Early warning


A simple blood test can identify breast cancer patients who may suffer a relapse months before the tumour appears on CT scans and MRIs, researchers at the Institute of Cancer Research and The Royal Marsden NHS Foundation Trust in the UK report in the journal Science Translation Medicine.

The blood test looks for circulating tumour DNA or traces of cancer cells that may have been left behind even after treatment.

For the study, 55 early stage breast cancer patients who had been treated with surgery and chemotherapy had blood tests every six months for about two years after surgery. The mutated DNA of the tumor was first analysed by scientists. They then looked for similar mutations in the blood samples.

Cancer came back in 15 patients. Twelve of them were identified by the blood test about eight months before any signs of cancer were visible on scans. Those who tested positive for circulating tumour DNA were 12 times more likely to suffer a relapse compared to those who tested negative.

“If we can identify better who is at risk of relapse, we can direct treatments to prevent relapse specifically to them," said the lead researcher. “In addition, the authors were able to shed light on the genetic events driving such metastases.... which could inform new drug-based therapies on the basis of the patients’ individual mutations.”


Fat firstborn

Firstborns may be the apple of their parents' eyes, but when it comes to their weight, it may not be a good place to be.

According to study from New Zealand published in the Journal of Epidemiology & Community Health, firstborn girls are more likely to be overweight or obese as adults compared to their younger sisters.

Data from 13,406 pairs of sisters in Sweden was analysed for the study. The sisters' height and weight at birth were assessed from Swedish Birth Register and as adults at their first prenatal visit when they were around 3 months pregnant.

Although firstborns were found to be lighter than their sisters at birth, as adults they were 29 per cent more likely to be overweight and 40 per cent more likely to be obese than their second-born sisters. In addition, firstborns were also slightly taller than second-born sisters.

The findings are in line with previous studies in men that showed that firstborns are more likely to be heavier and develop high blood pressure and insulin resistance, which is a risk factor for diabetes.

The researchers think that this could be because blood vessels are narrower in the first pregnancy and this may reduce blood flow and nutrient supply to the placenta than in later pregnancies. “This reprograms metabolism and regulation of fat.”

Did You Know
Rats with Alzheimer's disease that were injected with a chemical called IRL-1620 showed 50-60 per cent improvement in memory and 45-50 per cent reduction in oxidative stress. IRL-1620 also “enhanced certain recovery processes within the AD-damaged brain, resulting in more new blood vessels and neuronal cells. This indicates reparative processes occurring in the damaged brain”: American Psychological Society


Hearty siesta

A siesta may sound like a luxury in today's hectic work pace. But a Greek study presented at the European Society of Cardiology Congress found that midday naps can lower blood pressure and reduce the need for blood pressure medications.

The study focused on 200 men and 186 women, average age of 61.4 years, who had high blood pressure. Nappers had a 5 per cent lower average 24-hour ambulatory systolic BP compared to those who did not take naps. Also, their average systolic BP readings were four per cent lower when they were awake and six per cent lower while they slept at night.

“Although the mean BP decrease seems low, it has to be mentioned that reductions as small as 2mmHg in systolic blood pressure can reduce the risk of cardiovascular events by up to 10 per cent,” said the study author.

Additionally, midday sleepers' pulse wave velocity levels were 11 per cent lower and left atrium diameter was 5 per cent smaller, suggesting "less damage from high blood pressure in their arteries and heart".

"We found that midday sleep is associated with lower 24-hour blood pressure, an enhanced fall of BP in night, and less damage to the arteries and the heart. The longer the midday sleep, the lower the systolic BP levels and probably fewer drugs needed to lower BP," the study concluded.

Did You Know
Young adults (18-45) with mild hypertension who drink four or more cups of coffee daily have four times greater risk for cardiovascular events, especially heart attacks. The risk was three times higher for moderate coffee drinkers (one to three cups): European Society of Cardiology Congress


Post replacement risk

Patients who have total hip or knee replacement surgery may have greater short-term risk for heart attacks and long-term risk for blood clots.

For the study in the journal Arthritis & Rheumatology, researchers compared data on 13,849 patients aged 50 or older with osteoarthritis who had a total knee replacement surgery and 6,063 patients who had a total hip replacement surgery with a similar number of people who did not have the procedure.

Those who had total knee replacement surgery had a more than eight times greater risk of heart attack  in the first 30 days after surgery compared to those who did not have the procedure. The risk of a heart attack was more than four times greater in the first month following total hip replacement surgery.

But the risk of heart attack declined over time and by three years both the surgery and control groups had similar heart attack rates; 190 knee replacement patients and 78 hip replacement patients had a venous thromboembolism in the first month of surgery compared to three and one in the control group, respectively. The elevated  risk for blood clots, however, did not decline with time.

"The potential underlying mechanisms behind the increased risk of postoperative myocardial infarction include cardiac or hemodynamic stressors associated with surgery (e.g., the effects of anesthesia on the cardiovascular system, blood loss, fluid shifts, arrhythmias, and hypoxia) as well as fat embolisation (particularly after total hip arthroplasty)," the researchers suggested.


Flush out flab

Shedding pounds may be as simple as drinking water! According to a British study published in the journal Obesity, drinking 500ml of water half an hour before each meal can help obese adults lose weight.

For the study, 84 obese adults were randomised into two groups—one group was asked to preload with water (drink 500ml of water 30 minutes before breakfast, lunch and dinner) every day for 12 weeks, while the other group was asked to imagine they had a full stomach before each meal.

All the participants were advised on ways to improve their diet and physical activity levels.

At the end of 12 weeks, those who preloaded with water lost an average of 1.3kg more than those in the control group. Those who preloaded before all three meals lost an average of 4.3kg, whereas those who only preloaded once, or not at all, only lost an average of 0.8kg.

“The beauty of these findings is in the simplicity. Just drinking a pint of water, three times a day, before your main meals may help reduce your weight. When combined with brief instructions on how to increase your amount of physical activity and on a healthy diet, this seems to help people to achieve some extra weight loss—at a moderate and healthy rate. It’s something that doesn’t take much work to integrate into our busy everyday lives,” the study author noted.

Did You Know
Diabetes patients who take a new class of medications called DPP-4 inhibitors that include sitagliptin, saxagliptin, linagliptin and alogliptin may suffer from severe and disabling joint pain: Food and Drug Administration


Calories count

Want to fend off age-related diseases and stay healthy longer? A two-year study from the US National Institutes of Health published in the Journal of Gerontology: Medical Sciences suggests that eating less or consuming fewer calories can help normal-weight and moderately overweight people reduce their risk for age-related diseases.

In animal studies, reducing calorie intake without deprivation of essential nutrients has shown to increase longevity and delay the progression of a number of age-related diseases.

For the study, 218 healthy young and middle-aged adults who were normal-weight or moderately overweight were assigned to either a calorie restriction group or a control group who continued their regular eating habits.

The calorie restriction group had a target of 15.5 per cent weight loss by reducing their calorie intake by 25 per cent in the first year. They had to maintain their weight during the second year.

Though they did not meet the target, the calorie restriction group lost an average of 10 per cent of their body weight in the first year, by restricting their calorie intake by 12 per cent and maintained this weight over the second year. The control group’s weight and calorie intake were stable over the period.

The calorie restriction group significantly lowered several predictors of cardiovascular disease: average blood pressure decreased by 4 per cent; total cholesterol decreased by 6 per cent; HDL or good cholesterol increased; C-reactive protein, an inflammatory factor linked to cardiovascular disease, reduced by 47 per cent; and insulin resistance, an indicator of diabetes, decreased.

The findings “show that this degree of sustained calorie restriction can influence disease risk factors and possible predictors of longevity in healthy, non-obese people,” said study co-author.

Stethoscope with replay

A next generation digital stethoscope has received the green light to enter the market. The US Food and Drug Administration has approved Eko Core, a digital stethoscope that can record a patient's heart beat and wirelessly transmit them to an iPhone app and also to the patient's electronic medical records.

Eko Core is the only stethoscope that allows doctors to switch between digital and analog modes easily. It's an electronic attachment that can be used with your stethoscope. It has an audio filter that removes background noises and the volume can be amplified which enables doctors to listen to hard-to-hear cardiac murmurs and lung sounds.

Since the heartbeats are recorded, it can be played back. Second opinions can be sought at the click of a button saving patients time and money.

“If we can bring the expert cardiologists from Johns Hopkins to the patient in rural Nebraska or the rural village in India, that opens up the opportunity to save lives. What we’re seeing with the age of telemedicine is now we can take a heart sound from a rural, underserved community and send that to a cardiologist for an instant second opinion,” said the chief operating officer at Eko Devices. The company is also working on an algorithm that can identify heart conditions.


Wellness Sleep

Try to get a good night's sleep to avoid the common cold. According to a study published in the journal Sleep you are more likely to catch a cold if you sleep six hours a night or less.

The researchers tracked the sleeping habits of 164 healthy men and women aged 18 to 55 for a week using a wrist sensor. The volunteers were then sequestered in a hotel for five days and exposed to the cold virus through nasal drops.

Only 18 per cent of those who slept more than six hours got sick compared to about 39 per cent of those who slept six hours or less.

Those who slept between 5 to 6 hours a night were 4.2 times more likely to catch a cold compared to those who slept more than seven hours a night. Those who slept less than five hours were 4.5 times more likely to get sick.

Sleep emerged as the strongest predictor of catching a cold even after factors including age, race, income, stress levels and smoking status were accounted for.

Sleep deprivation can weaken the immune system and increase inflammation.

According to the National Sleep Foundation, adults need to get at least seven hours of sleep per night and children and teens need more than 8 hours of sleep.

Current for motion sickness

Researchers at Imperial College London have developed a device that can ease symptoms of motion sickness by applying a mild electrical current to the scalp.

Motion sickness is thought to be the result of mixed messages coming to our brains from our ears and eyes. It can cause nausea and headaches and in extreme cases dizziness, severe nausea and cold sweats. The electrical stimulation dampens the confusing messages received by the brain and reduces the symptoms.

For the study in the journal Neurology, 20 volunteers were strapped to a rotating chair that also tilts to induce motion sickness. When mild electrical current was passed via electrodes placed on their heads, they were less likely to suffer from motion sickness. Before stimulation the volunteers developed motion sickness quicker and their recovery was slower. But after stimulation, it took longer for them to develop motion sickness and they also recovered more quickly.

According to Dr Qadeer Arshad, who led the research, they hope to have such as device available in five to ten years. They might even have a version that integrates with a cell phone and delivers electric current via the headphone jack.

The medications that are effective now can make people very drowsy. “We are really excited about the potential of this new treatment to provide an effective measure to prevent motion sickness with no apparent side effects. z The benefits that we saw are very close to the effects we see with the best travel sickness medications available,” another researcher added.


Is your heart older than you?

Your heart may be older than you are, increasing your risk of cardiovascular events such as heart attack and stroke.

According to a study from the US Centers for Disease Control and Prevention, 3 out of 4 American adults have a heart age that is older than their actual age—the average heart age of adult men is 8 years older than their chronological age and for women it is 5 years older. The study also found that heart age increases with age and decreases with higher education and household income.

Heart age is actually the age of a person’s heart and blood vessels. It is calculated based on certain risk factors including high blood pressure, smoking, diabetes and body mass index. About three-fourths of heart attacks and strokes are due to risk factors that increase heart age.

Knowing one's heart age and risk of dying from heart attack or stroke can lead to better awareness and adoption of a healthier lifestyle such as not smoking, eating a healthy diet, regular exercise and maintaining healthy blood pressure, cholesterol and blood sugar levels.

For example, the heart age of a 45-year-old man may be 75 years because he is a smoker and has diabetes and high blood pressure. But he can lower his heart age to 59 years just by not smoking and controlling high blood pressure.

"It is never too late to turn back the clock on your heart age," said the CDC Director.

You can calculate your heart age at http://www.cdc.gov/vitalsigns/cardiovasculardisease/heartage.html


Midlife weight risk

Your weight at age 50 can influence your risk of Alzheimer's disease. According to a study published in the journal Molecular Psychiatry, being overweight in midlife can accelerate the onset of the disease.

The study focused on 1,394 adults who were part of an ongoing study on ageing. The participants did not have dementia at the outset and took cognitive tests every one to two years for about 14 years; 142 of them developed Alzheimer's disease.

The participants were on average 83 years old when diagnosed with Alzheimer's. Having a higher BMI at age 50 was associated with earlier onset of Alzheimer's. For each unit increase in body mass index (BMI) at age 50, Alzheimer's symptoms appeared about seven months earlier.

Additionally, 191 autopsy results showed people who had higher BMI in midlife had more neurofibrillary tangles in the brain, an important hallmark of Alzheimer's.

“From a public health perspective, the most relevant message here is that maintaining a healthy BMI as early as midlife could have a protective effect in terms of delaying Alzheimer's disease decades later," said Madhav Thambisetty, lead researcher.

Did You Know
Parents should start talking to children about the dangers of alcohol at age 9 because that's when they are “starting to develop impressions about alcohol”: American Academy of Pediatrics


Edgy and dying

A study presented at the 28th European College of Neuropsychopharmacology (ECNP) Congress in Amsterdam has identified certain behaviour patterns that precede suicide attempts.

More than 8 lakh people commit suicide every year, with 20 times more people attempting suicides, according to the WHO. Suicide is one of the leading causes of death among young adults. Identifying those at risk can help prevent many of these cases.

The study focused on 2,811 patients suffering from depression, of whom 628 had already attempted suicide. The study looked for behavioural patterns in people who had attempted suicide and compared these to depressed patients who had not attempted suicide.

According to the study author “depressive mixed states” often preceded suicide attempts. “A depressive mixed state is where a patient is depressed, but also has symptoms of “excitation”, or mania. 40 per cent of all the depressed patients who attempted suicide had a “mixed episode” rather than just depression. All the patients who suffer from mixed depression are at much higher risk of suicide.”

The risk of suicide attempts is also 50 per cent higher in depressed patients with the following symptoms: *risky behaviour (for example, reckless driving, promiscuous behaviour)

*psychomotor agitation (pacing around a room, wringing one's hands, pulling off clothing and putting it back on and other similar actions)

*impulsivity (acting on a whim, displaying behaviour characterised by little or no forethought, reflection, or consideration of the consequences).

“In our opinion, assessing these symptoms in every depressed patient we see is extremely important, and has immense therapeutical implications. Most of these symptoms will not be spontaneously referred by the patient, the clinician needs to inquire directly, and many clinicians may not be aware of the importance of looking at these symptoms before deciding to treat depressed patients,” the study author suggested.


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