Renato Torlaschi | MY SPECIAL DOCTOR

Chronic kidney disease, genetic analysis promises better therapeutic approaches

18 February 20246 January 2024 by Renato Torlaschi

Chronic kidney disease is often clinically silent, and conventional clinical data alone do not allow differentiation of disease subtypes, but the results of a recent study supports the use of genetic analysis to improve its diagnosis and treatment.

In clinical practice, diagnosis and monitoring of chronic kidney disease are based on clinical parameters and only rarely involve renal biopsy. However, in many cases the disease occurs in a “silent” form and is difficult to discriminate using clinical data alone.

Thus, in many individuals, the precise cause of progressive damage to the kidneys remains unknown and the diagnosis is made late, reducing the opportunity for early therapeutic intervention; moreover, few of the current treatment approaches are individualized, but according to the study published in the New England Journal of Medicine, genetic testing could help overcome these critical issues.

The authors performed exome sequencing (the set of all portions of the genome that “code” for proteins) of 3,315 patients with chronic kidney disease due to different causes and reported a 9.3 percent rate of diagnostic genetic variants, comprising 66 monogenic sites already known to be associated with kidney disorders.

“This study,” reads an editorial in Nature Reviews Nephrology. highlights the potential of genetic testing for adults with chronic kidney disease and end-stage renal disease (Esrd). Discovering the underlying genetics of different forms of kidney disease will serve to improve diagnostic accuracy and develop new approaches according to “precision medicine.” Obtaining a genetic diagnosis for a patient with chronic kidney disease could improve clinical management, including choice of therapy, and enable targeted disease surveillance. Deepening the genetic basis could also reveal new biological mechanisms associated with the disease and lead to defining new therapeutic targets that could benefit a large number of patients.”

Groopman, EE et al. Diagnostic utility of exome sequencing for kidney disease. N Engl J Med. 2019 Jan 10;380(2):142-151.

Artificial skin with superpowers thanks to nanotechnology

18 February 20246 January 2024 by Renato Torlaschi

A new type of sensor could lead to the creation of a skin type artificial that can help burn victims and better protect certain categories of citizens who are particularly exposed due to their professional activities: at an advanced stage of development, it was presented in an article that appeared in Advanced Materials.

The ability of the skin to sensing pressure, vibration, heat and cold are critical to ensuring safety, a function that most people take for granted: those who have suffered burns or who, for whatever reason, have lost skin sensitivity often injure themselves unintentionally.

Chemists Islam Mosa and James Rusling of the University of Connecticut and engineer Abdelsalam Ahmed of the University of Toronto are developing a sensor that can mimic the sensory properties of the skin, but not only that. “It would be very nice,” Mosa said, ” if the new artificial skin could also incorporate capabilities that natural human skin does not possess, such as the ability to detect magnetic fields, sound waves and abnormal behavior.

The team created a prototype sensor with a silicon tube wrapped in copper wire and filled with a special fluid made of tiny iron oxide particles just a billionth of a meter long. The collisions of the nanoparticles inside the silicone tube create an electric current, and the copper wire picks it up as a signal. When the tube is bumped by something that produces pressure, the nanoparticles move and the electrical signal changes. Sound waves are transmitted in the nanoparticle fluid, and again the electrical signal changes, but in a different and recognizable way.

The researchers found that magnetic fields also alter the signal in a way distinct from pressure or sound waves. Finally, when a person wearing the sensor moves, the electric current changes and produces different signals depending on whether he or she is walking, running, jumping or swimming.

This “metal skin” might appear to be a super-power similar to those possessed by comic book heroes, but researchers have designed it to help burn victims be aware again of the sensations provided by normal human skin and, possibly, help those who, through work, might be exposed to dangerous magnetic fields. The device is completely sealed by the rubber exterior and could also be used in water.

The next step is to change the shape of the sensor so that it takes on a flat, more skin-like configuration and see if it maintains the extraordinary properties shown by the test device.

Ahmed A, Hassan I, Mosa IM, Elsanadidy E, Sharafeldin M, Rusling JF, Ren S. An Ultra-Shapeable, Smart Sensing Platform Based on a Multimodal Ferrofluid-Infused Surface. Adv Mater. 2019 Mar;31(11):e1807201.

Alzheimer’s, a protein in the blood detects nerve cell degeneration

17 February 20246 January 2024 by Renato Torlaschi

A new study, recently published in JAMA Neurology, indicates that a simple blood test can reveal whether nerve cells in the brain are deteriorating at an abnormal rate. Researchers analyzed the presence of a protein, the so-called Neurofilament light Chain (NfL), in blood in patients with Alzheimer’s disease, finding a particularly high concentration of the protein.

Blood samples were collected over several years, and on several occasions, from 1,182 patients with varying degrees of cognitive impairment and 401 healthy subjects who made up the control group.

When nerve cells in the brain are damaged or die, the NfL protein enters the cerebrospinal fluid and then the blood: there were already suspicions about this, but long-term studies were lacking.

“We found that, in patients who develop Alzheimer’s disease, the concentration of NfL increases over time and that elevated levels correlate with the extent of accumulated brain damage,” said study coordinator Niklas Mattsson.

As is well known, Alzheimer’s is a complex disease that develops gradually and is difficult to analyze in its early, asymptomatic stages; the disease involves deterioration of cognitive and physical functions along with atrophy and death of brain cells. At present, there is no treatment that can reduce the loss of nerve cells in the brain, and available drugs are able to mitigate cognitive impairment but not slow the course of the disease. Measurements of NfL concentration in blood could be used to assess the effectiveness of a drug in influencing nerve cell loss and determine its optimal dosage.

Mattsson believes the method may soon translate into a standard clinical procedure: “at Sahlgrenska University Hospital in Gothenburg, we are doing the preparatory work to make this method available as a clinical procedure in the near future. Through a simple blood test, doctors will be able to measure nerve cell damage, produced by Alzheimer’s disease or other brain disorders.”.

Mattsson N, Cullen NC, Andreasson U, Zetterberg H, Blennow K. Association Between Longitudinal Plasma Neurofilament Light and Neurodegeneration in Patients With Alzheimer Disease. JAMA Neurol. 2019 Apr 22.

Improving sleep with a smartphone or portable kit is now possible

18 February 20246 January 2024 by Renato Torlaschi

A cutting-edge kit that helps analyze an individual’s microbiome may provide insight into why some people sleep poorly: that’s one of the new technologies that were unveiled at the Consumer Digital Association 2019 Digital Health Summit in Las Vegas, developed for the purpose of improving sleep.

It is not easy to give the doctor objective information about sleep quality or to explain why you have difficulty having deep sleep-it is a complicated problem to describe and solve.

Using the kit, consumers send a stool sample to a laboratory that, using special metagenomic technology, is able to assess the presence of different bacteria in the gut.

In addition to the effect of microorganisms on gluten sensitivity, inflammation, lactose intolerance, weight and metabolism, the analysis examines the levels of bacteria that produce certain neurotransmitters involved in natural sleep rhythms, such as serotonin and gamma-aminobutyric acid (GABA).

The report generated by the microbiome analysis provides information on ways in which diet and lifestyle can help change the bacterial composition of the gut. A second test is recommended to verify the effectiveness of the interventions.

Another technology presented at the summit makes it possible to assess sleep quality. It is in this case a App which can tell whether the user is in a waking, light sleep, deep sleep or REM sleep state: simply place your smartphone on the bedside table to detect, every 30 seconds, the radio frequency and low-power energy emitted by the body. An algorithm built into the App generates a score from 0 to 100 to indicate a person’s sleep quality-the data can provide doctors and patients with objective information.

Again, the instrument not only measures sleep quality but also offers breathing techniques for relaxation and provides personalized advice; it also has a smart alarm clock that sounds during the light sleep phase, when waking up is less traumatic.

According to Daniel Kraft, who works in medicine and neuroscience at Singularity University, an organization dedicated to technology development, these are examples of the kind of tools that will increasingly allow us to affect not only sleep, but different aspects of our health: “Insights into the microbiome, glucose monitoring, metabolic data from respiration, and much more, detectable with a simple handheld device…the combination of all of this gives us new ways to get detailed information. We will be able to use these tools to track not only vital signs, but also behaviors, providing help to change them and make them healthier.”

Effects of nutrition on mortality, extensive research worldwide

17 February 20246 January 2024 by Renato Torlaschi

A new international study, published in The Lancet and carried out on truly huge and significant numbers, assessed the impact of diet on disease-particularly cancer, cardiovascular disease, and diabetes-and mortality between 1990 and 2017 and offers an in-depth look at the various “risk” foods consumed in 195 countries around the world. “While sugars and fats have been the focus of debates over the past two decades,” said Christopher Murray of the University of Washington. Our research suggests that the main dietary risk factors are high sodium intake and low intake of healthy foods, such as whole grains, fruits, vegetables, nuts and seeds.”

In other words: what you do not eat is just as important to your overall health as the harmful foods you consume.

The countries with the highest rates of food-related deaths, in that order, were Uzbekistan (892 deaths per 100,000 people) and Afghanistan, while the lowest related mortality was in Israel (89 deaths per 100,000 people), France, Spain and Japan.

The study found that diets high in salt are among the leading contributors to diet-related deaths, followed by deficient intake of whole grains and insufficient intake of fruits and vegetables.

In particular, low intake of whole grains has been evaluated as a major dietary risk factor for death and disease in India, Brazil, Pakistan, Nigeria, Russia, Egypt, Germany, Iran, and Turkey. Instead, high sodium intake (more than three grams per day) is the main dietary risk for those living in China, Japan and Thailand. It is also noteworthy that in Western Europe and the United States the main risks are from the consumption of red meat, processed meats (cured meats), and sugary drinks, what is now, increasingly, referred to as “junk food.”

Although many experts stressed the high quality of the study, others noted its limitations: the authors ignored many important factors, such as alcohol intake and exercise.

GBD 2017 Diet Collaborators. Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019 Apr 3. pii: S0140-6736(19)30041-8.

Doctor-prescribed fruits and vegetables? Surprising savings for the health care system

18 February 20246 January 2024 by Renato Torlaschi

Healthy foods prescribed as if they were drugs: a new study published in March in PLoS Medicine suggests adopting this strategy in the United States for beneficiaries of Medicare and Medicaid-the two major federal health insurance programs-with the stated aim of reducing the risk of chronic diseases, such as cardiovascular disease or diabetes, while lowering the cost of care.

Making use of computer models, researchers at Tufts University in Boston estimated that healthy food prescriptions could prevent millions of cardiovascular events, such as heart attacks and strokes, and save billions of dollars in health care costs.

To run the simulations, the authors included people between the ages of 35 and 80 years and enrolled in Medicare or Medicaid; as part of the modeling, they used data from the three most recent surveys on the health and nutrition of U.S. citizens, as well as those produced by published studies in the literature and meta-analyses that included demographic information, dietary habits, and health care costs.

Several hypotheses were examined in the study: including an estimate of the impact that a 30 percent discount for purchasing doctor-prescribed healthy foods might have.

Already limiting prescriptions to
fruits and vegetables,
now consumed in insufficient quantities in the U.S., it has been estimated that 1.93 million cardiovascular events could be avoided, with a total savings of $39.7 billion. When they ran the estimate assuming a wider prescription of healthy foods, they calculated that 3.28 million cardiovascular events and 120,000 cases of diabetes would be prevented and $100.2 billion would be saved.

“We found that partial coverage of the cost of purchasing fruits, vegetables, whole grains, nuts, seeds and vegetable oils would be highly cost-effective, ” said Yujin Lee, first author of the study. and would be quite similar in cost-effectiveness to prescription drugs for high cholesterol or hypertension.”

Lee Y, Mozaffarian D, Sy S, Huang Y, Liu J, Wilde PE, Abrahams-Gessel S, Jardim TSV, Gaziano TA, Micha R. Cost-effectiveness of financial incentives for improving diet and health through Medicare and Medicaid: A microsimulation study. PLoS Med. 2019 Mar 19;16(3):e1002761.

Irritable bowel syndrome, psychological approach effective

18 February 20246 January 2024 by Renato Torlaschi

Cognitive behavioral therapy is the latest recommended treatment in the fight against irritable bowel syndrome: according to a study published in the medical journal Gut, it is more effective in relieving patients’ discomfort than current standard therapy.

Irritable bowel syndrome affects about 10 percent of the population and is responsible for persistent symptoms such as stomach pain or cramping, abdominal bloating, constipation, or diarrhea; other frequent signs are also flatulence, fatigue, nausea, and incontinence. In its most severe form, the condition can have a major impact on the daily routine and quality of life of the sufferer, however, it is a so-called “functional disorder,” a way of saying that no one really knows the cause, in fact it is not associated with pathological changes that can be detected today with specific tests: the diagnosis is made on the basis of symptoms.

Current treatment approaches include medications and lifestyle and dietary advice, but psychological therapy could be an alternative method of managing the symptoms of irritable bowel syndrome.

The study involved 558 patients who had longstanding symptoms and had tried other treatments for at least one year: while some continued to receive the traditional treatments, others were offered eight sessions of cognitive behavioral therapy specifically designed for the treatment of irritable bowel syndrome. Twelve months later, it was the second group that reported the most significant improvements in symptoms: based on a measurement system on a scale from 0 to 500 (Irritable bowel syndrome severity scoring system – IBS-SSS), their symptoms were 61 points lower. Surprisingly, cognitive behavioral therapy proved effective even when it was not delivered through face-to-face interviews with the therapist: “the fact that both phone and Web-based therapy sessions have been shown to be effective is a really important and exciting finding, – said Hazel Everitt, associate professor of general medicine at the University of Southampton, England, and first author of the study – patients can follow these treatments at home, at the most convenient times.”.

Everitt HA, Landau S et al. Assessing telephone-delivered cognitive-behavioural therapy (CBT) and web-delivered CBT versus treatment as usual in irritable bowel syndrome (ACTIB): a multicentre randomized trial. Gut. 2019 Apr 10. pii: gutjnl-2018-317805.

Daily consumption of sugar-sweetened beverages associated with higher premature mortality

18 February 20246 January 2024 by Renato Torlaschi

People who consume a lot of
sugary drinks
and sports drinks every day may be more prone to die prematurely from heart disease and cancer than those with little or no use. This is suggested by a study that appeared in Circulation and was conducted by U.S. researchers, mostly belonging to the Chan School of Public Health in Boston.

Heavy soda consumption was associated with an increased risk of premature death from any cause by 28 percent, from heart disease by 31 percent, and from cancer by 16 percent. The result is the result of the analysis of a large amount of data: 37,716 men and 80,647 women examined along a multi-decade follow-up, from 28 to 34 years.

“Here in the United States,” said study coordinator, nutritionist Vasanti Malik. About half of the population consumes at least one sugary drink a day. Replacing them with other beverages, particularly water, is an effective strategy for improving health and longevity.”

Although, in the U.S., consumption has declined overall over the past decade, there has been a slight increase again recently, with each person taking in an average of 145 calories per day through consumption of these beverages. The study takes on particular value because of the large sample taken, but it is not a controlled experiment that can demonstrate a direct cause between sugary drink consumption and the onset of disease, Malik pointed out; however, it is likely that both the added sugars and calories contributed by these drinks play a role. High consumption could make people more likely to develop risk factors for diabetes, heart disease, and other chronic health problems; in addition, excess calories contribute to obesity and all the harms that come with it. As for the observed increased cancer risk, according to the American researcher, “it probably concerns those cancers related to diet, including breast cancer and, to a lesser extent, colon cancer.”

Malik VS, Li Y, Pan A, De Koning L, Schernhammer E, Willett WC, Hu FB. Long-Term Consumption of Sugar-Sweetened and Artificially Sweetened Beverages and Risk of Mortality in US Adults. Circulation. 2019 Mar 18.

Gut bacteria deployed to combat anxiety

15 February 20246 January 2024 by Renato Torlaschi

The human gut is home to billions of bacteria that collectively form the gut microbiota, whose crucial role in digestion has long been known. But a growing body of scientific evidence is pointing out that these microorganisms also affect our behavior and even our brains. Now, the authors of a new systematic review show that bringing about a change in our gut flora can be an effective way to alleviate the symptoms of anxious states.

Researchers from Shanghai Jiao Tong University School of Medicine analyzed 21 studies focusing on interventions to treat anxiety through modulation of gut bacteria. The review, which involved 1,503 subjects and was published in the journal General Psychiatry, confirmed that some approaches are indeed effective.

To manipulate gut bacteria in participants, two main approaches were used: in seven of the studies included in the analysis, patients’ diet was changed, while in the other 14, probiotic supplements were administered. Probiotics, often referred to as “good bacteria,” are found in certain foods and can help rebalance depleted intestinal flora. Of the probiotic studies, seven used only one type of bacteria, two used two types, and the remaining five used three or more bacterial strains.

In all the studies reviewed, the Chinese researchers found a positive effect; in some cases it was small, but in eleven of them there was a marked improvement in anxiety symptoms: five through the probiotic approach and six through the dietary approach. The review also improved our knowledge regarding the combination of traditional anxiety medications with intervention on gut bacteria: to this propósito, the authors found that improvements occurred only when dietary interventions were combined with medications and not with probiotic intake.

Taken alone, the diet interventions had an 86 percent efficacy rate, which could be related to the more effective growth of different types of bacteria following the dietary regime change. Regarding supplementation with probiotics, however, experts speculate that the bacteria in the supplements might compete against each other and consequently fail to produce the desired changes to the gut microbiome. It is also possible that only certain types of bacteria make a difference, and identifying them will be the task of future research.

Yang B, Wei J, Ju P et al. Effects of regulating intestinal microbiota on anxiety symptoms: A systematic review

General Psychiatry 2019;32:e100056.

Melanoma, doubts about generalized screening but all agree on the importance of prevention

16 February 20246 January 2024 by Renato Torlaschi

Because melanoma cases have been steadily increasing, U.S. citizens have been asked to undergo early screening for this most dangerous skin cancer for a few years now. But some dermatologists wonder whether widespread screening of people without symptoms has resulted in overdiagnosis, with loads of anxiety and unnecessary treatments. An account of the ongoing debate was reported on Medscape, the portal dedicated to medical and scientific popularization.

While the number of melanoma cases diagnosed in the United States doubled from 1982 to 2011 and continues to grow, mortality rates have decreased only slightly. From 2007 to 2016, deaths from melanoma fell by 4 percent in adults up to age 50 and 2 percent in those older.

“The large increase in diagnosed melanomas should be associated with a sharp decline in mortality,” argues Ade Adamson, dermatologist and professor at the University of Texas. But this is a very sensitive discussion because we are led to believe that screening healthy people and early detection will save lives, regardless of the type of cancer.”

According to Adamson, the technological advances contribute to the diagnosis excessive, and brings up the example of skin scanning instruments that detect small changes that the eye cannot see: but even for an expert it is difficult, sometimes impossible, to distinguish the malignant lesion of a melanoma from a benign one in its early stages. Damage such as misdiagnosis, overdiagnosis, cosmetic effects due to biopsies, and side effects associated with medications, as well as the inevitable psychological distress for patients, can result.

However, there are those who think differently. Joel Cohen, a spokesperson for the American Academy of Dermatology, believes that early diagnosis is absolutely essential: “intercepting a very small melanoma is something to celebrate.” After all, according to data provided by the American Society of Clinical Oncology, five-year survival rates for people whose melanoma is detected early are 92 percent; however, if the cancer has spread to other parts of the body, the rate drops to 23 percent.

However, experts all agree on one fact: prevention is the first important step in avoiding skin cancer. The American Academy of Dermatology urges everyone to follow a few behaviors: limit sun exposure, especially during the middle hours of the day; wear protective clothing such as wide-brimmed hats, sunglasses, long pants and long-sleeved shirts; generously apply a water-resistant, broad-spectrum sunscreen with SPF 30 or higher, even on cloudy days; reapply sunscreen every two hours; avoid tanning beds; and have your skin checked for new or suspicious spots.

https://www.medscape.com/viewarticle/912697

Smelling with the tongue, taste and smell are more connected than previously thought

17 February 20246 January 2024 by Renato Torlaschi

Researchers at the Monell Center in Philadelphia have discovered that functional olfactory receptors, the sensors in the nose that are used to sense odors, are also present in the taste cells found on the tongue. The findings, published in Chemical Senses, suggest that interactions between the senses of smell and taste, the primary components of food flavor, may begin on the tongue and not in the brain, as previously thought.

“Our research,” said Mehmet Hakan Ozdener, the study’s cell biologist and senior author. can help explain how odor molecules also modulate taste perception. This may lead to the development of odor-based taste modifiers that can help combat excess salt, sugar, and fat intake associated with diet-related diseases such as obesity and diabetes.”. Ozdener’s futuristic hypothesis is supported by the fact that taste has evolved over time to enable us to assess the nutritional value and potential toxicity of what we put in our mouths.

Through the taste buds, we are able to detect the basic tastes of sweet, salty, sour, bitter and umami and their countless variations; the brain combines the signals provided by taste receptors, smell and other senses to create the overall taste sensation.

Until now, taste and smell were considered as independent sensory systems that did not interact until their respective information reached the brain. Ozdener was prompted to challenge this belief after his 12-year-old son asked him if snakes extend their tongues in order to sniff.

The resulting study suggests that olfactory receptors may play a role in the system leading to taste perception by interacting with taste receptors directly on the tongue. In support of this possibility, other experiments conducted by Monell scientists have shown that a single tongue cell can contain both taste and olfactory receptors.

Lo studio opens opportunities for researchers to conduct numerous other investigations: there are many questions about the mechanisms of operation of the 400 different types of human olfactory receptors; as taste cells cultured in the laboratory respond to odors, they could be used to identify which molecules bind to specific olfactory receptors. Further research may explore the ways in which the molecules that produce different odors modify taste bud responses and ultimately human perception of tastes.

Malik B, Elkaddi N, Turkistani J, Spielman AI, Ozdener MH. Mammalian Taste Cells Express Functional Olfactory Receptors. Chemical Senses, April 24, 2019.

An army of micro-robots can wipe out dental plaque

16 February 20246 January 2024 by Renato Torlaschi

A swarm of micro-robots, directed by magnets, can dislodge and remove the biofilm that forms the characteristic plaque that forms around teeth and promotes and sustains common oral diseases, from caries to periodontal disease.

The innovation stems from a partnership between dentists, biologists and engineers at the University of Pennsylvania and has been described in Science Robotics . With two types of robotic systems, one designed to work on surfaces and the other to operate within confined spaces, scientists have shown that robots with catalytic activity have the ability to destroy oral biofilm, that complex aggregation of microorganisms that is deposited on dental hard substance, restorations and prosthetic restorations, gingiva, mucous membranes, tongue and periodontal pockets. These robotic biofilm removal systems promise to be useful in a wide range of potential applications: while they will be able to keep water tubes and catheters clean, they will also go a long way toward reducing the risk of caries, endodontic infections, and implant contamination.

Coordinating the study were Hyun Koo of the School of Dental Medicine and Edward Steager of the School of Engineering and Applied Science. “Underlying our result ,” said Koo. there was a truly synergistic and multidisciplinary interaction. We are harnessing the expertise of microbiologists, clinical scientists, and engineers to design the best possible microbial eradication system, which is also an important aspect for other biomedical fields facing drug-resistant biofilms, just as the world is approaching a post-antibiotic era.”.

And Steager added, “treating biofilms that form on teeth requires a great deal of manual labor, with our innovation we hope to improve treatment options and reduce the difficulty of care.”

According to the U.S. researchers, current treatments for biofilms are ineffective because they are unable to simultaneously degrade the protective matrix, kill the embedded bacteria and physically remove the biodegraded products. Instead, according to Koo, “these robots can do the three things at the same time and very effectively, leaving no biofilm behind.”

Hwang G, Paula JA, Hunter EE et al. Catalytic antimicrobial robots for biofilm eradication. Science Robotics 24 Apr 2019: Vol. 4, Issue 29, eaaw2388.

Diagnose and treat skin diseases without incising it, new technology from Canada

16 February 20246 January 2024 by Renato Torlaschi

Researchers at the University of British Columbia in Vancouver, Canada, have developed a very special microscope that has the potential ability to diagnose diseases such as skin cancer and perform extremely precise surgeries, all without incising the epidermis.

“Our technology,” explained Yimei Huang, one of the authors of the study, published in Science Advances – allows us to rapidly scan tissues, and when we see a suspicious or abnormal cell structure, we can perform ultra-precise surgery and selectively treat the unwanted or diseased structure within the tissue, without cutting the skin.”

The device is a type of multiphoton excitation microscope that allows imaging of living tissue down to about one millimeter depth using an ultrafast infrared laser beam. What distinguishes the microscope from previous technology is that it can not only digitize living tissue, but also treat it by intensifying the heat produced by the laser.

The researchers wanted to make the multiphoton microscope technology more versatile while increasing its accuracy, being able to identify what is happening under the skin from different angles.

When applied to the treatment of skin diseases, the microscope enables doctors to pinpoint the exact location of the abnormality, diagnose it and treat it immediately. It could be used to treat any structure in the body that is reached by light and requires extremely precise treatment, including nerves or blood vessels in the skin, eyes, brain, or other vital structures.

“We are able to change the path of blood vessels without affecting any of the surrounding vessels or tissues,” said Harvey Lui, another author of the study and a professor in the Department of Dermatology and Skin Sciences at the University of British Columbia – For diagnosing and analyzing diseases such as skin cancer, this could be revolutionary.”

Huang Y, Wu Z, Lui H et al. Precise closure of single blood vessels via multiphoton absorption-based photothermolysis. Sci Adv. 2019 May 15;5(5):eaan9388.

Too much gluten in young children could increase risk of celiac disease

15 February 20246 January 2024 by Renato Torlaschi

High gluten intake early in life was associated with an increased risk of celiac disease in a new study by a team of researchers in northern Europe.

“We found that a one-year-old child in the highest range of gluten intake has twice the risk of developing autoimmunity of celiac disease, a stage that often preludes to full-blown celiac disease; â€ research coordinator Karl Marild of theNorwegian Institute of Public Health and Queen Silvia Children’s Hospital in Gothenburg, Sweden-. It was surprising to me to find such a strong association, given the ubiquitous nature of gluten in our diet.”

Marild and colleagues used data on 1,875 children provided by another study (Daisy – Diabetes AutoImmunity Study in the Young) that aimed instead to investigate susceptibility to type 1 diabetes mellitus. Among the plus points was the very long follow-up: participants were followed from 1993 until January 2017. The children were divided into three groups according to their dietary gluten intake during the period when they were one year to two years old. The researchers then compared the data of the now-adult participants in the higher gluten intake bracket with those in the lower bracket, showing for the former a 96 percent higher risk of celiac disease and 117 percent higher risk of celiac disease autoimmunity: in other words, a doubling of risk. “If our results are confirmed ,” said Marild. may provide a somewhat better understanding of a significant aspect of the likely multifactorial etiology of this disease. Importantly, we do not recommend a change in pediatric feeding practices, because ours was an observational study and unable to show a cause-and-effect relationship.” It is also necessary to specify that the consumption of gluten-rich foods in non-celiac adults has never been associated with any adverse effects. Gluten-free diets, much in vogue in the United States, challenging, unnecessary and expensive, may carry risks, and their health effect is among the many unproven but widespread “hoaxes” in nutrition.

Mårild K, Dong F et al. Gluten Intake and Risk of Celiac Disease: Long-Term Follow-up of an At-Risk Birth Cohort. Am J Gastroenterol. 2019 May 9.

Alzheimer’s: a new blood test will allow diagnosis many years in advance

15 February 20246 January 2024 by Renato Torlaschi

Among the many critical issues related to Alzheimer’s disease, one concerns the difficulty of diagnosing it in its early stages. Although research has not yet identified a viable therapeutic approach, diagnostically the situation may soon change with the development of a blood test that scientists say can Diagnose up to 94 percent of Alzheimer’s cases 20 years earlier That the symptoms of the disease occur. The researchers in question are from Washington University in St Louis and described the test in the journal Neurology.

The disease is characterized by the increase ofbeta-amyloid plaques in the brain, associated with the accumulation of tau protein tangles, and the test proposed by the U.S. researchers relies precisely on the measurement of beta-amyloid in the blood, which would correlate with that in the brain .

The idea is not new and is a refinement of a technique already presented two years ago; it uses mass spectrometry to measure beta-amyloid-or, more precisely, the ratio between two forms of the protein, called A-β 42 and A-β 40 – and associates its blood concentration with two fundamental risk factors for developing Alzheimer’s: advanced age and the presence of a genetic variant called APOE4.

In this way, the accuracy of the test outperforms that of previous blood tests.

The team recruited 158 adults over the age of 50; all but 10 were described as cognitively normal. Each participant underwent at least one blood test and one PET scan with amyloid tracers , which is the current gold standard, and each test was labeled as amyloid positive or amyloid negative depending on the results produced.

Among experts, there is a growing consensus that in order to manage or treat Alzheimer’s, it is important to intercept it as early as possible, before symptoms begin to appear and the brain is not too damaged.

More than for a cure, which is not currently available, the test could further research. Today, to conduct clinical trials, we check people with scans, which is time-consuming and expensive, whereas with a blood test we could easily examine a large number of subjects, which would help us find treatments more quickly, with a huge potential impact.

Source: Schindler SE, Bollinger JG, et al. High-precision plasma β-amyloid 42/40 predicts current and future brain amyloidosis. Neurology. 2019 Aug 1.

Melanoma, a new laser detects cancer cells in the blood and may help destroy them

15 February 20246 January 2024 by Renato Torlaschi

In the future, doctors may be able to detect and kill cancer cells with a noninvasive laser . This is promised in a paper published in Science Transitional Medicine, in which researchers at the University of Arkansas Medical Sciences showcased the performance of their innovative laser device, which boasts a 96 percent success rate and 1,000 times greater sensitivity than current technology.
As the authors point out, one of the most frightening aspects of the melanoma is its ability to metastasize early in the progression of the disease, and once metastases have involved distant organs, the average five-year survival rate plummets, from near 100 percent in cases of non-metastatic, early resected cancer, to just 10 to 15 percent.
Therefore, it is essential to eliminate the tumor before it has a chance to spread, and to do this, researchers aim to identify tumor cells released from the primary tumor and circulating in the bloodstream. This is precisely where the new device comes in, a short-pulsed laser that recognizes melanoma cells in the blood vessels near the surface of the body, which heat up slightly because of their darker coloration. The heating activates a small acoustic wave that is then intercepted by the laser’s ultrasound detector, effective enough to detect a single cell present in a liter of blood.
Tested on 28 melanoma patients and 19 healthy subjects used as controls, the laser detected circulating tumor cells in 27 of the melanoma patients and in none of the healthy people.
The device not only detects tumor cells but also appears to be able to destroy them, in a treatment that lasts less than an hour, the safety levels of which remain to be fine-tuned, however. According to the authors, the treatment will probably not be enough to completely eliminate the tumor, but it could be used in conjunction with other treatments to improve its performance. This laser could also be used to monitor the effectiveness of anti-cancer drugs, check for signs of melanoma post-treatment, or take on a preventive role similar to mammography.

Galanzha EI, Menyaev YA et al. In vivo liquid biopsy using Cytophone platform for photoacoustic detection of circulating tumor cells in patients with melanoma. Sci Transl Med. 2019 Jun 12;11(496).

How to help the body regrow bone tissue

15 February 20246 January 2024 by Renato Torlaschi

For the first time, scientists have been able to study how well synthetic bone grafts withstand the stresses they receive during the daily lives of patients to whom they are implanted, and how quickly they help bone regrowth and repair.
The team in question, which examined in microscopic detail what takes place between the graft and the bone, was coordinated by Gianluca Tozzi, one of the many “brains” that have fled abroad, who after graduating from the University of Bologna is now director of the Zeiss Global Centre at the University of Portsmouth (UK). The researcher hopes the result will help find ways to improve the body’s ability to regrow its own bones and enable orthopedic surgeons to predict the success of a synthetic graft.
“Every three seconds,” Tozzi explained to ScienceDaily. A person incurs a fracture due to bone fragility. In addition to breaking easily, brittle bones are also more difficult to repair, especially when the defect area is large. It is vital to understand what happens at that interface where the bone meets the graft, because then we can better engineer the sophisticated materials used. Bones are very complex biological tissues, and a synthetic bone substitute must have specific requirements to allow blood flow and encourage new bone growth.”.

New generation synthetic grafts have the potential to be resorbed by the body over time, allowing gradual bone regeneration at the site where the defect is, but biomaterials that degrade too quickly do not give enough time for new bone to grow, and those that degrade too slowly can cause mechanical instability at the implant site.
The team succeeded in the feat thanks to a device, located in the Zeiss Global Centre, that performs a special X-ray tomography (synchrotron X-ray computed tomography – SR-XCT): “In this way,” said Tozzi, “we can predict the clinical outcome of biomaterials in a living body, significantly improving our knowledge.

Peña Fernández M, Dall’Ara E et al. Full-Field Strain Analysis of Bone-Biomaterial Systems Produced by the Implantation of Osteoregenerative Biomaterials in an Ovine Model. ACS Biomaterials Science & Engineering 2019 5 (5), 2543-2554.

Swimming in the ocean alters the skin microbiome, the risk is infections

15 February 20246 January 2024 by Renato Torlaschi

Swimming in the ocean alters the microbiome skin and may increase the likelihood of infection, according to research presented at ASM Microbe 2019, the annual meeting of the American Society for Microbiology.

“Our data,” said Marisa Chattman Nielsen, a Ph.D. student at the University of California, Irvine, and lead author of the study, “are very good. demonstrate for the first time that exposure to ocean water can alter the diversity and composition of the human skin microbiome. We have observed that while swimming, normally resident bacteria are washed away while ocean bacteria are deposited on the skin.”

The researchers found the ocean bacteria on all study participants immediately after swimming and air-drying their bodies, but also after six hours and even after one day; however, there were differences and some acquired more ocean bacteria than others or retained them longer.

This is not just curious news, because previous studies had already shown associations between ocean swimming and infections, and many U.S. beaches bordering the Pacific Ocean are washed by poor-quality water due to sewage runoff and rainwater. Recent research has shown that changes in the microbiome can increase susceptibility to infection and influence disease states. Exposure to these waters can cause gastrointestinal and respiratory diseases, ear and skin infections.

The research was conducted on nine volunteers without sunscreen, who had previously been exposed only sporadically to ocean waters, who had not bathed in the past 12 hours, and who had not taken antibiotics in the previous six months.

The most frequently detected ocean bacteria include those of the genus Vibrio; the researchers did not specify the species found, but Nielsen said, “Many Vibrio are not pathogenic, but our research shows that pathogenic species could potentially persist on the skin after swimming.”

Indeed, the fraction of Vibrio detected on human skin was more than 10 times higher than that found in ocean water samples, suggesting a specific affinity that determines its attachment to human skin.

ASM Microbe is the annual meeting of the American Society for Microbiology, which This year it was held from June 20 to 24 in San Francisco, California.

Melanoma cases among young U.S. declined by nearly a quarter in 10 years: information campaigns work

11 February 20246 January 2024 by Renato Torlaschi

Public health campaigns encouraging people to protect themselves from the sun in the United States seem to be paying off, although for now they are only visible in the younger population. In fact, a new analysis found that the incidence of invasive melanoma in the United States has decreased in adolescents and young adults over the past decade, although it has increased in older age groups.

To be fair, the study’s senior author, dermatologist Jennifer Gardner of the University of Washington, Seattle, cautiously told Medscape Medical News that “we don’t know why this trend in melanoma reduction is occurring.”

However, it is a fact that in the U.S. there have been, over the years, campaigns and numerous expert messages relaunched by the media aimed at promoting sun protection starting in childhood and slowly there has been a widespread awareness of the dangers of excessive exposure to ultraviolet rays, which has certainly affected the habits of Americans.

The U.S. data are in line with what we have already seen in Australia, where a reduction in the incidence of melanoma cases has been documented since the 1980s, and again there have been numerous information campaigns.

Jennifer Gardner’s team analyzed data on 988,103 cases of invasive melanoma that had been recorded in two large databases, covering the first 15 years of this century. In particular, it was seen that between 2006 and 2015 the incidence of melanoma decreased significantly, by almost a quarter, among adolescents (aged 10 to 19 years) and young adults (aged 20 to 29 years). In contrast, skin cancers have increased significantly in adults aged 40 years and older: by an average of 1.8 percent per year in both men and women, with particularly pronounced increases in older age groups.

“We know that early childhood sunburn and excessive ultraviolet exposure early in life are a risk factor for the development of melanoma later in life. It is therefore possible,” Gardner explained, “that public health interventions may not have affected the incidence of melanoma in people over the age of 40 because they have been affected by prior exposure. It may be that older people have adopted UV protection behaviors later in life and we have not yet seen the impact of this change. However, to minimize the risk of developing skin cancers, we still strongly advocate that protection should be adopted throughout life.”

Source: Paulson KG, Gupta D et al. Age-Specific Incidence of Melanoma in the United States. JAMA Dermatol. 2019 Nov 13.

Fine dust, even more dangerous than previously thought

11 February 20246 January 2024 by Renato Torlaschi

Extensive research has confirmed previously known links between short-term exposure to particulate matter and an increased risk of hospitalization and death from heart and lung disease, diabetes, and thromboembolism. But it also identified an increased risk of hospitalization for numerous conditions, ranging from sepsis to kidney failure.

These innovations are emphasized by Yaguang Wei, researcher at Harvard School of Public Health, Boston, and first author of the study: ” We discovered previously unknown links between pollution and common diseases among older people, such as alterations in fluid volumes and electrolyte concentrations, septicemia, anemia, urinary tract infections and renal failure, even when daily PM2.5 concentrations were lower than the levels indicated in air quality guidelines issued by the World Health Organization.”

For these diseases, which are rarely studied in relation to pollution, each short-term increase of 1 microgram per cubic meter in average PM 2.5 levels was associated with an average of 2,050 additional hospitalizations per year, 12,216 total days in the hospital, and $31 million in hospital and post-acute costs.

Dust produced by pollution is classified according to its size: PM 2.5 has a diameter of less than 2.5 micrometers and is the most dangerous to human health, being able to penetrate the pulmonary alveoli with eventual diffusion into the bloodstream. According to the aforementioned WHO guidelines published in 2005, people should not be exposed to 24-hour average levels of PM 2.5 exceeding 25 micrograms per cubic meter of air.

The team that conducted this new study examined hospital data of Medicare patients, the main medical insurance program administered by the U.S. government aimed at the elderly, from 2000 to 2012. They focused on 214 health conditions and analyzed data on average air pollution levels on the day of admission and the previous day in the location where the patients resided.

Often, people are unable to avoid exposure to air pollution, but they can still take some precautions.

Anyone, but especially those with health problems that can be exacerbated by air pollution, such as cardiovascular conditions, asthma, and chronic obstructive pulmonary disease (COPD), should inquire about local air quality levels and, on particularly critical days, follow the advice of experts, who suggest closing windows and avoiding outdoor exercise. “In addition,” it said in an editorial that presented the study by the U.S. researchers, “both patients and physicians should be aware of the impact that poor air quality can have on disease exacerbation in order to better understand and perhaps treat such flare-ups.

Source: Wei Y, Wang et al. Short-term exposure to fine particulate matter and hospital admission risks and costs in the Medicare population: time stratified, case crossover study. BMJ. 2019 Nov 27;367:l6258.

Poor hand hygiene may be the most common means of transmission of E. coli bacteria

11 February 20246 January 2024 by Renato Torlaschi

According to a British study, one of the best ways to reduce antibiotic-resistant Escherichia coli infections would be the generalized habit of washing hands after using the bathroom. Infections produced by this bacterium-dangerous and potentially fatal-are commonly attributed to undercooked meat or raw vegetables, but when researchers did a genetic analysis of thousands of samples, they found that most E. coli infections in the United Kingdom were caused by a strain found in the human gut and sewage, but rarely found in food.

The authors of the study published in Lancet Infectious Diseases infer that the infection is spread primarily by human fecal particles transmitted from person to person. David M. Livermore, the University of East Anglia medical microbiologist who coordinated the study, calls E. coli a “Jekyll and Hyde organism”: in fact, the bacterium lives normally in the intestines of humans and animals without producing any harm, but some strains can be very dangerous and can be responsible for food poisoning and bloodstream infections. Until recently, these conditions were easily treated with antibiotic prophylaxis, but for the past 15 years or so, Escherichia coli has become more resistant to antibiotics and much more difficult to treat, effectively turning into “superbugs”, one of those deadly bacteria that, in Italy alone, causes more than 10,000 deaths a year.

To learn more about the spread of E. coli and thus infer its mode of transmission, british researchers performed genome sequencing on samples collected in 2013 and 2014 from humans, animals and sewage in five areas: London, East Anglia, Northwest England, Scotland, and Wales.

DNA sequencing showed an abundance of antibiotic-resistant E. coli strains in wastewater and retail chicken meat, rarely on other meats and never on plant-based foods. In addition, samples of a particular resistant strain, called ST131, collected from human blood, feces, and sewage combined: ” the problem we encountered – Livermore deduced from this – is the circulation of resistant E. coli adapted to the human organism and not infections derived from the food chain“.

As some infectiologists have pointed out, it is obviously important to practice good food safety practices, but the study suggests that good hand hygiene to prevent transmission is by far the most effective measure. Attention to hygiene is particularly relevant in homes for the elderly, as most serious E. coli urinary tract infections occur in those settings.

Source: Day MJ, Hopkins KL et al. Extended-spectrum β-lactamase-producing Escherichia coli in human-derived and foodchain-derived samples from England, Wales, and Scotland: an epidemiological surveillance and typing study. Lancet Infect Dis. 2019 Oct 22.

ALIMENTAZIONE E NUTRIZIONE	NATURA SPORT LUOGHI	COLTIVARE LA SALUTE	MENOPAUSA	MAMMA IN FORMA
MEDICINA TRADIZIONALE CINESE	CARDIOCHIRURGIA	FARMACI E DISPOSITIVI MEDICI	GENITORIALITÀ	LA CULTURA DELLA SALUTE
LE UTILITIES DELLA SALUTE	MEDICINA GENERALE	MEDICINA NATURALE, TERMALE	MENTE E CERVELLO	DISTONIA NEUROVEGETATIVA
MODI DI ESSERE	SALUTE E SOCIETÀ	SANITÀ E PAZIENTI	SESSUALITÀ	TERZA ETÀ
TUMORI	URGENZE

ALIMENTAZIONE E NUTRIZIONE	NATURA SPORT LUOGHI
COLTIVARE LA SALUTE	MENOPAUSA
MAMMA IN FORMA	MEDICINA TRADIZIONALE CINESE
CARDIOCHIRURGIA	FARMACI E DISPOSITIVI MEDICI
GENITORIALITÀ	LA CULTURA DELLA SALUTE
LE UTILITIES DELLA SALUTE	MEDICINA GENERALE
MEDICINA NATURALE, TERMALE	MENTE E CERVELLO
DISTONIA NEUROVEGETATIVA	MODI DI ESSERE
SALUTE E SOCIETÀ	SANITÀ E PAZIENTI
SESSUALITÀ	TERZA ETÀ
TUMORI	URGENZE

APPARATO DIGERENTE	APPARATO RESPIRATORIO	APPARATO UROGENITALE	CUORE E CIRCOLAZIONE	CUTE
INFETTIVOLOGIA	OCCHI	ORECCHIE NASO E GOLA	OSSA E LEGAMENTI	SISTEMA ENDOCRINO
SISTEMA NERVOSO

APPARATO DIGERENTE	APPARATO RESPIRATORIO
APPARATO UROGENITALE	CUORE E CIRCOLAZIONE
CUTE	INFETTIVOLOGIA
OCCHI	ORECCHIE NASO E GOLA
OSSA E LEGAMENTI	SISTEMA ENDOCRINO
SISTEMA NERVOSO

CULTURA E SALUTE	AGGIORNAMENTI
PERCORSI

RELATED SPECIALISTS

RELATED SPECIALISTS

RELATED ARTICLES

Maybe it’s the drugs?

Goodbye fillings? Gel that regrows nail polish discovered

Managing menopausal age with an appropriate lifestyle

Do you love to eat at restaurants? Beware of bacteria

Allergies: between truth and false myths

Always thirsty? It may depend on.

Keeping fit without a gym?

Anorexia nervosa

DESCRIPTION

Spontaneous chronic urticaria

portal info

for patients

for doctors

your advertisingexclusively ONMY SPECIAL DOCTOR

complete the form and you will be contacted by one of our managers

your advertising
exclusively ON
MY SPECIAL DOCTOR