are developing breathalyser devices that only measure exposure to cannabis but not impairment from cannabis,” said Dr Gilman. “We need a method that won’t penalise medical marijuana users or others with insufficient amounts of cannabis in their system to impair their performance. While it requires further study, we believe brain-based testing could provide an objective, practical and much needed solution.”

Source: Massachusetts General Hospital