Medical News Today: Contaminated hospital floors may help to spread infection

A new study suggests that the floor may be an overlooked source of healthcare-associated infection and may help to spread pathogens such as Clostridium difficile and MRSA though contact with high-touch objects. The researchers call for further research to confirm their findings, which are based on a study of five hospitals.
hospital corridor
The study suggests that hospital floors may be a source of infection that spreads through contact with high-touch objects.


The team – including researchers from the Case Western Reserve University School of Medicine in Cleveland, OH – reports the study in the American Journal of Infection Control.


Healthcare-associated infections are infections that patients acquire during admission to a healthcare setting such as a hospital or nursing home. They are a major, but often preventable, threat to patient safety.


Healthcare-associated infections are most often linked to the use of invasive devices such as central lines, ventilators, and urinary catheters. They can also develop following an operation, at the place on the body where surgery was performed.


Patients treated in intensive care units (ICUs) are at particular risk for infection, and the risk rises with the amount of time spent in ICUs.


According to the World Health Organization (WHO), healthcare-associated infections are the “most frequent adverse event” in the delivery of healthcare worldwide. They affect hundreds of millions of patients every year and are linked to significant numbers of deaths and high healthcare costs.


The annual financial losses attributed to healthcare-associated infections in the United States are estimated to be in the region of $6.5 billion.


The Centers for Disease Control and Prevention (CDC) say that much progress has been made in tackling healthcare-associated infections, but there is still a lot of work to do. They estimate that at any given time in the U.S., around 1 in 25 hospital patients has at least one infection associated with healthcare.


Floors not classed as frequently touched surface


The researchers behind the new study suggest that their findings highlight an area that may be overlooked in measures to prevent and control healthcare-associated infections.


They note that: “Efforts to improve disinfection in the hospital environment usually focus on surfaces that are frequently touched by the hands of healthcare workers or patients.”


Even though floors are heavily contaminated, because they are not classed as a frequently touched surface, they do not receive as much attention as high-touch objects, they add.


For their study, the researchers investigated five hospitals in the Cleveland area. Altogether, they cultured and examined samples from 318 floor sites from 159 patient rooms (two sites per room), including C. difficile infection (CDI) isolation rooms and non-CDI rooms.


They also took samples from the bare and gloved hands of healthcare staff, as well as from other high-touch surfaces including call buttons, medical devices, linen, medical supplies, and clothing.


High-touch objects often in contact with contaminated floors


The results showed that floors in patient rooms were often contaminated with MRSA, vancomycin-resistant enterococci, and C. difficile, with C. difficile being “the most frequently recovered pathogen in both CDI isolation rooms and non-CDI rooms.”


The researchers also found that high-touch objects, including call buttons and blood pressure cuffs, were frequently in contact with the floor, and contact with objects on the floor often led to the transfer of pathogens to hands.


They suggest that further research should now be done to investigate the extent to which the floors of hospital rooms might be an underappreciated source for the spread of pathogens.


Linda Greene, president of the Association for Professionals in Infection Control and Epidemiology, says that: “Understanding gaps in infection prevention is critically important for institutions seeking to improve the quality of care offered to patients,” and concludes:



“Even though most facilities believe they are taking the proper precautions, this study points out the importance of ensuring cleanliness of the hospital environment and the need for education of both staff and patients on this issue.”





Learn about the WHO’s global priority list of antibiotic-resistant bacteria.



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Medical News Today: COPD hypoxia: Causes, symptoms, and treatment

MNT Knowledge Center


Chronic obstructive pulmonary disease is a name for several conditions that affect a person’s breathing. Examples of these conditions include chronic bronchitis and emphysema.


An estimated 30 million people in the United States have chronic obstructive pulmonary disease (COPD), according to the COPD Foundation.



COPD is caused by obstructions to a person’s airflow, where oxygen doesn’t move well through their lungs. Over time, the lungs become inflamed and damaged.





Causes of hypoxia and hypoxemia



Because a person needs oxygen to survive, COPD can have harmful effects on the body. Two disorders that a person with COPD can develop are hypoxia and hypoxemia.


a woman having difficulty breathing
Shortness of breath and frequent coughing may indicate COPD-related hypoxia.



Hypoxia and hypoxemia are important terms to know in connection with COPD because their progression can ultimately lead to disability and death.



Oxygen passes from the lung tissue to the blood via the alveoli, or air sacs. Ideally, oxygenated blood leaves the lungs and travels to the other tissues in the body. The body, especially the brain and heart, needs sufficient amounts of oxygen to survive.



COPD damages the lungs, and if they get seriously damaged, a person may develop hypoxia. Hypoxia occurs when the blood does not deliver enough oxygen to the air sacs in the lungs.



The body can adapt in certain ways in order to cope with lower than normal oxygen levels. However, in the case of COPD, hypoxia in the lungs can cause hypoxemia in the body.



Hypoxemia occurs when oxygen levels in the blood become so low that tissues and organs in the body don’t get the oxygen they need. This happens because COPD damages the air sacs, which means the lungs cannot transfer the available oxygen to the bloodstream.



Hypoxemia is harmful because organs, such as the heart and the brain, that are particularly sensitive to changes in oxygen levels can become injured or damaged.



Symptoms and complications



Feeling short of breath and having difficulty catching one’s breath can indicate that a person is experiencing hypoxia. People with COPD-related hypoxia may experience the following symptoms:


  • coughing frequently
  • feeling as if one is choking because they are short of breath
  • less ability to tolerate physical activity
  • rapid breathing
  • waking up in the middle of the night without being able to catch their breath


Hypoxia and hypoxemia can also lead to other conditions including:




Neurocognitive dysfunction



When a person has difficulty getting enough oxygen through the body, the brain can become affected. In low oxygen states, a person may experience injury to nerve cells and changes in function of the brain.



Low oxygen levels as a result of COPD can also lead to fewer neurotransmitters, the chemical messengers of the brain, being created. Creating these neurotransmitters often requires oxygen in order to work properly.




Pulmonary hypertension



The right side of the heart pumps blood that is low in oxygen to the lungs. Once in the lungs, blood can pick up oxygen again from the air that has been breathed in. The oxygenated blood then returns to the left side of the heart where it is pumped throughout the body.



A person with COPD can experience inflammation in the pulmonary arteries that transfer blood from the right side of the heart to the lungs. This inflammation can cause high pressures to build up in the lungs. This higher pressure means that the right side of the heart has to work harder to pump blood through those arteries. If this continues, the heart can become damaged and weakened.




Secondary polycythemia



Secondary polycythemia is the body’s response to chronic hypoxia from COPD. The body starts creating extra red blood cells to help carry more oxygen.



When extra blood cells are made the blood is more prone to clotting. In COPD, this condition can also increase the risk of abnormal heart rhythms, cause longer hospital stays, and lead to more breathing complications.




Skeletal muscle dysfunction



People whose COPD has reached a more advanced stage can have difficulty engaging in physical exercise and activity. As a result, their muscles start to become weaker. The weakened muscles are more easily fatigued, making it even harder for a person with COPD to exercise.




Systemic inflammation



The chronic lack of oxygen can cause inflammation in the body’s tissues, which can lead to a number of conditions.



Examples include atherosclerosis, which is the hardening of the arteries. This makes a person more prone to heart disease, which can lead to heart attack and stroke.



Treatments



The best treatments for COPD-related hypoxia and hypoxemia are those that keep the airways open and reduce inflammation. Preventing infections that can worsen lung function can also help.


man using bronchodilator therapy
Bronchodilator therapy may help to alleviate COPD hypoxia by improving oxygen flow.



Examples of management for COPD hypoxia and hypoxemia include:


  • Bronchodilator therapy: These are typically inhaled medications that reduce the spasm and tightening of the smooth muscle in the airways to improve oxygen flow.
  • Immunizations: Getting a regular flu shot and scheduled pneumonia and pertussis (whooping cough) vaccines can help a person prevent infections that could make lung hypoxia and COPD worse.
  • Oral or inhaled corticosteroids: These medications reduce inflammation in the airways and in the body during a COPD flare. Examples include beclomethasone and prednisone.
  • Quitting smoking: If a person with COPD smokes, quitting smoking can have significant benefits in treating the condition and reducing its symptoms. Quitting also boosts the immune system.
  • Pulmonary rehabilitation therapy: This treatment involves breathing “retraining” to teach a person the best ways to breathe when their lungs are impaired. It also slows the decline of lung function and increases a person’s ability to exercise.


Along with nutritional counseling, pulmonary rehabilitation therapy can help a person with COPD breathe better.



If a person has severe hypoxemia due to COPD, a doctor will commonly recommend oxygen therapy. This involves breathing in extra oxygen through a small, flexible tube that fits in the nostrils known as a nasal cannula.



According to an article in the International Journal of Chronic Obstructive Pulmonary Diseases, long-term oxygen therapy may improve quality of life in patients with COPD hypoxemia by decreasing COPD flares and increasing tolerance to physical activity.



Current studies show that individuals with severe COPD are likely to benefit the most from oxygen treatment. However, not everyone with COPD is a good candidate for supplemental oxygen. It is very important that a doctor carefully prescribes and closely monitors oxygen therapy, as too much oxygen can lead to higher carbon dioxide levels.



Although exercise can be difficult to accomplish when a person has COPD, exercise can improve the oxygen uptake in the lungs of a person with mild COPD and improve their breathing patterns. However, those in more advanced stages of COPD may have difficulty with any amount of physical activity.


Outlook



COPD is a progressive condition, which means it gets worse as time goes on. COPD also causes airflow difficulties that cannot be fully reversed, even with medications and treatments. This is especially true if smoking was a key factor in developing COPD and a person continues to smoke.



There are several key factors that affect the outlook for a person with COPD.




Man standing over weighing scales
Body mass index and age may affect the outlook for a person with COPD.



Examples include:


  • age
  • body mass index
  • how often a person experiences COPD flares
  • how short of breath a person is with activity
  • level of hypoxemia
  • pulmonary artery pressures
  • pulmonary function test results
  • resting heart rate
  • smoking status
  • other health conditions not related to the lungs


The more often a person requires hospitalization with COPD, the poorer their health outlook tends to be. According to the Cleveland Clinic, of more than 1,000 patients admitted to the hospital with respiratory failure and raised carbon dioxide levels in the blood, 89 percent survived the hospitalization, but only about a half of these people were still alive after 2 years.



However, some people have more stable COPD and can live for a long time with the condition. The best outcomes are related to good follow-up with doctors, taking all prescribed medications as directed, and living a healthful and fit lifestyle.


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Medical News Today: Investigational drug shows promise for hard-to-treat renal cancer

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Medical News Today: The neuroscience of humor investigated

A study published in Frontiers in Neuroscience takes a look inside the brains of professional comedians and compares them with less humorous humans. They attempt to home in on the seat of creative humor and ask what it can tell us about creativity.
[Woman laughing at a brain]
A new study investigates the neuroscience of jokes.



Researchers from the University of Southern California (USC) in Los Angeles recently undertook a rather ambitious project: they set out to spy on the neural correlates of creating a joke.


The study was led by a USC doctoral student, Ori Amir, and Irving Biederman, a professor of psychology and computer science.


Creativity is a muddy area of research; it is nebulous and ethereal by its very nature. However, regardless of these difficulties (and perhaps because of them), many researchers have set their sights on unpicking the processes that underly creativity.


Earlier studies have taken images of the brain as it writes poetry, improvises jazz, and draws pictures, but humor offers a unique avenue to understanding the creative process.

Humor and the study of creativity


Humor has a clear beginning, middle, and end, and it also takes place over a relatively short space of time – which is convenient for brain imaging. Additionally, the end product is easy to assess; Biederman need only ask: “Does it make you laugh?” It’s much simpler than rating the quality of a doodle, haiku, or musical jam.


The study enrolled professional and amateur comedians, as well as a control group of non-comedians.


Each participant viewed a cartoon from the New Yorker without any text and were asked to come up with their own accompanying captions. They wrote two versions of text – one mundane and one funny.


As this task was completed, their brains were scanned using functional magnetic resonance imaging (fMRI). Afterward, a panel assessed each caption for its humor level.


Once the data from the fMRI scans had been analyzed, two sections of the brain were shown to be particularly busy during the creation of humorous comments:


  • Medial prefrontal cortex – an area at the front of the brain thought to be involved in learning associations between locations and events, and the appropriate emotional responses. It helps us respond correctly in social interactions.
  • Temporal association regions – part of the temporal lobe thought to be involved in the recognition and identification of complex stimuli.


Interestingly, the activation in these particular regions was different depending on the level of comedic expertise. As Amir explains: “What we found is that the more experienced someone is at doing comedy, the more activation we saw in the temporal lobe.”


The temporal lobe receives sensory information and plays a pivotal role in understanding speech and imagery. It also appears to be the region where semantic and abstract information converges with remote associations.


Conversely, non-comedians and amateur comedians saw less activity in the temporal lobe and more activity in the prefrontal cortex, an area that deals with executive functions such as complex planning and decision-making.

“The professional improv comedians let their free associations give them solutions. The more experience you have doing comedy, the less you need to engage in the top-down control and the more you rely on your spontaneous associations.”

Ori Amir


Amir and Biederman also found that the independent funniness ratings were highest for captions created when there was more activity in the temporal regions of the brain.

The importance of the medial prefrontal cortex


In other studies investigating the neural activity that underpins humor, the medial prefrontal cortex often makes an appearance. Amir says: “The question is, what does it do exactly? It seems like it’s not the source of creativity, but rather the cognitive control top-down director of the creative process. The creativity itself appears to occur elsewhere depending on the creative task.”


The current study adds a new layer to previous research conducted at Biederman’s Image Understanding Laboratory. His earlier work looking at the cortical basis of high-level visual recognition found that the same regions in the temporal lobe were activated. Humor and the appreciation of a beautiful vista both appear to use similar parts of the brain.


Biederman also notes that the activation, and therefore pleasure, associated with any experience diminishes with each repetition. This, he theorizes, is why humans tend to be “infovores,” eternally driven to find new experiences, forever craving new information (and jokes).


Learn more about the neuroscience of creativity.

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Medical News Today: Poor diet during teens, early adulthood may raise breast cancer risk

The risk of developing premenopausal breast cancer may be higher for women who have a poor diet during adolescence and early adulthood, new research finds.
[A woman eating a burger]
Researchers have associated an unhealthful diet in adolescence or early adulthood with greater risk of developing premenopausal breast cancer.


Previous studies have associated an unhealthful diet – particularly one that is low in vegetables, high in refined sugar and carbohydrates, and high in red and processed meats – with chronic inflammation, which may raise the risk of certain cancers.


According to the new study, it is this diet-induced inflammation that may increase a woman’s risk of breast cancer prior to menopause.


Study co-author Karin B. Michels, Ph.D. – professor and chair of the Department of Epidemiology at the Fielding School of Public Health at the University of California-Los Angeles – and colleagues recently reported their findings in the journal Cancer Epidemiology, Biomarkers & Prevention.


After skin cancer, breast cancer is the most common cancer among women in the United States. This year, around 252,710 new cases of invasive breast cancer will be diagnosed, and more than 40,000 women will die from the disease.


“About 12 percent of women in the U.S. develop breast cancer in their lifetimes,” notes Michels. “However, each woman’s breast cancer risk is different based on numerous factors, including genetic predisposition, demographics, and lifestyle.”


For this latest study, Michels and colleagues set out to determine how a pro-inflammatory diet during adolescence or early adulthood might influence women’s risk of breast cancer in later life.

Up to 41 percent greater breast cancer risk with pro-inflammatory diet


The researchers analyzed the data of 45,204 women who were part of the Nurses’ Health Study II.


Some of the women completed a food frequency questionnaire in 1991, when they were aged between 27 and 44 years, which disclosed details of their diet in early adulthood. The questionnaire was completed again every 4 years thereafter.


In 1998 – when aged between 33 and 52 – some women completed a food frequency questionnaire that detailed their diet during high school.


Using a technique that associates food intake with markers of inflammation in the blood, the researchers allocated an inflammatory score to each woman’s diet. The women were then divided into five groups based on their inflammatory score.


Compared with women who had the lowest inflammatory diet score during adolescence, those who had the highest score were found to be at a 35 percent higher risk of developing premenopausal breast cancer.


Women with the highest inflammatory diet score during early adulthood were found to have a 41 percent increased risk of premenopausal breast cancer, compared with those who had the lowest inflammatory diet score.


A pro-inflammatory diet was not associated with the overall incidence of breast cancer or the risk of postmenopausal breast cancer, the team reports.


Although the study cannot prove cause and effect between a pro-inflammatory diet during adolescence or early adulthood and premenopausal breast cancer, the team believes that the results further highlight the importance of a healthful diet.

“Our study suggests that a habitual adolescent/early adulthood diet that promotes chronic inflammation may be another factor that impacts an individual woman’s risk.


During adolescence and early adulthood, when the mammary gland is rapidly developing and is therefore particularly susceptible to lifestyle factors, it is important to consume a diet rich in vegetables, fruit, whole grains, nuts, seeds, and legumes and to avoid soda consumption and a high intake of sugar, refined carbohydrates, and red and processed meats.”

Karin B. Michels, Ph.D.


There are a number of limitations to the study. For example, participants reported their adolescent diet years later, so their recollections could be subject to error. Additionally, the researchers did not have access to subjects’ measurements of inflammatory blood markers during adolescence or early adulthood.


Learn how exercise is the best lifestyle change for reducing breast cancer recurrence.

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Medical News Today: Frontotemporal dementia: Types, symptoms, treatment

MNT Knowledge Center


Frontotemporal dementia refers to a group of disorders that cause dementia to start at a younger age. Around 60 percent of people who develop frontotemporal dementia are between the ages of 45 and 64 years. This type of dementia is uncommon.


Dementia is the decline in mental ability that is faster than would be expected with normal aging. Dementia affects everyday activities and gets progressively worse.



Symptoms of dementia include memory loss and difficulties with thinking, language, and problem-solving.



Frontotemporal dementia mainly affects the frontal and temporal lobes of the brain. The frontal lobe is located at the front of the brain, and the temporal lobe is located at the side of the brain. These areas of the brain are responsible for controlling behavior, personality, language, and the ability to plan and organize.



Less than 5 percent of all people who develop dementia have frontotemporal dementia.





Types of frontotemporal dementia


Brain diagram
The frontal and temporal lobes of the brain are located at the front and side of the brain respectively.



The disorders that make up frontotemporal dementia fall into the following categories of symptoms, including:


  • behavior and personality decline
  • language decline
  • motor decline


These symptoms are caused by damage to parts of the frontal and temporal lobes. The symptoms and the lobes that are affected determine the type of frontotemporal dementia a person has.


Behavior and personality decline



Behavior and personality decline is marked by progressive changes in a person’s behavior, personality, emotions, and judgment.



These symptoms often mean that a person has a type of frontotemporal dementia called behavioral variant frontotemporal dementia.



Behavioral variant frontotemporal dementia may cause changes in personality, emotional blunting, and loss of empathy. Around 60 percent of people with frontotemporal dementia have behavioral variant frontotemporal dementia.


Language decline



Language decline is marked by early changes in a person’s language ability, which includes speaking, understanding, reading, and writing.



If a person displays language decline, they may have one of the types of frontotemporal dementia that include:


  • progressive non-fluent aphasia – trouble producing speech
  • semantic dementia – loss of the ability to understand single words, familiar people, and everyday objects


Around 20 percent of people with frontotemporal dementia have the progressive non-fluent aphasia subtype, and 20 percent have semantic dementia.


Motor decline



Motor decline refers to problems with physical movement. The person may have difficulties using limbs and walking. They may shake, frequently fall, and have poor coordination.



In some cases, motor disorders may occur with frontotemporal dementia. These include:


  • motor neuron disease or ALS – a progressive disease that attacks the nerves in the brain and spinal cord
  • progressive supranuclear palsy – a brain disorder that causes difficulties with walking, eye movements, and balance
  • corticobasal syndrome – the gradual degeneration of movement, speech, memory, and swallowing

Causes



The cause of frontotemporal dementia is not entirely understood. However, the symptoms may occur because the frontal and temporal lobes of the brain shrink over time.



Shrinkage may happen due to a buildup of abnormal proteins in the brain that clump together. The cluster of abnormal proteins become toxic to brain cells and gradually kill them, which causes the brain areas to shrink.



While several gene mutations have been linked to types of frontotemporal dementia, most people with the condition do not have a family history of dementia.



Frontotemporal dementia and ALS have been shown to share genetics and molecular pathways. However, further studies are needed to work out the significance of this link.



Symptoms


senior man looking confused at a calendar
Issues with planning and prioritizing alongside other behaviors may be a symptom of frontotemporal dementia.



Frontotemporal dementia symptoms vary from person to person and depend on the subtype of the disorder diagnosed.



Symptoms tend to cluster into categories of behavior and personality changes, language difficulties, and movement problems.



Eventually, most people with the condition will experience problems in more than one of these symptom categories, and the disease will spread to affect most of the brain’s functions.


Behavior and personality changes



People who have the behavioral subtype of frontotemporal dementia may experience:


  • problems with planning, judgment, sequencing, prioritizing, multitasking, and controlling behavior
  • repetitive and obsessive behaviors, such as humming or walking the same route repeatedly
  • impulsive and inappropriate behavior
  • compulsive eating
  • personal hygiene neglect
  • irritability and aggression
  • difficulty resisting the impulse to pick up and use objects for no apparent reason
  • a lack of interest, enthusiasm, or initiative
  • flat, improper, or exaggerated emotions
  • an inability to read social signs, such as facial expressions
  • loss of empathy, no emotional reaction
  • being more or less outgoing


Quite often, the person with frontotemporal dementia is unaware that they have developed these unusual behaviors. As the disorder progresses, the person may become socially withdrawn and isolated.


Language difficulties



The language subtypes of frontotemporal dementia cause symptoms such as:


  • inability to understand and use words, but with normal physical speaking ability
  • inability to physically speak properly or slurred speech, but with no effect on intelligence or understanding
  • incorrectly using words
  • reduced vocabulary
  • repetition of a few phrases
  • declining conversation and speech


Sometimes, people with frontotemporal dementia completely lose their ability to speak.


Movement problems



Movement problems that are associated with frontotemporal dementia include:


  • inability to perform complex coordinated movements, such as eating with a knife and fork
  • difficulty maneuvering small objects such as buttons and frequently dropping them
  • uncontrollable contracting of muscles that cause abnormal postures
  • walking abnormalities that cause shuffling or frequent falls
  • muscle weakness and cramps
  • shakiness that usually happens in the hands
  • difficulty swallowing


Some people with frontotemporal dementia develop urinary incontinence and bowel incontinence.



Diagnosis


Doctor in discussion with older man
To diagnose frontotemporal dementia, a doctor may conduct several tests and assessments to rule out other conditions.



Diagnosing frontotemporal dementia can be challenging, because other conditions can cause many of the same symptoms.



Doctors conduct several tests and assessments to make a correct diagnosis and rule out other potential conditions. A doctor may:


  • assess symptoms
  • evaluate mental abilities
  • perform a physical examination
  • review personal and family medical history
  • order blood tests
  • conduct brain scans to detect any loss of brain cells in the frontal and temporal brain regions
  • order testing to identify genetic mutations


Research is ongoing to find a more accurate way to diagnose frontotemporal disorders at an earlier stage.



Treatments



There is currently no way to slow down the progression of frontotemporal dementia and no cure. However, treatment can help manage some of the symptoms.


Treating behavioral problems



There is no medication specifically for frontotemporal dementia. The following medications may help with controlling behavioral problems and managing loss of inhibitions, overeating, and compulsive behavior in some people:


  • antidepressants – trazodone or selective reuptake inhibitors (SSRIs), such as sertraline or fluvoxamine
  • antipsychotics, such as olanzapine or quetiapine


People with frontotemporal dementia will be carefully monitored while taking these medications. The side effects of these drugs include a greater risk of death in people with dementia.


Coping with language difficulties



The goals of dealing with language difficulties in frontotemporal dementia include:


  • maintaining language skills
  • using tools and new ways to communicate


The person with frontotemporal dementia may need to communicate through a notebook, gestures, sign language, or drawings. They might also benefit from photos of people and objects being labeled with names.



Caregivers may need to speak slowly and clearly to the person using simple sentences and wait for a response. Strategies may need to be altered over time as the disease progresses.


Managing movement problems



There are no treatments to slow down the progression of movement problems that are related to frontotemporal dementia. However, certain medications and physical therapy may help with some symptoms.



Researchers continue to investigate more effective treatments for frontotemporal dementia.



One route researchers are currently studying is therapies that target the abnormal proteins that cluster in the brain that may be responsible for frontotemporal dementia.





Outlook



Frontotemporal dementia is progressive. Most people with the disease will experience a decline in functions they use in everyday life. They may come to require around-the-clock care in a residential care facility.



If people have motor neuron disease-related or ALS-related frontotemporal dementia, they may live for around 3-5 years. However, people with other subtypes of the disease may live for 10 years or more. Survival time after symptoms begin can vary significantly.



Caring for someone with frontotemporal dementia can be stressful and challenging. Caregivers may need support from other family members, friends, and support groups.


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Medical News Today: Risk factors for heart failure subtypes studied in new detail

High BMI and reduced physical activity are both known risk factors for heart failure. A recent study investigates the impact of these factors on a specific subtype: heart failure with preserved ejection fraction.
[Doctor holding a heart]
BMI and exercise influence heart failure subtypes differently, the new study shows.



When the heart is no longer able to pump enough blood to meet the body’s oxygen demands, it is referred to as heart failure – a chronic and progressive condition.


An estimated 5.7 million adults in the United States have heart failure. In fact, heart failure was responsible for 1 in 9 deaths in the U.S. in 2009.


There are a number of subtypes of heart failure, one of which is called heart failure with preserved ejection fraction (HFpEF). This form of the condition is characterized by a stiffening of the left ventricle and a reduction in its ability to relax between contractions.


The stiffening associated with HFpEF means that the ventricle is unable to fill with an adequate amount of blood, and it therefore pumps less oxygen-rich blood around the body.


Lifestyle factors are known to increase the risk of heart failure, including lower levels of physical activity and a higher BMI. Because HFpEF accounts for roughly half of all heart failure cases and typically responds less well to current therapies, there is an important emphasis on prevention.

Examining HFpEF


A new study, carried out at the University of Texas Southwestern Medical Center in Dallas, aimed to investigate the influence of common risk factors on HFpEF, specifically. Their results are published this week in the Journal of the American College of Cardiology.


The investigators – led by Dr. Jarett D. Berry, associate professor in the department of internal medicine and clinical sciences – used data from 51,541 participants. This information was taken from three studies: the Women’s Health Initiative, the Multiethnic Study of Atherosclerosis, and the Cardiovascular Health Study.


All participants were free of cardiovascular disease at the start of the study and were assessed for levels of physical activity and BMI. Across the cohort, over the following years, there were 3,180 heart failure events, as confirmed by independent medical experts.



The data showed that participants with higher levels of physical activity were most often male, white, and likely to have had higher income and education levels. They were also less likely to smoke, have diabetes, obesity, and hypertension.


Conversely, participants with higher BMIs tended to be younger, exercise less, and have a higher prevalence of cardiovascular risk factors.


“We consistently found an association between physical activity, BMI, and overall heart failure risk. This was not unexpected; however, the impact of these lifestyle factors on heart failure subtypes was quite different.”

Dr. Jarett D. Berry



Of the 3,180 heart failure events, 39.4 percent were HFpEF, 28.7 percent were heart failure with reduced ejection fraction (HFrEF) – a subtype associated with a weaker heart muscle that cannot pump adequately – and 31.9 percent were unclassified.


Compared with individuals who did no physical activity, the researchers found a reduction in heart failure risk that matched the exercise level:

  • Low physical activity: 6 percent reduction in risk
  • Participants who met recommended levels of physical activity: 11 percent reduction in risk
  • Participants who exceeded recommended levels of physical activity: 22 percent reduction in risk.

HFpEF vs. HFrEF


When the data were further split into HFpEF and HFrEF, differences in the effect of exercise on heart failure risk were uncovered. Individuals who exceeded recommended levels of activity had a 19 percent reduced risk of HFpEF, compared with those who did not exercise. However, there was no such association between elevated physical activity and risk of HFrEF.


Higher BMIs were, unsurprisingly, associated with a higher overall heart failure risk. However, the relationship between BMI and heart failure subtypes was similar to that of exercise. BMI had a more significant impact on the risk of HFpEF than HFrEF.


The findings hammer home the importance of BMI and physical activity in preventing HFpEF. First author, Dr. Ambarish Pandey, a cardiology fellow at the University of Texas Southwestern Medical Center, said:


“There was a distinct relationship between both physical activity and BMI and the different heart failure subtypes, which may have important clinical and public health implications. These data suggest the importance of modifying lifestyle patterns to help prevent HFpEF in the general population.”


Although the study was observational and, therefore, cannot prove cause and effect, it will certainly spur further investigation.


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Medical News Today: Living with COPD: Tips, activities, and treatments

MNT Knowledge Center


Chronic obstructive pulmonary disease is a lung condition that affects a person’s ability to breathe. A person who is diagnosed with this illness usually has both emphysema and chronic bronchitis. These conditions result in less air flowing in and out of the lungs.


The symptoms of chronic obstructive pulmonary disease (COPD), including shortness of breath, wheezing, and chronic cough, can make daily tasks more challenging.



Everyday things that may not seem physically demanding can be difficult for someone with COPD. Eating, getting dressed, and doing household tasks can be hard to manage when a person has trouble breathing.



However, a COPD diagnosis doesn’t have to mean that a person will lose their independence, or that they will have to stop enjoying their favorite activities.



Following a treatment plan can significantly improve a person’s life and help them find their “new normal.”





Keeping up with life with COPD


Man breaking cigarette in half
For people with COPD, quitting smoking is highly recommended.



With some changes and effective treatments, many people with COPD can lead fulfilling lives. Though the diagnosis of COPD can be overwhelming, there are ways to make everyday life easier and more enjoyable:


  • Quitting smoking. This is the best way to help the lungs heal and function at their best, and it benefits the heart and other organs as well. Quitting smoking also strengthens a person’s immune system.
  • Allowing more time to get to and from appointments and events. People can try setting an alarm with an extra 10-20 minutes of time to get out the door. This can help avoid stress, anxiety, and rushing, which can lead to more shortness of breath or wheezing.
  • Considering ways to modify tasks to make them easier to do. Breathing exercises and rest breaks can make walking or gardening more enjoyable, for example.
  • Explaining COPD symptoms to friends and family. If others understand that certain activities are more difficult, they can provide support and compassion. This can reduce worry and give others the opportunity to help when needed.


People should be open with doctors and members of their healthcare team. With a new COPD diagnosis, symptoms may be confusing or even frightening. Talking to the healthcare team about symptoms and challenges helps people to work through them, learn the best way to stay healthy, and still take part in life’s activities.


COPD and medical appointments



After a person has been diagnosed with COPD, they will have to attend regular appointments with their doctor and get used to new treatments. Developing a treatment plan is an essential part of living well with COPD. A treatment plan may include medications, oxygen therapy, pulmonary rehabilitation, lifestyle changes, and education about COPD.



People with COPD sometimes have a large healthcare team around them that can include doctors, nurses, therapists, dietitians, psychologists, social workers, and spiritual advisors such as a chaplain. All of these professionals play an important role in helping a person with COPD stay as healthy as possible.



Many patients have regular pulmonary rehabilitation appointments. A study in the International Journal of Chronic Obstructive Pulmonary Disease suggests that pulmonary rehab can help people with COPD lead quality lives in a number of ways, including increasing their ability to exercise.



In addition to medical care, people with COPD can make some changes at home to keep themselves feeling well and to help manage symptoms. With the right treatment and home changes, many people with COPD can continue to do what they enjoy.



Diet changes for COPD


a colorful selection of fruits and vegetables
A healthful diet that includes a variety of fruits and vegetables alongside other healthful whole foods is recommended for people with COPD.



Eating is a part of daily life, and people with COPD should follow a healthful diet to help with their condition. Choosing the right foods may help a person with COPD continue their daily activities because they will be healthier, more energetic, and less short of breath.



A diet suitable for people with COPD doesn’t have to be overly strict or complex. In general, people with COPD should focus on healthful whole foods including:


  • A variety of fruits and vegetables in different colors. Fresh and frozen are ideal, but canned fruits and vegetables are also fine if they have no sugar, salt, or additives.
  • Whole grains. Ensure that breads and pastas are “100 percent whole grain” or “100 percent whole wheat,” by checking the labels. Whole grain brown rice and steel-cut oatmeal are other popular whole grain choices.
  • Legumes. Peas, beans, lentils and peanuts are common legumes that offer protein and fiber. If excess gas is an issue, these may need to be decreased or eliminated.
  • Lean sources of protein. Eggs, fish, poultry, soy, and milk are healthful sources of protein, which is important for a healthy immune system.
  • Probiotics. Probiotics are protective bacteria and yeast found in many fermented foods like yogurt, kefir, and kombucha. Studies suggest a diet supplemented with probiotics, especially Lactobacillus, can decrease viral lung infections in people with COPD and help with heart health.


Many people with COPD will be given diet guidelines by their healthcare team. Following a healthful diet can have a strong impact on how a person feels and can help them avoid lung infections and other complications.



Though it may seem unrelated to the lungs, consuming healthful food is an effective way to help people with COPD feel better and remain active and involved in daily life. A study in Translational Research suggests that intake of certain vitamins and nutrients, especially vitamins E, D, C, and A, was associated with better lung function.



Physical activity and COPD


older person walks their dog in a park
Studies suggest that staying active may reduce the mortality rate for people with COPD.



Exercise can – and should – be a part of life for people with COPD. Staying active with COPD may be difficult at first, but it is well worth the effort.



A moderate amount of exercise can help a person with COPD carry on with their everyday tasks without shortness of breath and other symptoms standing in their way. A study in the CHEST Journal suggested that the more active a person with COPD is, the lower their mortality risk.



Unfortunately, many people with COPD avoid exercise because they are afraid they will be short of breath or simply don’t have the energy. As a person exercises less, their fitness level declines. Over time, they may be unable to do much activity at all.



This drop in fitness can be reduced if a person with COPD keeps physically active. Even those who haven’t been active in the past can begin an exercise program slowly and gradually with a doctor’s guidance. Though exercise cannot reverse COPD, it can help a person remain independent and healthy for as long as possible.


COPD breathing exercises



Breathing exercises are a special way of moving air in and out that can help relax the body and allow the lungs to take in more oxygen. These exercises help relieve immediate symptoms of COPD. They can also increase confidence so that a person feels less afraid to go for a walk, prepare a meal, or do other activities that they have always done.



Breathing exercises are a valuable tool for those with COPD. They can help a person remain active and involved in daily life.



The most common breathing exercises for COPD are pursed lip breathing and belly breathing. A pulmonary rehabilitation specialist can demonstrate how these are done and help people master them so they can be used anytime.



Avoiding illness



A person who has been diagnosed with COPD needs to stay as healthy as they can and should avoid illness as much as possible by:


  • washing hands frequently with soap and water, especially before eating and touching the face and after using the bathroom
  • getting vaccinated against flu, pneumonia, and pertussis (whooping cough)
  • avoiding people who are sick
  • getting adequate sleep and drinking plenty of water


Being mindful of illnesses and germs can help avoid lung infections, which can be serious.





Looking ahead



A COPD diagnosis doesn’t have to mean the end of enjoying life. With the guidance of a healthcare team and a healthful lifestyle, many people are able to continue some or all of their regular activities.


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Medical News Today: Rare but fatal pediatric brain tumor may be stopped with new molecule

Researchers may have found a molecule that inhibits the growth of a rare but fatal tumor that occurs in children, called diffuse intrinsic pontine glioma.
[brain tumor]
New research uncovers a molecule that successfully halts DIPG – a fatal pediatric brain tumor.


Diffuse intrinsic pontine glioma (DIPG) is a pediatric brain tumor that mainly affects children under 10 years of age.


Approximately 300 children – usually between 5 and 9 years old – are diagnosed with DIPG every year. DIPGs are located in the brain’s pons – a brain region that controls many of the body’s vital functions, including breathing and heart rate.


DIPGs are extremely aggressive and difficult to treat, so being diagnosed with the tumor typically results in death within a year.


New research, however, offers hope for treating DIPG. Scientists from Northwestern University in Evanston, IL, may have found a molecule that could stop the development of the tumor. The team was led by Ali Shilatifard, Robert Francis Furchgott professor of biochemistry and pediatrics, and chair of biochemistry and molecular genetics at Northwestern University’s Feinberg School of Medicine.


The new findings – published in the journal Nature Medicine – build on research that Shilatifard and colleagues have carried out in the past. Shilatifard and his team identified the pathway through which a genetic mutation causes cancer in a study published in the magazine Science, and a follow-up study – conducted in collaboration with Rintaro Hashizume and his team – used this knowledge to test the effects of pharmacological therapy on DIPG in mice.


The latter study inhibited the previously identified genetic pathway and successfully prolonged the life of mice by 20 days. The drug was administered through the mice’s abdomen, but in this latest research, the team set out to investigate whether injecting the cells into the mice’s brainstem would have more robust effects.


BET bromodomain inhibitors successfully halt tumor growth



The scientists sampled tumor cell lines from an untreated patient and injected them into a mouse’s brainstem, where it grew into a tumor. Subsequently, the scientists treated the mouse with a BET bromodomain inhibitor and went on to clinically monitor the tumor.


The BET bromodomain inhibitor has proven efficacious in several cancer models before.


In this study, by using the inhibitor, bromodomain proteins could no longer bind to the histone H3K27M – a mutant protein found in 80 percent of DIPG tumors. BET inhibitors stopped the proliferation of tumor cells, and forced them to differentiate into other cells instead.
This successfully stopped tumor growth.


The study’s first author, Andrea Piunti – a postdoctoral fellow in Shilatifard’s laboratory in biochemistry and molecular genetics at Northwestern University Feinberg School of Medicine – suggests that BET inhibitors should next be tested in a pediatric trial to treat DIPG, especially since the drugs are already being tested for pediatric leukemia.


“To the best of our knowledge, this is the most effective molecule so far in treating this tumor. Every other therapy that has been tried so far has failed.”

Ali Shilatifard, senior author



The senior author also notes that the currently available radiation therapy is ineffective in treating DIPG; it only adds a few months to the patients’ survival.


Shilatifard comments on the importance of Northwestern University for making this research possible:


“This work could not have been done anywhere in the world except Northwestern Medicine, because of all the scientists and physicians who have been recruited here during the past five years and how they work together to link basic scientific research to the clinic,” Shilatifard says. “This discovery is the perfect example of how we take basic science discoveries and translate them to cure diseases at Northwestern Medicine.”

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Medical News Today: Can red ginseng help treat erectile dysfunction?

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