NOTICIAS DIARIAS

Highlights

Gastroenterology

Younger People Getting Cancer Due To Obesity

The researches find that the obesity rates around the globe are ballooning - literally! Approximately 1.9 billion adults who are 18 years and older were overweight in 2016, and of these; more than 650 million were obese. The number of obese people has nearly tripled since 1975. Therefore among younger people, the rates of obesity increase uncontrollably. An estimated 340 million children and adolescents between the ages of 5 and 19 years old were overweight or obese in the same year.
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Cells Have A Built In Self Destruct Mechanism Strands Of DNA

Cells Have A Built In Self Destruct Mechanism Strands Of DNA

Healthy cells have a built in self destruct mechanism; Strands of DNA called "telomeres" act as protective caps on the ends of your chromosomes. Each time a cell replicates, telomeres get a little shorter. Think of it like filing your nails with an Emory board after enough filing, you hit your fingertip ouch; In the case of healthy cells, after enough replications, telomeres are "filed" away, leaving bare ends of the chromosomes exposed.
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General medicine

Poor Water Quality Linked To Sugar Drink Consumption

The researches find that the consumption of sugary drinks is common among Aboriginal and Torres Strait Islander infants and toddlers, and it could be down to water quality, according to a study from The Australian National University (ANU). Therefore Lead author, Dr. Katie Thurber, says there are clear opportunities to improve nutrition for Aboriginal and Torres Strait Islander children, as well as non-Indigenous children, across Australia. But "Families living in regional and remote settings have expressed concern about the safety and quality of drinking water," said Dr. Thurber, from the Research School of Population Health.
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Burst Firings Appeared In The Culturing SCN Slice Of Fetal Mice

Burst Firings Appeared In The Culturing SCN Slice Of Fetal Mice

The study finding that burst firings of 35–80 Hz appeared in the culturing SCN slice of fetal mice; and obscured the circadian firing rhythm when GABA signaling was genetically or pharmacologically disrupted. Calcium spikes, which synchronizing with burst firings; were also observing in GABA-deficient SCN. Researchers discover role of GABA neurons in the central circadian clock.
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hematology

Hemophilia Much More Prevalent Than Previously Thought

The study find that the inherited bleeding disorder of hemophilia, and 418,000 of those have a severe version of the mostly undiagnosed disease, says a new study led by McMaster University researchers. This is three times what is previously know. Only 400,000 people globally are estimated to have the disorder which is cause by a defect in the F8 or F9 gene which encodes instructions for making the factor proteins that helps blood clot. For those with ; lack of treatment leads to chronic and disabling joint disease; while bleeding into organs and brain hemorrhages can lead to disability and death.
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Inadequate Sleep Is Most Difficult Problems Faced Night Workers

Good sleep at any age is essential to overall health. But for 3 million older people in the U.S. who work at night, sound rest is hard to come by. Sleep disruption can lead to depression, cardiovascular diseases and accidents on the job or at home; according to Zhang, who lives in Westford. A UMass Lowell expert on sleep is examining strategies to help night workers get more restful shuteye, critical to preventing ill health effects. By next year, a quarter of the workforce will be over 55 years old. Inadequate sleep is one of the most difficult problems; facing American night workers. Given our increasing understanding of how sleep deficiency contributes to adverse performance; health and safety, finding solutions to this issue has never been more important." Yuan Zhang, associate professor in UMass Lowell's Solomont School of Nursing. Different sleep schedules Zhang is partnering on a four-year; $1.7 million research project funded by the National Institute of Aging to examine how different sleep schedules for night-shift employees age 50 to 65 may help them be more productive on the job. Most employees who work the overnight shift sleep in the morning when they come home; which means they wake up eight or more hours before their next shift. That routine not only has them working when their biological clock wants their body to sleep; Zhang said, but they have been awake longer before starting work. But an alternative schedule may be more beneficial for these workers; according to Zhang. To find out, the research team which includes UMass Lowell nursing majors Rachel Nunes of Foxborough and Janine Reidy of Westwood will recruit 75 study participants who work the overnight shift in the health-care industry to test several sleep patterns for two weeks. While one group of workers will follow their usual routine of sleeping after the night shift, two other groups will sleep continuously for eight hours ;either starting in the early afternoon or as they prefer. Night-shift workers The researchers will also survey a group of 1,000 night-shift workers; and conduct focus groups with a subgroup of the participants to help; determine whether the proposed sleep schedules are acceptable and beneficial in real-world conditions. In her role, Zhang will lead the recruitment of health-care workers to the study, assist with the survey development and study's data collection; facilitate the focus groups and disseminate the study findings to health-care workers. At UMass Lowell, she teaches nursing courses including nursing research at both the undergraduate and graduate levels, proper medication dosing and senior clinical seminars. Jeanne Duffy, a researcher in the Division of Sleep and Circadian Disorders at Brigham and Women's Hospital in Boston and associate professor at Harvard Medical School, is leading the research; which builds upon her earlier work that found participants were more alert, performed better at night and had lower levels of cortisol a hormone that is released in the body when an individual is under stress - in their system when they spent eight hours in bed after attempting to sleep beginning in the early afternoon, Zhang said.

Postpartum Women In Cardiovascular Monitoring By Telemedicine

Since cardiovascular disease is the primary cause; researchers at the University of Pittsburgh School of Medicine and the Magee-Womens Research Institute (MWRI) created a blood pressure home-monitoring program; to rapidly detect concerning trends in postpartum women before their situation becomes critical. To address the rising maternal mortality rate, the American College of Obstetricians and Gynecologists (ACOG); recently upped their recommended frequency for postpartum checkups, starting within three weeks of birth. But right now; only about 66% of new mothers diagnosed with a hypertensive disorder are making it back to the clinic; for what is usually a single follow-up appointment around six weeks postpartum. Blood pressure cuff That figure jumped to 88% when the researchers gave women a blood pressure cuff; and periodically prompted them to text their readings to a nurse, according to a study published today in the journal Obstetrics & Gynecology."They are meeting women where they are instead of saying they have to come to the hospital; for all these blood pressure checks when they have a new baby," said lead author Alisse Hauspurg, M.D., assistant professor of obstetrics; gynecology and reproductive sciences at Pitt. "I think this is supported by recent ACOG recommendations; and is an opportunity to improve care for high-risk women." Between February 2018 and January 2019, the researchers enrolled 499 patients with preeclampsia; eclampsia or chronic, gestational or postpartum hypertension. Each discharged from the postpartum unit with an automatic blood pressure cuff; and instructions on how to take their own readings at home. However, a computerized system integrated with the participants' electronic health records prompts them to take their own blood pressure; and heart rate readings once a day for five days. If their readings are normal, their one-week follow-up appointment is automatically cancelled; which was the case for 43% of the women. Patients taking blood pressure medications start to taper down; and patients who aren't taking any medications decrease the frequency of their readings. Intensive cardiovascular monitoring Abnormal readings lead to an increase in monitoring frequency; and automatically notify the patient's health care provider. Dangerously high readings trigger a trip to the emergency room. Overall, 83% of participants continued the program beyond three weeks postpartum; and 74% continued for four weeks or more. According to the researchers, this study demonstrates feasibility and high levels of engagement in the program, which should be straightforward to expand. "One of the big advantages here is scalability," said senior author Hyagriv Simhan, M.D., professor of obstetrics, gynecology and reproductive sciences at Pitt, and executive vice chair of obstetrical services UPMC Magee-Womens Hospital. "Connecting women in their 'fourth trimester' to online care allows us to engage a larger number of patients over a larger geography with the infrastructure and workforce they already have." Of the 250 women who filled out a post-program survey, 94% said they were satisfied with the experience and 82% said they were more comfortable knowing that a nurse was checking on their health every day. One goal of the program is to bridge care from obstetricians to ongoing albeit less intensive cardiovascular monitoring. So far, 63% of the study participants have either scheduled an appointment or established care with a primary care provider.

Self Monitoring Solution In Mobile App Can Help Uncontrolled Asthma

A study by researchers at Karolinska Institutet shows that a treatment-adjustment algorithm based on lung function and symptoms in a mobile phone is useful for managing uncontrolled asthma. For fuss-free measuring of lung function, the phone connects to a wireless spirometer, and the app can register respiratory symptoms and provide visual feedback on treatment. The study is published in the highly respected European Respiratory Journal. Asthma is a widespread disease that affects around 10 percent of Sweden's population. Approximately half the affect people have so-called uncontrol asthma, and frequently experience breathing difficulties or asthma attacks. Inadequate management and/or incorrect use of medicines are common causes of this. Asthma sufferers' health "Previous research has shown that asthma sufferers' health and quality of life improves with patient education that focuses on self-care, self-testing and clear management plans. Additionally, health and medical care costs fall if patient involvement and knowledge can be leveraged," says Björn Nordlund, pediatric nurse and research group leader at the Department of Women's and Children's Health, Karolinska Institutet, Sweden. Consequently, along with his colleagues, Björn develop a digital, automate self-care system for asthma. Called AsthmaTuner, it enables the measurement of lung function via a wireless spirometer connect to a mobile telephone app. Symptoms are evaluate using questions link to an individual treatment plan. The system was approve for use in medical care in 2018. It is now marketed by MediTuner AB, a company partly own by Bjorn Nordlund. "The system analyses lung function and symptoms in accordance with asthma care guidelines," he explains. "It then gives feedback in the form of automated, doctor-prescribed, treatment recommendation. Users also receive a picture of the inhaler that is to be use and instructions on whether the medication is to be maintained, increase or decreased." Support for self-management The study was carry out in primary care and at the Astrid Lindgren Children's Hospital in Stockholm, Sweden. Its purpose was to evaluate the digital tool's impact on symptoms and whether users more readily remember to take their medicines. The study comprise 77 uncontrolled asthma sufferers aged six and up. Around half of these were children and adolescents. Study participants were randomly chose to use AsthmaTuner for at least eight weeks as a support for self-management; also to receive traditional asthma care with a printed, individual treatment plan for at least eight weeks. "In part, the results were hard to interpret. However, we could see that asthma symptoms improved more with the digital tool than they did with traditional care. Adult patients who use the tool at least once a week also more often remember to take their medicines. Thus, we conclude that this tool can contribute to alleviating uncontrol asthma sufferers' symptoms," says Björn Nordlund. As asthma requires long-term, regular management, the researchers regard the shortness of the study as a weakness. Hence the plans to continue the work. "We do not know if the effects last longer than eight weeks. Thus, we are starting a larger study this autumn. It will run for a longer period and be conduct in Norrtälje's Tiohundra medical care district and pediatric medical care in Stockholm (the Astrid Lindgren Children's Hospital)."

Emergency Departments Are Effective In Monitoring Doctor

Simple button terminals featuring "emoji" reflecting a range of emotions and sentiments stationed around emergency departments (EDs) are effective in monitoring doctor and patient sentiments in real time, a Penn Medicine study found. Traditionally, surveys are mailed or sent electronically to evaluate patient experiences; but response rates can be low and those that respond do so well after the visit. Using touch terminals could help inform immediate adjustments in the emergency departments that would not just better serve patients; but also the clinicians treating them. The findings of this trial were publish Sept. 4 in Annals of Emergency Medicine. "This study begins to shed light on simple, fast ways of identifying trends and providing high-level information on how patients and providers are feeling in real time," said Anish Agarwal, MD, an assistant professor of Emergency Medicine at Penn Medicine. The emergency departments "They want to see if people would even notice these buttons; which they did and they push them a lot." The terminals Agarwal and his fellow researchers use are similar to those use to gauge visitor satisfaction in sports arenas and airports. Each terminal features four buttons; ranging from very positive (green, with a happy face) to very negative (red, with a frowning face). They were establish in three different locations in an urban emergency department to capture the sentiments of three specific groups: doctors, nurses, and patients. As such, one was set up near physician workstations; another at nurses' workstations; also the last at the patient exit. During the five-month study period in 2018, nearly 14,000 sentiments were record across the three terminals, with roughly 68% coming from the provider-facing terminals. The nurses' station terminal record the most sentiments; accounting for 53% of those capture for the study; but across all three terminals, an average of 108 sentiments were record per day; numbers which were encouraging to the researchers. "This work suggests that we can collect real-time provider and patient feedback that we haven't previously been able to identify," said the study's senior author, Raina Merchant, MD, the director of the Penn Medicine Center for Digital Health and an associate professor of Emergency Medicine. The patient exit terminal "This can allow for support when things are going well and addressing challenges when they occur." Although primarily a feasibility study, the researchers did uncover some associations between the record sentiments; also things like identity and patient volume. For instance, high satisfaction numbers; hence were with the patient exit terminal; where positive responses outnumber the negative each day by 25%; on average. "They think our staff are happier when things are working smoothly; times where we can quickly treat people and keep things moving," Agarwal said. Now with evidence that button terminals are use at a high level in the emergency departments; Agarwal hopes to dive deeper on his findings with future work to determine why sentiment shifts happen; also determine the best ways that they can be quickly respond to. "Frictionless feedback is key in helping drive quality improvement in healthcare; also they need to explore more ways in which we can expand it," Agarwal said. "They would argue that the day-to-day frustrations and joy clinicians experience likely contributes to their long-term satisfaction or burnout. So they need to rethink how we engage with providers and patients."

Antiplatelet Therapy In Patients With Atrial Fibrillation

Edoxaban in combination with a P2Y12 inhibitor is noninferior to standard triple therapy for preventing bleeding in patients with atrial fibrillation after coronary stenting. The late breaking results of the ENTRUST-AF PCI trial are present in a Hot Line Session today at ESC Congress 2019 together with the World Congress of Cardiology and published in The Lancet. Patients with atrial fibrillation Until now, no large randomize trial has test the effects of the non-vitamin K antagonist oral anticoagulant (NOAC) edoxaban in combination with antiplatelet therapy in patients with atrial fibrillation following percutaneous coronary intervention (PCI). ESC guidelines recommend a short period of triple therapy (oral anticoagulant, aspirin, clopidogrel); follow by a period of dual therapy (oral anticoagulant plus aspirin or clopidogrel); in atrial fibrillation patients after PCI with stenting. ENTRUST-AF PCI enroll 1,506 patients with atrial fibrillation after successful stent placement for acute coronary syndrome or stable coronary artery disease. Patients were recruit from 186 sites in 18 countries. Participants were randomly allocate to a 12-month antithrombotic regimen of edoxaban and a P2Y12 inhibitor or standard therapy with a vitamin K antagonist (VKA) and P2Y12 inhibitor plus aspirin for one to 12 months. The edoxaban regimen was noninferior to standard therapy for the composite primary endpoint of major bleeding or clinically relevant non-major bleeding. With 128 (17.0%) events in the edoxaban group and 152 (20.1%) events in the VKA group; there was a trend towards less bleeding; but statistical superiority was not met (hazard ratio [HR] 0.83; upper limit of the 95% confidence interval [CI] 1.047). The edoxaban group So the bleeding outcomes were consistent; regardless of bleeding definitions (ISTH, TIMI, BARC); also their individual components. There were four intracranial hemorrhages in the edoxaban group and nine in the VKA group. Fatal bleeding occur in one patient on edoxaban and seven on VKA. Principal investigator Professor Andreas Goette of St. Vincenz-Hospital, Paderborn, Germany said: "The rate of major or clinically relevant non-major bleeding in ENTRUST-AF PCI was comparable to other NOAC studies in atrial fibrillation patients undergoing PCI." So the main efficacy endpoint was a composite of cardiovascular death; stroke, systemic embolism, myocardial infarction and definite stent thrombosis. It occurred in 49 (6.5%) patients in the edoxaban group; also in 46 (6.1%) patients in the VKA group (HR 1.06; 95% CI 0.71-1.59). Hence the study was not power for formal statistical testing of the main efficacy endpoint. No numerical trends were observe for any individual component of the main efficacy endpoint. Professor Goette said: ENTRUST-AF PCI shows that edoxaban base dual therapy (excluding aspirin); so is a safe alternative to VKA-based triple therapy (including aspirin for one to 12 months) in the prevention of major or clinically relevant non major bleeding in atrial fibrillation; patients after successful PCI for acute coronary syndrome or stable coronary artery disease."

Initiative Malaria Outbreak Evolution In South Asia

According to the study, satellites provide meteorological data; including land surface temperatures, atmospheric water content and information about land cover; including forest, shrubland, settlements or water. The initiative Malaria Evolution in South Asia; which was first funded in 2010 is one of 10 NIH-supported International Centers of Excellence for Malaria Research, or ICEMRs. Malaria cases and deaths plummeted by more than 90% in Myanmar between 2010 and 2017, World Health Organization (WHO) figures show, a success largely credited to better rural health services and wider use of treated bednets. But the country still has a higher prevalence than its neighbours in the Mekong region. Several drug-resistant strains are taking hold across Southeast Asia and it is feared these could migrate to Africa where more than 90 percent of cases globally occur. To counter this threat, NASA is deploying "cutting edge" spatial technology to tackle malaria outbreaks before they happen, scientist Tatiana Loboda told AFP. Initiative malaria outbreak She is applying her expertise in geo-spatial and risk modelling coupling with a background in predicting wildfire outbreaks in the US to identify potential hotspots so medicines and health workers can be mobilised in advance. A lot of people use a little spatial modelling but not to the same depth and capabilities as we're doing here. The project is only in its third year but Loboda's team; has already seen a high correlation between the rate of deforestation and the disease. One unproving theory is that these areas often dotting with logging sites, mines; and plantations are host to a disproportionate number of migrant or seasonal workers; bringing with them new strains of the parasite. Immune to geopolitics The Maryland University team is working closely with local government and military scientists, collecting data from civilians and troops respectively. But that brings challenges in a country where the armed forces keep their operations shrouded in mystery. We're not allowing to ask where they go. This is coupling with a lack of access to Myanmar's myriad conflict areas. But the study working with big data," Loboda bemoaned. "I want to blanket the whole country with random locations but I can't. The project is not immune to geopolitics either. The state of US-Myanmar relations can complicate meetings with the military in the capital Naypyidaw. Sometimes I can go, sometimes I can't

Suicide Are The Second Leading Cause Of Death

Every October, after school starts and each May, as it ends there is a spike in the number of teenagers who go to the Yale New Haven Children's Hospital (YNHCH) emergency department because they are thinking about attempting suicide. They may or may not have struggled with a mental health issue before. But they often have a story: Bullies are harassing them, their parents are divorcing, the academic pressure is crushing them. For some, it's gender concerns they have come out as trans or non binary, and their peers are shutting them out. "It's everything all the pitfalls of being a teenager," says Kirsten A. Bechtel, MD, a Yale Medicine specialist in the YNHCH, where she says 1,500 to 1,700 of the 40,000 patients a year come in for care for anxiety, depression, and other mental health and behavioral problems, and about 500 of those have suicidal thinking or behavior. In some cases, there may be no clear reason at all, she says. Suicide is preventable, but rates of suicide are increasing worldwide, and it is now the second leading cause of death in adolescents and young adults (unintentional motor vehicle accidents are first). Going to the emergency room may be the smartest thing these teenagers can do, Dr. Bechtel says. YNHCH is a Level 1 pediatric trauma center and provides subspecialty care for vulnerable children. Even a single attempt, not to mention an actual suicide, is a tragedy, she says, and a sign that there is a need for more prevention. Satisfying social life However, some of the biggest issues teens face are not new at all, Dr. Poncin says. A common one is loss a romantic breakup, the end of a friendship, a death or divorce in the family combined with underlying psychiatric disorders such as anxiety, depression, and bipolar disorder, which are also on the rise. Another is bullying: In a 2008 study, Yale researchers reviewed studies from 13 countries and found a connection between bullying and suicide. Dr. Lebowitz tells parents who are worried to look at the teen's ability to function. "'Normal' is ultimately the ability to function in way that is in line with expectations for someone of a similar age," he says. For a teenager, that means attendance, performance; also the ability to get along with others at school, he explains. It is having a satisfying social life in and out of school; also the ability to participate in a reasonably functioning family life (whether or not it is devoid of conflict). It includes the "ability to eat, sleep, and get through a day feeling OK," he says. Jennifer Dwyer, MD, Ph.D., a psychiatrist at the Yale Child Study Center; says parents should pay attention if their teenager is chronically angry, cranky, or irritable, since teen depression may manifest through these behaviors rather than strictly through sadness or crying. But sadness can be a symptom too, she adds. Parents also should take note if teenagers are isolating themselves from friends, in constant conflict with the family or peers, having mood swings, giving away their belongings; or increasing their use of alcohol and drugs, she says. Reduction in suicide in adults Ketamine is also associate with a reduction in suicidality in adults; even after controlling for any improvements in depressive symptoms. Ketamine and esketamine are only now beginning to undergo rigorous testing for adolescents with treatment-resistant depression and suicidality. A small randomize clinical trial at Yale show a positive effect of a single ketamine infusion in adolescents with treatment-resistant depression compare to a placebo; but this study only look at short-term (two-week) outcomes. If the crisis warrants going to the emergency room; one of the first things that will happen is a counselor will sit with the teenager and listen to their concerns. In some cases, the patient will be admit to the hospital or refer to YNHCH's Partial Hospitalization Program. But, Dr. Bechtel says; "I'm always amaze how some of these kids are alright. Maybe they need some respite, or maybe the biggest problem is that their behavioral health needs aren't being met in the community," she says. For most young patients; thoughts of suicide are manageable, specialists say. "It may be a lifelong vulnerability, but there are many people who used to have an anxiety disorder or depression," says Dr. Lebowitz. "They need to foster a belief in treatment and the understanding that having these problems can be part of life."