Born late term are smarter kids


Children born late term, at 41 weeks, tend to have higher cognitive abilities and perform better in school compared to those born full term‚ at 39 or 40 weeks. But there is a downside—they are more likely to have physical problems.

It is a well-known fact that children born late term are at an increased risk of physical disabilities, but this is the first study to suggest cognitive benefits.

For the study, published in JAMA Pediatrics, researchers examined data on more than 1.4 million children born between 37 and 41 weeks of gestation. The authors compared three school-based cognitive measures and two physical outcomes (abnormal newborn conditions and physical disabilities noted in the school record) among babies born late term and full term.

Children born late term outperformed full term children in all three cognitive measures—higher average test scores in elementary and middle school, a 2.8 per cent higher probability of being gifted, and a 3.1 per cent reduced probability of poor cognitive outcomes.

However, late term infants also had a 2.1 per cent higher rate of physical disabilities at school age and higher rates of abnormal conditions at birth.


Saviour aspirin

Taking aspirin immediately after a transient ischaemic attack (TIA), commonly called a mini stroke, or when experiencing stroke-like symptoms, could considerably reduce the risk of a major stroke over the next few days, according to a European study published in The Lancet.

During TIA, blood flow to the brain is blocked only for a short period, usually less than five minutes, and it usually does not cause any long-term injury. But the risk of a major stroke in the next few days is about 1,000 times higher immediately after a minor stroke compared to the general population. About 30 per cent of people who have TIA will experience a subsequent stroke.

A look at data on about 56,000 patients found that taking aspirin after a mini stroke reduced the early risk of a fatal or disabling stroke by about 70-80 per cent over the next few days and weeks.

"This finding has implications for doctors, who should give aspirin immediately if a TIA or minor stroke is suspected, rather than waiting for specialist assessment and investigations,” the study author suggested.

Most patients do not seek medical help at all after a TIA. Half of recurrent strokes in people who had a TIA occur before they seek medical care.

“Encouraging people to take aspirin if they think they may have had a TIA or minor stroke—experiencing sudden-onset unfamiliar neurological symptoms—could help to address this situation, particularly if urgent medical help is unavailable.”

Did You Know
It’s harder for chronic alcohol users to quit smoking because their bodies quickly metabolise nicotine and they get the urge to smoke again sooner.
Drug and Alcohol Dependence


Preventive lifestyle

About 20 to 40 per cent of cancer cases and about 50 per cent of cancer deaths could potentially be prevented if people follow four key healthy lifestyle factors, according to a Harvard study published in JAMA Oncology.

A healthy lifestyle was defined as never smoking or having quit smoking; drinking no alcohol, or not more than one drink a day for women, and two or less for men; maintaining a BMI between 18.5 and 27.5; and getting moderate weekly exercise for at least 150 minutes or vigorous exercise for at least 75 minutes.

Participants who met all four criteria were considered low-risk and everyone else was high-risk.

The study was based on data from about 1,40,000 participants who were followed long-term and whose health status was updated frequently. Women in the high-risk group were 25 per cent more likely to get cancer and 48 per cent more likely to die from cancer compared to women in the low-risk group. The risk among men was 33 per cent and 44 per cent, respectively.

Extrapolating the findings to the US population at large, the study estimates that 41 per cent of cancer cases and 59 per cent of cancer deaths in women and 63 per cent of cancer cases and 67 per cent of deaths in men could be prevented by following all four lifestyle factors.

Cancers of the lung, colon, pancreas, kidney, throat, liver, breast and prostate would see the biggest reductions.

Did You Know
Women with endometriosis, or excess growth of uterine lining tissue, are more likely to suffer a heart attack, to have angina or chest pain, or coronary bypass or stent surgery. The increased risk was greatest for women of age 40 and younger, who were about three times more likely to suffer from the combined heart disease end points. Circulation: Cardiovascular Quality and Outcomes


Chest of signs

Mammograms are widely used to screen for breast cancer. According to a study published in JACC: Cardiology Imaging, it can also be an effective tool in assessing the heart health of women.

Mammograms can also reveal calcium deposits that have built up in the arteries of the breasts and this can reflect similar deposits in the arteries leading to the heart, an early indicator of heart disease.

The researchers compared data for 292 women without heart disease who underwent both a mammography and a non-contrast computed tomography (CT) scan of the chest.

The mammograms showed breast arterial calcification in 42.5 per cent of the women and 70 per cent of these women also had coronary arterial calcification or CAC. Sixty-three per cent of women whose CT scans showed CAC also had breast arterial calcification.

Half of the women younger than age 60 had both CAC and breast arterial calcification. Eighty-three per cent of younger women with breast arterial calcification also had CAC.

Breast artery calcification appears to be an equal or stronger predictor of CAC than other well-known cardiovascular risk factors such as high cholesterol, high blood pressure and diabetes.

Did You Know
Antacids that contain aspirin can cause stomach or intestinal bleeding, especially in people 60 or older; have a history of stomach ulcers or bleeding problems; take blood-thinning drugs, steroid medicine such as prednisone, or NSAIDS such as ibuprofen or naproxen; and consume three or more alcoholic drinks daily.
The US Food and Drug Administration


It's the air

Both short- and long-term exposure to some air pollutants can increase the risk of developing high blood pressure.

High blood pressure is a major risk factor for heart disease and stroke, a leading cause of death worldwide.

For the study published in the journal Hypertension, Chinese researchers analysed all the studies conducted around the world that examined the possible link between blood pressure and common air pollutants, such as vehicle exhaust, coal burning and airborne dirt or dust.

Both short-term exposure to sulfur dioxide from burning fossil fuels and to particulates like dust, smoke and dirt in the air as well as long-term exposure to nitrogen dioxide, which comes from power plants and vehicle exhaust, were significantly associated with high blood pressure risk.

Air pollution can contribute to hypertension by causing inflammation and oxidative stress which may lead to changes in the arteries, the authors suggested.

Migraines up risk

Women who suffer from migraine headaches have an increased risk for heart disease, stroke and death from these conditions and are also more likely to need heart procedures.

For the study in The BMJ, researchers analysed data on 1,15,541 women who were free from heart disease and were aged 25 to 42 at the start of the study. Those who suffered from migraine was 15.2 per cent, 1,329 women had a heart attack or stroke and 223 died from one of those conditions during 20 years of follow-up; 203 women had chest pain or needed heart-related procedures.

Women who had migraine had a 50 per cent greater risk for a major cardiovascular event compared to women without migraine. Women in the same category had about 39 per cent greater risk of heart attack, 62 per cent greater risk of stroke and 73 per cent greater risk of angina and needed heart procedures. Migraine was also associated with 37 per cent greater risk of death from heart attack or stroke.

These associations remained even after accounting for other risk factors such as smoking, high blood pressure, age, postmenopausal hormone therapy and use of oral contraceptives.

"Physicians should be aware of the association between migraine and cardiovascular disease, and women with migraine should be evaluated for their risk," the study author commented.

Did You Know
Running barefoot can increase our working memory—our ability to recall and process information—by nearly 16 per cent compared to running in shoes. Barefoot running requires more focus and attention to avoid stepping on objects that could potentially injure the foot, which may account for the working memory improvements.
Perceptual and Motor Skills

One donor, one recipient, multiple organs

A 55-year-old man is doing well after receiving simultaneous transplantation of a "composite" skull and scalp flap as well as a kidney and pancreas, all from the same donor, according to a report in the journal Plastic and Reconstructive Surgery. The procedure combined "vascularised composite allotransplantation" (VCA) with multiple organ transplants.

VCA refers to transplant procedures involving different types of tissues, such as skin, muscle, blood vessels, nerves and bone. Face and hand transplantations are the best examples. But the complications of lifelong immunosuppression are a major drawback.

The patient had a kidney transplantation for diabetic kidney disease about two decades ago, but that kidney was now failing. He also had a large, unstable wound of the scalp and skull which was the result of a complication from surgery and radiation therapy for a scalp tumour.

Because the patient was already receiving immunosuppressive therapy from previous transplant the doctors decided to do a VCA of scalp and skull together with a kidney/ pancreas transplant, all coming from the same donor.

A suitable deceased donor became available after 18 months on the waiting list. Twenty physicians were involved in the combined procedure that took 15 hours to complete.

One year after the procedure, the patient is doing well. “The fact that both the composite transplant and organs are from the same donor minimizes the risk of rejecting tissues stimulated by a second donor’s tissue.”


Wrong assumption

Terminally ill cancer patients who choose to die at home actually live longer than those who decide to spend the last few days in a hospital.

The Japanese study published in the journal Cancer compared 1,582 patients who received hospital-based palliative care and 487 patients who chose home-based palliative care.

Even though most people prefer to die at home, cancer patients and their family usually hesitate to choose home-based palliative care thinking that the quality of medical care provided at home may be inferior to that given in a hospital and that survival might be shortened.

But the current study found that the survival of patients who died at home was significantly longer than that of patients who died in hospitals, even after accounting for patients' demographic and clinical characteristics, as well as other factors.

The study urges patients and their family to “choose the place of death in terms of their preference and values".

Stemming stroke

Chronic stroke patients regained their ability to walk and talk after scientists at Stanford University injected modified, human, adult stem cells directly into their brains.

Eighteen stroke survivors whose average age was 61 and had experienced a stroke at least one year prior to the start of the study were part of a small clinical trial. The patients had significant motor impairment for six months or more and had difficulty moving their arm or leg, or walking or talking.

The doctors first drilled a small hole through the skull of the patients, who needed only minimal anaesthesia. They then injected modified stem cells directly into several sites around the brain areas damaged by stroke. The patients were allowed to go home the following day.

The patients showed significant recovery within the first month itself, and continued to improve for several months afterward. The improvements remained at six and 12 months after surgery.

“Within days some were lifting their arms over their head. Lifting their legs off their bed. Walking, when they hadn't in months or years. Patients who were in wheelchairs are walking now. The results were very exciting," the lead researcher noted.

There weren’t any significant side effects. Some patients had temporary headaches, nausea and vomiting.

The researchers are now recruiting patients for an expanded trial involving 156 stroke patients.

The findings, which appear in the journal Stroke, question the scientific notion that the brain cannot recover once it is damaged after a stroke or traumatic injury and even neurodegenerative disorders.

Six months after a stroke, brain circuits are thought to be dead and the damage, permanent and irreversible.

"Somehow putting these stem cells directly into the brain jumpstarts circuits we had thought were irreversibly damaged or dead, with remarkable results."


Sleep right

Shift work may not be good for cardiovascular health.

A study in the journal Hypertension finds that people who are sleep deprived and have an abnormal sleep cycle are at an increased risk of cardiovascular disease.

They are at risk of higher heart rate; reduced heart rate variability at night; increased levels of the stress hormone norepinephrine which can narrow blood vessels, increase blood pressure and expand the windpipe; and decreased activity for the vagal nerve which helps control the heart rate variability.

According to the study author, all physiological and behavioural processes follow a circadian rhythm regulated by an internal clock located in the brain.

"When our sleep-wake and feeding cycles are not in tune with the rhythms dictated by our internal clock, circadian misalignment occurs. Shift workers who are chronically exposed to circadian misalignment, might not fully benefit from the restorative cardiovascular effects of nighttime sleep following a shift-work rotation."

Shift workers account for 15 to 30 per cent of the working population in industrial countries. Shift workers should try to minimise their risk of cardiovascular disease by eating a healthy diet, exercising regularly and sleeping as much as possible.


Cut won't harm

Will circumcision in infancy reduce penile sensitivity in adult life? Parents often hesitate, thinking it would.

The American Academy of Pediatrics supports routine circumcision of newborn males to reduce the risk of contracting sexually transmitted infections.

A new Canadian study published in the Journal of Urology that sought to clarify the debate concluded that there is no difference in penile sensitivity between circumcised and uncircumcised men.

The study had 62 healthy male participants, aged 18 to 37 years, 30 circumcised and 32 intact.

Researchers performed sensory tests, to assess touch and pain thresholds as well as warmth and heat detection at a control site on the forearm, as well as four different points on the men's penises.

There were no differences in all four types of sensitivity between the circumcised and uncircumcised participants.

Additionally, the study also found that the foreskin is not the most sensitive part of the penis, thus challenging past research suggesting that the foreskin is the most sensitive and, hence, the most sexually relevant part of the adult penis. The researchers also assessed sexual function and found no differences in sexual functioning between the two groups.

“Findings from the current sample of men indicate that neonatal circumcision is not associated with decreased penile sensitivity in adulthood compared to men who have never undergone the procedure," the researchers concluded.

Y of memory loss

Men who lose Y chromosomes as they age are more likely to develop Alzheimer's disease.

Men have an X and a Y chromosome, while women have two X chromosomes. Men can lose Y chromosome from their cells as they age, and this is more likely in those who smoke.

An earlier study had found that men with a loss of Y had an increased risk of death from other causes, including many cancers.

The study published in the American Journal of Human Genetics was based on blood samples from over 3,200 men, average age 73. Nearly 17 per cent of the men had loss of Y, and this increased with age.

Men who were already diagnosed with Alzheimer's were nearly three times more likely to show a loss of the Y chromosome. And men with loss of Y chromosomes in their samples faced a higher risk of developing Alzheimer's during follow-up. The greater the loss of Y, the higher the risk of developing Alzheimer's.

According to the researchers, reduced functioning of the immune system could be the reason for the link.

The findings raise the possibility of testing loss of Y chromosome to identify those at risk of developing Alzheimer's.

“The addition of LOY testing in the general population could give medical practitioners the possibility of using preventive strategies in men at risk. In short, the widespread use of LOY testing could radically decrease male mortality rates, and even perhaps eliminate the difference in life expectancy between the sexes,” the study author commented.


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