Study finds how obstructive sleep apnea may increase risk of abdominal aortic aneurysms

Obstructive sleep apnea may increase the chance of developing abdominal aortic aneurysms, according to experts from the University of Missouri School of Medicine and NextGen Precision Health.

Abdominal aortic aneurysms form when the major artery, the aorta, expands and potentially ruptures, resulting in life-threatening internal haemorrhage. Obstructive sleep apnoea is a chronic disorder in which patients stop and start breathing while sleeping, increasing the risk of cardiovascular complications. Citing studies indicating a higher occurrence of abdominal aortic aneurysms in people with obstructive sleep apnea, MU researchers investigated the link between the two using mouse models.

The research team found that intermittent hypoxia - when the body isn't getting enough oxygen for a given period of time - caused by obstructive sleep apnea increased the susceptibility of mice to develop abdominal aortic aneurysms.

"Chronic intermittent hypoxia by itself is not enough to cause abdominal aortic aneurysms, but for a patient with obstructive sleep apnea who also has additional metabolic problems like obesity, our findings suggest it may help degrade aortic structures and promote aneurysm development," said Luis Martinez-Lemus, study author and a professor of medical pharmacology and physiology.

Intermittent hypoxia happens during obstructive sleep apnea when throat muscles relax and block the flow of air into the lungs. According to the research, the loss of oxygen triggers certain enzymes called MMPs. The increased enzyme activity can degrade the extracellular matrix, which acts like a cell scaffolding network, weakening the aorta.

"Patients with abdominal aortic aneurysms usually don't notice any symptoms, except for some back and belly pain, until the aneurysm bursts. Once that happens, it's crucial to get the patient to surgery quickly so doctors can repair the aorta," said Neekun Sharma, the lead author of the study. "Learning how these aneurysms develop can help us find ways to monitor or slow down their progression, especially for patients who have obstructive sleep apnea."

https://www.newkerala.com/news/2024/60869.htm

AMR containment strategies must be urgently integrated in health programmes: Centre

India has reaffirmed its commitment to combat antimicrobial resistance (AMR) at the 79th United Nations General Assembly (UNGA) high-level meeting on AMR, the Ministry of Health and Family Welfare said on Friday.

Addressing the gathering of global leaders, Union Minister of State for Health and Family Welfare Anupriya Patel called for urgently integrating AMR containment strategies in various health programmes.

Patel also highlighted the urgent need for global cooperation to address the growing threat of AMR.

"AMR poses a critical threat to global public health undermining decades of progress made in the field of modern medicine," said Patel.

AMR occurs when bacteria, viruses, fungi, and parasites no longer respond to medicines. This leads to infections becoming difficult or impossible to treat, increasing the risk of disease spread, severe illness, and death.

"Urgent integration of AMR containment strategies into the various health programmes" is the need of the hour, the MoS added.

She called for the inclusion of AMR strategies in programmes that focus "on pandemic preparedness, health system strengthening and universal health coverage with the focus of resource utilisation more on prevention and mitigation than surveillance".

The Union Minister also highlighted India's significant strides in combating AMR since the launch of its National Action Plan (NAP AMR) in April 2017.

She underscored the progress made in expanding surveillance networks both in the human and animal sectors. This includes reducing hospital-acquired infections by improving infection prevention and control and promoting responsible antimicrobial use across human and animal health sectors.

Under the Clean India Mission, the country's sanitation, hygiene, and infection control in healthcare facilities has significantly improved, the MoS said.

In addition, "a nationwide systematic and standardised surveillance of healthcare-associated infections (HAI) has been initiated in the country," Patel said, adding that regulations have been made to "ensure prescription-based sales of antimicrobials".

The UNGA was informed that India has developed an Antimicrobial Stewardship (AMS) programme to reduce unnecessary antibiotic prescriptions and combat rising AMR.

"India remains fully committed to addressing the AMR challenge," Patel said while calling for collective work to "mitigate the risks posed by AMR and safeguard the future of public health worldwide".

Meanwhile, global leaders at the UNGA committed to a clear set of targets and actions, including reducing the estimated 4.95 million human deaths associated with bacterial AMR annually by 10 per cent by 2030.

https://www.newkerala.com/news/2024/60829.htm

Researchers discover potential new treatment for liver fibrosis

A new study from the University of Pittsburgh School of Pharmacy provides light on the processes that contribute to liver fibrosis and proposes a unique therapy method for this prevalent and serious disorder.

The work, led by senior author Wen Xie, M.D., Ph.D., professor and Joseph Koslow endowed chair of the Department of Pharmaceutical Sciences, and co-first authors Hung-Chun Tung, graduate student, and Jong-Won Kim, Ph.D., postdoctoral associate, was published today in Science Translational Medicine.

In this Q&A, Xie expands on the study's findings and discusses why new diagnostic tools and therapy options for liver fibrosis are critically needed.

Liver fibrosis is the formation of tissue scars in the liver due to chronic inflammation and injury. Over time, fibrosis can impair liver function and may lead to cirrhosis or even liver cancer. Those at risk include individuals with chronic viral hepatitis, obesity, diabetes and excessive alcohol use. Early detection and intervention are crucial to prevent progression to more severe liver disease.

Currently there are no FDA-approved drugs that specifically treat liver fibrosis. The only treatment option is to treat diseases that cause liver fibrosis in the first place, such as hepatitis, obesity, type 2 diabetes and alcoholic liver disease. Preventive measures include avoiding excessive alcohol, maintaining a healthy body weight and early screening for liver diseases to prevent fibrosis from advancing to cirrhosis or liver failure.

HSCs are a unique cell type in the liver. When the liver is injured or inflamed, HSCs become activated and produce excess collagen and other extracellular matrix proteins. The accumulation of collagen and other extracellular matrix proteins leads to scar tissue formation and liver fibrosis.

This study identified the enzyme CYP1B1 as a biomarker and predictor of HSC activation and liver fibrosis in both patients and mice. Inhibition of CYP1B1 led to the accumulation of a sugar called trehalose, which we showed for the first time that trehalose has anti-fibrotic activity. Moreover, treatment of mice with trehalose, its analog lactotrehalose or CYP1B1 inhibitor protected mice from getting liver fibrosis.

It was surprising to identify a liver function of CYP1B1, an enzyme traditionally known for its functions outside the liver. Although the concentration of CYP1B1 in the whole liver is not high, this enzyme is uniquely and abundantly present in HSCs and thus plays an important role in HSC activation and liver fibrosis.

Liver fibrosis is a common, potentially deadly and costly liver disease that lacks FDA-approved drugs. Our findings are clinically important because we identified CYP1B1 as a predictor of HSC and liver fibrosis in patients, which may help with the early diagnosis of this disease. More importantly, we found that trehalose and lactotrehalose are potential novel drugs that could be used to treat liver fibrosis in the future.

https://www.newkerala.com/news/2024/60811.htm

Can you get a heart attack during an angiography?

Angiography is a common test done to visualise blood vessels in the heart, looking for blockages or narrowing that could result in heart disease.

Recently, an acquaintance complained of mild chest pain and discomfort after dinner. The 33-year-old male was rushed to a hospital in Chennai where an Echocardiogram and ECG were done. While both results came out normal, he was kept under overnight observation, which was followed by a treadmill ECG in the morning. Since this test result showed a variation, he was advised an angiography (a procedure that uses X-rays to produce an angiogram to reveal the health of blood vessels) during which he had a major heart attack and collapsed.

With only 10 per cent of his heart functioning, the doctor suggested a transplant. Now his left leg, until mid-thigh, has been amputated which has improved heart functioning by one per cent and if the patient remains stable, a heart transplant may not be required.

Taking a cue from this case, let’s understand the odds of getting a heart attack during angiography, a common test done to visualise blood vessels in the heart, looking for blockages or narrowing that could result in heart disease.

According to Dr Brajesh Kumar Mishra, interventional cardiologist and cardiac electrophysiologist, Manipal Hospital, Gurugram, it is often performed when one has symptoms of chest pain or shortness of breath or if there’s suspicion of a heart condition. “While generally considered a safe procedure, patients sometimes report a little anxiety regarding the risk involved,” said Dr Mishra.

What happens during the test?

It is a relatively non-invasive test. A thin tube, also called a catheter, is inserted via a vein — usually in the groin or wrist — and is advanced towards the heart. “A specialised dye is injected which allows for blockages or narrow arteries to be visualised under X-ray guidance by the doctor,” said Dr Mishra.

Can a heart attack occur?

Dr Mishra told indianxpress.com, “Although very rare, it may result in the complication of a heart attack”. “The occurrence of a heart attack during an angiogram is usually less than 0.001 per cent, especially for those patients who are being diagnosed through the procedure. Most of the patients do not experience any severe problems while undergoing the procedure,” said Dr Mishra.

In most instances of a heart attack occurring, Dr Mishra explained that it is usually based on the prevailing condition of the heart, such as severely clogged arteries, that the angiogram tests for. “A probable dislodgment of the plaque or rupture of plaque in the arteries by either the catheter or dye may cause the blockage that may bring about a heart attack. The doctors are, nonetheless, fully trained to take swift and appropriate action in case such a possibility may arise,” said Dr Mishra.

How to avoid complications?

Physicians take many precautions to avoid complications, even heart attacks, asserted Dr Mishra. “You will be thoroughly screened for the procedure by blood tests and imaging to make sure your heart is in stable condition. The procedure itself is controlled by very experienced cardiologists,” said Dr Mishra.

What to keep in mind?

However, Dr Vidya Suratkal, cardiologist, Lilavati Hospital Mumbai emphasised that it is important to note that the risk of choosing not to undergo an angiogram is even greater if you have symptoms of a heart attack such as chest pain or discomfort, tightness in the chest, difficulty in breathing, or weakness, especially on the one side of the body. “If you are concerned or curious about the risks associated with the angiography process then consider consulting a doctor for detailed discussion,” said Dr Suratkal.

https://indianexpress.com/article/lifestyle/health/possible-to-get-heart-attack-during-angiography-procedure-angiogram-experts-9551581/

Paracetamol among 53 drugs to fail quality control: What safe alternatives can you turn to?

There are a few staple names one turns to when the usual, inescapable bouts of cough, cold and fever come knocking at the door. It is after all temperature change season, and random onsets of flu and fever are more common than not. Having weathered the same for years, your medicine box is bound to have the usual bunch of strips which tend to these symptoms like clockwork. In this regard, Paracetamol for fever, has been a no-brainer option for decades and across generations.

If you're a Paracetamol loyalist then, it looks like you're going to have to consider a little switcheroo. The Central Drugs Standards Control Organisation (CDSCO) has labelled Paracetamol, alongside 52 other drugs as 'NSQ', which refers to 'not of standard quality'. NSQ alerts are circulated after random quality check tests administered by state drug officers. The alerts not only carried the list of drugs slapped with the NSQ label, but also a list of responses from their manufacturers. Though one manufacturer in particular referred to the batch being subjected to inspection as potentially carrying spurious drugs, it is always better to be safe than sorry.

So if not Paracetamol then what? Broth, ginger and turmeric to the rescue

Dr. Minesh Mehta, Consultant Intensive and Critical Care Specialist at Ahmedabad's Shalby Hospital signs off on Ibuprofen, Meprocin, Meftal, Diclofenac and Nimesulide as alternatives.

Dr. Vibhu Kawatra, Pediatric Pulmonologist and Allergy Specialist at Delhi's Rainbow Hospital also lists out a few natural remedies you can add to your sick day routines, to speed up the recovery process. He shares, "Drinking plenty of fluids, like water, herbal teas, and clear broths, helps keep the body hydrated and can aid in cooling. Drinking ginger or peppermint tea too may help soothe discomfort and promote sweating, which can aid in cooling the body". A few more approaches suggested by Dr. Kawatra include willow bark which may help alleviate pain and reduce fever as well as turmeric which is known for its anti-inflammatory properties.

He concludes, "Applying a cool, damp cloth to the forehead, wrists, or neck can provide relief and help lower body temperature. Taking a lukewarm bath can help bring down a fever gently. Avoid taking cold baths as they can cause shivering and raise body temperature. Also ensure adequate rest which will help the body fight off infections, which often tends to be the underlying cause of fever".

It is worth mentioning that besides Paracetamol, drugs like vitamin C and D3 tablets, Shelcal, vitamin B complex, vitamin C softgels, Pan-D, Glimepiride and Telmisartan, have also made the NSQ alert list.

We strongly suggest personally consulting with a medical practitioner before making any changes to your medications. Stay safe!

https://www.hindustantimes.com/htcity/wellness/paracetamol-shelcal-glimepiride-telmisartan-fail-cdscos-quality-control-what-safe-alternatives-can-you-turn-to-101727334636036.html

Surrogacy linked to higher risk of severe pregnancy complications: Study

According to new research, individuals who are gestational carriers (also known as "surrogates") may be more susceptible to severe complications during pregnancy and the early postpartum period, hypertension during pregnancy, and postpartum hemorrhage than those who conceive naturally or through IVF. New research from ICES and Queen's University.

Those who are not otherwise able to carry a pregnancy are assisted in becoming pregnant by gestational carriers, who also give birth to their offspring. It is unclear if there is a greater chance of serious health consequences for newborns and gestational carriers, both throughout pregnancy and after delivery. One of the first significant population-based studies comparing health outcomes for three distinct methods of conception--unassisted, in vitro fertilization (IVF), and gestational carriage--has examined connected health databases.

Research Indicates Gestational Carriers Face Severe Complications in Pregnancy

"The study was prompted by an increased in the use of gestational carriers worldwide and a lack of information about the impact of this reproductive modality on pregnancy outcomes, for the gestational carrier and the offspring," says lead author Dr. Maria Velez, an adjunct scientist at ICES and at the time of this study, an associate professor in the department of Obstetrics and Gynaecology at Queen's University. Velez is currently an associate professor and a clinician scientist at McGill University and the Research Institute of the McGill University Health Centre (RI-MUHC)

The study, published in the journal Annals of Internal Medicine, included 863,017 singleton births at more than 20 weeks' gestation in Ontario, Canada, between 2012 and 2021. The groups included 846,124 (97.6%) who were conceived without assistance, 16,087 (1.8%) by IVF, and 806 (0.1%) using gestational carriers. The researchers analyzed severe maternal morbidity (SMM) and severe neonatal morbidity (SNM), which combine many different health indicators for both birthing people and babies. They also assessed hypertensive disorders (such as pre-eclampsia), cesarean delivery, preterm birth, and postpartum hemorrhage.

One limitation of the study was that there was a lack of information about why gestational carriage was chosen by the intended parents, egg and sperm donor sources, the type of IVF used, and reasons why people chose to become gestational carriers. Future research could help to assess whether any of these factors would impact the health outcomes of the pregnant person or the baby. "Clinicians involved in the care of individuals and couples who need a gestational carrier to build their family should counsel their patients and the gestational carriers about the potential risk during pregnancy and early postpartum," says Velez.

"There are guidelines about the eligibility criteria to minimize the risk of pregnancy complications among gestational carriers," she adds. “However, these guidelines are not always strictly followed.” The study, "Severe Maternal and Neonatal Morbidity Among Gestational Carriers: A cohort Study" was published in Annals of Internal Medicine.

https://www.hindustantimes.com/lifestyle/health/surrogacy-linked-to-higher-risk-of-severe-pregnancy-complications-study-101727358192129.html

Psilocybin may bring greater long-term depression symptom relief than SSRIs

A new clinical trial looks at how psilocybin compares to a commonly prescribed antidepressant.

• About 5% of adults worldwide live with depression.
• One commonly prescribed medication for treating depression is selective serotonin reuptake inhibitors (SSRIs), which have quite a few potential side effects.
• Researchers from Imperial College London in the United Kingdom say that psilocybin provides similar improvement of depression symptoms as an SSRI.
• They found that participants also reported greater improvements in social functioning and psychological connectedness after 6 months.

Researchers estimate that 5% of adultsTrusted Source around the world live with depression — a mental health condition that causes a person to feel sad, hopeless, and/or unable to experience joy.

In addition to psychological counseling, there are several types of antidepressant medications available to treat depression. One of the most commonly prescribed are selective serotonin reuptake inhibitors (SSRIs)Trusted Source.

As with all medications, SSRIs have side effects that can include nervousness or anxiety, headache, nausea, dry mouth, sleeping issues, and loss of libido. Additionally, past studies show that SSRIs do not work for about 30% of people with depression.

Now, researchers from Imperial College London in the United Kingdom say that psilocybin — a psychedelic compound found in certain types of mushrooms — provides similar improvement of depression symptoms as an SSRI, as well as better psychosocial functioning and other long-term benefits.

The study was recently published in the journal Lancet eClinical MedicineTrusted Source and presented at the 37th European College of Neuropsychopharmacology (ECNP) Congress.

Psilocybin offers same depression symptom improvement as SSRIs

For this study, researchers recruited 59 adults with a diagnosis of moderate-to-severe depression. Thirty participants received two 25-milligram doses of psilocybin, while the remaining 29 followed a 6-week course of an SSRI called escitalopram.

Participants also received about 20 hours of psychological support.

At the study’s conclusion, researchers found that both groups showed notable improvement in their depression symptoms, even up to the 6-month follow-up.

“[Psilocybin] disrupts the persistent ruminative loops of negative thinking that underpins depression,” David Nutt, DM, FRCP, FRCPsych, FMedSci, DLaws, the Edmond J. Safra Professor of Neuropsychopharmacology and director of the Neuropsychopharmacology Unit in the Division of Brain Sciences at Imperial College London and one of the authors of this study, told Medical News Today.

“We did show that remission rates were much higher for psilocybin than for escitalopram even though the mean scores for depression reductions were not different,” he added.

“The reasons for this are complex and likely due to high variability of some scores and the fact that after the two month treatment trial, we did not control what the patients took in terms of medicines, i.e. they could seek out other treatments,” Nutt explained.

Psilocybin improves social functioning after 6 months

Additionally, in the psilocybin group, participants also reported significant advancement in social functioning and psychological connectedness during the 6-month follow-up.

“This is important because improving connectedness and having greater meaning in life can significantly enhance a person’s quality of life and long-term mental health,” David Erritzoe, MD, PhD, MRCPsych, clinical director and deputy head of the Centre for Psychedelic Research at Imperial College London and co-first author of the study stated in a press release.

“The study suggests that psilocybin therapy might be a more holistic treatment option for depression, addressing both the symptoms of depression and overall well-being. This could make a substantial difference in the overall happiness and daily activities of those suffering from depression, providing a more joined-up approach to mental health treatment,” Erritzoe advised.

As to Nutt, he also pointed out that:

“This further supports the view that psilocybin works quite differently to escitalopram, especially that it doesn’t suppress emotions like escitalopram does. Just 2 psilocybin doses are at least as effective at treating depression as 6 weeks treatment with escitalopram with better remission rates and improved well-being outcomes up to 6 months.”

“We will be reporting outcomes of psilocybin treatment in anorexia, OCD [obsessive-compulsive disorder], and fibromyalgia next year,” he told us. “Our current research is exploring if just a single dose of psilocybin can help treat addictions to heroin and gambling.”

Promising results for possible antidepressant alternative

After reviewing this study, Simon B. Goldberg, PhD, Kellner Family Distinguished Chair in Education and Well-Being and associate professor in the Department of Counseling Psychology and Core Faculty at the Center for Healthy Minds at the University of Wisconsin – Madison, who was not involved in the research, told MNT that he thought it was very exciting that work investigating alternatives to antidepressants is showing these kinds of promising results.

“Depression is extremely common and burdensome, so there is a huge public health need for effective treatments,” Goldberg explained. “It was quite intriguing that the psychedelic condition was showing benefits above and beyond escitalopram on some measures of well-being.”

“Although antidepressants are helpful for many people, they have some important limitations,” he continued. “Many patients do not respond to them, they can have substantial side effects, and benefits may not persist when someone stops taking the antidepressant. There is some evidence that there also may be withdrawal symptoms associated with discontinuing antidepressants.”

MNT also spoke with David Merrill, MD, PhD, a board-certified geriatric psychiatrist at Providence Saint John’s Health Center in Santa Monica, CA, and Singleton Endowed Chair in Integrative Brain Health, about this study.

“The mind-altering and intensive nature of psychedelics makes it such that comparing the two is nice in theory but the access barriers for one treatment versus the other remain significant,” Merrill, who was also not involved in the research, pointed out.

“It will take some doing before the comparable effectiveness matches the realistic opportunity for patients to access the two treatments equally,” he added.

Merrill said it is important for researchers to continue to look for alternatives to standard SSRIs as it helps us understand mechanisms of depression.

“There may be ways to achieve the benefits of psychedelics without the drugs,” he noted. “For example, through holotropic breathingTrusted Source. But even that can be of an intensity such that it’s recommended to be tried only under direct supervision of an experienced practitioner.”

More studies needed before psilocybin can be approved for depression treatment

Matthew W. Johnson, PhD, senior investigator at the Sheppard Pratt Center of Excellence for Psilocybin Research and Treatment in Baltimore, MD — who reviewed this study for MNT — pointed out that psilocybin has not been approved for depression by the Food and Drug Administration (FDA), the European Medicines Agency (EMA), or similar regulatory bodies.

“Therefore it is important to move toward and complete phase 3 trials to potentially garner that approval,” Johnson continued. “Such larger studies are also better able to study the risks of psilocybin, which is something I have researched over the years.“

“Larger studies are better equipped to identify relatively uncommon adverse effects. We need to know how prevalent such effects are under clinical conditions and optimize screening and treatment methods to minimize harm,” Johnson explained.

Finally, MNT also spoke with Rachel Yehuda, PhD, Endowed Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai and director of The Parsons Research Center for Psychedelic Healing at Mount Sinai, who commented this is an important study showing that the long term effects of both psilocybin and escitalopram are durable six months after treatment.

“This is the kind of information that the field needs in order to understand long-term impacts of psychedelic therapies,” Yehuda, who was not involved in this research, explained.

“What I really liked about this study is that we are finally starting to talk about outcome measures beyond symptom severity, which in mental health, can be extremely informative. Many people with symptoms can tolerate them better if they can live lives full of meaning, connectedness, and social functioning. Simply measuring severity of depression or other mental health conditions often does [not] give the full picture of well-being,” she told us.

“That said, the study also calls for more long-term follow up of psychedelic therapies as there is a suggestion in the data, particularly in the supplementary tables, that the magnitude of the symptom severity differences are reduced over time in the psilocybin group compared to the escitalopram group. Again, if overall people feel like their lives have improved, this argues for a more diverse set of primary outcomes in evaluating the efficacy and long-term benefits of any mental health treatment.”– Rachel Yehuda, PhD.

https://www.medicalnewstoday.com/articles/psilocybin-may-bring-greater-long-term-depression-symptom-relief-than-ssris

Interstitial Lung Disease: What is the importance of timely diagnosis and treatment

Interstitial Lung Disease (ILD) is a chronic condition marked by lung inflammation and scarring that makes breathing difficult. Early diagnosis is vital for effective management. Contributing factors include genetics, environmental exposures, and underlying conditions. Treatments involve medications, oxygen therapy, pulmonary rehabilitation, and lifestyle changes to enhance patients' quality of life.

Interstitial Lung Disease: What is the importance of timely diagnosis and treatment

Interstitial Lung Disease (ILD) is a clustering of the diseases which comprises inflammation and scarring (fibrosis) of the lung parenchyma. Which in turn causes lung stiffness, making it difficult to breathe and eventually leading to poor oxygenation of the blood. The effects of ILD are chronic and permanent. It cannot be reversed and may potentially develop further over time if regular treatment is not administered.

On a global level, it has been reported that millions of patients suffer from ILD. Often regarded as the most common form of ILD, idiopathic pulmonary fibrosis (IPF) has an estimated incidence rate which ranges from 3-9 per 100,000 people. In India, various studies have shown that there is a rising concern on cases of ILD with possible causes including air pollution, smoking and occupational exposure. ILD predisposes people and there is high prevalence especially in the industrialized areas hence the emphasis on the need to address the environmental aspects in the Health promotion.

Risk factors for ILD

• Genetic factors: There are many genetic factors that predispose a person to ILD. Some of these mutations can predispose the status, which is why there is an increasing call for these genetic tests. Treatments that prevent the onset of illness, control disease progression, and alleviate symptoms for patients and families may be possible in all at risk persons with genetic screening.

• Environmental exposures:

Air pollution and smoking are other known causes for illiberation of ILD. In India, environmental pollution increases the risk especially in industrial areas and urban cities. Occupational and environmental exposures like asbestos exposure leading to asbestosis and exposure to pigeon droppings are risk factors.

• Underlying conditions: Some sarcoidosis and rheumatoid arthritis patients are more susceptible to developing kidney infecting lung disease (ILD). Another confluent cause of ILD is hypersensitivity pneumonitis, which is an allergy caused by environmental agents.

Symptoms of ILD

Generally, ILD patients will have:

• Breathlessness

• A cough that produces little sputum or none and lingers.

• Pain in the throat

• Weakness

• Rare cases with weight loss

Diagnosis of ILD

Diagnosis at the early stage is very essential because at that stage, the signs are often well recognizable even when the disease has advanced and caused significant damage to the lungs. A variety of diagnostic methods are employed:

• Radiological investigations: lower thoracic x-rays and high-resolution CT images of the thorax often reveal the lung pathology. Although high-resolution CT is the most effective method in COID, a number of clinical specialists may interpret her differently. AI, which has been applied to detect diseases, including images and sounds of disease, has, unlike other areas, already shown an assurance level of 78 – 91% accuracy, and thus most uses of such image analyzers are not yet adequately established.

• Lung Function Tests (LFT): These include a set of procedures to check the functional status of the respiratory system.

• Blood tests: It is also necessary to carry out blood tests using advanced serological techniques such as Immunofluorescence, Immunoblots and Monospecific ELISA.

• Invasive procedures: Bronchoscopy and in select cases lung biopsy may be needed to establish a conclusive diagnosis.

Challenges in diagnosis in India

ILD turned out to be particularly difficult in India due to certain peculiarities such as the high incidence of tuberculosis. In most of India and especially smaller towns and rural areas healthcare costs are limited and the way this disease is diagnosed is not well-established which leads to slow recognition of the disease. There may be limitations to modern diagnostic modalities such as HRCT or invasive diagnostic tests in these areas.

Treatment and management

The treatment of ILD varies based on the cause and severity of the disease. Since lung damage is irreversible and the disease is progressive, early diagnosis and timely intervention are important to improving quality of life and reducing symptoms.

• Medications: Corticosteroids and other anti-inflammatory drugs are commonly prescribed to reduce lung inflammation.

• Oxygen therapy: This is critical to symptom relief, helping patients breathe more easily and preventing complications.

• Pulmonary rehabilitation: A structured program that includes physical activity, breathing exercises, and education is recommended to improve patients’ quality of life. Many ILD patients experience low levels of physical activity, especially in the advanced stages, so it’s important to encourage light stretching, aerobic, and strength-building exercises.

• Lifestyle modifications: Patients should quit smoking, use air purifiers at home, and avoid foods that cause gas or bloating. Regular monitoring of oxygen levels and relaxation techniques, such as listening to calming apps, can also aid in symptom management.

• Genetic testing and personalized care: Genetic screening can help guide personalized treatment plans for patients with a genetic predisposition, improving outcomes through targeted therapies.

Role of support systems

Managing chronic diseases like ILD involves not only medical interventions but also emotional and practical support. Family and community support systems are vital for improving patient outcomes. Family support can provide emotional assistance, help coordinate care, and reduce stress, all of which are important for long-term disease management. These support systems also play a crucial role in ensuring adherence to treatments and improving patients' overall quality of life.

Interstitial Lung Disease is a serious and progressive condition, but early diagnosis and timely treatment can significantly improve outcomes. With increasing awareness about genetic factors, environmental risks, and the importance of supportive care, it is possible to enhance the quality of life for individuals affected by ILD.

https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/interstitial-lung-disease-what-is-the-importance-of-timely-diagnosis-and-treatment/articleshow/113667349.cms

1 in 3 children, teens globally affected by short-sightedness, study estimates

Attaining puberty before boys and tending to spend lesser time outdoors could be possible reasons why girls are affected more by short-sightedness

About a third of children and teens around the world are short-sighted, with cases estimated to touch 74 crore by 2050, according to a study that analysed available evidence.

Short-sightedness, or myopia, is a common condition of the vision in which one has trouble seeing distant objects clearly. It usually develops in early childhood and tends to worsen with age.

Researchers from Sun Yat-Sen University in China looked at 276 studies, published up to June 2023. Over 54 lakh participants aged 5-19 years and 19 lakh cases of short-sightedness from 50 countries, including those in Asia and Africa, were analysed.

Cases of short-sightedness rose from 24 per cent during 1990-2000 to 25 per cent during 2001-10, followed by sharper increases of 30 per cent between 2011-19, and 36 per cent between 2020-23, which is roughly the same as one in every three children and teens, the team said.

“The global prevalence of childhood myopia is substantial, affecting approximately one-third of children and adolescents, with notable variations in prevalence across different demographic groups,” the authors wrote.

They advised more physical activity and less screen time for all children and teens.

Between 1990 and 2023, prevalence was found to have more than tripled and low- and middle-income countries were significantly affected more compared to high-income ones.

Further, being female, east Asian, or living in urban environments were found to be key factors influencing prevalence.

“... individuals residing in East Asia (35.22 per cent) or in urban areas (28.55 per cent), female gender (33.57 per cent), adolescents (47 per cent), and high school students (45.71 per cent) exhibit a higher proportion of myopia prevalence,” the authors wrote in the study published in the British Journal of Ophthalmology.

The researchers observed a correlation between the duration of education in East Asian countries and cases of myopia, which they said could explain geographical differences in prevalence.

“... a correlation between the duration of education and the occurrence of myopia has been observed, suggesting that the early implementation of formal education in certain East Asian nations could potentially serve as a contributing element,” they wrote.

Conversely, in African countries, the researchers noted a lower prevalence of short-sightedness, likely related to lower literacy levels and a delayed start of formal education, they said.

Attaining puberty before boys and tending to spend lesser time outdoors could be possible reasons why girls are affected more by short-sightedness, the researchers suggested.

“According to our projections, there is an anticipated 9 per cent rise in the overall prevalence of myopia between 2023 and 2050, which will lead to a substantial burden of ocular disease, affecting more than 74,05,92,000 children and adolescents,” they wrote.

https://www.tribuneindia.com/news/health/1-in-3-children-teens-globally-affected-by-short-sightedness-study-estimates/

Study finds 200 chemicals linked to breast cancer in food packaging plastics, paper

A team of researchers has identified nearly 200 potential breast carcinogens in food packaging materials, including plastics, paper, and cardboard highlighting widespread exposure despite existing regulation.

The findings, published in 'Frontiers in Toxicology' on Tuesday, underscore an urgent need for stronger preventative measures to reduce these chemicals in everyday products.

"This study is important because it shows that there is a huge opportunity for prevention of human exposure to breast cancer-causing chemicals," said Jane Muncke, Managing Director of the Food Packaging Forum and co-author of the study.

"The potential for cancer prevention by reducing hazardous chemicals in your daily life is underexplored and deserves much more attention," she added.

Breast cancer is the second most common cancer worldwide. It is the number one cancer in women.

In 2022, 2.3 million women were diagnosed with breast cancer and 670,000 died globally, according to the World Health Organization (WHO).

For the study, the team compared a recently published list of potential breast carcinogens. They found 189 potential breast carcinogens have been detected in food contact materials (FCMs), including 143 in plastics and 89 in paper or board.

Further, the team limited their study to the most recently available studies in 2020-2022.

They also found evidence of exposure to 76 suspected mammary carcinogens from FCMs purchased all over the world, 61 of which (80 per cent) are from plastics.

This indicates continued exposure of the global population to these chemicals under realistic use conditions.

Importantly, the food contact materials were purchased within the last few years from markets in highly regulated regions, including the EU and the US.

Despite existing regulations in these countries, intended to limit carcinogenic substances in FCMs, the study highlights gaps in current regulatory frameworks.

"Our findings imply that chronic exposure of the entire population to suspected mammary carcinogens from FCMs is the norm and highlights an important, but currently underappreciated, opportunity for prevention," the researchers said.

https://www.newkerala.com/news/2024/59916.htm

Study calls for tailoring treatment for alcohol use disorders in men, women

Hormonal and biochemical factors that affect alcohol dependence (also known as alcohol use disorder), suggesting that men and women with alcohol problems require different treatments, finds a study.

While it has been previously known that men and women have different risks related to alcohol misuse and related problems, the biological mechanisms underlying those differences are not well understood.

"This is the first large study to confirm that some of the variability in alcohol use disorder (AUD) and related problems is associated with particular combinations of hormones and chemical biomarkers in men and women," said lead researcher Victor Karpyak, Professor of Psychiatry at Mayo Clinic in Rochester, Minnesota (US).

Karpyak said this means that "sex-specific treatments can be tailored to improve responses for men and women with alcohol problems".

The researchers focussed on hormonal and protein markers of 268 men and 132 women with AUD; and correlated them with psychological markers, such as depressed mood, anxiety, craving, alcohol consumption, and treatment outcomes during the first 3 months of treatment.

At the beginning of the trial -- before anyone had taken any medication -- the researchers tested men and women for several sex-specific blood markers, including sex hormones (testosterone, oestrogens, progesterone) as well as proteins known to impact their reproduction (such as follicle-stimulating hormone, and luteinizing hormone) or bioavailability of these hormones in the blood (albumin and sex hormone-binding globulin).

They found that men with alcohol use disorder, symptoms of depression, and higher craving for alcohol, also had lower levels of the hormones testosterone, oestrone, oestradiol, as well as the protein sex hormone binding globulin.

However, no such associations were found in women with AUD.

Further, women who had higher levels of testosterone, sex hormone-binding globulin, and albumin were also more likely to relapse during the first three months of treatment compared to women with lower levels of those biochemical markers.

But "no such relationships were found in men," Karpyak said.

Karpyak said this implies that what works for a man may not work for a woman, and vice versa. The researcher also called for further studies to understand the differences between men and women with AUD to tailor treatment options.

The study was presented at the ongoing European College of Neuropsychopharmacology (ECNP) Conference in Milan, Italy.

https://www.newkerala.com/news/2024/59649.htm

Fever drives enhanced activity, mitochondrial damage in immune cells: Study

Fever increases immune cell metabolism, proliferation, and activity, but it also causes mitochondrial stress, DNA damage, and cell death in a specific subgroup of T cells, according to Vanderbilt University Medical Centre researchers.

The study, published in Science Immunology, sheds light on how cells respond to heat and how persistent inflammation can lead to cancer.

The impact of fever temperatures on cells is a relatively understudied area, said Jeff Rathmell, PhD, Cornelius Vanderbilt Professor of Immunobiology and corresponding author of the new study. Most of the existing temperature-related research relates to agriculture and how extreme temperatures impact crops and livestock, he noted. It's challenging to change the temperature of animal models without causing stress, and cells in the laboratory are generally cultured in incubators that are set at a human body temperature, 37 degrees Celsius (98.6 degrees Fahrenheit).

"Standard body temperature is not actually the temperature for most inflammatory processes, but few have really gone to the trouble to see what happens when you change the temperature," said Rathmell, who also directs the Vanderbilt Center for Immunobiology.

Graduate student Darren Heintzman was interested in the impact of fevers for personal reasons: Before he joined the Rathmell lab, his father developed an autoimmune disease and had a constant fever for months on end.

"I started thinking about what an increased set point temperature like that might do. It was intriguing," Heintzman said.

Heintzman cultured immune system T cells at 39 degrees Celsius (about 102 degrees Fahrenheit). He found that heat increased helper T cell metabolism, proliferation and inflammatory effector activity and decreased regulatory T cell suppressive capacity.

"If you think about a normal response to infection, it makes a lot of sense: You want effector (helper) T cells to be better at responding to the pathogen, and you want suppressor (regulatory) T cells to not suppress the immune response," Heintzman said.

But the researchers also made an unexpected discovery that a certain subset of helper T cells, called Th1 cells, developed mitochondrial stress and DNA damage, and some of them died. The finding was confusing, the researchers said, because Th1 cells are involved in settings where there is often fever, like viral infections. Why would the cells that are needed to fight the infection die?

The researchers discovered that only a portion of the Th1 cells die, and that the rest undergo an adaptation, change their mitochondria, and become more resistant to stress.

"There's a wave of stress, and some of the cells die, but the ones that adapt and survive are better -- they proliferate more and make more cytokine (immune signaling molecules)," Rathmell said.

Heintzman was able to define the molecular events of the cell response to fever temperatures. He found that heat rapidly impaired electron transport chain complex 1 (ETC1), a mitochondrial protein complex that generates energy. ETC1 impairment set off signaling mechanisms that led to DNA damage and activation of the tumor suppressor protein p53, which aids DNA repair or triggers cell death to maintain genome integrity. Th1 cells were more sensitive to impaired ETC1 than other T cell subtypes.

The researchers found Th1 cells with similar changes in sequencing databases for samples from patients with Crohn's disease and rheumatoid arthritis, adding support to the molecular signaling pathway they defined.

"We think this response is a fundamental way that cells can sense heat and respond to stress," Rathmell said. "Temperature varies across tissues and changes all the time, and we don't really know what it does. If temperature changes shift the way cells are forced to do metabolism because of ETC1, that's going to have a big impact. This is fundamental textbook kind of stuff."

The findings suggest that heat can be mutagenic -- when cells that respond with mitochondrial stress don't properly repair the DNA damage or die.

"Chronic inflammation with sustained periods of elevated tissue temperatures could explain how some cells become tumorigenic," Heintzman said, noting that up to 25% of cancers are linked to chronic inflammation.

"People ask me, 'Is fever good or bad?'" Rathmell added. "The short answer is: A little bit of fever is good, but a lot of fever is bad. We already knew that, but now we have a mechanism for why it's bad."

https://www.newkerala.com/news/2024/59624.htm

Shifts in brain activity may signal Alzheimer's long before symptoms appear

Scientists have spotted changes in brain activity that may point to Alzheimer’s.

Right now, the most widely accepted theory behind the cause of Alzheimer’s disease includes the build-up of amyloid-beta and tau proteins in the brain.

• Scientists are still not clear as to how these two proteins might cause Alzheimer’s disease.
• Researchers from McGill University found people with increased levels of both amyloid-beta and tau proteins in the brain may lead to changed brain activity before the cognitive symptoms of Alzheimer’s disease appear.

Currently, the most widely accepted theory on what causes Alzheimer’s disease revolves around the buildup of two proteins — amyloid-beta and tau — in the brain.

However, there are still questions on how amyloid plaques and tau tangles might cause this type of dementia.

“The role of amyloid-beta and tau proteins in Alzheimer’s disease has been well-established for decades,” Sylvain Baillet, PhD, professor of neurology and neurosurgery, and computer science and associate dean of research in the Faculty of Medicine & Health Sciences at McGill University in Canada explained to Medical News Today.

“While amyloid starts accumulating early in the aging brain, it alone isn’t enough to cause Alzheimer’s. The accumulation of tau comes later, and together, these proteins are present in the brains of Alzheimer’s patients. However, how the earliest deposits of both proteins affect brain activity in humans, especially before cognitive symptoms appear, wasn’t well understood,” he said.

Baillet is the senior author of a new study recently published in the journal Nature Neuroscience that offers new insight into this question.

The study found that increased levels of both amyloid-beta and tau proteins in the brain may lead to changed brain activity before the cognitive symptoms of Alzheimer’s disease appear.

Focusing on amyloid-beta and tau proteins

For this study, researchers recruited 104 people who had a family history of Alzheimer’s disease. All study participants received positron emission tomography (PET) to look for any signs of the two proteins in the brain, as well as magnetoencephalography (MEG) to record brain activity in the areas where the proteins were present.

“Amyloid-beta and tau proteins are naturally found in the brain, but in Alzheimer’s disease, they both start to accumulate, possibly because brain activity is altered early in the disease and/or these accumulations modify brain activity, leading to a form of pathological chain reaction,” Baillet explained.

AMYLOID-BETA VS. TAU PROTEINS

“Amyloid-beta is a protein that can become sticky and form plaques between brain cells. These plaques block communication between cells and can cause inflammation, which damages the brain over time. Tau is a protein that usually helps support the internal structure of brain cells. In Alzheimer’s, tau proteins start to tangle inside the cells, disrupting their function and eventually leading to cell death.”— Sylvain Baillet, PhD

Brain slowing found in areas with both proteins

At the study’s conclusion, Baillet and his team found that the brain areas within participants with increased levels of amyloid-beta show signs of brain hyperactivity.

However, those with higher levels of both amyloid-beta and tau proteins experienced hypoactivity or brain slowing. The researchers used cognitive tests and found hypoactivity study participants also had increased levels of attention and memory decline.

“We weren’t entirely surprised by this finding, but it was significant to observe it so clearly in humans,” Baillet said. “Animal models had predicted that amyloid-beta would accelerate brain activity, while the combination of amyloid-beta and tau would eventually lead to hypoactivity, or slowing of brain activity. However, this had not been directly observed in human subjects until now.”

“What was surprising was the extent to which this early slowing of brain activity in the presence of both proteins was predictive of later cognitive decline — three to four years after the MEG brain scans were collected. This connection between the early buildup of amyloid-beta and tau, changes in brain activity, and later memory and attention deficits highlights just how important it is to understand these proteins’ impact on the brain, and how brain activity may alter in a subtle fashion, long before symptoms appear.”— Sylvain Baillet, PhD

Baillet said their next research steps involve continuing to follow the same participants over nearly 10 years, with follow-up MEG scans, amyloid, and tau PET imaging, and detailed cognitive testing currently being performed.

“Using these unique datasets from the PREVENT-AD cohort, we aim to refine how well we can predict cognitive decline and Alzheimer’s symptoms from short MEG scans, potentially up to a decade before they emerge,” he continued. “I want to emphasize that these PREVENT-AD datasets will be released to all researchers, for replication and encouraging novel findings.”

More research still needed

MNT also spoke with Clifford Segil, DO, neurologist at Providence Saint John’s Health Center in Santa Monica, CA, about this study.

“This is a creative study which leaves me asking how the authors determined that its participants would have long-term cognitive declines as the data I reviewed noted its participants scored on average a 28.1 out of 30 on a Montreal Cognitive Assessment (MoCa) score and then a 28.8 on MMSE (mini-mental state examination) score during MEG-PE, but there is no data to support these patients would have cognitive decline,” Segil said.

“When I reviewed this paper, I (was) left confused how the authors determined that its participants would have ‘longitudinal declines’ or worsening memory loss as the belief that brain amyloid and tau levels always cause cognitive issues remains controversial,” he continued.

“Many clinical neurologists like me remain unconvinced that the build of any brain proteins is pathological and leads to cognitive decline. As the clinical use of anti-amyloid medications in practice continues to not provide any meaningful or observational changes in mental status, cognitive abilities or anything noticeable in patients receiving anti-brain amyloid medications, researchers position that amyloid and tau proteins caused memory loss is becoming more unbelievable,” he added.

Segil said he would like to see follow-up cognitive testing done to determine if patients with high brain amyloid or tau have poor cognition, as practicing neurologists continue to believe that brain amyloid is not directly proportional to cognitive burden.

“The clinical use of anti-brain amyloid medications [in] the United States is demonstrating that the patients receiving these anti-amyloid medications are without any noticeable changes in [cognition], supporting clinician’s positions that brain amyloid and tau are less likely to be toxic or cause dementia’s cognitive symptoms.”— Clifford Segil, DO

https://www.medicalnewstoday.com/articles/shifts-brain-activity-tau-amyloid-beta-may-signal-alzheimers-symptoms-appear