Renato Torlaschi | MY SPECIAL DOCTOR

Regaining hearing may be possible by reproducing mechanisms found in birds

22 February 20246 January 2024 by Renato Torlaschi

Humans are unable to reverse the effects of hearing loss, but a biological process identified in other animal species may offer an unexpected way to address this widespread problem.

Advancing age or excessive exposure to loud noises can damage the cochlea, a component of the inner ear, causing permanent hearing loss. According to the World Health Organization, a reduction, more or less severe, in hearing affects more than 400 million people worldwide today. Traditional treatment involves the use of hearing aids, the effectiveness of which is highly dependent on the individual.

But scientists have long known that animals such as fish and birds are able to keep their hearing intact by regenerating sensory cells in the cochlea-in fact, mammals are the only vertebrates that are unable to do so.

Back in 2012, Patricia White of the University of Rochester identified a group of receptors responsible for the regeneration process that can activate supporting cells in the auditory system of birds: they called them epidermal growth factor, or Egf. These supporting cells then activate the production of new sensory hair cells.

Now, in a new study that has been published in the European Journal of Neuroscience, Dr. White explains that she has begun a series of experiments to recreate this process in mammals. “The process of hearing repair ,” said the researcher. – is a complex problem and requires a series of cellular events. Sensory cilia cells in the ear need to be regenerated, and these cells need to function properly and connect with the corresponding network of neurons. Our research has identified a signaling pathway that can be activated by different methods and could represent a new approach to cochlear regeneration and, ultimately, hearing restoration.”

Why psoriasis increases the risk of diabetes

22 February 20246 January 2024 by Renato Torlaschi

Previous research had already shown that having psoriasis increases the risk of developing type 2 diabetes. A new study from King’s College London has sought to understand why this occurs; lead author Elizabeth Evans presented the findings at the recent Society for Endocrinology annual conference held in Glasgow.

British researchers studied human and animal skin samples, looking for any molecular alterations associated with psoriasis that might induce diabetes. In doing so, they identified, in the skin of mice with psoriasis, an inflammatory state and insulin resistance, a known risk factor for diabetes. This resistance means that cells do not respond properly to the hormone insulin and do not remove glucose from the bloodstream. Specifically, fat tissue was seen to absorb glucose less readily, and the researchers measured a reduction in levels of glucose transporter type 4, a receptor needed to move glucose into fat cells. In addition, beta cells in mice with psoriasis produced more insulin than those in unaffected mice: the trial authors believe this overproduction is an attempt to compensate for insulin resistance.

In short, the inflammation associated with psoriasis caused insulin resistance and increased insulin production.

But this is just the beginning of the research: now the team wants to identify which factors released by psoriatic skin may play a role in the development of diabetes. The survey results are expected to improve our understanding of this common skin disease and may also help us better understand diabetes.

Elizabeth Evans said, “If we can discover skin-derived factors that directly influence blood glucose control, we can pave the way for the identification of potential therapeutic targets for the treatment of diabetes or insulin resistance.”

Evans E. et al. Skin-endocrine regulation of whole-body metabolism. Endocrine Abstracts (2018) 59 P102.

https://it.wikipedia.org/wiki/File:Psoriasis_of_the_palms.jpg

Probiotics beneficial, but beware of some possible side effects

22 February 20246 January 2024 by Renato Torlaschi

Probiotics are healthy strains of live bacteria and yeast; taking them can provide a number of benefits, but they can also cause side effects. An article in Medscape clarifies how probiotics promote health and how they can be safely taken.

As is well known, there are billions of bacteria and other microorganisms living in the gut-this community makes up the gut microbiota, and more and more research is showing its importance for digestion, gut health, and the whole body, for example, through supporting the immune system. Many bacteria provide benefits to their human hosts, but others cause harm: altering the natural balance of bacteria in the gut can lead to some problems. Products such as certain yogurts, supplements, and fermented foods, including kefir, sauerkraut, and tempeh, contain probiotics, and numerous research suggests that their consumption can lead to an increase in healthier bacteria, which help restore the balance of the gut microbiota.

There is evidence on the positive effects produced by probiotics for various conditions: eczema, obesity, insulin resistance, type 2 diabetes, nonalcoholic liver steatosis, and immune system function.

However, some side effects may occur. Among these, experts list: digestive symptoms, skin problems, allergy risks, increased risks of infections, and bacterial overproliferation syndrome (Sibo).

Finally, albeit rarely, beneficial probiotics may contain antibiotic-resistant genes and could transmit these genes to other strains of bacteria, including dangerous and infection-causing ones. Manufacturers routinely test for antibiotic resistance in the probiotic strains placed on the market; therefore, the advice is to always obtain probiotics from reputable manufacturers.

More generally, it is recommended to read the labeling carefully and not to exceed the indicated dosage, although very little evidence suggests the possibility of probiotic overdose. However, if a probiotic is suspected of causing symptoms or side effects, its dosage should be reduced or its intake discontinued.

Whole grains help prevent liver cancer, according to a US study

19 February 20246 January 2024 by Renato Torlaschi

An increased supply of whole grains and fiber is associated with a reduced risk of hepatocellular carcinoma, the most common form of liver cancer, according to a large observational study with a long follow-up, published in Jama Oncology and coordinated by Xuehong Zhang of Brigham and Women’s Hospital, affiliated with Harvard Medical School in Boston.

Experts have long suspected that diet may be an important risk factor for hepatocellular carcinoma, but until now scientific evidence had only been produced regarding the consumption of certain mushroom-contaminated foods and large amounts of alcohol. In this case, the researchers focused instead on whole grains and dietary fiber, which had already been associated a lower risk of obesity, type 2 diabetes, and nonalcoholic liver steatosis-all known predisposing factors for hepatocellular carcinoma.

The team conducted a cohort study of 125,455 people and examined their intakes of whole grains, their components (bran and germ), and dietary fiber, which are present not only in unrefined grains but also in fruits and vegetables. Study participants were asked to fill out questionnaires regarding their eating habits every two years, and to analyze the data, the researchers then divided the study subjects into tertiles based on their consumption levels of the foods considered.

During an average follow-up that lasted a full 24 years, 141 participants were affected by hepatocellular carcinoma.

Statistical analysis of the data showed that a higher intake of whole grains was significantly associated with a lower risk of this cancer.

“If our results are confirmed, increasing fiber consumption of whole grains could serve as a possible strategy for primary prevention of hepatocellular carcinoma,” Zhang said in an email to Medscape Medical News.

E Nicola McKeown, an expert in nutrition epidemiology from Tufts University in Boston, commented that the benefits of these foods go beyond preventing a specific cancer: “More studies will be needed to ascertain the impact on liver cancer of whole grains, but introducing more of them into one’s diet is a good strategy for improving overall health.”.

New blood test detects eight types of cancer

22 February 20246 January 2024 by Renato Torlaschi

Diagnosing cancer can be complicated and involve unpleasant procedures such as mammograms and colonoscopies; in addition, tumors are often detected only when they have reached a certain size. Researchers are therefore working to find better, less invasive alternatives that can detect cancer earlier, when it is most treatable, through blood.

Now, researchers at the Cambridge Institute in Britain have developed a blood test-or “liquid biopsy” -that can detect eight different types of cancer, including breast cancer, ovarian cancer, skin cancer (basal cell carcinoma among the most common) and brain cancer. This is not the first blood test developed for cancer detection, but this one has the advantage of being relatively quick, as it does not involve the time-consuming genetic sequencing of the patient’s blood.

Instead, the new test works by tracking the carcinogenic Dna circulating in the blood based on its size. Tracking the Dna of a tumor is usually very difficult because it is immersed in a vastly larger amount of healthy Dna, but the British team identified that there are differences in the size of Dna fragments in cancer cells and those in healthy tissue and used them as a key to making the diagnosis. The finding was published in the journal Science Translational Medicine.

The researchers then conducted an experiment to see how effective the new method was in determining the presence of cancer and were able to detect colorectal, bile duct, ovarian, breast and skin cancer in 94 percent of the 68 patients tested. A slightly lower success rate was achieved for pancreatic, kidney and brain cancers, detecting cancer in 65 percent of the 57 patients tested.

The new test is obviously not perfect and also gave a false positive, mistakenly detecting cancer in a healthy patient. However, liquid biopsy is certainly promising, and as study coordinator Florent Mouliere told New Scientist, the blood test could easily be performed by commercial laboratories, meaning the transition from research lab to real life may not be too far away.

Mouliere F et al. Enhanced detection of circulating tumor DNA by fragment size analysis. Science Translational Medicine 07 Nov 2018: Vol. 10, Issue 466, eaat4921.

https://pixabay.com/en/medicine-withdrawals-nurses-3493688/

Zika, prenatal blood test may intercept unborn child’s defects

22 February 20246 January 2024 by Renato Torlaschi

Two years ago, the Zika epidemic had terrified pregnant women residing in regions endemic to the virus, such as Brazil and even parts of the United States. Their fear was justified by the link between Zika virus infection during pregnancy and the risk of some serious birth defects in the unborn child, particularly the condition known as microcephaly, in which there is incomplete skull development, mostly accompanied by mental failure.

The absence of early prenatal diagnosis or treatment has led to enormous concerns and numerous pregnancy terminations. Fetal MRI captures high-resolution snapshots of the fetus, but this imaging technique can be used only in the second or third trimester, when terminating a pregnancy is more complex.

At University of Southern California, a team of researchers is studying the mechanisms behind the devastating consequences of Zika with the goal of developing new prenatal diagnostic tests that can determine whether babies will be born healthy and now, as can be read in their study published in JCI INsight, have taken a significant step forward.

“Our results,” the authors write in The Conversation. – revealed an elevated production of 16 specific protein biomarkers found in the blood of pregnant women who gave birth to children with developmental delays and ocular abnormalities. These biomarkers are potentially useful for predicting Zika pregnancy outcomes simply by using blood samples from the mother-to-be at any stage of pregnancy.”

The number of Zika cases has decreased dramatically following the decline of major outbreaks in 2016, yet many children are still suffering from the terrible consequences of prenatal infection. And the risk of new outbreaks is by no means averted, as the Zika virus has not been eradicated and Aedes mosquitoes-which are its transmission vector-are still widely spread.

Source: Foo SS et al. Biomarkers and immunoprofiles associated with fetal abnormalities of ZIKV-positive pregnancies. JCI Insight. 2018 Nov 2;3(21).

https://www.flickr.com/photos/dcmot/24977548510

Severe acne, the mode of hair follicle formation may be at the root

22 February 20246 January 2024 by Renato Torlaschi

Why do some people suffer from severe acne? A large genetic study reveals that hair follicle formation may be the key: published in Nature Communications, it examined 26,722 individuals, of whom 5,602 suffered from severe acne.

The study was conducted by a team of British researchers, who identified 15 regions of the genome linked to the development of acne, 12 of which had not previously been linked to the condition. Many variants have been seen to influence hair follicle formation, a previously unknown risk factor.

Acne is one of those conditions that still has no perfect treatment, with expensive creams and pills providing some benefits but often not completely solving the problem. The large British study suggests that we may have overlooked an important factor in determining its development. “Applying these genetic approaches to acne is something totally innovative and a significant step forward,” said one of the authors, Jonathan Barker of King’s College London.

The researchers were surprised by the fact that there are numerous genetic variants that seem to affect the structure and function of hair follicles and hypothesized that some of them make this structure more prone to inflammation and bacterial infection, which are typical manifestations of acne.

One of these variants, called WNT10A, is related to ectodermal dysplasia, a condition that causes sparse, thin hair as well as physical abnormalities of the nails, teeth, skin, and glands. About 22 percent of the variability in characteristics observed in acne patients was explained by the genetic variants examined in the study, but the researchers believe that other regions of the genome also contribute to the disorder, the mechanisms of which remain largely unknown. Some genetic variants point to interesting mechanisms that could be good targets for new drugs or treatments that are more effective and have fewer side effects than current ones, such as those associated with isotretinoin, now widely used to treat severe forms of acne that do not respond to other therapies.

Ebola, new rapid test may help control the spread of the virus

22 February 20246 January 2024 by Renato Torlaschi

In the general silence of the Western media, the second largest Ebola outbreak in history has been raging in the Democratic Republic of Congo for several weeks, with hundreds of deaths.

Since the first patients were diagnosed in North Kivu province in late summer, experts from the World Health Organization and other public health groups have been working to contain the spread of the virus and, given the emergency, have resorted to several experimental vaccines, licensed for human administration even before approval by regulatory agencies, under a protocol for compassionate use.

One of the difficulties in preventing the spread of virus outbreaks is the lack of rapid and accurate diagnostic tests. Currently, blood must be drawn from infected suspects and the samples sent to a laboratory for analysis: the process takes several days, and during this time infected people may continue to move within the community even when they should be quarantined.

As you can read in Science Translational Medicine, a potentially revolutionary breakthrough comes from an international research team that has developed a portable, battery-powered device that can detect the presence of Ebola virus particles in a small blood sample in less than 30 minutes.

In early evaluations, conducted in both animal and human models, the device correctly identified 90 percent of Ebola cases and provided only 2.1 percent false positives.

The researchers were surprised by an unexpected fact: although developed for the diagnosis of Ebola, the test proved capable of indentifying malaria, with 100 percent sensitivity and 99.6 percent specificity, and Lassa fever.

The test makes use of surface-amplified Raman spectroscopy, commonly called Sers, a technique that exploits the amplification of Raman scattering by molecules absorbed on an irregular metal surface: normal cells, viruses, and the malaria parasite reflect light in different, recognizable ways, which the device is able to intercept. “If the results are confirmed,” the authors wrote , “the technique may be useful in outbreaks of febrile-type infectious diseases.

Vegetable charcoal: useless, indeed harmful

22 February 20246 January 2024 by Renato Torlaschi

On her website, Gwyneth Paltrow stated that activated charcoal lemonade is one of the “best juices,” and products containing this substance are becoming increasingly popular. But its supposed detoxifying action is another case where amateur nutritionists misinterpret the properties of a food.

Some sellers of these products claim that charcoal can increase energy, make the skin glow and reduce swelling; however, its main virtue would be its ability to detoxify the body.

It is easy to understand the origin of this belief: in fact, activated charcoal is used in emergency medicine to reduce the toxic load when someone has ingested a poison or taken an overdose of drugs: the charcoal binds to the poison in the gastrointestinal tract and prevents it from being absorbed into the bloodstream; the toxins are then excreted from the body through the feces.

However, according to experts, the detoxifying action of charcoal is a myth and indeed there are several reasons why it should be avoided.

The first is that activated charcoal binds with a whole range of beneficial substances found in food, including certain vitamins, minerals and antioxidants; charcoal is sometimes added to fruit and vegetable juices, with the result that many of the vitamins in them are not absorbed by the body. Of course, activated charcoal acts similarly with respect to certain drugs, including some antidepressants and anti-inflammatories, reducing their effectiveness-the negative health consequences are easy to see.

It should then be pointed out that charcoal only binds with substances that are in the stomach or intestines at the time it is taken, since it works through direct contact: if the intention is to detoxify from alcohol or unhealthy foods consumed the night before, it will have no action, because these will have already been absorbed by the body.

Finally, activated charcoal slows bowel function and can cause nausea and constipation.

In short, it is a useless, undigestible substance that makes food less nutritious.

A new test allows each person’s internal clock to be read

22 February 20246 January 2024 by Renato Torlaschi

It is called TestSignature and it is a new patented method of reading the time marked by the human body’s internal clock.

It is well known that an internal clock, the circadian rhythm, regulates a huge variety of processes: when you sleep and wake up, when you are hungry, when you are more or less productive. Given its palpable effect on so much of our lives, it is not surprising that it has a huge impact on our health as well. Researchers have linked circadian health to higher or lower risk of diabetes, cardiovascular and neurodegenerative diseases. It is also known that the timing of when meals are eaten and medications are taken can affect how they are metabolized.

The ability to measure each person’s internal clock could therefore prove invaluable for fundamental to improving health and personalizing medicine; it could be used to predict who is at risk of illness, monitor recovery from injuries, and more.

For these reasons, the development of a method to read the internal clock is a challenge that has engaged many scientists in recent years, and until now the best approach required taking blood every hour, for a full day and night, and measuring levels of melatonin, the hormone that controls sleep, which was obviously expensive and very inconvenient for the patient, so much so that routine use was impossible.

But now we are on the verge of a breakthrough, thanks to a test developed by a team at Northwestern University Feinberg School of Medicine in Chicago, coordinated by biologist Rosemary I. Braun, which promises to be effective with just two blood tests that can be performed at any time of day.

Simplicity for the patient is the result of a highly sophisticated approach. In fact, the test involves the evaluation of 40 markers, which were identified through a machine-learning algorithm: the program learned to read the time of the internal clock based on the expression of as many as 20 thousand genes, and thus paved the way for a whole new round of research to understand its true clinical potential.

Braun R, Kath WL, Iwanaszko M, Kula-Eversole E, Abbott SM, Reid KJ, Zee PC, Allada R. Universal method for robust detection of circadian state from gene expression. Proc Natl Acad Sci U S A. 2018 Sep 25;115(39):E9247-E9256.

Basal cell carcinoma, unclear which technique is best

22 February 20246 January 2024 by Renato Torlaschi

A systematic review and meta-analysis of 40 randomized clinical trials and five nonrandomized clinical trials evaluated the efficacy and safety of treatments for basal cell carcinoma, the most common form of skin cancer. At the end of his effort, Aaron M. Drucker of Brown University (Rhode Island) andthe University of Toronto, the study’s coordinator, commented on the findings, “I was very surprised by the lack of scientific evidence behind several interventions that are often used to treat this cancer.”

Drucker gave the example of curettage and electrodissection surgery, in which the superficial part of the tumor is scraped off and then the base of the tumor is burned: ” It is one of the most frequently used treatments for basal cell carcinoma located on the chest or back, but we have not found any clinical trials that have evaluated its efficacy at these sites.”

Surgical removal is widely believed to be the gold standard for the treatment of basal cell carcinoma, but the relative safety and efficacy of the various techniques are unclear.

The work of the American researchers made it possible to calculate the average recidivism rates, which were similar after excision (3.3 percent), Mohs surgery (3.8 percent), curettage and diathermy (5.9 percent), and external radiation (3.2 percent), while they were substantially higher after cryotherapy, curettage and cryotherapy, 5-fluorouracil administration, imiquimod treatment, and photodynamic therapy (PDT) with methyl-aminolevulinic acid or aminolevulinic acid.

Surgical excision without intraoperative margin assessment was associated with the lowest rates of lack of histologic clearance. Rates for other treatments were higher but inaccurately estimated.

The authors also examined patients’ reactions to the cosmetic results, which were found to be better after photodynamic therapy than after standard excision, cryotherapy, or PDT combined with laser preparation of the lesion.

Drucker AM, Adam GP, Rofeberg V, Gazula A, Smith B, Moustafa F, Weinstock MA, Trikalinos TA. Treatments of Primary Basal Cell Carcinoma of the Skin: A Systematic Review and Network Meta-analysis. Ann Intern Med. 2018 Sep 18. [Epub ahead of print]

Obesity, disease or choice?

22 February 20246 January 2024 by Renato Torlaschi

In 2013, theAmerican Medical Association (AMA) declared obesity a disease, requiring a range of interventions to promote its prevention and treatment.

Five years later, U.S. health care professionals are still not fully aware of this, the surprising results of a survey conducted for Medscape, the well-known medical portal, reveal.

When asked whether obesity should be considered a disease, only 57 percent of respondents answered in the affirmative, and more than one-third of health professionals do not consider it a disease state, a percentage that is even higher among primary care physicians.

According to experts, the persistence of this belief is an obstacle in finally addressing a situation that is reaching pandemic proportions. “It’s time for us to recognize obesity as a disease, ” says endocrinologist Akshay Jain. Until we medical professionals take obesity seriously, we will be ineffective in treating its biopsychosocial and economic consequences. Defining obesity as a disease is the first step toward objectively assessing the factors that cause it and its prevention and treatment.”. There are several reasons why obesity is to be considered a disease: first, it is associated with impaired body function; second, it results from the dysfunction of a complex system of physiological regulation, fostered by multiple factors particularly present in today’s societies.

Finally, it should not be forgotten that obesity causes, worsens, or accelerates more than 160 comorbid conditions that arise as metabolic, structural, inflammatory, degenerative, neoplastic, or psychological complications of obesity itself, significantly affect the quality of life and also its duration.

So that the misconception that obesity is simply a choice can be overcome, the American Association of Clinical Endocrinologists has proposed to change its name and rename it as “chronic adipose disease,” so that it is readily recognized as a real health threat and not just a cosmetic problem.

Postpartum depression: possibly linked to an inflammatory state

22 February 20246 January 2024 by Renato Torlaschi

Birth is always a serene and joyful event. In some cases, however, it can generate in the new mother a series of worries, negative thoughts and feelings of inadequacy that, if not overcome within a few days, are amplified, spiral out of control and acquire the connotations of so-called postpartum depression. This is a complex condition that, based on estimates, affects at least 10 percent of women who give birth and also affects the well-being of the newborn and the entire family unit.Inflammatory status

Although numerous risk factors are known (e.g., mood disorders, particular personality traits, childhood traumatic events, course of pregnancy), biological markers have never been identified. A recent Swedish study, conducted on 169 women who were asked to complete a questionnaire (a screening tool for depression) at 17, 32 weeks and after delivery, sought to identify possible indices. The researchers focused specifically on inflammatory parameters, evaluating as many as 70 different ones. Of these, 5, in particular, were found to be markedly higher in the 62 women who showed depressive symptoms, and may be future candidates for a small blood test battery. The interpretation of these results is in line with what was already known, namely that the transition from pregnancy to postpartum is characterized by a complex adaptation pathway of the immune system. A pathway that in women predisposed to depression seems less flexible and smooth, to the point of theorizing a link between extent of depressive symptomatology and level of inflammation.

The topic requires further study and confirmation, but these data lead one to hope for at least two practical aspects, namely the availability of a tool that allows not only reliable recognition of depression, whose manifestations are often subtle and not easy to catch, but also an assessment of its potential severity.

Depression, an algorithm can diagnose it by analyzing Facebook posts

22 February 20246 January 2024 by Renato Torlaschi

There are many articles and essays suggesting connections between social media use patterns and various forms of mental illness, but today it appears that these same sites can be used to diagnose certain cases of depression early , even before those suffering from it seek clinical attention.

Researchers at Stony Brook University and the University of Pennsylvania have developed an algorithm that analyzes the language used on Facebook to predict a user’s diagnosis of depression.

“What people write on social media and online captures aspects of life that medicine and research find difficult to access by other means;- said one of the authors, Andrew Schwartz – it is a relatively unused dimension to the biophysical markers of disease, yet people suffering from anxiety, depression, or post-traumatic stress disorder leave many signs of their condition in the way they express themselves through digital media.”

Thealgorithm, described in a paper published in Proceedings of the National Academy of Scientists, was created using 524,292 Facebook updates, some of which were from individuals who were later diagnosed with depression. Researchers identified the most frequently used words and phrases and classified them into 200 categories to identify so-called “linguistic markers associated with depression.”

To validate the effectiveness of the software, the researchers then analyzed the content and frequency of the posts of 683 Facebook users; of these, 114 had already been diagnosed with depression, and the algorithm was able to identify them through language markers. Reportedly, people with depression are more likely to use pronouns referring to their own person, such as I, my or me, and words expressing sadness(tears, crying, sorrow), loneliness(lack, much, child), anxiety (fear, upset, worry) and hostility.

Eichstaedt JC et al. Facebook language predicts depression in medical records. JAMA Dermatol. 2018 Oct 17. Proc Natl Acad Sci U S A. 2018 Oct 15.

Ankle fracture, cast for six weeks not necessary

20 February 20246 January 2024 by Renato Torlaschi

After an ankle fracture, a cast is often worn for a long time, with all the limitations that come with it. But the duration of immobilization has never been determined on a scientific basis. A recent study shows that the traditional six weeks of immobilization with a cast offers no faster healing than three weeks, while halving the time reduces health risks and improves quality of life.

Tero Kortekangas, an orthopedic surgeon at the Finnish Hospital of the University of Oulu, started from the consideration that remaining in a cast has health consequences: the longer a limb remains immobilized, the greater the likelihood of skin damage, deep vein thrombosis, and stiffness after the cast is removed. It thus enrolled 247 patients, with an average age of 45 years, who had incurred the most common type of ankle fracture between 2012 and 2016 but had not been referred for surgery. Divided into three groups, one third of them were made to wear a cast for the traditional six weeks, one third had the cast removed after three weeks, and the others were fitted with a simple ankle brace.

The degree of recovery was evaluated at three successive points in time: after six weeks, three months, and one year, based on the Oma (Olerud-Molander ankle) index, which is considered the most accurate system for measuring ankle health and is based on a scale of one to one hundred, where the highest scores correspond to the best condition.

After one year, as can be read in the British Medical Journal, those who had worn the cast for six weeks had the least favorable results, with an average score of 87.6 compared with 91.7 recorded in the group in which the cast was maintained for only three weeks. Also at the last follow-up, patients in all three groups showed a similar situation with regard to both the absence of pain and quality of life, but those who had worn an ankle bracelet were able to perform a slightly larger ankle movement.

It is true that ankle fractures are not particularly common, but the implications could be much broader. In fact, as Kortekangas pointed out, the result could also apply to fractures occurring in other bone segments, and so the study opens the way for a whole series of new insights.

Good oral hygiene could help prevent Alzheimer’s disease

21 February 20246 January 2024 by Renato Torlaschi

According to surprising research published in the journal Science Advances, there is a significant link between the bacterium Porphyromonas gingivalis-the leading cause of periodontal disease-and Alzheimer’s disease.

In fact, a group of scientists from the University of Louisville, Kentucky, detected the presence of P. gingivalis in the brains of deceased people who had suffered from Alzheimer’s disease. The researchers also detected the bacterium’s Dna in spinal fluid and some toxic enzymes that are produced by the microorganism, gingipains, in the brain, where they measured higher levels of tau protein and ubiquitin, both linked to Alzheimer’s disease.

Interestingly, the brains of 50 cadavers used as controls, of elderly people who did not have Alzheimer‘s disease, had low levels of gingipain instead. This is an important result, because it is true that previous studies had already found an association between P. gingivalis and Alzheimer’s disease, but it was unclear whether poor oral care was only a side effect of dementia: it now appears that the opposite is true and that oral pathology may promote the development of Alzheimer’s disease.

For confirmation, the team conducted an experiment on laboratory mice for the purpose of testing whether P. gingivalis could enter the brain following oral infection and found that within six weeks this very passage occurred; they also observed dying nerve cells and high levels of beta-amyloid protein, a hallmark of Alzheimer’s disease.

The study does not prove that the bacterium causes Alzheimer’s, but that it is a likely contributing factor in the development of the disease.

“We know that diseases such as Alzheimer’s are complex and have multiple causes, but strong genetic evidence indicates that factors other than bacterial infections are central to the development of Alzheimer’s; therefore, these new findings need to be evaluated in the context of existing knowledge,” commented David Reynolds, scientific director of Alzheimer’s Research UK.

U.S. researchers even managed to find a way to kill P. gingivalis in the brains of mice; they used a compound targeting gingipain enzymes to successfully eliminate them, reduce neurodegeneration and beta-amyloid protein formation.

Rosacea: drinking coffee reduces the risk of being affected by it

22 February 20246 January 2024 by Renato Torlaschi

Adding to the long list of scientific insights that have demonstrated health benefits associated with coffee consumption, a new study published in JAMA Dermatology reports that women who regularly drink non-decaffeinated coffee have a reduced likelihood of being affected by rosacea.

It is a pathological skin disorder, usually affecting the central area of the face and manifested by erythema and inflammatory lesions similar to those produced by acne.

Researchers at Brown University in Providence, Rhode Island, correlated the protective effect with the amount of coffee consumed: those who drink at least four cups a day are 23 percent less likely to contract rosacea than those who do not drink coffee.

The authors of the research, led by Professor of Dermatology and Epidemiology Wen-Qing Li, analyzed data produced by an earlier cohort study that had collected dietary and medical information from tens of thousands of nurses between the 1990s and early 2000s in order to examine risk factors for major diseases.

For their statistical analysis, Li and his colleagues included information on caffeine intake reported by each subject, collected between 1991 and the final follow-up in June 2005. To reduce the risk of confounding factors as much as possible, the team adjusted the calculations to account for the influence of smoking, alcohol intake, body mass index, and physical activity level, all of which have been linked to the onset of rosacea.

It was thus shown that the
caffeine
contained in other beverages or chocolate is not associated with a reduction in rosacea, as well as the decaffeinated coffee. Therefore, the authors speculate that only the unique combination of caffeine and other bioactive compounds found in coffee can counteract rosacea symptoms through vasoconstrictive and anti-inflammatory mechanisms, although this will need to be confirmed by future research.

Li S et al. Association of Caffeine Intake and Caffeinated Coffee Consumption With Risk of Incident Rosacea In Women. JAMA Dermatol. 2018 Oct 17.

New test detects cervical cancer in 100% of cases

21 February 20246 January 2024 by Renato Torlaschi

A new test to diagnose cervical cancer, developed by researchers at Queen Mary University of London, has shown a 100 percent success rate, significantly outperforming diagnostic tests that are currently used, such as the Pap test and Hpv test.

Hpv, also known as human papillomavirus, is responsible for the vast majority of cervical cancer cases worldwide and is transmitted primarily through sexual activity. There are over a hundred different types, and a small proportion of these are recognized causes of cancer.

The Pap test is the most traditional diagnostic test and involves taking a sample of cells from the cervix and examining them under a microscope; it can quickly and early detect the presence of changes, including those that may be due to cervical cancer. Even the current Hpv test consists of taking a small amount of cells from the cervix and detects the presence of the virus rather than the actual risk of developing cancer: it is more effective than the Pap test, but Hpv often does not cause any problems, so many women who test positive undergo completely unnecessary stress.

Neither method is 100% effective, however.

The test developed by the London researchers was put to the test in a randomized clinical trial conducted in Canada among 15,744 women aged 25-65 years, and the result was resoundingly positive, detecting all eight types of invasive cervical cancers that developed in women, while the Pap test detected only a quarter and the Hpv test half.

The results were published in theInternational Journal of Cancer, which specified that the new test makes use of knowledge about epigenetics: instead of analyzing changes in the genetic code, it focuses on the ways in which genes are expressed, that is, when they “turn on” instead of remaining inactive.

“This is a huge development,” said study coordinator Attila Lorincz, ” Not only are we amazed at the way this test detects cervical cancer, but it is the first time anyone has demonstrated the key role of epigenetics in the development of a major solid tumor.

Regaining hearing lost with age may be possible

22 February 20246 January 2024 by Renato Torlaschi

Hearing loss due to old age impacts many people and often finds its cause in the depletion of those sensory receptors known as hair cells. At birth there are about 15,500, but they do not regenerate over time. Loud noises, infections, toxins, and the natural aging process damage them, which can lead to hearing loss.

However, researchers may now have found a way to regenerate them. In a study published in the European Journal of Neuroscience, a team coordinated by Patricia White of the University of Rochester in upstate New York has shown that it is possible to regrow hair cells in the cochlea of mice. This major breakthrough was made possible through the study of birds, whose bodies are capable of regrowing these cells, as is the case for other vertebrates, but not of mammals.

“From this point of view,” says Jingyuan Zhang, co-author of the study, “ mammals are an extravagant exception in the animal kingdom when it comes to cochlear regeneration.

As early as 2012, Patricia White found that hair cell generation is promoted by neighboring cells; in birds, it is a family of receptors called epidermal growth factor (EGF) that activates supporting cells. In mammals this signal is blocked, so the researchers looked for a way to turn it on temporarily.

They tried three different methods, all focused on a specific receptor called ERBB2, which is found in the supporting cells within the cochlea, and finally succeeded in reactivating it and achieving the desired effect. ERBB2 stimulated the supporting cells, and as they began to multiply, neighboring stem cells transformed into new sensory hair cells. In addition, hair cells naturally integrated with nerve cells. This is a crucial step without which regaining hearing would not be possible.

“The process of hearing repair ,” explains Patricia White. is a complex problem and requires a series of cellular events; regeneration of sensory hair cells is necessary and that these cells function properly, connecting with the network of neurons. This research could represent a new approach to cochlear regeneration and ultimately to hearing restoration.”

Zhang J, Wang Q, Abdul-Aziz D, Mattiacio J, Edge ASB, White PM. ERBB2 signaling drives supporting cell proliferation in vitro and apparent supernumerary hair cell formation in vivo in the neonatal mouse cochlea. Eur J Neurosci. 2018 Sep 30.

In elderly men, hyperglycemia increases the risk of fractures

21 February 20246 January 2024 by Renato Torlaschi

According to Japanese researchers, elderly men with hyperglycemia have an elevated risk of osteoporosis fracture.

In an article published on the online site of the journal Bone, Masayuki Iki of Kindai University School of Medicine, Osaka, reported the results of a study of a large sample of elderly community-dwelling residents, in which those with type 2 diabetes mellitus showed a higher likelihood of incurring fractures than their healthy peers.

Masayuki and his colleagues enrolled men aged 65 and older and followed them with regular follow-ups for five years. After excluding those with a history of type 1 diabetes and those who had been on thiazolidinedione, an antidiabetic drug, the team analyzed data on 1,951 subjects: of these, 200 had type 2 diabetes diagnosed at the start of the trial.

Osteoporotic fracture has been defined as a radiographically confirmed fracture occurring at any skeletal site except the head, fingers, lower thigh, and foot, and occurring in the absence of the application of an external force that may have caused the injury.

Compared with participants who had normal blood glucose values, those with hyperglycemia such as to configure the presence of diabetes (glycated hemoglobin of 6.5% or higher) had a significantly higher risk of osteoporotic fracture, with a hazard ratio that remained at 2.76 (thus nearly tripling) even after excluding confounding factors such as insulin use.

An elevated risk of osteoporotic fracture of the spine, hip, proximal humerus, or distal radius was also observed in participants who fell into a pre-diabetic category (with glycated hemoglobin of 5.7 percent or higher but less than 6.5 percent).

In contrast to previous studies, the relationship between high glycemic levels and fractures appeared to be linear: as the former increased, the risk of fracture increased in a directly proportional manner.

Limit skin damage by sunbathing every other day and tanning more

22 February 20246 January 2024 by Renato Torlaschi

While the tan summer is fading with November rains, comes a study that can help you make the most of exposure to the rays of the sun. We know that this is a difficult balancing act: too much sun can lead to skin cancer, too little to the Vitamin D deficiency and to depression; aesthetic considerations can further complicate matters for those who like to have tanned skin.

Sunstroke is the skin’s response to stress involving inflammation, cell proliferation, and repair of DNA damaged by ultraviolet radiation. This painful reaction can begin within minutes of cellular damage, while the production of dark pigmented melanin, which serves to protect against subsequent damaging attacks, takes hours or days.

The discovery of Carmit Levy of Tel Aviv University is that our skin’s response to the sun’s rays works on a 48-hour cycle.

“The results,” Levy said in a note, “were surprising: we expected a synchronization on a daily basis of the cell’s protective cycles.

The study was initially done on laboratory mice: those that were subjected to a cycle of exposure every two days developed darker-colored epidermal cells than those exposed every day or every three days, and more importantly, they did less damage to DNA.

The result was later confirmed for human skin as well. In both mice and humans, it is the MITF (short for melanogenesis associated transcription factor) protein that controls melanin production and its diffusion into neighboring cells, where it acts as a kind of microscopic sunshade. In both models, Levy found that MITF worked most effectively with exposure every 48 hours.

It is difficult to speculate why such a rhythm was formed in the human body, given that our ancestors exposed themselves to the sun every day, but Levy speculated that there is a connection with vitamin D produced by the skin, which is stable in the blood for 48 hours after sun exposure.

Malcov-Brog H, Alpert A, Golan T, Khaled M, Shen-Orr A, Levy C. UV-Protection Timer Controls Linkage between Stress and Pigmentation Skin Protection Systems. Molecular Cell Oct 25, 2018.

High meat consumption increases the likelihood of hepatic steatosis

19 February 20246 January 2024 by Renato Torlaschi

People who eat a lot of animal protein are more likely to have excess fat in their liver and a higher risk of nonalcoholic fatty liver disease (NAFLD) than people whose main source of protein is vegetables. This is suggested by a Dutch study from Erasmus MC University Medical Center published in the journal Gut.

Th e researchers, coordinated by hepatologist Sarwa Darwish Murad, examined data obtained from liver fat scans and questionnaires regarding the eating habits of 3,882 people, with an average age of 70 years: 34 percent (1,337) were found to have NAFLD, and among them, 1,205 were overweight.

Overweight people who consumed the most protein from foods of animal origin showed 54 percent greater odds of having fatty liver than people who consumed less meat.

“The association,” Murad explained, “was maintained independent of other recognized risk factors for steatosis, such as metabolic and sociodemographic factors, lifestyle, and, especially relevant, even total caloric intake

Study participants without fatty liver consumed an average of 2,052 calories per day, compared with 1,996 calories per day for people with fatty liver; the latter also got a larger share of their total calories from protein. Vegetable consumption was similar in both groups, while meats accounted for the most noticeable difference in protein consumption.

The study has methodological limitations, acknowledged by the authors themselves, who also relied on questionnaires, which may be unreliable, to assess participants’ diets and caloric intake, and did not collect other data related to possible nondietary causes of fat accumulation in the liver, such as viral infections or taking certain medications.

But these findings add to other evidence confirming the potential of healthy eating habits to minimize the risk of steatosis, even when people have a genetic risk for the condition. Experts suggest that people should limit red and processed meat and follow a Mediterranean diet, rich in whole grains, vegetables and olive oil.

Sunscreens: fda proposes new safety rules

19 February 20246 January 2024 by Renato Torlaschi

The Food and Drug Administration (Fda) has issued a plan – long overdue – to update product regulations for the protection sunscreen marketed in the United States. The move could mean major changes to widely used sunscreens, many of which contain chemicals that the regulatory agency says have not been proven safe.

“Since the initial evaluation of these products was done, we have accumulated a great deal of new knowledge about the effects of the sun and how sunscreens are absorbed through the skin,” Fda Commissioner Scott Gottlieb said in a note.

Over-the-counter sunscreen products are regulated by the Fda under the Sunscreen Innovation Act, a process put in place in 2014, but some ingredients can be marketed without going through this screening because they are generally considered safe.

The new regulation proposes to maintain free distribution, without the need for further approvals, of certain ingredients and formulations, such as zinc oxide and titanium dioxide, but two substances have disappeared from the list: PABA and trolamine salicylate, now deemed “unsafe,” and, for 12 other ingredients, the Fda has asked manufacturers for new data confirming their safety.

Labels will also have to change: active ingredients will have to appear prominently, and there will be informative claims about the consequences of excessive sun exposure for aging skin and melanoma risk.

The maximum sun protection factor (Spf) value will be allowed to increase from +50 to +60; “we believe there is no data to support additional benefits by a factor of more than 60.”, said Theresa Michele, director of the Fda’s OTC Products Division, but the agency is proposing to allow products with Spf up to 80, to give manufacturers more flexibility. In any case, sunscreens with protection of at least 15 should also provide broad-spectrum protection; then, as the Spf increases, protection against Uva rays should also increase. As usual, the Fda solicits participation in decisions from insiders and ordinary citizens, who are given three months to submit comments and proposals.

Improvements to coronary plaque with biologic therapy for psoriasis

18 February 20246 January 2024 by Renato Torlaschi

ILa biological therapy in patients with psoriasis severe is associated with significant improvements in coronary plaque characteristics, according to new research coordinated by Nehal N. Mehta, of the National Heart, Lung, and Blood Institute in Bethesda, USA, ad published in Cardiovascular Research, a journal of the European Society of Cardiology.

The severe psoriasis is characterized by a high risk of myocardial infarction early and coronary artery disease rates similar to those of type 2 diabetes, and in affected patients, the extent of noncalcified plaque correlates significantly with both traditional cardiovascular risk factors and psoriasis severity.

Mehta and colleagues characterized coronary plaque before and after therapy in 121 individuals with moderate to severe psoriasis. Of these, 32 received topical treatment and 89 received biologic therapy, of three different types: anti-TNF, anti-IL12/23 or anti-IL17.

After one year of follow-up, in patients treated with biologic drugs, the U.S. researchers found a 5 percent reduction in total coronary plaque and also in non-calcified plaque, while in those who had undergone topical therapy there was no significant improvement. Indeed, in the latter subjects, coronary artery disease has progressed, and part of the fibrous component of the plaque has converted to fat-fibrous, signaling a lipid infiltration whose consequences are well known: the fibrous wall thins and may eventually rupture, increasing the risks of thrombus formation.

Patients treated with biological therapy also improved in terms of systemic inflammation, although the authors themselves recommend caution and urge larger, randomized studies.

However, optimism is also warranted because the result adds to that of previous research, in which biological therapy was seen to reduce the risk of a new cardiovascular event in subjects who had already had a myocardial infarction.