Tag: 31/7/24

Categories : Cardiovascular DiseaseTags : Leave a comment

Daily Physical Activity not Sufficient to Protect Against Stroke

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Photo by Emmanuel Ikwuegbe on Unsplash

Research conducted at the University of Gothenburg shows that daily physical activities, at work or in the home, are not sufficient to protect against stroke. Fortunately, the findings, published in JAMA Network Open, suggest that exercising in free time and using active modes of transport are associated with a decreased risk of stroke.

“Physical activity during leisure time and as transportation is becoming increasingly important now that many jobs and domestic activities are becoming more sedentary,” says lead author of the study Adam Viktorisson, researcher at Sahlgrenska Academy at the University of Gothenburg, Sweden.

Twenty year follow-up

The research study covers 3614 people from the region of Västra Götaland, 269 of whom suffered a stroke in the twenty years spanned by the study. Three months after the stroke, 120 of these had died or were dependent on help to carry out activities of daily living.

Physical activity data was gathered from surveys. Some participants were also given a pedometer to wear. Physical activity during leisure time or for transportation showed a link to the objective measurements from the pedometers, while physical activity at work did not.

Occupational physical activity not protective

The health benefits of physical activity are well known, but earlier studies tend to mainly focus on physical activity during leisure time. Research in recent years has shown that physical activity at work can instead have negative health impacts, increasing the risk of cardiovascular disease.

“How and when we carry out physical activity seems to play a crucial role in determining its health benefits. In our study leisure time and transport related physical activities were associated with a lower risk of stroke, whereas activities during work time or in the household were not” Adam Viktorisson points out.

“Physically demanding jobs are often linked to stress, little opportunity for recovery, air pollution and generally poorer socioeconomic conditions, which can counteract the positive effects of physical activity.”

Promote public health

The study used data from the INTERGENE cohort at the University of Gothenburg. Study participants were surveyed and data was collected from 2001 to 2004, consisting of both clinical and questionnaire data. The researchers hope that these results will bring greater awareness and lead to changes in public health policy to encourage physical activity in society.

“Encouraging people to be physically active in their daily lives, for example by walking, cycling and doing other types of exercise, can be an important strategy in reducing the number of strokes and improving the prognosis of people who suffer a stroke,” says Adam Viktorisson.

Source: University of Gothenburg

Categories : Skeletal SystemTags : Leave a comment

Patients with Osteoarthritis are Often Prescribed NSAIDs Despite Contraindications

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Photo by Towfiqu barbhuiya

A new study published in the journal Osteoarthritis and Cartilage has found that people with newly diagnosed osteoarthritis (OA) of the knee or hip with contraindications to or precautions for NSAIDs still continue to be prescribed these drugs. Additionally they had higher use of opioids and slightly lower physical therapy (PT) use within the first year of OA diagnosis, both of which are not consistent with treatment guidelines for OA.

“We found individuals with contraindications to NSAIDs were still commonly prescribed them, placing them at risk for NSAID-related adverse events,” explains corresponding author Tuhina Neogi, MD, PhD, the Alan S. Cohen Professor of Rheumatology and professor of medicine at the school. “Additionally, they were not more likely to receive safer alternatives like PT despite its widespread recommendation as first-line intervention.”

The researchers used population-based register data to identify adults residing in Sweden (between 2004-13) without a previous knee or hip OA diagnosis. Among this group, between 2014-18, they identified people with knee or hip OA diagnosis and presence of contraindications to or precautions for oral NSAIDs at the time of OA diagnosis. They then estimated the risk of: 1) regular oral NSAID use; 2) regular opioid use; 3) PT during the first year after diagnosis among those with versus without contraindications or precautions.

Despite having contraindications to NSAIDs, 21% of those in the study were regular users of NSAIDs within the first year of their OA diagnosis. Similarly, 21% of those with precautions for using NSAIDs were also regular users. They also found a higher proportion of persons with contraindications were regular users of opioids than those without a contraindication or precaution, while a slightly lower proportion received PT.

Neogi stresses that more options for effective and safe management of OA symptoms are urgently needed, and greater work is required in narrowing and ultimately closing the evidence-knowledge-practice gap.

Source: Boston University

Categories : IT in HealthcareTags : 4 Comments

Introducing the Future of Personalised Healthcare: Ajuda

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Dr Liza Street and Taryn Uhlmann, Co-founders of Ajuda

As technology continues to shrink the world, migration is becoming easier. According to Statista, nearly a million South Africans emigrated in 2020, and the semigration trend in recent years has seen hundreds of thousands of South Africans relocating between provinces. While belongings can go into a truck or shipping container, something even more important is slipping through the cracks: personal health records.

Two highly-motivated, entrepreneurial women are looking to change that with an innovative, user-friendly solution – a secure digital health vault called Ajuda, where anyone and everyone can store their health information and get quick access to it anytime, anywhere, using a secure login from their digital device.

Designed With You In Mind

Ajuda (which means ‘help’ in Portuguese) was founded and developed by both Dr Liza Street, a paediatrician, and Taryn Uhlmann, a technology and marketing business executive.

The two – both moms of three – met when Street began treating Uhlmann’s children. After COVID-19, with all the disruptions and innovations that arose during that time, they got chatting about how disempowering it was for moms not to have easy access to their children’s medical records and thus having to rely on memory when it came to their children’s developmental milestones, doctor consults and medication names. “We don’t realise how often we need to recall this information – for new schools, at doctors’ visits and even when relocating. This frustration, especially for busy parents, is where it all started,” says Uhlmann.

That conversation, three years ago, was the seed for what has blossomed into Ajuda. Uhlmann and Street recently welcomed a third member, Allan Sweidan, as an investor and advisor. Sweidan, a clinical psychologist, brings his experience from co-founding Akeso, Netcare’s mental healthcare clinics, and more recently the mental health app, October Health (Panda), to Ajuda.

Why a Central Health Information Vault?

While the idea may have been born out of a conversation about time-strapped moms managing their kids’ health, Uhlmann and Street soon realised that not having the means to securely and conveniently store one’s health information and have access to one’s medical history was a challenge faced by everyone.

Accurate medical records are necessary in emergency situations, anytime you’re having new medication prescribed, for insurance applications, school applications, visa applications, and in many other instances.

What’s more, not having access to personal health information makes it difficult for people to take control of their own health. Having accurate information on hand helps people keep track of which medications to take, in what dosages and when. It also helps healthcare providers make informed decisions around treatments and prescriptions, based on their patients’ health histories, and can lower the risk of adverse drug interactions. In an age of the ‘sandwich generation’, where adults today often take care of both their children and their parents, a centralised repository of their family’s health information is game-changing.

“We looked at all the challenges,” says Uhlmann. “Memory is a big challenge; migration and movement is a big challenge; and the fact that medical care is fragmented – you might have a scan at one hospital and a blood test at another, or maybe you take your child to a GP while you’re on holiday, and in the end, because you don’t have access to all those records in one place, it means no doctor has all the information required to ever look at you holistically. There are many separate medical apps for various healthcare organisations, but no centralised, consumer facing solution pulling it all together. ” 

Everything In One Place

Ajuda addresses these concerns with a secure, easy-to use digital storage vault that users can access anywhere, anytime, free of charge.

A second time-saving feature of Ajuda is the ‘One Time Form.’  When signing up, a new user creates a profile for themselves and/or their children, which generates a ‘One Time Form’ and they’re set for life. Creating a profile is simple and interactive, and Ajuda users are guided through the process of completing and uploading their personal and health details, step by step, with user-friendly prompts and explanations.

“This is the same core information that you fill in every time you see a new doctor, have a blood test, or do any medical procedure, which becomes frustrating and time consuming,” says Street. “Now you just need to complete it once, unpressurised, in the comfort of your home, with the correct information at hand, and then take it each time you go to a healthcare provider. It’s a win-win for doctors and patients.”

If users don’t have all their information on hand, no problem – they can fill in the gaps later. Once they’ve completed their profile, they can then enjoy the peace of mind that their personal health information is safely, conveniently and accurately stored.

“For healthcare providers, it provides a comprehensive record of a patient’s health history, not only at their own practice but anywhere the patient has received treatment,” says Street.

Free and Independent

Ajuda is free to use, and you don’t need to be a member of a particular medical scheme or use a particular healthcare provider to access it. By making it free to use, Uhlmann and Street hope to empower everyone with the means to take control of their own health information.

For more information on Ajuda or to sign up, visit Ajuda.co.za 

Categories : Implants and ProsthesesTags : Leave a comment

Common Skin Bacteria in Increasing Cases of Implant-associated Osteomyelitis

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Osteomyelitis from Staphylococcus Aureus infection. Credit: Scientific Animations CC0

In patients who have undergone knee or hip replacement surgery, clinicians are noticing increasing numbers of chronic bone infections linked to a bacterial strain commonly found on the skin. A new study published in the Journal of Orthopaedic Research provides insights into the mechanisms involved, and how the bacteria lingers in bone reservoirs.

Utilising mouse models of bone infection and systematic electron microscopy studies, scientists found that the common skin bacteria Cutibacterium acnes can persist as layers of biofilms for weeks on contaminated titanium or stainless-steel implants. In mice, C. acnes could persist for 28 days in the tibia, and the researchers also observed C. acnes spreading to internal organs. compared to Staphylococcus aureus infections, C. acnes chronic osteomyelitis revealed markedly reduced bone osteolysis and abscess formation.

C. acnes can also invade deep pockets of the bone called osteocyte lacuno-canalicular networks and persist there.

“Our study highlights that osteocyte lacuno-canalicular networks can be a major reservoir for this bacterium and potentially provides a novel mechanism of why Cutibacterium acnes chronic bone infections are difficult to treat in the clinic,” said corresponding author Gowrishankar Muthukrishnan, PhD, of the University of Rochester Medical Center.

Source: Wiley

Categories : Diet and Nutrition GastrointestinalTags : Leave a comment

Specific Type of Dietary Fibre Could Stimulate GLP-1 Release

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Gut Microbiome. Credit Darryl Leja National Human Genome Research Institute National Institutes Of Health

New research led by Frank Duca, associate professor at the University of Arizona, suggests that consuming foods rich in beta-glucan, a type of fibre found in oats and barley, can reduce body weight and obesity by stimulating the release of glucagon-like peptide-1 (GLP-1). The study, published in The Journal of Nutrition, analysed the impact of different fibres on gut microbiota.

“We know that fibre is important and beneficial; the problem is that there are so many different types of fibre,” Duca said. “We wanted to know what kind of fibre would be most beneficial for weight loss and improvements in glucose homeostasis so that we can inform the community, the consumer and then also inform the agricultural industry.”

Not all fibre is created equal

The researchers looked at the effect of five different plant-based fibres in rodent diets: pectin, beta-glucan, wheat dextrin, starch and cellulose. Only beta-glucan resulted in reduction of body weight and fat, as well as improvements in glucose homeostasis. Beta-glucan is a unique fibre that is found in many foods, including oats, barley, mushrooms and yeasts, and future studies will examine how different sources of beta-glucan could differ in their effectiveness.

Changes in metabolites – the molecules produced when gut bacteria interact with fibre – seemed to be responsible for the weight-loss effects,  particularly a specific metabolite called butyrate. Butyrate is a key fuel source for colon cells, promoting a healthy gut barrier to reduce systemic inflammation. Butyrate also induces the release of gut peptides, or messengers that regulate the functions of the gut, such GLP-1.

Drugs like semaglutide are synthetic versions of GLP-1, which stimulate insulin and can also help people feel full. One key difference of naturally occurring GLP-1 is its rapid degradation near the intestine, whereas semaglutide is made to last longer and target the brain.

“Part of the benefits of consuming dietary fibre is through the release of GLP-1 and other gut peptides that regulate appetite and body weight,” Duca said. “However, we don’t think that’s all of the effect. We think that there are other beneficial things that butyrate could be doing that are not gut peptide related, such as improving gut barrier health and targeting peripheral organs like the liver.”

Duca is researching other types of fibre that can be beneficial for weight reduction. In a previous study, the Duca Lab discovered that barley flour was the most effective in promoting weight loss compared to several other commercially available flours. Other studies involving oligofructose have also demonstrated beneficial effects. In the future, Duca hopes to collaborate with other researchers to develop enhanced fibres that can optimise the release of butyrate.

Source: University of Arizona