New research published in the Journal of Bone and Mineral Research identified a number of risk factors for cardiovascular disease in adults with compromised bone health, such as osteoporosis or a fragility fracture. Male sex was associated with a 61% increase in cardiovascular risk in the case of osteoporosis.
The prospective cohort study used data from a UK primary care database. Major adverse cardiovascular events (MACE, a composite outcome for the occurrence of either myocardial infarction [MI], stroke, or CVD death) were identified in patients aged 50 years or older at high or imminent fracture risk identified in three different cohorts (not mutually exclusive): recently diagnosed with osteoporosis (OST, n = 65 295), incident fragility fracture (IFX, n = 67 065), and starting oral bisphosphonates (OBP, n = 145 959). About 1.90%, 4.39%, and 2.38% of the participants in OST, IFX, and OBP cohorts, respectively, experienced MACE events. IFX was the cohort with the higher risk: MACE incidence rates (cases/1000 person-years) were 19.63 (18.54–20.73) in OST, 52.64 (50.7–54.5) in IFX, and 26.26 (25.41–27.12) in OBP cohorts.
The researchers found that risk factors for MACE in the three cohorts included male sex, older age, smoking, alcohol consumption, atrial fibrillation, use of anti-hypertensive medications, history of heart attack or stroke, established cardiovascular disease, low kidney function, high systolic blood pressure, elevated cholesterol level, and use of multiple concomitant medicines.
“Although there are some calculators to produce risk estimates of cardiovascular disease, these are not targeted at those at high risk of fracture,” said corresponding author Daniel Prieto-Alhambra, MD, PhD, of the University of Oxford. “To our knowledge, this is the first study to identify cardiovascular disease risk factors for osteoporotic individuals using data that is routinely collected and readily available.”
A new publication in Nature Communications explains how T cell protection against tuberculosis is controlled by their oxygen responses.
In 2021, 10 million people fell ill and 1.5 million died of Tuberculosis (TB), caused by infection with the intracellular Mycobacterium tuberculosis bacteria. Proper CD4 T cell responses are critical for the control of M. tuberculosis infection by activating intracellular bacterial killing.
Professor Martin Rottenberg and PhD student Ruining Liu at the Karolinska Institutet, explained how they discovered that hypoxia-inducible factors (HIF-1 and HIF-2) control T cell metabolism as well as activation and differentiation in response to hypoxia or during inflammation.
“We showed that genetically modified mice, in which HIF-1 expression T cells was stabilised by genetic manipulation, were highly susceptible to the infection with M. tuberculosis and did not respond to vaccination. CD4 T cells from these mice were profoundly weakened in their early responses to mycobacteria-specific antigens, said Prof Rottenberg. “By impairing and or controlling HIF-1 stabilisation in T cells, responses to vaccines and protection against infections might be improved”.
The studies were carried out on mouse models of M. tuberculosis infection. The mice used were genetically modified to either lack or overexpress HIF-1 in T cells.
“The infection with M. tuberculosis, and the immune responses it generates in man, is fairly mimicked in the mouse infection. Our next step is to identify the molecular targets HIF-1 in T cells that account for their impaired activation, which could be targeted for improving T cell responses,” Prof Rottenberg concluded.
Women and men share most of the same risk factors for cardiovascular disease (CVD), according to a study published in The Lancet. This is the first such study to include people not only from high income countries, but also from low- and middle-income countries – which have the highest burden of CVD. One of the differences observed was a greater sensitivity to diet in women than in men.
The global study assessed risk factors, including metabolic (eg hypertension, obesity and diabetes), behavioural (smoking and diet), and psychosocial (economic status and depression) in about 156 000 people without a history of CVD between the ages of 35 and 70. Living in 21 low, middle and high-income countries on five continents, they were followed for an average of 10 years.
“Women and men have similar CVD risk factors, which emphasises the importance of a similar strategy for the prevention of CVD in men and women,” said first author Marjan Walli-Attaei, a research fellow at the Population Health Research Institute (PHRI) of McMaster University and Hamilton Health Sciences (HHS).
Overall, women had a lower risk of developing CVD than men, especially at younger ages.
However, diet was more strongly associated with CVD risk in women than men – “something that’s not been previous described, and which requires independent confirmation,” said Salim Yusuf, lead investigator of the study, senior author, executive director of PHRI, professor of medicine at McMaster University, and cardiologist at HHS.
High levels of bad (LDL) cholesterol and symptoms of depression were more strongly associated with CVD risk in men than in women. The patterns of these findings were generally similar in high-income countries and upper-middle-income countries, and in low-income and lower-middle-income countries.
A new international study revealed that eight in 10 Europeans believe tans are attractive with almost as many (73%) saying tans are healthy, according to a new study presented at the 31st European Academy of Dermatology and Venereology (EADV) Congress.
This is despite decades of awareness campaigns linking too much sun exposure to skin cancer and ageing in many countries. Latest estimates also presented at EADV 2022 found that about 1.7% of adults in Europe have skin cancer (around 7.3 million people).
Results from a survey, conducted by La Roche-Posay Laboratoires and IPSOS, of 17 000 people from 17 countries, including 6 000 people from the UK, Germany, France, Spain, Italy, and Russia, found the ‘healthy tan’ and other myths about sun safety are still very much alive in Europe and other countries.
Other myths included believing sun protection was not needed in cloudy weather and that you did not need sunscreen if you already had a tan.
People surveyed from non-European countries, including North and South America, Africa, Oceania, and Asia, were slightly less enthusiastic about suntans than Europeans, with 67% saying a tan was attractive and 59% believing a tan was healthy.
Although 92% of Europeans were aware of the skin ageing risks posed by the sun (86% outside of Europe), 84% of them admitted they did not protect themselves all year round (79% outside of Europe).
Lead researcher Prof Thierry Passeron commented on the findings: “This research shows just how entrenched the ‘healthy’ suntan myth is – even in those who have already suffered sun damage or developed skin cancer.”
“We must drive awareness of the damage to skin cells caused by exposure to the sun, which can lead to photoaging and skin cancer. This is particularly important in Europe where sun protection appears most inadequate compared to other countries” added Prof Passeron.
The survey also revealed that only 56% of Europeans know sun protection is useful when the weather is overcast (vs 64% outside of Europe), and 24% thought it was safe to go outside without sun protection when they were already tanned (vs 21% outside of Europe).
Only in 10% of Europeans said they routinely or often used all forms of sun protection, such as applying sunscreen, staying in the shade, wearing a hat and protective clothing all year round, compared to 14% amongst those outside of Europe.
“The public must also understand that they need to protect their skin all year round, even during overcast weather conditions. Once sunscreen has been applied, it must be reapplied every two hours to ensure sufficient protection. Other measures such as wearing sunglasses, a hat, and protective clothing, and seeking shade when it is possible, are also key photoprotection habits”, commented Prof Passeron.
Other study findings include:
Just over half of Europeans (51%) said they were likely to wear a hat routinely or often, compared to 57% outside Europe.
When it comes to staying in the shade (73%) of Europeans said they did so routinely or often, compared to 80% of those outside Europe.
A second analysis by the team found awareness of the dangers of the sun were higher in at-risk* groups of people. But 59% of this group said they could not imagine coming back from a holiday without a tan, compared to 48% of those without a medical history.
62% of Europeans and 52% of non-Europeans applied sunscreen routinely or often, especially on their arms, legs, and chest. But 10% of Europeans said they never used suncream at all, compared to 16% outside Europe. Of those who applied sunscreen in the sun – 34% applied it only once a day, compared to 49% outside Europe.
90% of those in at-risk groups said they were aware of the risks the sun posed to their skin, yet 72% still regarded a tan as healthy, which is higher than those who had no history of skin cancer or other sun-exposure related skin conditions (62%). Additionally, of those who said they applied sunscreen in at-risk groups, only 1 in 4 (26%) applied it every 2 hours or more often than is recommended.
Opioid use is a significant cause of premature death, caused by supressing respiratory activity. New research, published in The Journal of Physiology, points to a novel treatment for respiratory depression associated with opioid use that administers electrical pulses to the back of the neck, helping patients regain respiratory control following high dosage opioid use.
Breathing problems can occur after opioid use or post-operative complications from anaesthesia because opioids desensitise the brain stem to rises in carbon dioxide. This can cause respiratory failure, which can be fatal. Current treatments, such as manual lung inflation and medication, can work in the short term to combat breathing problems following opioid use, but getting patients to breathe independently remains a challenge. Therefore, this new research, which administers epidural electrical stimulation (EES) offers an alternative, non-pharmacological treatment.
EES administered at the cervical spinal cord, which is located at the back of the neck, activates a network of neurons in the brainstem that stimulates and coordinates respiratory muscles and improves the rate and depth of breathing.
Researchers from the University of California, Los Angeles (UCLA), targeted sensory-motor circuits in the cervical spinal cord of 18 patients with degenerative spine diseases who were anaesthetised for surgical treatment. They delivered 30 Hertz of EES to the cervical spinal cord continuously for no longer than 90 seconds.
They found that short periods of continuous low-intensity EES not only increased the volume of breath but also actively controlled the frequency and rhythm during opioid-induced breathing problems. The rhythmic breathing pattern was sustained briefly after the EES stopped in the presence of high-dose opioids.
Senior author Dr Daniel Lu, UCLA professor and vice chair of neurosurgery, said: “Our results provide proof of principle that cervical EES could improve respiration following opioid use. We can compare the human body to a car, our goal is to jump start the body so it can run by itself without periodic pushes. We hope to use EES to provide novel approaches to restore breathing for healthcare providers as we are now using defibrillation devices for restoring cardiac activities.”
Future human trials with larger cohorts will be conducted to further assess the practical application and impact of EES to determine whether EES can alleviate or reduce the need for ventilator support in acute pathological conditions such as OIRD, stroke, and traumatic brain, brain stem or spinal cord injury. Experimental studies in mice will be carried out to further investigate the role specific neurons play in response to EES.
