Adolescent and young adult (AYA) cancer survivors are at risk of experiencing treatment-related effects later in life, including cardiac damage. New research published in in CANCER has identified a number of sociodemographic and modifiable risk factors linked to these patients’ risk of developing cardiovascular disease (CVD).
The study by investigators at Duke University and The University of Texas MD Anderson Cancer Center relied on 2009–2018 data from the National Health Interview Survey, which collects information on a broad range of health topics through personal interviews of US households. Responses from 4766 AYA cancer survivors and 47 660 controls (without a history of cancer) were included.
The risk of CVD was significantly higher in survivors than controls by sex, race/ethnicity, income, education, smoking status, and physical activity.
In the AYA survivor population, male sex, Black race, household income under $50 000 a year, and current or former smoking were all associated with higher odds of CVD. Household income < $50 000 a year disproportionately increased the odds of CVD in survivors compared with controls. Performing any moderate to vigorous intensity physical activity was associated with lower CVD odds.
“These results highlight the importance of long-term surveillance of AYAs after cancer treatment to ensure that appropriate screenings are initiated to reduce the risk of CVD and to promote healthy behavioural changes, such as physical activity, which impact long-term CVD outcomes,” said lead author Amy Berkman, MD, of the Duke University School of Medicine.
After an intermittent fasting diet intervention, patients achieved complete diabetes remission, defined as an HbA1c level of < 6.5% at least one year after stopping diabetes medication, according to a new study published in the Journal of Clinical Endocrinology & Metabolism.
Intermittent fasting diets, which involve restricting eating to a specific window of time, have become popular in recent years as an effective weight loss method. Previous studies have shown that intermittent fasting can lower the risk of diabetes and heart disease.
“Type 2 diabetes is not necessarily a permanent, lifelong disease. Diabetes remission is possible if patients lose weight by changing their diet and exercise habits,” said Dongbo Liu, PhD, of Hunan Agricultural University in China. “Our research shows an intermittent fasting, Chinese Medical Nutrition Therapy (CMNT), can lead to diabetes remission in people with type 2 diabetes, and these findings could have a major impact on the over 537 million adults worldwide who suffer from the disease.”
The researchers conducted a 3-month intermittent fasting diet intervention among 36 people with diabetes and found almost 90% of participants, including those who took blood sugar-lowering agents and insulin, reduced their diabetes medication intake after intermittent fasting. Fifty-five percent of these people experienced diabetes remission, discontinued their diabetes medication and maintained it for at least one year.
The study challenges the conventional view that diabetes remission can only be achieved in those with a shorter diabetes duration (0–6 years). Sixty-five percent of the study participants who achieved diabetes remission had a diabetes duration of more than six years (6–11 years).
“Diabetes medications are costly and a barrier for many patients who are trying to effectively manage their diabetes. Our study saw medication costs decrease by 77% in people with diabetes after intermittent fasting,” Liu said.
In a new study published in the journal Nature Communications, researchers have taken a close look at three treatment approaches that have been widely believed to slow the ageing process. However, when tested in mice, these treatments proved largely ineffective in their supposed impact on ageing.
“There is no internal clock of ageing that you can regulate with a simple switch – at least not in the form of the treatments studied here,” concludes Dr Dan Ehninger of the German Centre for Neurodegenerative Diseases (DZNE), the initiator of the study. The team has developed a new analytical approach to make influences on ageing processes measurable.
“We chose three regulators for our interventions that many experts believe slow down aging,” explains Prof Martin Hrab de Angelis, who also drove the project with his team. One of them is intermittent fasting, in which the calories consumed are reduced. Number two targets a central node of cell metabolism (mTOR), which is also the target of the supposed “anti-ageing drug” rapamycin. Number three, in turn, interferes with the release of growth hormone. Similar treatments are also used by humans, although their efficacy with regard to ageing has not been sufficiently proven.
For the assessment in mice, the scientists developed a new answer to the question of how to measure ageing. “Many researchers in recent decades have used lifespan as an indirect measure of ageing,” explains Dan Ehninger, who is a senior scientist at DZNE. So, for example, how old do mice get – and how can that lifespan be extended? “It is often assumed that if they just live longer, they will also age more slowly. But the problem is that mice, like many other organisms, do not die from general old age, but from very specific diseases,” says Ehninger. For example, up to 90 percent of mice die from tumors that form in their bodies at an advanced age. “So, if you were to look at the whole genome for factors that make mice become long-lived, you would like find many genes that suppress tumor development – and not necessarily genes that play a general role in aging.”
For their study, the scientists therefore chose an approach that does not emphasize lifespan, but rather focused on a comprehensive investigation of age-related changes in a wide range of bodily functions. “You can think of it as a complete health status survey,” says Martin Hrab de Angelis: “The health check results in a compendium of hundreds of factors covering many areas of physiology” – an exact description of the state of the animal at the moment of examination. That’s exactly the approach the researchers applied to the animals subjected to one of the three treatment approaches that supposedly slow ageing. Across different life stages, they were analysed and compared: How much does each parameter typically change at a given stage of life? And, do parameters change more slowly when the mice are given one of the three treatments? This study design makes it possible to determine precisely whether the natural aging process can be slowed, and with it the deterioration of important physiological functions.
The results were unambiguous: Although the researchers were able to identify individual cases in which old mice looked younger than they actually were, it was clear that “this effect was not due to slowing down aging, but rather due to age-independent factors,” says Dan Ehninger. “The fact that a treatment already has its effect in young mice – prior to the appearance of age-dependent change in health measures – proves that these are compensatory, general health-promoting effects, not a targeting of aging mechanisms.”
The DZNE and Helmholtz Diabetes Center teams have now set their sights on the next goal: They want to investigate other treatment approaches that experts believe can slow aging. The researchers hope that the new research method will provide a more comprehensive picture of possible treatment approaches and their effectiveness.
The year 2022 finally saw the COVID pandemic petering out, largely through the less-lethal but still highly contagious Omicron variant. Significant strides were made in cancer and Alzheimer’s research, although not without controversy. Amid growing public healthcare challenges in South Africa, the NHI Bill advanced closer to reality.
As Omicron displayed greatly reduced severity compared to prior strains, South African medical experts were some of the first to justify no longer being at ‘code red’. This brought an end to the cycles of lockdowns and travel restrictions characterised by the two previous years.
A number of key medical advances were made during the year for a variety of conditions. Studies showed that administering steroids after COVID hospitalisation with severe inflammation reduced mortality up to one year post-infection.
COVID was found to be linked to a spate of new-onset Type 1 diabetes, but this may just have been due to medical checkups as a result of developing COVID. The rheumatoid arthritis drug auranofin was found to relieve diabetes symptoms. And research suggested a possible way to deliver insulin and cancer drugs orally, by adding a ‘tag’ that lets them enter the bloodstream through the intestines.
The fields of cancer and Alzheimer’s research was rocked by findings of numerous red flags. This controversy did not stop real progress: the first new drug that had any real effectiveness against Alzheimer’s disease was confirmed in a historic trial. Fortunately, the flu jab also seems to protect against developing the disease. Indeed, serious infections appear to increase the risk of both Alzheimer’s and Parkinson’s.
In advanced ER-positive, HER-2 negative breast cancers, the new drug capivasertib halved the rate of progression.
Despite lessons learned in the COVID pandemic, South Africa saw the progression of systemic problems in healthcare such as a critical shortage of nurses. Dr Tim de Maayer’s open letter on appalling conditions at Rahima Moosa exposed deep-seated problems in Gauteng’s public healthcare system. This was followed by the shock resignation of top cancer surgeon Professor Carol-Ann Benn. The appointment of Nomantu Nkomo-Ralehoko as Gauteng Health MEC should hopefully change the province’s situation.
People with cluster headaches may be more than three times more likely to have other medical conditions such as heart disease, mental disorders and other neurologic diseases, according to a study published in Neurology.
Cluster headaches are short but extremely painful headaches that can occur many days, or even weeks, in a row. The headaches can last anywhere from 15 minutes to three hours.
“Around the world, headaches have an incredibly negative impact on people’s quality of life, both economically and socially,” said study author Caroline Ran, PhD, of the Karolinska Institutet in Stockholm, Sweden. “Our results show that people with cluster headaches not only have an increased risk of other illnesses, those with at least one additional illness missed four times as many days of work due to sickness and disability than those with just cluster headaches. They also have a higher chance of a long-term absence from work.”
The study involved 3240 people with cluster headaches ages 16–64 in Sweden who were compared to 16 200 matched controls. The majority were men, typical of cluster headache.
Researchers looked at work records and disability benefits to determine how many days during a year people were absent from work due to sickness and disability.
Among those with cluster headaches, 92%, or 2977 people, had at least one additional illness. Of those without cluster headaches, 78%, or 12 575 people, had two or more illnesses.
Of those with cluster headaches, more women had additional illnesses than men, 96% and 90% respectively.
The average number of days a person was absent due to sickness and disability was nearly twice as high among people with cluster headaches with 63 days compared to those without cluster headaches with 34 days.
People with cluster headaches and at least one additional illness had four times as many absence days compared to people with cluster headaches who did not have an additional illness.
“Increasing our understanding of the other conditions that affect people with cluster headache and how they impact their ability to work is very important,” added Ran. “This information can help us as we make decisions on treatments, prevention and prognoses.”
A limitation of the study was that information on personal data, such as smoking, alcohol consumption and BMI, which could affect the occurrence of diseases, was not available.
