Tag: 23/10/23

Categories : Cardiovascular DiseaseTags :

Researchers ID Two Probiotics that can Help Bring Down Hypertension

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Recent studies suggest that probiotics may offer a protective effect against hypertension, but how gut microbiota can regulate blood pressure has remained something of a mystery. Now a study published in mSystems showed that two probiotics, Bifidobacterium lactis and Lactobacillus rhamnosus, returned blood pressure in hypertensive mouse models to normal levels. The researchers also tracked how those probiotics altered the animals’ gut microbial mix over 16 weeks, identifying specific microbes and metabolic pathways that may help explain the protective effect. 

“Accumulated evidence supports an antihypertensive effect of probiotics and probiotic fermented foods in both in vitro and in vivo experiments,” said computational biologist Jun Li, PhD, at the City University of Hong Kong. Her team worked with that of microbiologist Zhihong Sun, PhD, at Inner Mongolia Agricultural University, on the study. “So, we believed that the dietary intake of probiotic foods would well supplement traditional hypertension treatment.” 

Previous studies have connected the rising rates of hypertension worldwide to increasing consumption of sugar. It likely boosts blood pressure through many mechanisms, such as increased insulin resistance or salt retention, but in recent years researchers have also investigated sugar’s effect on the gut microbiome. 

In the new study, the researchers tested the two probiotic strains on mice that developed hypertension after consuming water mixed with fructose. Over the course of 16 weeks, they measured the animals’ blood pressures every 4 weeks. They found that fructose-fed mice that received either probiotic showed significantly lower blood pressures than those fed a high fructose diet and not treated with probiotics. 

In addition, the researchers found no difference between the blood pressure readings of fructose-fed mice that received probiotics and a control group of mice that only drank water. According to Li, that suggests probiotic interventions would maintain blood pressure at normal levels. 

The researchers used shotgun metagenomic sequencing to probe connections between the altered gut microbiota and the change in blood pressure. They found that a high-fructose diet in the mice led to an increase in Bacteroidetes and a decrease in Firmicutes bacteria; however, treatment with probiotics returned those populations to those found in the control group. In addition, the analysis identified new microbial signatures associated with blood pressure: Increased levels of Lawsonia and Pyrolobus bacteria, and reduced levels of Alistipes and Alloprevotella, were associated with lower blood pressure. 

The researchers are now planning a large clinical trial to see if the protective effect of probiotics extend to people with hypertension. “Probiotics present a promising avenue in preventive medicine,” Sun said, “offering potential in regulating hypertension and reshaping our approach to cardiovascular health.”

Source: American Society for Microbiology

Categories : Mental Health NeurologyTags :

The Eyes may Hold the Secret to the Greatest Benefits from TMS Therapy

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Photo by Victor Freitas on Pexels

A pair of recently published studies from researchers at UCLA Health suggest that measuring changes in how pupils react to light could help predict recovery from depression and personalise transcranial magnetic stimulation (TMS) treatment of major depressive disorder.

TMS is a safe, non-invasive therapy that uses magnetic fields to stimulate parts of the brain involved in mood regulation. While TMS is proven effective, not all patients respond equally well to the therapy. The ability to predict who will benefit most could allow doctors to better customise and target treatments.

In two recent studies, UCLA scientists found that the pupil’s response to light before treatment correlated with improvements in depression symptoms over the course of therapy. Pupil size reflects activation of the autonomic nervous system, which controls involuntary functions and is negatively impacted in people with depression.

The first study, appearing in the Journal of Affective Disorders, reports on outcomes for 51 patients who underwent daily TMS sessions. Before receiving treatment, researchers measured the patients’ baseline pupillary constriction amplitude, or CA: how much the pupil shrinks when exposed to light. The pupil’s constriction is an indicator of parasympathetic nervous system function. The researchers found a significant association between baseline pupil constriction amplitude and symptom improvement, indicating that a greater constriction amplitude at baseline was associated with a better outcome. In other words, those with larger pupil constriction in response to light at baseline showed greater symptom improvement over their full treatment.

The second study, published in Brain Stimulation, went further and compared patients who were treated for depression with one of two common TMS protocols: 10Hz stimulation and intermittent theta burst stimulation (iTBS). In 10Hz stimulation, magnetic pulses are delivered in a continuous and relatively high-frequency stimulation. iTBS is a faster form of stimulation with bursts of three pulses at 50Hz, repeated with short breaks between bursts. This pattern is thought to mimic the natural rhythm of certain brain activities.

The researchers found that people with slower pupillary constriction had significantly greater improvement in depression after 10 sessions if they received iTBS rather than 10Hz treatment.

“These results suggest we may be able to use a simple test of the pupil to identify who is most likely to respond to electromagnetic stimulation of the brain to treat their depression,” said researcher Cole Citrenbaum, lead author of both studies.

Tailored TMS treatments

The researchers propose that measuring pupillary reactivity before starting TMS could guide treatment selection. “Additionally, we may be able to tailor the frequency of stimulation to the individual patient to maximise their benefit from treatment,” Citrenbaum said.

“At the present time, about 65% of patients treated with TMS have a substantial improvement in their depression,” said Dr Andrew F. Leuchter, senior author of both studies. “Our goal is to have more than 85% of patients fully recover from depression. As we better understand the complex brain activity underlying depression, we move closer to matching patients with the treatments that ensure their full recovery. Pupil testing may be one useful tool in reaching this goal.”

The studies add to growing evidence on the benefits of biologically-based personalization in treating major depression. UCLA researchers plan further trials to confirm the value of pupillometry in optimizing transcranial magnetic stimulation.

Source: University of California – Los Angeles Health Sciences

Categories : Dentistry PaediatricsTags :

Rotary Club Elevates Paediatric Dentistry in South Africa

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Dr Nicoline Potgieter at the Paediatric and Special Needs Dental Care Unit

The landscape of paediatric dental care in South Africa is poised for a significant transformation, marked by the launch of the nation’s first specialised Paediatric and Special Needs Dental Care Unit. This pioneering initiative, a result of the dedicated efforts of the Department of Paediatric Dentistry of the University of the Western Cape (UWC), The Provincial Government of the Western Cape (PGWC) and Rotary Club, is set to revolutionise Paediatric Dentistry in South Africa. It promises enhanced efficiency, a reduction in anxiety for young patients and a sharpened focus on providing dedicated oral health services to children and especially children with special health care needs.

Working towards the acknowledgment of Paediatric Dentistry as a specialty in South Africa, the need for a dedicated, specialised, child-friendly facility was identified – particularly in the Western Cape. This project stands as a steadfast response to establish such a paediatric dental unit, promising to positively impact service delivery to the children of the Western Cape.

Dalene Swart, President of the Rotary Club of Bellville, is passionate about this transformative initiative. She underscores the present scenario wherein young patients often undergo dental procedures under general anaesthesia.

“The establishment of a dedicated paediatric dentistry surgery unit, equipped with the latest materials and state-of-the-art equipment, not only enhances service quality but also serves as an invaluable training ground for postgraduate students,” she says.

However, the impact transcends mere smiles; it represents a pivotal advancement in South African healthcare, focused on the oral health of children. This project is expected to increase treatment capacity in the field of Paediatric Dentistry, thereby alleviating the workload of local healthcare professionals. It will also foster disease prevention and treatment programmes, bolster healthcare systems, and in time, significantly reduce the burden of disease and need for care under general anaesthesia.

Dr Nicoline Potgieter, president of the South African Association of Paediatric Dentistry and course coordinator for the Masters programme in Paediatric Dentistry at UWC, emphasises the enduring plight of the children in South Africa, who are in dire need of expert oral health care. “It is important to note, oral health directly impacts general health which directly impacts quality of life. It is our responsibility to provide the basic health care needs of our children. The technological advances incorporated into the unit, support minimally invasive techniques and preventative dentistry and the environment is focused on making the dental visit more pleasant for the child patient. Hopefully this is the first of many dedicated paediatric and special needs units across South Africa!”

This project, scheduled for full implementation by the end of October 2023, is the outcome of a collaboration between dedicated Rotary Club participants and the Tygerberg Oral Health Centre, which is a joint platform between UWC and PGWC. It seamlessly aligns with the UWC mission to train paediatric dentists as specialists in South Africa, reaffirming the institution’s commitment to community health and well-being. Similarly, it aligns with PGWC that is dedicated to high quality service rendering to all patients. Under this initiative, the first paediatric dentists will receive specialised training each year, while hundreds of children will benefit from disease prevention and interventions.

The project, funded with a capital expenditure of R1.2 million, draws support from various sources, including cash contributions from the Rotary Club of Bellville, Rotary Foundation and six other Rotary Clubs from the UK, USA and Canada. A significant portion of the funds raised was allocated to state-of-the-art essential dental equipment, consumables, and building materials.

Swart concludes by underlining that this project transcends immediate community needs for specialised paediatric dental care; it is about advancing medical care in South Africa and laying the groundwork for the long-term sustainability and transformation of dental care needs. This is why it enjoys unwavering support from local Rotarians.

Categories : Obstetrics & GynaecologyTags : 1 Comment

Trial Shows Add-on NSAID Increases Success Rate of Morning-after Pill

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Research on adding a long-acting nonsteroidal anti-inflammatory drug (NSAID) to an oral emergency contraceptive pill (also known as the morning-after pill) showed that it increases the effectiveness of pregnancy prevention. The study findings were recently published in The Lancet.

Emergency contraception is a contraceptive method that can be used to prevent an unintended pregnancy when a regular contraceptive method fails or is not used. It can be in the form of an oral emergency contraceptive pill or the insertion of a copper intrauterine contraceptive device (Cu-IUD). The oral levonorgestrel emergency contraceptive pill is one of the most popular choices of emergency contraception and is widely used in most countries. It was pioneered by a clinical trial in Hong Kong led by HKUMed’s Professor Ho Pak-chung, published in 1993. However, all contraceptive methods have a failure rate. Hence, the research team is continuing its efforts to explore more effective options.

Prostaglandins mediate a number of biological processes, including inflammatory responses. In the reproductive system, prostaglandin is an important mediator of processes like ovulation, fertilisation and embryo implantation. The research team postulated that adding a medication that blocks prostaglandin synthesis may have an additional complementary effect in achieving contraception.

The collaborative research team, including members of LKS Faculty of Medicine of the University of Hong Kong (HKUMed), as well as The Family Planning Association of Hong Kong (FPAHK) and Sweden’s Karolinska Institutet, conducted the world’s first randomised, placebo-controlled trial on the use of piroxicam, an NSAID used to treat arthritis pain, which blocks prostaglandin production in the body, in combination with the levonorgestrel emergency contraceptive pill. The findings revealed that with the new combination regimen, only one out of 418 women became pregnant, while seven out of another 418 women receiving levonorgestrel and a placebo became pregnant. The results showed that the percentage of pregnancies prevented by piroxicam-levonorgestrel co-treatment (94.7%) was significantly higher than that of the levonorgestrel emergency contraceptive pill alone (63.4%). There was no significant difference in the occurrence of adverse effects, including changes to the menstrual bleeding pattern and stomach ache following intake of the two regimens.

Significance of the study

Chief-investigator Dr Raymond Li Hang-wun, from HKUMed, said, “Our study is the first to find that piroxicam, a readily available medication, taken at the same time as the levonorgestrel pill can prevent more pregnancies than levonorgestrel alone. We hope these findings will lead to further research and ultimately changes in clinical guidelines to enable women around the world to access more effective emergency contraception.”

Co-investigator Dr Sue Lo Seen-tsing, from FPAHK, said, “The levonorgestrel pill was registered in Hong Kong in 2002 and has been used safely since then. Locally, emergency contraceptives must be prescribed by healthcare providers, who assess which emergency contraceptive method is the most suitable in each case. Contraceptive counselling should be provided to help women seeking emergency contraception understand that it cannot replace regular contraceptives and to motivate them to use the latter. Since there is still a small failure rate, a follow-up visit is important. The levonorgestrel emergency contraception pill should be taken within 72 hours after unprotected sex; the earlier it is taken, the more effective it is.”

Source: The University of Hong Kong