Tag: 6/2/24

Categories : Cancer General InterestTags :

UK’s King Charles Diagnosed with Cancer

On By ModernMedia
By White House, Public Domain

The UK’s King Charles has been diagnosed with cancer, though reportedly at an early stage. This follows a brief hospital stay where he underwent a procedure for a benign enlarged prostate. For the time being, he will not being public duties, but will continue his private duties.

Speaking to the BBC, UK Prime Minister Rishi Sunak said that the cancer was “caught early”. The nature of the cancer was not disclosed by Buckingham Palace, which is in line with its usual practice of sharing only basic information concerning the health of the royal family. It however noted that it was not connected to his prostate treatment, ruling out prostate cancer.

Well-wishes for the king have come in from around the globe. Mia Mottley, Barbados’ first female PM, wished wishes King Charles a “full and speedy recovery”. Barbados became a republic in 2021, ending the the role of UK monarchs as its Head of State.

Since the UK is a constitutional democracy, his private duties consist of governmental approvals. For example, the king has constitutional duties, such as approving the passing of laws and appoints new judges, ambassadors and prime ministers. Public activities such as charity events and giving honours for public or voluntary service.

It is expected that certain activities such as his weekly meetings with Prime Minister Sunak will continue unless his doctors advise otherwise. Other members of the royal family will be able to stand in for him for ceremonial duties if he is unable to perform them. Recently, 41-year-old Catherine, Princess of Wales,

It is not an unexpected medical condition to occur for the 75-year old monarch – age is a major factor for almost all cancers – just over a quarter of all cancers are diagnosed from age 75 onward. The American Cancer Society now recommends general cancer screenings start at 45.

Categories : Ageing Neurodegenerative DiseasesTags :

Did the Ancient Greeks and Romans Suffer from Dementia?

On By ModernMedia
Bust of Hippocrates. By ESM – Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=90175388

Age-related dementia is often assumed to having been with us all along, stretching back to the ancient world. But a new analysis of classical Greek and Roman medical texts suggests that it was extremely rare 2000 to 2500 years ago, in the time of Aristotle, Galen and Pliny the Elder.

The USC-led research, published in the Journal of Alzheimer’s Disease, bolsters the idea that Alzheimer’s disease and related dementias are diseases of modern environments and lifestyles, with sedentary behaviour and exposure to air pollution largely to blame.

“The ancient Greeks had very, very few – but we found them – mentions of something that would be like mild cognitive impairment,” said first author Caleb Finch, a University Professor at the USC Leonard Davis School of Gerontology.

“When we got to the Romans, and we uncovered at least four statements that suggest rare cases of advanced dementia – we can’t tell if it’s Alzheimer’s. So, there was a progression going from the ancient Greeks to the Romans.”

Ancient Greeks recognised that aging commonly brought memory issues that we would recognise as mild cognitive impairment, but nothing approaching a major loss of memory, speech and reasoning as caused by Alzheimer’s and other types of dementia.

Finch and co-author Stanley Burstein, a historian at California State University, Los Angeles, pored over a major body of ancient medical writing by Hippocrates and his followers.

The text catalogues ailments of the elderly such as deafness, dizziness and digestive disorders – but makes no mention of memory loss.

Centuries later in ancient Rome, a few mentions crop up. Galen remarks that at the age of 80, some elderly begin to have difficulty learning new things.

Pliny the Elder notes that the senator and famous orator Valerius Messalla Corvinus forgot his own name.

Cicero prudently observed that “elderly silliness … is characteristic of irresponsible old men, but not of all old men.”

Finch speculates that as Roman cities grew denser, pollution increased, driving up cases of cognitive decline.

In addition, Roman aristocrats used lead cooking vessels, lead water pipes and even added lead acetate into their wine to sweeten it – unwittingly poisoning themselves with the powerful neurotoxin.

(A few ancient writers recognised the toxicity of lead-containing material, but little progress was made in dealing with the problem until well into the 20th century. Some scholars blame lead poisoning for the fall of the Roman Empire.)

For this paper, Finch did not just think about the Roman Empire or the Greeks.

In the absence of demographic data for ancient Greece and Rome, Finch turned to a surprising model for ancient aging: today’s Tsimane Amerindians, an Indigenous people of the Bolivian Amazon.

The Tsimane, like the ancient Greeks and Romans, have a preindustrial lifestyle that is very physically active, and they have extremely low rates of dementia.

An international team of cognitive researchers led by Margaret Gatz, a professor of psychology, gerontology and preventive medicine at the USC Leonard Davis School, found among older Tsimane people, only about 1% suffer from dementia.

In contrast, 11% of people aged 65 and older living in the United States have dementia, according to the Alzheimer’s Association.

“The Tsimane data, which is quite deep, is very valuable,” Finch said.

“This is the best-documented large population of older people that have minimal dementia, all of which indicates that the environment is a huge determinant on dementia risk. They give us a template for asking these questions.”

Source: University of Southern California

Categories : Pain ManagementTags :

New Small Molecule Brings Hope for Neuropathic Pain

On By ModernMedia
Source: Pixabay CC0

Neuropathic pain is one of the hardest types of pain to alleviate – many of the available pain medications are only moderately effective and often come with serious side effects, as well as risk of addiction.

Now researchers at UT Austin, The University of Texas at Dallas and the University of Miami have identified a molecule that reduces hypersensitivity in trials in mice by binding to a protein they have shown is involved in neuropathic pain. The findings appear in the journal Proceedings of the National Academy of Sciences.

“We found it to be an effective painkiller, and the effects were rather long-lived,” said Stephen Martin, co-corresponding author of the paper at The University of Texas at Austin.

“When we tested it on different models, diabetic neuropathy and chemotherapy-induced neuropathy, for example, we found this compound has an incredible beneficial effect.”

The new compound, dubbed FEM-1689, does not engage opioid receptors in the body, making it a possible alternative to existing pain medications linked to addiction.

In addition to reducing sensitivity, the compound can help regulate the integrated stress response (ISR), a network of cellular signaling that helps the body respond to injuries and diseases.

When well regulated, the ISR restores balance and promotes healing. When it goes awry, the ISR can contribute to diseases such as cancer, diabetes and metabolic disorders.

“It’s our goal to make this compound into a drug that can be used to treat chronic pain without the dangers of opioids,” Martin said.

“Neuropathic pain is often a debilitating condition that can affect people their entire lives, and we need a treatment that is well tolerated and effective.”

Source: University of Texas at Austin

Categories : Healthcare Politics and Regulations HospitalsTags :

Officials Raise Alarm over Hiring Freeze at Western Cape’s Largest Hospitals

On By ModernMedia

By Daniel Steyn for GroundUp

Health workers at Groote Schuur Hospital and Red Cross Children’s Hospital in Cape Town are starting to feel the effects of an ongoing freeze on the hiring of critical medical staff.

According to senior officials at these hospitals, speaking to GroundUp anonymously, the situation has reached a point where managers are struggling to fill shift rosters. An impact on patient care and waiting times is inevitable, the officials say.

A senior hospital manager at Groote Schuur told GroundUp that almost half of medical officer (doctor) posts in the medicine department are vacant, in addition to hundreds of other nursing and operational posts. 

Another senior official at Red Cross Children’s Hospital told GroundUp that “critical medical posts” are being left vacant, including medical officer, registrar (doctors in training for a speciality), and specialist posts.

Groote Schuur Hospital is one of the largest government hospitals in the Western Cape and Red Cross Children’s Hospital is the largest children’s hospital in Sub-Saharan Africa. The Daily Maverick reported in November that the budget shortfall for these two hospitals amounts to more than R300-million for 2023/2024.

In addition to hiring freezes at Groote Schuur and Red Cross, the Western Cape Department of Health decided to de-escalate services at the hospitals for a period of four weeks over December and January. Hospital managers were also told to reduce spending on consumables by 50%, according to the Daily Maverick.

At the start of 2023, large cuts were made to the conditional grants that fund these hospitals. And then in the middle of the year, National Treasury announced significant austerity measures including a R21-billion reduction in national government spending for 2023/24.

In August last year, a letter by National Treasury to provincial governments recommended several “cost containment” measures for the 2023/24 financial year and suggested a freeze on hiring of new employees.

It appears that each province’s health department is dealing with the “cost containment” measures in different ways. In the Eastern Cape, for example, hiring freezes have been implemented but not for clinical staff, Sizwe Kupelo, spokesperson for that province’s health department, told GroundUp.

In the Western Cape, as of May 2022, the vacancy rate of medical posts was 5%, compared to 14% in the Eastern Cape, 20% in Gauteng and 28% in KwaZulu-Natal. Health experts are concerned that budget cuts and hiring freezes will have a devastating impact on these provinces.

Hospital officials at Groote Schuur and Red Cross told GroundUp that there has been a lack of clarity from the provincial department on how long hiring freezes will last and whether there will be a permanent reduction in medical posts.

Senior officials fear that the hiring freeze is undoing decades of investment by the government in the capacity of state hospitals. Newly graduated doctors looking to specialise need to take up a registrar post in a state facility, but with registrar posts frozen in the Western Cape, this is almost impossible for them to do.

Hospital managers told GroundUp that some medical officers have resigned from Western Cape hospitals to take up registrar posts in other provinces or even other countries.

Officials are also concerned that if hiring freezes are implemented in primary and secondary care facilities, referrals to hospitals will increase, putting further pressure on an already overburdened tertiary health system.

Dwayne Evans, spokesperson for the Western Cape Department of Health, told GroundUp that the department is unable to respond to specific questions on budget shortfalls or the number of posts frozen, as the 2024/25 budgets are being finalised.

Evans told GroundUp that as part of the hiring freeze, the filling of vacant posts now needs to be authorised by the provincial department to attain “provincial consensus”. 820 vacant nursing posts and 441 doctor positions have been “earmarked to be filled soon”, Evans said.

“We are doing everything we can to reduce the impact on our patients. No patients will be refused emergency and basic medical care and treatment,” he said.

The National Department of Health did not respond to GroundUp’s questions despite several follow-up attempts. National Treasury said that guidance will be given during the upcoming budget speech by Finance Minister Enoch Godongwana.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Categories : Cardiovascular Disease Metabolic DisordersTags :

Long-term Blood Pressure Control from Bariatric Surgery is Most Effective

On By ModernMedia
Sleeve gastrectomy. Credit: Scientific Animations CC4.0

Compared to antihypertensives alone, bariatric surgery is more effective in controlling hypertension rates in people with obesity and uncontrolled hypertension, according to a study published in the Journal of the American College of Cardiology. People who underwent bariatric surgery had lower BMI and were on fewer medications after five years while maintaining normal blood pressure levels than those who only used antihypertensive medications.

“In clinical practice, obesity is an overlooked condition. As a consequence, there is a frequent failure in approaching obesity as a crucial step for mitigating the risk of important cardiovascular risk factors including hypertension,” said Carlos Aurelio Schiavon, MD, FACS, lead author of the study and a surgeon specialising in bariatric surgery at Heart Hospital (hcor) and BP Hospital in Sao Paulo.

Researchers in this study looked at the impact of treating obesity to lower hypertension. While new weight loss drugs exist, long-term adherence to medication can be challenging.

This study looks at bariatric surgery as a better long-term solution to control obesity and, as a result, hypertension.

The GATEWAY trial included 100 people (76% of whom were female) who had a body mass index (BMI) of around 36.9kg/m2. All participants had hypertension and were using at least two medications. People with previous cardiovascular events and poorly controlled Type 2 diabetes were excluded.

Subjects were assigned to either Roux-en-Y gastric bypass with medical therapy or medial therapy alone and the primary outcome was reduction of at least 30% antihypertensive medications while maintaining blood pressure levels less than 140/90mmHg at five years.

At five years, BMI was 28.01kg/m2 for those who received bariatric surgery and 36.40kg/m2 for those on medical therapy alone.

People who had bariatric surgery had an 80.7% reduction in the number of medications they were taking compared to a 13.7% reduction in those only using medical therapy.

Hypertension remission, defined as controlled blood pressure without medications, was 46.9% in those who underwent bariatric surgery compared to 2.4% in those on medical therapy alone.

“Our results underscore the importance of approaching obesity in reducing hypertension rates,” Schiavon said.

Limitations of the study include that it was a single-center, open-label study with a small sample size and there was loss of follow up in some patients.

In an accompanying editorial comment, Michael Hall, MD, MSc, professor and chair of the Department of Medicine at the University of Mississippi Medical Center, said the study provides important long-term data on the benefits of gastric bypass on weight loss and blood pressure control, but questions remain.

“Further studies assessing the threshold for bariatric surgery in people with obesity, optimal timing of bariatric surgery in obese people with cardiometabolic diseases, type of bariatric surgery and comparative studies of obesity pharmacotherapies and bariatric surgery are needed to clarify the optimal treatment pathways for this common and growing disease,” he said.

Source: American College of Cardiology