Scientists have for the first time showed that changes in the gut bacteria may be linked to Parkinson’s disease and even cause the deterioration of motor skills that is the hallmark of the disorder. Parkinson’s disease (PD) affects up to 10 million people worldwide, making it the second most common neurodegenerative disease. Also watch: Characteristic features of PD include symptoms such as tremors and difficulty walking, aggregation of a protein called alpha-synuclein (aSyn) within cells in the brain and gut, and the presence of inflammatory molecules called cytokines within the brain. In addition, 75 per cent of people with PD have gastrointestinal (GI) abnormalities, primarily constipation. “The gut is a permanent home to a diverse community of beneficial and sometimes harmful bacteria, known as the microbiome, that is important for the development and function of the immune and nervous systems,” said Sarkis Mazmanian, California Institute of Technology in the US. “Because GI problems often precede the motor symptoms by many years, and because most PD cases are caused by environmental factors, we hypothesised that bacteria in the gut may contribute to PD,” he said. Researchers utilised mice that overproduce aSyn and display symptoms of Parkinson’s. One group of mice had a complex consortium of gut bacteria; the others, called germ-free mice, were bred in a completely sterile environment and thus lacked gut bacteria. The researchers had both groups of mice perform several tasks to measure their motor skills, such as running on treadmills, crossing a beam, and descending from a pole. The germ-free mice performed significantly better than the mice with a complete microbiome. “Once you remove the microbiome, the mice have normal motor skills even with the overproduction of aSyn,” Sampson said. “All three of the hallmark traits of Parkinson’s were gone in the germ-free models,” Sampson said. When gut bacteria break down dietary fibre, they produce molecules called short-chain fatty acids (SCFAs), such as acetate and butyrate. Previous research has shown that these molecules also can activate immune responses in the brain. Thus, Mazmanian’s group hypothesised that an imbalance in the levels of SCFAs regulates brain inflammation and other symptoms of PD. Indeed, when germ-free mice were fed SCFAs, cells called microglia – which are immune cells residing in the brain—became activated. Such inflammatory processes can cause neurons to malfunction or even die. In fact, germ-free mice fed SCFAs now showed motor disabilities and aSyn aggregation in regions of the brain linked to PD. The study was published in the journal Cell.
An imbalance in the levels of SCFAs regulates brain inflammation and other symptoms of parkinson’s disease.
Thứ Ba, 31 tháng 1, 2017
Gut bacteria linked to Parkinson’s disease
Brain teasers may protect against mild cognitive impairment
Keeping your brain busy and sharp with a steady flow of activities is likely you help you fight against mild brain disabilities. Rochester-based Mayo Clinic researchers have found that engaging in mentally stimulating activities, even late in life, may protect against new-onset mild cognitive impairment, which is the intermediate stage between normal cognitiveaging and dementia. The study, published in the January 30 edition of JAMA Neurology, found that cognitively normal people 70 or older who engaged in computer use, craft activities, social activities and playing games had a decreased risk of developing mild cognitive impairment. Watch What Else Is Making News: Rearchers followed 1,929 cognitively normal participants of the population-based Mayo Clinic Study of Aging in Olmsted County, Minnesota, for an average duration of four years. After adjusting for sex, age and educational level, researchers discovered that the risk of new-onset mild cognitive impairment decreased by 30 percent with computer use, 28 percent with craft activities, 23 percent with social activities, and 22 percent with playing games. MD, psychiatrist and behavioural neurologist at Mayo Clinic’s Arizona campus, Yonas Geda said, “Our team found that persons who performed these activities at least one to two times per week had less cognitive decline than those who engaged in the same activities only two to three times per month or less”. The benefits of being cognitively engaged even were seen among apolipoprotein E (APOE) e4 carriers. APOE e4 is a genetic risk factor for mild cognitiveimpairment and Alzheimer’s dementia. However, for APOE e4 carriers, only computer use and social activities were associated with a decreased risk of mild cognitive impairment.
Rearchers followed 1,929 cognitively normal participants of the population-based Mayo Clinic Study of Aging in Olmsted County, Minnesota, for an average duration of four years.
Novartis says 82 pct of leukemia patients in remission after CAR-T
An experimental cancer therapy being developed by Novartis AG eliminated an aggressive form of blood cancer in 82 percent of children and young adults treated with modified immune cells in a mid-stage trial, the company said on Saturday. Interim results from the multi-center trial for 50 patients with acute lymphoblastic leukemia whose cancer returned or did not respond to other treatment, showed that 41 were disease-free three months after treatment with the drug, called CTL019. The trial results were presented at a meeting of the American Society of Hematology in San Diego. Novartis estimated that 60 percent of those responders were relapse-free after six months. Complete remission was defined as including “remission with incomplete blood count recovery.” CTL019 is part of an experimental class of drugs that are made by genetically altering a patient’s T-cells, a type of white blood cell, in the lab to help the immune system find and kill cancer cells. The modified cells, called chimeric antigen receptor T-cells, or CAR-T, are infused into the patient. Novartis said it plans to file early next year for US Food and Drug Administration approval of CTL019. The company said nearly half of trial patients experienced severe cytokine release syndrome, a dangerous buildup of toxic debris known as CRS, and 15 percent experienced serious neurological problems including delirium. Researchers said the side effects were treated, and no patients died due to CRS. CRS, a known side effect of CAR-T therapy, led to the decision last week to halt a trial of JCAR015, a rival drug being developed by Juno Therapeutics Inc. “We have learned that the patients who come in with more leukemia in their body have a much higher risk of getting sick,” said Dr. Stephan Gruff, the Novartis trial’s lead investigator and director of the cancer immunotherapy program at the Children’s Hospital of Philadelphia. He said the trial did not show a big difference between patients whose leukemia was refractory, meaning they had stopped responding to treatment, and patients who had relapsed, or might have responded temporarily to chemotherapy. “We do see a difference in toxicity,” the researcher said. “Refractory patients with high disease burden can get sicker temporarily on the way to remission.”
Thứ Hai, 30 tháng 1, 2017
Using natural oil jabs for muscle gain may be harmful: Study
Gym-goers, take note! Using natural oil injections to improve muscle definition may harm your body, warn doctors including one of Indian origin who reported a serious complication experienced by an amateur bodybuilder in the UK. The 25-year-old man was referred to hospital because of pain and loss of function in his right arm over several months. An ultrasound scan showed a rupture in his triceps – a rare condition in young patients – and multiple cysts within the arm muscles, said doctors including Ajay Sahu from London North West Healthcare NHS Trust in the UK. ALSO READ| Sleep loss may take a toll on your heart He had taken up bodybuilding four years prior and attended the gym three times each week. He admitted to injecting coconut oil and other concerning practices to improve his muscular appearance. He was using non-prescribed and self-administered insulin, vitamin B12 injections, steroids, and protein supplements, they said. These practices resulted in numerous adverse reactions, including seizures, infections, and a range of conditions, some of which required surgery. Surgery to repair the rupture in his arm was successful, said doctors. However, he continues to practice unsafe techniques to achieve his desired body image, despite being advised about the potential future risks, they said. What else is making news Steroid use among bodybuilders to bulk up muscles is well known. Other compounds may be used, including natural oils, such as sesame oil, walnut oil and paraffin. These are often less costly than other synthetic compounds and are an attractive option, particularly to amateur bodybuilders. Use of natural oils for this purpose is well known among Arab and Middle Eastern communities and on internet sites, but there is not much information about the practice in medical literature. “The few cases of natural oil self-inoculation formally reported are likely to be the tip of the iceberg,” the doctors said. “We need to be aware of these cases to enable correct clinical diagnoses and also to recognise other self-abusive and potentially life-threatening practices which may be seen in conjunction,” they added. The study appears in the journal BMJ Case Reports.
Using natural oil injections can result in numerous adverse reactions, including seizures, infections and a range of conditions, some of which required surgery. (Source: Pixabay)
Saturated fat may be healthy for you: Study
Consuming saturated fat in diet may actually be good for you, claims a new study which challenges the long-held belief that dietary fat is unhealthy for most people. Researchers at the University of Bergen in Norway found strikingly similar health effects of diets based on either slowly processed carbohydrates or fats. In the randomised controlled trial, 38 men with abdominal obesity followed a dietary pattern high in either carbohydrates or fat, of which about half was saturated. ALSO READ| Gut bacteria linked to Parkinson’s disease Fat mass in the abdominal region, liver and heart was measured with accurate analyses, along with a number of key risk factors for cardiovascular disease. “The very high intake of total and saturated fat did not increase the calculated risk of cardiovascular diseases,” said professor Ottar Nygard. “Participants on the very-high-fat diet also had substantial improvements in several important cardiometabolic risk factors, such as ectopic fat storage, blood pressure, blood lipids (triglycerides), insulin and blood sugar,” said Nygard. Both groups had similar intakes of energy, proteins, polyunsaturated fatty acids, the food types were the same and varied mainly in quantity and intake of added sugar was minimised. “We here looked at effects of total and saturated fat in the context of a healthy diet rich in fresh, slowly processed and nutritious foods, including high amounts of vegetables and rice instead of flour-based products,” said PhD candidate Vivian Veum. “The fat sources were also slowly processed, mainly butter, cream and cold-pressed oils,” said Veum. Total energy intake was within the normal range. Even the participants with increased energy intake during the study showed substantial reductions in fat stores and disease risk. “Our findings indicate that the overriding principle of a healthy diet is not the quantity of fat or carbohydrates, but the quality of the foods we eat,” said PhD candidate Johnny Laupsa-Borge. Saturated fat has been thought to promote cardiovascular diseases by raising the “bad” LDL cholesterol in the blood. However, even with a higher fat intake in the Norwegian diet intervention (FATFUNC) study compared to most comparable studies, the researchers found no significant increase in LDL cholesterol. What else is making news Rather, the “good” cholesterol increased only on the very-high-fat diet. “These results indicate that most healthy people probably tolerate a high intake of saturated fat well, as long as the fat quality is good and total energy intake is not too high. It may even be healthy,” said Nygard. “Future studies should examine which people or patients may need to limit their intake of saturated fat,” said assistant professor Simon Nitter Dankel, who co-led the study. The study was published in The American Journal of Clinical Nutrition.
Even the participants with increased energy intake during the study showed substantial reductions in fat stores and disease risk. (Source: File Photo)
Chủ Nhật, 29 tháng 1, 2017
Accidents common cause of injuries in boys, most girls suffered fall injuries: Study
AROUND 70 per cent of paediatric trauma patients who underwent treatment at Postgraduate Institute of Medical Education and Research (PGIMER) were boys. Road accidents were the most common cause of injuries in boys at the paediatric trauma while the majority of the girls suffered fall injuries. The study conducted by PGIMER and Dr RML Hospital, New Delhi, was aimed at assessing the epidemiology, pattern, and outcome of trauma in paediatric population. The study revealed that road traffic accident (RTA) was the most common mode of trauma in boys while in girls, fall was the most common mode of trauma. Watch What Else Is Making News: The study has been published by Journal of Indian Association of Pediatric Surgeons. For the study, the authors had collected detailed demographic information, gender, site of injury, mode of injury, place of injury, nature of injury, any intervention required, and final outcome of the trauma of the patients. Parental consent was sought from all the patients and detailed history taken and examination of all the paediatric trauma patients was done, the report said. According to the study report, a total of 1,148 patients up to 15 year olds with a history of trauma between July 2013 and June 2016 were included. The patients were categorised into four age groups of 1 year, 1-5 years, 6-10 years and 11-15 years. The study revealed that the majority of the paediatric trauma cases were seen in boys — 69.86 per cent — and it was 30.13 per cent in girls. Road traffic accident (RTA) was the most common mode of trauma in boys (59.47 per cent), followed by fall injuries (29.42 per cent). In girls, fall was the most common mode of trauma, i.e. 52.31 per cent, followed by RTA. Fall injuries occurred mostly at homes, the report said. Among RTA, the report said, “Hit by vehicle on road while playing was the most common, followed by passenger accidents on two-wheelers, followed by hit by vehicle while walking to school.” Among fall cases, fall while playing at home was the most common. The study stated that out of a total of 1,148 patients, 304 (26.48 per cent) comprised poly trauma cases (involvement of more than two organ systems), followed by abdominal/pelvic trauma (20.99 per cent), followed by head/face trauma (19.86 per cent). The report concluded that “the high incidence of paediatric trauma on roads and falls indicate the need for more supervision during playing and identification of specific risk factors for these injuries in our setting”.
Jayalalithaa health update: What does ‘being put on ECMO’ mean?
On Sunday (December 4), Tamil Nadu Chief Minister J Jayalalithaa was put on assisted breathing after suffering a cardiac arrest in the evening, at Chennai’s Apollo Hospitals. The 68-year-old had been shifted back to the Intensive Care Unit after a fortnight of being moved to a private room, and put on Extracorporeal Membrane Oxygenation (ECMO), a heart assist device that helps cardiac and respiratory functions. LIVE UPDATES ALSO READ | Jayalalithaa: Why Amma is important to Tamil Nadu For those unaware of what the ECMO device does, it is basically an advanced machine used as a rescue method when a patient does not respond to conventional CPR or Cardiopulmonary resuscitation. It works by draining blood from a vein, adding oxygen through the oxygenator machine and removing the carbon dioxide. It also warms up the blood, returning it to the artery and, in some cases, pumps the blood through the body. This enables the blood to bypass the heart and lungs. In the case of Jayalalithaa, the hospital said, “She is on extracorporeal membrane heart assist device and is being treated by a team of expert doctors and critical care specialists. Dr Richard Beale from London has also been consulted and he has concurred with the line of treatment by our cardiologists & pulmonologists.” The survival rates after being put on ECMO varies, though some reports say that the chances of survival do improve. ECMO is opted for when it can be rapidly implemented and where the doctors believe that the suspected cause of the cardiac arrest is potentially reversible. RELATED | Jayalalithaa in hospital: A timeline of events In the meanwhile, Amma supporters have thronged the hospital since Sunday night, and Tamil Nadu has been put on high alert. As word spread and supporters started gathering, police stepped up deployment in and around Greams Road where the hospital is located. On social media, people have been wishing for the speedy recovery of the veteran politician whose stature in the state’s political scenario is unrivalled.
After suffering a cardiac arrest, J Jayalalithaa has been put on Extracorporeal Membrane Oxygenation (ECMO), a heart assist device that helps cardiac and respiratory functions. (Source: PTI)
An extracorporeal membrane oxygenation (ECMO) machine with intra-aortic balloon counterpulsation in ICU. (Source: Thinkstock Images)
Explained: Jayalalithaa suffers cardiac arrest; What is it and how is it different from heart attack
As the news of Tamil Nadu Chief Minister Jayalalithaa suffering a cardiac arrest on late Sunday evening trickled in, Tamil Nadu was on the edge. Her supporters were shocked to hear the news of her cardiac arrest. Within a day, Tamil Nadu’s beloved Amma had passed away, breathing her last at 11:30 pm on Monday. Jayalalithaa, who has been receiving treatment in Chennai’s Apollo Hospital since September 22, briefly recovered from her illness and, even, thanked the voters for backing her party, AIADMK, in the recently concluded bypolls. During her recovery, rumours did rounds about her ‘worsening’ condition and a few were also arrested by the state police for spreading them. Here, we attempt to explain what a cardiac arrest is, and how it is different from a heart attack. LIVE UPDATES The Apollo Hospital on Monday morning had released a bulletin while Jayalalithaa was being treated. The bulletin revealed that amma was moved back to the Intensive Care and was put on Extracorporeal Membrane Oxygenation (ECMO), a heart device that would aid her in recovery by increasing the cardiac and respiratory functions. What is a cardiac arrest? It is something that gets triggered by an electrical malfunction in the heart. Cardiac arrest disrupts the heart’s pumping action and causes an irregular heartbeat, known as arrhythmia in medical terms. This leads to the blood not reaching the body’s critical organs — brain and lungs — that keep us alive. What happens next? In most cases, the person suffering a cardiac arrest becomes unresponsive and, usually, stops breathing. In certain cases the person is only gasping, indicating a difficulty in breathing. Without proper treatment — performing a CPR or using an Automated External Defibrillator — a person will die within minutes. In a 2012 paper published by the US-based National Center for Biotechnology Information, Sudden Cardiac Death (SCD) contributed to 10.3 per cent of overall mortality in this population from Southern India. How is it different from a heart attack? Heart attack usually occurs when a person’s arteries are clogged, stopping the blood from reaching the heart. If the blockage is not immediately removed, the heart begins to die, according to the American Heart Association. However, unlike in cases of cardiac arrest, the heart usually doesn’t stop beating in a heart attack. What happens next? A person suffering a heart attack usually complains of deep pain in the chest, shortness of breath, feeling nauseous. In some cases, it may also lead to serve pain in the back or jaw. According to a paper published by the American Heart Association, at least 37 million Indian died of cardiovascular diseases (CVDs) in 2010, an increase of 59 per cent since 1990. The average number of deaths in India due to CVD is 272 per 100 000 population, much higher that the global average.
Supporters of Tamil Nadu Chief Minister Jayalalithaa hold her photograph as they pray for her health at a temple in Mumbai, India, Monday, Dec. 5, 2016. Thousands of Jayalalitha supporters and well wishers across India prayed for her speedy recovery after she suffered a cardiac arrest on Sunday evening. (Source: AP Photo/Rafiq Maqbool)
Women with dementia receive less medical attention compared to male counterparts
A recent study conducted at the University College London found that women with dementia have fewer visits to the doctors, receive less health monitoring and take more potentially harmful medication than men with dementia. The study, published in Age and Ageing, also found that only half of all dementia patients had a documented annual review even though general practitioners are offered financial incentives to carry these out. Women were found to be at particular risk of staying on antipsychotic or sedative medication for longer. Watch What Else Is Making News This might be because they have fewer appointments where their treatment can be reviewed. “As women tend to live longer than men, they are more likely to live alone without a family carer to help them access healthcare,” said Claudia Cooper, who led the research. Adding, “Perhaps because of this, they are more at risk of missing out on medical help that might help them stay well for longer. We found that women were more likely to be on psychotropic drugs – sedatives or anti-psychotics -which can be harmful in the long term and may not be appropriate. Women tended to stay on such drugs for longer, perhaps because they have fewer check-ups to see if the drugs were still needed.” Women with dementia who live on their own may need additional support accessing healthcare services. “We should ensure GPs have the resources to proactively engage with these patients and review their condition regularly to make sure their treatment plan, including any drugs, is appropriate. Improving access to healthcare and reducing psychotropic drug use in people with dementia, especially women, could help them to live well with dementia for longer,” said cooper. The researchers analysed the records of 68,000 dementia patients and 259,000 people without dementia to compare their access to healthcare services, using The Health Improvement Network (THIN) database. Overall, people with dementia received less medical care than those without even though they are more vulnerable to physical and mental illnesses. “Dementia can cause a wide range of physical complications, including difficulties swallowing and mobility problems,” said Dr Cooper. Adding, “People with dementia are particularly susceptible to malnutrition, as they may have difficulties eating, preparing food or remembering to eat. Previous research has shown that up to 45 percent of dementia patients experience clinically significant weight loss, which can lead to further physical problems and frailty. However, despite this high risk, less than half of dementia patients are currently receiving an annual weight check-up. The good news is that things seem to be improving: only 24 percent of patients had their weight monitored in 2002 compared with 43 percent in 2013.” Improvements may be linked to the government’s National Dementia Strategy which launched in 2009. Around the time this was launched, GP surgeries were offered additional financial incentives through the NHS Quality and Outcomes Framework to review dementia patients annually. However, the latest study suggests that there is still more work to be done to ensure that people with dementia, particularly women, are able to access the services they need.
Women with dementia who live on their own may need additional support accessing healthcare services. (Source: Pixabay)
Thứ Bảy, 28 tháng 1, 2017
Now, a hormone in brain that can trigger fat burning: Study
Scientists, have identified a brain hormone that can trigger fat burning in the gut. Researchers from The Scripps Research Institute (TSRI) in the US found a brain hormone that specifically and selectively stimulates fat metabolism, without any effect on food intake. The findings, published in the journal Nature Communications, in animal models could have implications for future pharmaceutical development. “This was basic science that unlocked an interesting mystery,” said senior author Supriya Srinivasan, an Indian origin researcher and a member of the TSRI. The researchers experimented with roundworms called C. elegans, which are often used as model organisms in biology. What else is making news These worms have simpler metabolic systems than humans, but their brains produce many of the same signaling molecules, leading many researchers to believe that findings in C. elegans may be relevant for humans. They deleted genes in C. elegans to see if they could interrupt the path between brain serotonin and fat burning. This process of elimination led them to a gene that codes for a neuropeptide hormone named FLP-7 (pronounced “flip 7”). They found that the mammalian version of FLP-7 (called Tachykinin) had been identified 80 years ago as a peptide that triggered muscle contractions when dribbled on pig intestines. The next step in the new study was to determine how FLP-7 was directly linked to serotonin levels in the brain. The study revealed that FLP-7 was, indeed, secreted from neurons in the brain in response to elevated serotonin levels. FLP-7 then travels through the circulatory system to start the fat burning process in the gut. The newly discovered fat-burning pathway works like this — a neural circuit in the brain produces serotonin in response to sensory cues, such as food availability. This signals another set of neurons to begin producing FLP-7 and then activates a receptor in intestinal cells and the intestines begin turning fat into energy.
When they said it’s all in the head, they weren’t entirely wrong. (Source: Thinkstock Images)
Handful of nuts a day may cut heart disease, cancer risk, says new study
Eating at least 20 grammes of nuts a day – equivalent to a handful – may lower the risk of heart disease, cancer and premature death, new research has claimed. The analysis of all current studies on nut consumption and disease risk showed that 20 grammes daily can cut people’s risk of coronary heart disease by nearly 30 per cent, cancer by 15 per cent, and premature death by 22 per cent. Watch What Else Is Making News An average of at least 20 grammes of nut consumption was also associated with a reduced risk of dying from respiratory disease by about a half, and diabetes by nearly 40 per cent, researchers said. Scientists from Imperial College London and Norwegian University of Science and Technology analysed 29 published studies from around the world that involved up to 819,000 participants, including more than 12,000 cases of coronary heart disease, 9,000 cases of stroke, 18,000 cases of cardiovascular disease and cancer and over 85,000 deaths. While there was some variation between the populations that were studied, such as between men and women, people living in different regions, or those with different risk factors, the researchers found that nut consumption was associated with reduction in disease risk across most of them. “In nutritional studies, so far much of the research has been on the big killers such as heart diseases, stroke and cancer, but now we are starting to see data for other diseases,” said Dagfinn Aune from the School of Public Health at Imperial. “We found a consistent reduction in risk across many different diseases, which is a strong indication that there is a real underlying relationship between nut consumption and different health outcomes. It is quite a substantial effect for such a small amount of food,” said Aune. The study included all kinds of tree nuts, such as hazel nuts and walnuts, and also peanuts – which are actually legumes. The results were in general similar whether total nut intake, tree nuts or peanuts were analysed. What makes nuts so potentially beneficial is their nutritional value, researchers said. “Nuts and peanuts are high in fibre, magnesium, and polyunsaturated fats – nutrients that are beneficial for cutting cardiovascular disease risk and which can reduce cholesterol levels,” said Aune. “Some nuts, particularly walnuts and pecan nuts are also high in antioxidants, which can fight oxidative stress and possibly reduce cancer risk. “Even though nuts are quite high in fat, they are also high in fibre and protein, and there is some evidence that suggests nuts might actually reduce your risk of obesity over time,” she said. The study also found that if people consumed on average more than 20 grammes of nuts per day, there was little evidence of further improvement in health outcomes. The research was published in the journal BMC Medicine.
The study also found that if people consumed on average more than 20 grammes of nuts per day, there was little evidence of further improvement in health outcomes. (Source: Thinkstock)
‘Yo-yo dieting’ may cause extra weight gain: Study
Yo-yo dieting – repeatedly going on and off diets – may lead to weight gain as the brain interprets these periods as short famines and urges the body to store more fat for future shortages. Researchers from the Universities of Exeter and Bristol in the UK conducted the study after the observation that animals respond to the risk of food shortage by gaining weight, which is why garden birds are fatter in the winter when seeds and insects are hard to find. This may explain why people who try low-calorie diets often overeat when not dieting and so do not keep the weight off. Watch What Else Is Making News By contrast, people who do not diet will learn that food supplies are reliable and they do not need to store so much fat, researchers said. They studied a mathematical model of an animal that knows whether food is currently abundant or limited, but does not know when things will change, so must learn about the changeability before deciding how fat to be. The model showed that if food supply is often restricted (as it is when dieting) an optimal animal – the one with the best chance of passing on its genes – should gain excess weight between food shortages. “Our model predicts that the average weight gain for dieters will actually be greater than those who never diet,” said Andrew Higginson from the University of Exeter. “This happens because non-dieters learn that the food supply is reliable so there is less need for the insurance of fat stores,” said Higginson. Humans evolved in a world where food was sometimes plentiful and sometimes scarce – and in the latter case those with more fat would be more likely to survive. Today, people can get into a vicious cycle of weight gain and ever more severe diets – so-called yo-yo dieting – which only convinces the brain it must store ever more fat. The model predicts that the urge to eat increases hugely as a diet goes on, and this urge will not diminish as weight is gained because the brain gets convinced that famines are likely. “Our simple model shows that weight gain does not mean that people’s physiology is malfunctioning or that they are being overwhelmed by unnaturally sweet tastes,” said John McNamara from the University of Bristol. “The brain could be functioning perfectly, but uncertainty about the food supply triggers the evolved response to gain weight,” said McNamara. “The best thing for weight loss is to take it steady. Our work suggests that eating only slightly less than you should, all the time, and doing physical exercise is much more likely to help you reach a healthy weight than going on low-calorie diets,” said Higginson. The study was published in the journal Evolution, Medicine and Public Health.
The model showed that if food supply is often restricted (as it is when dieting) an optimal animal – the one with the best chance of passing on its genes – should gain excess weight between food shortages.
Fighting for My Life
In October last year, 33-year-old Dimple Bawa walked down the corridor of the outpatient department of Fortis Hospital, Gurgaon. She stopped mid-way and walked back towards her doctor’s room. She had a query for Dr Vinod Raina, who has over 23 years of experience as a medical oncologist and has been a principal investigator in at least 50 research projects at the All India Institute of Medical Sciences (AIIMS), Delhi. “Can I get a tattoo?” she asked. Taken by surprise, Dr Raina said, “What does this have to do with the test? If you feel like getting a tattoo, go ahead. But more importantly, let’s get the test done from another lab — to be sure about the results.” A day before, Bawa had received a call from Dr Raina’s assistant. “Is it BRCA?” asked Dimple. “I don’t know. But I will fix an appointment for tomorrow,” the assistant said. Bawa sent a text message to Dr Raina: “I guess it’s bad.” He replied: “I can’t discuss this over the phone. But it will be good if you come with your husband tomorrow.” Bawa did not wait for the next day. She called up Strand Life Sciences, a laboratory in Bengaluru, where her blood sample had been sent for genomic testing for cancer. “I am the one whose blood was tested. Please send me the findings right now.” In the next hour, the report was emailed to Bawa. It read: tested positive for BRCA 1. “I was fine. I had overcome my fear of cancer,” says Bawa. BRCA 1 and BRCA 2 were some of the first breast cancer genes to be identified in the 1990s. BRCA 1 normally acts to restrain the growth of cells in the breast. But when mutated, the gene predisposes one to breast cancer as well as ovarian cancer. The cancer gene became a part of the international medical conversation in May 2013 after Angelina Jolie wrote in the New York Times about her experience of inheriting a faulty BRCA 1 gene and how, armed with that information, she decided to have a preventive double mastectomy. “Today it is possible to find out through a blood test whether you are highly susceptible to breast cancer and ovarian cancer,” Jolie wrote in the NYT. Later, the Harvard Medical School came out with some startling numbers: testing rates had increased by 64 per cent in the three weeks after the publication of Jolie’s essay. Her influence on people’s medical decision to opt for a BRCA test was termed the “Jolie effect”. Jolie wrote about her mother fighting cancer for almost a decade. She wrote about how the doctors had estimated, on the basis of the test, that she had a 87 per cent risk of breast cancer and 50 per cent risk of ovarian cancer. “Once I knew that this was my reality, I decided to be proactive and to minimise the risk as much I could. I made a decision to have preventive double mastectomy… I am writing about it now because I hope that other women can benefit from my experience,” Jolie wrote. Approximately 1.5 lakh Indians are diagnosed with breast cancer every year. The Indian cancer registry maintains no data about what proportion of the cancer cases are genetic. In the US, BRCA mutations account for 5-10 per cent of breast cancers and 10 to 15 per cent of ovarian cancers each year. Just a month before Jolie opened up about her difficult choices, Bawa was diagnosed with breast cancer. She was 31. The cancer was in an advanced stage; it had occupied more than half of the left breast. Also, her cancer was Triple Negative, a variant with a tendency to spread fast to other distant organs, which does not respond to hormonal tablets and was most likely inherited. Bawa was 12 when her mother was diagnosed with cancer. Having lost her father in a road accident, when she was five, Bawa’s mother, an entrepreneur, meant the world to her. “I lost my father at a very early age. But I don’t remember anything about the tragedy. My mother was everything to me. She ensured that I had the best childhood. I was a very happy child,” says Bawa, who is now 34. Less than a year later, her mother underwent mastectomy in September 2004, followed by chemotherapy and radiation. Just two years later, the cancer had spread to the lungs, liver and brain. In 2007, her mother passed away. She was 55. In May 2013, having nearly fought back the cancer through six rounds of chemotherapy, followed by mastectomy and radiation, Bawa was asked by her doctors if she wanted to know if her cancer was genetically induced by taking the BRCA test. “It was a clear no. I was not mentally prepared. I didn’t want to live my life in fear. The fear of getting cancer again. I had already accepted that I had Stage 3 breast cancer and that I would fight it. I didn’t want to focus on the future,” Bawa says. Three years later, she had changed her mind. It was a decision that came at the end of a long journey, which took her out of misery and helplessness to taking ownership of her battle and her body. It began on September 19, 2013. After a painful mastectomy of her left breast, one of her surgeons had held her hand and said, “As doctors, we only know about the treatment and the side-effects. But I cannot relate to your pain.” As she was being wheeled back to the ward, she smiled at her husband. “But that brief conversation with my doctor was running in my head. I told myself that the doctors could not relate to me. My family cannot relate to me. [Thinking back] I could only relate to what my mother had gone through. [And now] only my co-patients could relate to me,” she says. Cancer had alienated her from her near and dear ones, but it led her to seek out others like her. For the next three years, Bawa moved from fear to resilience. “I started meeting patients of all age groups. I started counselling them and I learned a lot from the survivors. A five-year-old child, a nine-year-old child, a 63-year-old man, a 65-year-old woman and a 31-year-old woman, who contacted me through Facebook,” says Bawa. “My relationship with cancer has been very complex…If there is one lesson that I have learnt from this journey is that if you have to fight cancer, prevention is everything,” she says. Looking back, Bawa says it was an accident that brought home the possibility that all was not well with her. “If I had not gone shopping that day to GK Market, if a pile of clothes had not hit my left breast, I don’t think I would have known. It had hurt a little,” Bawa recollects. The next day, Bawa and her family travelled to Shimla for a three-day break. “The pain persisted and I didn’t tell my husband. Once I returned, I went for a check-up at a hospital in south Delhi. The senior nurse referred me to a senior surgeon. He told me that as a precaution, I had to undergo the FNAC test,” Bawa says. Google told Bawa quickly enough what FNAC (Fine Needle Aspiration Cytology) test was. “It is a diagnostic procedure used to investigate lumps or masses, widely used in the diagnosis of cancer and inflammatory conditions. My mind was blank. It could either be an inflammation or cancer,” Bawa says. It was Holi the next day. “I was not excited. I was hyperactive and aggressive. I didn’t know how to handle the situation. My husband, by then, had found the prescription inside a bag. He tried to calm me down. But that didn’t work,”says Bawa. Over the next few days, as she waited for the doctor’s verdict, Bawa tried several things to distract herself, from a brunch at the India Habitat Centre to shopping with her daughter. When she arrived at the doctor’s the next day, her husband was standing outside. “As I walked towards him, I saw him break down. He just couldn’t look into my eyes. And that was it,” she says. Bawa was referred to an oncologist at Max Hospital, Saket. She remembers sitting silently in a chair, red-eyed and tearful. “Everything around me was a blur,” she says. She had many questions in her mind: “How curable is cancer? How long will the treatment take? Would I survive?” She was then introduced to her doctor. “It was a very unpleasant meeting. We hardly spoke. All he did was write the tests. There was no conversation. There were no answers to my questions. I just cried. I felt helpless,” Bawa says. As she hurtled from one laboratory to another to carry out the tests, far away from India, an oncologist from Cleveland, Ohio wrote to her: “Always remember that you have to follow a doctor and not the hospital,” the doctor told Bawa. “I wanted some reassurance. My cousin in the USA had sent my reports to an oncologist. He told me not to worry. And to follow one doctor. That was my first lesson in fighting cancer,” she says. “It was April 13. My first chemotherapy session. I wanted to feel happy. So I went to Big Chill,” she recalls. She ordered a smoked chicken salad, her favourite at the Khan Market cafe. Accompanying her was her brother-in-law. “We decided not to think about anything and enjoy the food. It was really tough,” says Maninder Singh. A slow drip was administered through an intravenous needle. The first of the six sessions had begun. “It was a really bad experience. I started dehydrating. My lips started peeling. I had a severe facial bone pain,” Bawa says. The second session was worse. “Without informing me, my dosage was increased. It was terrible. I had an argument with my doctor. I told him that I have to be mentally prepared for a higher dose,” she says. That session drastically altered her approach towards cancer. The liver function test results, conducted to assess how she had taken the chemotherapy, were out. “On each of the parameters, I was on the higher side. This was a wake-up call. Because of my cancer, I was damaging my other organs. I had to protect my body. I decided that day that I would change my eating and sleeping habits. I started researching about holistic therapy. This was the second lesson from my cancer treatment,” Bawa says. “For the first time in my life, I drank beetroot juice. I had more than 50 questions for my doctors — from how to protect my nails to details on nutrition. They told me to switch off the internet. But I told them this approach was working,” she says. Milk thistle, a flowering herb to detox the liver, green apple juice used at the Israel government cancer institute, and salads became a part of her new diet. “My doctors started observing the change. And by the end of six sessions, I had responded to the treatment. The tests showed that the disease had gone by 90 per cent,” says Bawa. After the chemotherapy, the doctors asked her for advice. “They said I should share and talk about the lifestyle changes I had made in my life with other patients,” Bawa says, with a sense of pride. Still, in August that year, Bawa was asked by doctors to undergo a mastectomy — she was a high-risk cancer patient and she was young; the disease could recur. That was the most difficult part. “I had reservations about losing my femininity. I wanted to save my breast,” she says. On September 15, the mastectomy process began. “Before undergoing anaesthetic clearance, I wore my black Promod dress. I told my husband that I wanted to look beautiful before I lose my breast,” she says. The surgery left her in turmoil. “I would stand in front of the mirror and cry. I could not accept the fact that I had lost my breast,” she says. A reconstruction surgery was also far away as the doctors advised radiation and observation for a few years before they could embark on that course. A month later, she was shaken out of her despondency. “I was in a hospital to try out a prosthetic bra. I was waiting outside the trial room. I saw a 22-year-old girl, crying in pain as she tried to wear an artificial foot. That day I told myself I have not lost anything. Instead, I have saved my life,” Bawa says. By the end of December, Bawa had completed her treatment. She had won the battle against cancer. She went on to start the Cheers to Life foundation, an NGO that works for cancer patients. Bawa organised seminars for cancer patients and survivors. “My focus had now shifted to breast cancer awareness. I started attending conferences. I started organising a few,” she says. Her husband Rupinder Singh, an entrepreneur, says he is worried about her involvement with cancer awareness. “She is doing a noble thing. But it involves a lot of physical activity. She is shuffling between hospitals or organising seminars. I’m not very sure if so much activity is good for her health,” he says. It was at one such seminar that Dr Raina spoke about the BRCA test. “He spoke about survivors who have had a relapse and underwent BRCA. He told me that I should undergo the test. I gave it a thought,” Bawa says. Her research connected her to many people, some of whom she met on social networks. If the test turned out positive, she might have to undergo preventive mastectomy on her right breast — and eventually, also remove her ovaries. Preventive prophylactic mastectomy cuts down the risk of breast cancer reoccurence by 85-90 per cent. The BRCA test can give three results – positive, negative and unknown. “There is what we call the variation of unknown significance (VUS), which is most important. VUS is the unknown factor, which means that the pathogenicity of the variant can neither be confirmed nor ruled out. This has to be told to the person taking the test because it means that the result can be positive later. Local laboratories in Delhi do not divulge these details,” says Dr Mandeep Singh Malhotra, who specialises in post mastectomy reconstruction and breast oncoplasty and who will carry out Bawa’s mastectomy. It was to ensure complete reliability of Bawa’s first test that the result was rechecked by Myriads Genetics, USA. Not everyone who tests BRCA positive must proceed to mastectomy. A person has the option to be kept under “intensive screening” — which implies regular MRIs, ultrasounds and mammograms. As it turned out, the BRCA test suggested that Bawa has an 80 per cent risk of breast cancer reoccurrence and 40 per cent risk of getting ovarian cancer. “It’s also about her daughter. There is a 50 per cent chance that it can pass on to her daughter. According to US guidelines, when her daughter attains adulthood, this needs to be divulged to her. This is a very important aspect of genetic testing,” says Malhotra. Bawa’s 15-year-old daughter has watched her mother’s struggle with cancer from close quarters. “I have divulged all the details about my mastectomy to my daughter. She knows what it means emotionally and physically. But about BRCA, she knows only bits and pieces. Slowly, when she turns 18, she will understand the importance of cancer prevention,” she says. Doctors say the BRCA test is rarely done in India. “Dimple understood the complexities of BRCA because she had fought cancer and understood the importance of prevention. If at 28, she had done the same test, we could have caught the cancer at a very early stage. In a country where there is so much stigma attached to cancer, a test like BRCA is like opening a Pandora’s box,” says Dr Malhotra, who does at least two mastectomy reconstructions in a week. “There are other genes also, but in BRCA, we know how to intervene. In case of the ovarian cancer, Dimple will be kept in an intensive follow-up and her ovaries removed when she approaches menopause,” the doctor says. When she finally agreed to the surgery, Bawa had one request: “My breasts have to be proportional. I cannot compromise on that”. All her husband wanted to know was how long it would take her to heal. “I told him to relax. I will be fine,” she says. Bawa is now getting ready for surgery in multiple phases. In the first phase, she will undergo a reconstruction of the left breast, earlier affected by cancer. “After it heals, the right breast would be removed. The skin would be retained, the duct and breast fat removed. After that, an implant would be inserted,” says Dr Malhotra. Last Monday, the reconstruction of her left breast started. In the next three months, Bawa will complete the preventive surgery and the reconstruction of the right breast. “Dimple says cancer chose the wrong girl. But I think it chose just the right girl, who is an inspiration to everyone,” says Suruchi Jain, Bawa’s close friend. For Bawa, another important step is complete: a tattoo on the right wrist. A blue angel, with a pink cancer ribbon bow. From the bow, wings emerge and birds fly out. “The feathers are my experiences from the encounter with cancer. And my wings are growing. And the birds are flying. I wanted the tattoo to be soft and yet powerful and expressive. That is me,” she says.
Always a woman to me: After the first mastectomy, Bawa had feared she had lost her femininity — she has got over that apprehension. (Source: Express photo by Oinam Anand)
Dimpal Bawa with her husband.
Dimple Bawa at her farmhouse. (Source: Express photo by Oinam Anand)
Cancer survivor Dimple Bawa also runs an NGO that counsels other cancer patients and works to raise awareness about the disease.
Bawa is now getting ready for surgery in multiple phases.
Thứ Sáu, 27 tháng 1, 2017
Bone changes may predict Alzheimer’s early
Changes in the bones may act as one of the earliest indicators of brain degeneration in people with Alzheimer’s disease, a new study has found. Researchers at Northeast Ohio Medical University (NEOMED) in the US have identified the link between areas of the brainstem – the ancient area that controls mood, sleep and metabolism – and detrimental changes to bone in a preclinical model of Alzheimer’s disease (AD). Watch What Else is Making News Alzheimer’s has major social, emotional and financial consequences for patients and their families. Incurable and seemingly unstoppable, less than five per cent of AD cases are due to a clear genetic reason, so it is hard to predict who will be at risk for acquiring this devastating disease. Researchers report that early reductions in bone mineral density (BMD) that occur in a preclinical model of AD are due to degeneration in an area of the brainstem that produces the majority of the brain’s serotonin – a neurochemical that controls mood and sleep, which are two processes that are also affected early in AD. One’s bones may be one of the earliest indicators of brain degeneration in Alzheimer’s disease. Reduced BMD, which sometimes leads to osteoporosis, translates to increased bone fracture risk, decreased quality of life, and increased mortality for AD patients. Researchers suggest that early bone loss and serotonin deficiency in AD may tell us something very important about how we approach diagnosing and treating this disease. “Measurement of bone density, which is routinely performed in the clinic, could serve as a useful biomarker for assessing AD risk in our ageing population,” said Christine Dengler-Crish, assistant professor at NEOMED. “The findings of this study motivate us to explore the serotonin system as a potential new therapeutic target for this devastating disease,” she said. The study appears in the Journal of Alzheimer’s Disease.
One’s bones may be one of the earliest indicators of brain degeneration in Alzheimer’s disease
Mediterranean diet may help treat HIV, diabetes patients
Consuming a Mediterranean diet — rich in fresh fruits and vegetables, lean proteins, high in healthy fats like olive oil and low in refined sugars and saturated fats — may provide a good nutritious balance that can improve medication adherence and mental health in patients with HIV-positive and Type 2 diabetes, researchers suggest. ALSO READ | Mushrooms may help delay or prevent dementia, Alzheimer’s People who received healthy food and snacks for six months showed dramatic improvements in depression, the distress of having diabetes, diabetes self-management, trading off between food and healthcare and HIV medication adherence. People with diabetes who ate the nutritious food showed better long-term control of their blood sugar, reduced hospitalisations or emergency department visits. They also consumed less sugar and lost weight. See what else is making news in lifestyle, here “We saw significant improvements in food security and in outcomes related to all three mechanisms through which we posited that food insecurity may affect HIV and diabetes health — nutritional, mental health and behavioural,” said Kartika Palar, Assistant Professor at University of California – San Francisco (UCSF), US. The Mediterranean diet fulfilled 100 per cent of daily caloric requirements for people living with HIV and Type 2 diabetes. The patients also had fewer symptoms of depression and were less likely to binge drink. For those with HIV, adherence to antiretroviral therapy increased from 47 to 70 per cent. The study appeared online in the Journal of Urban Health.
Mediterranean diet may provide a good nutritious balance. (Source: Pixabay)
Thứ Năm, 26 tháng 1, 2017
Sleepless nights bothering you? Here’s how to get a good sleep
People who fall asleep within 30 minutes or less and wake up no more than once at night qualify for several health benefits associated with good sleep, researchers have suggested. Sleeping for more time while in bed (at least 85 per cent of the total time) and being awake for 20 minutes or less after initially falling asleep are other key determinants of good quality sleep issued by the US non-profit National Sleep Foundation (NSF). ALSO READ | How our memories become permanent The researchers used at-home sleep technology devices — gadgets worn throughout sleep or placed on the bed stand — to analyse the amount of deep and light sleep people get each night, how frequently one wakes up and the length of tossing and turning on the bed. “Millions of Americans are sleep technology users. These devices provide a glimpse into one’s sleep universe, which is otherwise unknown and provide consumers with the resources needed to understand their sleep,” said Max Hirshkowitz, Chairman at NSF. See what else is making news in lifestyle, here According to NSF’s recent Sleep Health Index, as many as 27 per cent of people take longer than 30 minutes, on average, to fall asleep. Sleep deprivation may result in impairment of judgement, depression, heart problems, obesity and drastic reduction in general well-being of an individual. The report, published in the journal Sleep Health, also highlights areas where research is needed to identify and further delineate additional indicators of good sleep quality across age groups.
Sleep deprivation may result in impairment of judgement, depression and heart problems. (Source: Thinkstock Images)
Mushrooms may help delay or prevent dementia, Alzheimer’s
Regular consumption of mushrooms which act as functional food may enhance nerve growth in the brain to reduce or delay development of age-related neurodegenerative diseases like dementia and Alzheimer’s, researchers, including one of Indian-origin, has suggested. The prevalence of neurodegenerative diseases such as dementia and Alzheimer’s disease will continue to rise steadily and is expected to reach 42 million cases worldwide in 2020. WATCH WHAT ELSE IS IN THE NEWS The findings showed certain edible and medicinal mushrooms contain bioactive compounds that offer neuroprotective and cognitive benefits to protect against neurotoxic stimuli such as inflammation that contribute to neurodegenerative diseases. According to evidence, mushrooms exhibit antioxidant, anti-tumour, anti-virus, anti-cancer, anti-inflammatory, immunomodulating, anti-microbial, and anti-diabetic activities, said Vikineswary Sabaratnam from the University of Malaya in Malaysia. Mushrooms with anti-inflammatory properties can be used as functional foods to suppress inflammation, which contributes to many age-related chronic diseases, including neurodegenerative diseases. Current drug therapy for neurodegenerative diseases is ineffective with many side effects, and it only provides a short-term delay in the progression of the disease. It is, therefore, of utmost importance to find appropriate solutions to prevent or reduce the severity of neurodegenerative diseases associated with impaired neuritogenesis, Sabaratnam said. The study might stimulate the identification of more food materials that are neuroprotective, the researchers noted in the Journal of Medicinal Food.
Regular consumption of mushrooms which act as functional food may enhance nerve growth in the brain to reduce or delay development of age-related neurodegenerative diseases like dementia and Alzheimer’s, researchers, including one of Indian-origin, has suggested. (Representational Image)
Thứ Tư, 25 tháng 1, 2017
Fighting leprosy when the world thinks it's eradicated
Pobe (Benin) (AFP) – Farmer Folahan is one of up to 200 people in the west African country of Benin who still contract leprosy every year.
Her face is covered in nodules — a symptom of the condition — when she arrives at the screening centre in the town of Pobe, in the east of the country.
Doctors put her on medication straight away. If she takes it properly for 12 months and there are no side effects, she will be completely cured.
Leprosy is officially a disease of the past, relegated to the annals of history with conditions such as smallpox and bubonic plague.
But more than 210,000 people across the globe still contract it annually.
The disease, which affects the skin and nerves, causing grave damage to the hands, feet and eyes, is spread by close contact between people, particularly those living in poverty.
Folahan’s four-year-old son will need to be monitored closely.
In 2000, the World Health Organization said that leprosy, a disease long associated with biblical times, was no longer a public health problem with a rate of less than one case per 10,000 people.
“It’s true that leprosy affects fewer people than malaria,” said Beninese doctor Roch Christian Johnson, who is the current president of the International Leprosy Association (ILA), on a return visit to his home country.
“But here 25 percent of the cases detected already have serious and debilitating handicaps.”
In the tiny nation of Benin, between 150 and 200 new cases of leprosy are recorded every year, of which 10 percent are children. That number hasn’t changed much in a decade.
– Rural area –
The screening centre in the heart of Pobe was built by the Fondation Raoul Follereau on the site of a former leper colony and has taken in about 20 patients every year since 2000.
Pobe is situated near the border with Nigeria, Africa’s most populous nation, which every year records some 4,000 cases of leprosy.
“Patients always arrive too late, when their wounds are gangrenous,” said Thierry Gateau, who runs the Pobe centre.
People with leprosy are often farmers like Pascal Boton, who don’t get a diagnosis early enough and damage their numb limbs.
Boton had an accident and didn’t feel anything but, as it does with most cases, the wound got infected and his foot had to be amputated.
“Nurses came to give me medication and then they stopped,” he told AFP.
Without regular treatment, the symptoms of leprosy don’t go away.
– ‘A curse’ –
“It’s a sensitive issue,” said Annick Chauty, a French doctor, who has spent 15 years in Pobe.
“Here leprosy is associated with a curse so we pretend we’ve come to study skin diseases.”
In Benin, “it’s thought to be an illness caused by bad luck”, added Ambroise Adeye, a surgeon for the foundation and the town’s public hospital.
“People with leprosy first go to see traditional healers and that makes things worse. They then have to save up to pay for a consultation.”
But treatment for leprosy, which involves a course of three antibiotics, is free and prescribed in free clinics across Benin.
To spread the word, the National Programme Against Leprosy, run by the country’s health ministry, broadcasts messages on community radio stations and conducts awareness programmes.
– Illness of poverty –
People with leprosy, many of them left disabled by the disease, have seen their houses knocked down and fields trampled. Wives have been thrown out of their homes.
Oladele, a 24-year-old barber, for example has been leprosy free for three years. The only traces of the disease are his slightly clawed fingers.
“I don’t want to go back to the fields. The centre offered me training. I chose hairdressing,” he said.
Sessions with a physiotherapist mean he can hold the cutters and scissors without any problems.
His boss is supportive and his family paid for his apprenticeship. When money isn’t available, the Follereau foundation steps in and pays for rehabilitation.
“There’s better acceptance but people who’ve had leprosy need help,” said Gateau.
It’s possible to make leprosy a thing of the past, he said, but on one condition: “A country needs to develop. Leprosy is still an illness of poverty.”