Women can safely conceive within a year of stillbirth, and they do not have an increased risk of adverse outcomes such as stillbirth, preterm birth or small-for-gestational-age birth in the following pregnancy.
For the study published in the Lancet, researchers looked at 14,452 single births among women who had a stillbirth.
Among them, 63 per cent of the women got pregnant again within a year, and 37 per cent did within six months.
Only 228 pregnancies ended in another stillbirth; 98 per cent were live births; 18 per cent were preterm and 9 per cent were small-for-gestational-age births.
There was no additional risk of another stillbirth, preterm birth or small-for-gestational-age birth among women who conceived in less than 12 months after a stillbirth compared with women who waited 24 to 59 months to get pregnant again.
Work-life and depression
Women who clock long hours at work are more likely to suffer from depression, but not so for men, according to a British study published in the Journal of Epidemiology & Community Health.
Working weekends can increase the risk of depression for both men and women.
The researchers analysed data from 11,215 working men and 12,188 working women for the study. In general, women were more likely to be depressed than men, even though nearly half the men worked more than the standard 35-40 hours weekly, compared to fewer than one in four women.
Women who worked 55 or more hours a week had 7.3 per cent more depressive symptoms than women who worked the standard 35-40 hours weekly. But men who worked long hours did not show any depressive symptoms.
Women who worked for all or most weekends had 4.6 per cent more depressive symptoms on average compared to women working only weekdays. Men who worked all or most weekends had 3.4 per cent more depressive symptoms than men working only weekdays.
One round, no harm
One round of chemotherapy for testicular cancer will not affect sperm count and fertility, according to a study published in the Annals of Oncology.
Testicular patients often undergo chemotherapy or radiation therapy to reduce the risk of recurrence. Patients in advanced stage of cancer require several rounds of chemotherapy or high doses of radiotherapy, which is known to reduce sperm count and concentration. But patients with early stage cancer require only one course of postoperative chemotherapy or radiotherapy.
The study was based on 182 men, aged 18 to 50, who had surgery for stage-1 testicular cancer. After surgery, the patients had either one course of chemotherapy, one course of radiation therapy or no further treatment.
The men provided sperm samples immediately after surgery and then six months, one year, two years, three years and five years thereafter.
There was a drop in average sperm number and concentration six months after treatment in men who received radiotherapy, but it recovered thereafter. No such drop was seen in men who received chemotherapy.
It's never too late to start
According to a US study published in JAMA Network Open, you can reduce mortality risk even if you had been a couch potato all your life and started exercising in middle age.
For the study, the researchers used data from 3,15,059 adults, aged 50 to 71 years who reported their leisure-time physical activity at four different stages in their lives:15 to 18 years, 19 to 29 years, 35 to 39 years and 40 to 61 years.
Among them, 71,377 participants died during the study period; 22,219 deaths were from cardiovascular diseases and 16,388 were from cancer.
Participants who stayed physically active throughout their lives had the lowest risk for all-cause, cardiovascular disease related and cancer related mortality, compared with those who were inactive throughout adulthood. They had a 36 per cent lower risk of dying from all causes, 42 per cent reduced risk of dying from heart disease and 14 per cent reduced risk of dying from cancer.
Surprisingly, those who had been inactive when they were younger, but ramped up in middle-age had almost the same reduced mortality risk—35 per cent all-cause, 43 per cent heart-disease related and 16 per cent cancer-related mortality.
“Midlife is not too late to start physical activity,” the study concluded.
Did You Know
Smoking just one cigarette a day during pregnancy can double the risk of sudden unexpected infant death (SUID). The risk increased by 0.07 with each additional cigarette smoked.
Paediatrics
Sleep apnoea linked to Alzheimer’s
According to a study presented at the American Academy of Neurology, people with sleep apnoea have a high accumulation of an Alzheimer's disease biomarker called tau in an area of the brain that is important for memory.
Tau is a protein that forms tangles and is found in the brains of people with Alzheimer's. People with obstructive sleep apnoea stop breathing several times during sleep.
The study included 288 people, aged 65 and older, without cognitive impairment. PET brain scans were used to look for accumulation of tau tangles in an area of the brain in the temporal lobe that helps manage memory, navigation and perception of time.
The researchers asked the bed partners of the participants if they had witnessed episodes of stopped breathing during sleep. Bed partners of 43 participants (15 per cent) had witnessed episodes of apnoea.
Those who had sleep apnoea had on average 4.5 per cent more tau in the brain than those who did not have apnoea.
Antibiotics at the earliest
Older adults with urinary tract infection (UTI) should be prescribed antibiotics immediately to reduce the risk of sepsis (bloodstream infection) and death. Urinary tract infection is the most common bacterial infection in older patients.
For the study published in the BMJ, researchers analysed data from 1,57,264 patients over the age of 65 who had been diagnosed with UTI. Among them, 87 per cent were prescribed antibiotics immediately; 6.2per cent had antibiotics delayed by up to seven days and 7.2 per cent were not prescribed antibiotics at all.
Patients who had their prescription delayed or received no antibiotics at all were up to eight times more likely to develop sepsis compared to patients who received antibiotics immediately.
While 1.6 per cent of those who received antibiotics immediately died in the following 60 days, mortality risk was 16 per cent for those who had delayed prescription and more than double for those who received no antibiotics.
Men older than 85 years and those living in poor areas had the highest risk.
Midday nap is powerful
Taking a midday nap may be as effective at lowering blood pressure as lifestyle modifications such as diet and exercise and taking anti-hypertensive medications, according to a study presented at the American College of Cardiology.
The study included 212 people, average age 62 years, with a mean blood pressure of 129.9mmHg. The researchers compared the blood pressure readings of those who napped for about 49 minutes with those who did not.
The average systolic blood pressure was 5.3mmHg lower among those who napped than those who did not. People who napped had more favourable overall blood pressure readings—128.7/76.2 against 134.5/79.5mmHg. For every hour of napping, the average 24-hour systolic blood pressure dropped 3mmHg.
For comparison, reducing salt and alcohol can lower blood pressure levels by 3 to 5mmHg and taking a low-dose antihypertensive medication usually lowers blood pressure levels by 5 to 7mmHg.
Did You Know
Patients with fluctuating blood pressure after suffering a stroke have a higher risk of dying within 90 days.
American Stroke Association's International Stroke Conference
Yo-yo dieting is risky
Maintaining a healthy weight is a struggle for most people. Many women go through a pattern of weight loss followed by subsequent weight gain known as yo-yo dieting or weight cycling.
According to a study presented at an American Heart Association meeting, women with a history of yo-yo dieting have more cardiovascular risk factors than those who maintain a consistent weight.
The study included 485 women, aged 20 to 76 years, from different racial and ethnic backgrounds. The average body mass index (BMI) was 26, which is slightly overweight.
The women were asked the number of times, other than during pregnancy, they had lost at least 4.5kg and then regained it within a year. Among them, 73 per cent reported at least one episode of weight cycling. The range was zero to 20 cycles.
The researchers assessed the women’s cardiovascular health and observed that yo-yo dieters were 82 per cent less likely to be at an optimal weight and 29 per cent had poor cardiovascular health.
The negative effects of yo-yo dieting were stronger for women who had never been pregnant, probably because they might have started weight-cycling at an earlier age.
Did You Know
Obese patients often need higher doses of radiation during X-ray than normal weight people, increasing their risk of cancer by more than double (153 per cent) compared to normal weight people undergoing X-ray.
Journal of Radiological Protection
An eye on Alzheimer’s
A study published in the journal Ophthalmology Retina suggests that the blood vessels at the back of the eye inside the retina are less dense in people with Alzheimer's disease.
Using a noninvasive optical coherence tomography angiography (OCTA), the researchers scanned the eyes of over 200 people.
OCTA machines use light waves that reveal blood flow in every layer of the retina, even in tiny capillaries that are less than half the width of a human hair.
The eyes of 133 people with healthy brains had a dense microscopic network of blood vessels inside the retina. But the web was less dense and even sparse in the eyes of 39 people with Alzheimer's disease.
“It is possible that these changes in blood vessel density in the retina could mirror what is going on in the tiny blood vessels in the brain, perhaps before we are able to detect any changes in cognition,” said the lead author.
To fight depression
The US Food and Drug Administration has approved a nasal spray containing esketamine for the treatment of depression in adults who have failed to respond to other antidepressant medications.
Esketamine (Spravato is the brand name) is a powerful anesthetic used in surgery. It is approved only for patients who have not responded to two other conventional antidepressants and has to be used in conjunction with an oral antidepressant.
While other antidepressants take weeks to ease symptoms, Spravato’s effect is immediate. Patients cannot take the medicine at home. It has to be administered under the supervision of a health care provider. Patients have to be monitored for at least two hours after receiving a dose and cannot drive for the rest of the day.
The most common side effects are disassociation, dizziness, nausea, sedation, vertigo, decreased feeling or sensitivity, anxiety, lethargy, increased blood pressure and vomiting.
Did You Know
Drawing enhanced memory in older adults and helped them retain new information much better than other techniques including rewriting notes, visualisation exercises or passively looking at images.
Experimental Ageing and Research
Prenatal vitamins to lower the risk
If mothers take prenatal vitamins in the first month of pregnancy, the risk of autism spectrum disorder (ASD) is considerably reduced in the younger siblings of children with ASD who are at a high risk for the disorder.
The risk of ASD is 13 times greater for younger siblings of children with ASD compared to the general population.
The study published in JAMA Psychiatry included 241 younger siblings of children who had been diagnosed with ASD.
While most of the mothers (96 per cent) reported taking a prenatal vitamin during pregnancy, only 36 per cent followed the recommendations to take them six months before pregnancy.
The risk of being diagnosed with autism was reduced by half in younger siblings if their mothers took prenatal vitamins during the first month of pregnancy. And in children who did develop autism, the severity of the disorder was much lower and they had higher cognitive skills.
CONTRIBUTOR: SHYLA JOVITHA ABRAHAM