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Study Reveals Higher Breast Cancer Mortality Risk for Black Women Across All Tumor Types

The AHA! Team — Fri, 25 Oct 2024 08:15:48 +0000

Mass General Brigham via News-Medical – Breast cancer is the most diagnosed cancer among U.S. women and the second leading cause of cancer death. Black women who develop breast cancer are around 40% more likely to die of the disease than white women, but it was unclear until now whether this disparity exists across all types of breast cancer. Now, a meta-analysis led by Mass General Brigham researchers shows that Black women have a higher risk of dying from breast cancer for all tumor subtypes, and the size of this disparity varies from 17-50% depending on the type of breast cancer. These findings, published in the Journal of Clinical Oncology, demonstrate that higher mortality rates among Black women with breast cancer are at least partially attributable to factors that are independent of tumor biology-;for example, socioeconomic inequality, delays in diagnosis, and inadequate access to timely quality cancer treatment resulting from systemic racism. “Our findings demonstrate that multiple, interacting factors contribute to disparities in breast cancer survival between Black and white women. To achieve equity, intervention is necessary at multiple levels-;from community to healthcare systems and individual healthcare providers, to patients themselves learning about their disease and what their expectations should be for their care.” Erica Warner, ScD, MPH, senior author, cancer epidemiologist at Massachusetts General Hospital, founding member of the Mass General Brigham healthcare system Though it is often discussed as a single disease, breast cancer has multiple subtypes that differ in risk factors, treatment, and prognosis. These subtypes are defined based on whether the cancer cells carry hormone receptors for estrogen or progesterone, which can be targeted for treatment, and whether they carry HER2 (human epidermal growth receptor 2), a protein associated with cancer aggressiveness and another potential treatment target. Breast cancer has multiple subtypes that differ in risk factors, treatment, and prognosis “There had been an anecdotal sense in the research community that differences in survival between Black and white women were greater for the most treatable forms of the disease-;tumors that carry hormone receptors-;and smaller for the historically less-treatable, hormone-negative tumors,” said Warner. To investigate whether these anecdotes were supported by the evidence, Warner’s team combined data from 18 studies that were published between 2009 and 2022. Altogether, these studies analyzed 228,885 breast cancer cases, 34,262 of which were in Black women. They found that survival was worse for Black women for all breast cancer subtypes, though the size of these disparities varied between breast cancer subtypes. There was a larger racial disparity for hormone-positive tumors, which were associated with a 34-50% higher risk of death for Black women, compared to hormone-negative tumors, which were associated with a 17-20% higher risk of death for Black women. “These findings underscore a stark reality in our healthcare system: Black women are facing higher risks of death from breast cancer compared to their white counterparts, across all types of the disease. This disparity isn’t just about biology,” said co-author Paulette Chandler, MD, MPH, associate epidemiologist in the Division of Preventive Medicine at Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system. “It’s a call to action for healthcare providers, policymakers, and communities alike to confront these inequities head-on and strive for meaningful change in breast cancer outcomes.” Because hormone-negative tumors are less common, Warner says that racial disparities in breast cancer survival for hormone-negative subtypes were likely not observed previously because individual studies lacked statistical power due to the small number of cases. “There may also be differences in the biological characteristics of some tumor subtypes between racial groups that our therapies are not attuned to, potentially because of underrepresentation of Black women in clinical trials,” said Warner. The researchers point to several existing multilevel intervention programs However, these racial disparities are not inevitable, and the researchers point to several existing multilevel intervention programs that have successfully reduced disparities in cancer survival. These programs leverage multiple strategies, including helping patients navigate the healthcare system, proactively identifying social needs and connecting patients with resources to address those needs, and by implementing systems that alert healthcare workers of missed appointments or unmet care milestones. At the national level, interventions like ACCURE and Equal Hope aim to close gaps in mortality and survival between Black and white women. Locally, MGH is collaborating with Boston Medical Center on a virtual Equity Hub for Cancer Treatment with the goal of enhancing partnerships and improving cancer care for underserved patients at community-based mental health centers. Source: Mass General Brigham Journal reference: Torres, J. M., et al. (2024) Racial Differences in Breast Cancer Survival Between Black and White Women According to Tumor Subtype: A Systematic Review and Meta-Analysis. Journal of Clinical Oncology. doi.org/10.1200/JCO.23.02311. To read the original article click here.

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Hydroxychloroquine + Azithromycin Therapy at a Higher Dose Improved Survival by Nearly 200% in Ventilated COVID Patients

AHA Publisher — Mon, 07 Jun 2021 07:00:14 +0000

Dr. Liji Thomas, MD via News-Medical – Treatment options have been limited in the ongoing coronavirus disease 2019 (COVID-19) pandemic. Earlier optimism regarding immunomodulatory drugs such as azithromycin (AZM) and hydroxychloroquine (HCQ) seemed to be undermined by results of large interventional trials. However, a fascinating new study posted to the medRxiv* preprint server (not peer-reviewed*), suggests that such disappointment may have been both premature and unwarranted, based on a re-analysis of over 250 patients on invasive mechanical ventilation (IMV) during the first two months of the pandemic. Using computational modeling, the use of weight-adjusted HCQ and AZM appears to be associated with a more than 100% increase in survival, without a clear correlation with ECG abnormalities. Study Details In this study, based on a subset of critically ill COVID-19 patients, consisting of patients who required intubation and IMV, data from the medical records were analyzed using several novel methods. This included not only the vital signs and laboratory values but the therapeutic methods. The study was carried out on patients at Saint Barnabas Medical Center, New Jersey, with just over 1% having been clinically diagnosed to have COVID-19. Of the 255 patients, almost 80% died during the study period. Seven patients were transferred to another hospital on the ventilator, mostly after day 40 of hospitalization. Parameters were broadly comparable between survivors and non-survivors, except that all patients with an active malignancy, dementia, chronic obstructive pulmonary disease, and stroke failed to survive. However, sex, race, presentation severity, and blood type had no association with survival chances. A pre-print version of the research paper is available on the medRxiv* server. A preprint is a version of a scholarly or scientific paper that precedes formal peer review and publication in a peer-reviewed scholarly or scientific journal. Laboratory Markers Laboratory markers of inflammation, such as Ferritin, D-dimer, Lactate Dehydrogenase (LDH), and C-reactive protein (CRP), were above average in almost every patient (96%). While all parameters, except the LDH, were equivalent in survivors and non-survivors, three patients had D-dimer values above 69,000 ng/mL. LDH values were higher in non-survivors by almost 30%. The increase in these parameters over time was characteristically steeper in patients who did not survive. Clinical Complications More than three in four non-survivors developed acute kidney injury (AKI), of which a tenth received renal replacement therapy (RRT). Of this latter group, a fifth survived. Almost 60% of patients were intubated within three days of hospitalization. The time to intubation did not predict survival, but intubation beyond day 15 was associated with survival in only 1 of 16 patients. More than 90% of the patients in this cohort had high blood glucose levels above 140 mg/dL, peak at >200 mg/dL, without corticosteroid therapy. Although none were known to be diabetics, most probably had impaired glucose tolerance before they acquired SARS-CoV-2. This prevalence is higher than in most other studies, probably because the researchers looked actively for hyperglycemia Obesity While half of the patients were obese, and 30% were overweight, the older patients were significantly heavier. That is, 74% of those above 60 were obese, vs 37% of those below this age. The mean body weight was approximately 90 kg, but unlike most antibiotic clinical trials, the range of body weight was extensive. The heaviest patient thus weighed approximately seven times more than the lightest. Notably, blood glucose levels or obesity did not predict a good clinical outcome. Therapeutic Drugs The chief therapeutic classes included steroids, tocilizumab, convalescent plasma, hydroxychloroquine, and azithromycin. Corticosteroids, when given at 6 mg or more, reduced the mortality risk 1.4 times. Meanwhile, the interleukin-6 receptor blocker) tocilizumab had two-fold lower mortality. Convalescent plasma (CP) was used only from week 4, in a fifth of the patients, mostly younger than those who did not receive it. The survival of the group which received CP was almost doubled from CP non-users. HCQ was used in 94% of patients within 48 hours of emergency room arrival, while >55% received 2,000-3,000 mg, cumulatively. Of this number, approximately 63% also received AZM. This combination fell out of favor over the study period based on external recommendations. Effect of HCQ/AZM on Mortality With every log increase in the cumulative dose of HCQ, the mortality rate fell by 1.12 times, such that at 3 g HCQ, survival odds rose by 2.5 times. When given together with AZM, the benefit was still more significant. Chances of survival increased further. Among those who received both > 3g HCQ and >1g AZM, almost half survived, compared to one in seven (16%) among patients who received one of these drugs at the same dosages. This means a 32% absolute difference in survival, or a relative improvement in survival odds of 200%, with the combination of HCQ/AZM at this dosage. This far exceeds the survival benefit cited in any study of any intervention so far. When HCQ/AZM was given at lower dosages, the risk of death was over three times higher relative to the above combination and dosage regimen. When the cohort was divided into patients who received >3g HCQ/>1g AZM and those who did not, overall, the absolute chances of survival were 23% higher for the first group. The 17% survival in the second group would have increased to 39% with the former treatment, predicted the researchers. This indicates that treatment with >3g HCQ/>1g AZM was associated with a more than 130% increase in survival rate compared to any other standard therapy. Weight-Adjusted Cumulative Dosage The researchers also found that when adjusted for weight, the cumulative dose would have a still greater effect. In fact, the average treatment effect (difference in mean survival, in this case) shows a steep increase between 40-50 mg/kg to peak at 46% for a dose of 82 mg/kg. Thus, patients receiving HCQ above 80 mg/kg of HCQ with >1g AZM had 14 times higher survival odds compared to those who did not. If HCQ dosage was fixed at >3g, the odds of survival were 7 times higher, or less than half of that achieved with the weight-adjusted cumulative dosage. “The fact that weight-adjusted cumulative dose has an even greater effect on survival than cumulative HCQ dose is strong confirmation of the causal relationship between this treatment and improvement in survival rate.” Age was another major factor since those older than 60 were five times more likely to succumb than younger patients. Hyperlipidemia was the single comorbidity linked to approximately four times higher odds of death. Interestingly, there was no correlation between the cumulative dose of HCQ (or AZM) and the occurrence of QTc prolongation. In fact, the QT interval began to fall during the period when the cumulative dose of HCQ increased. None of the patients showed torsades de pointes. What Are the Implications? These findings indicate that a steeply rising ferritin, D-dimer and LDH over time predict poor survival, the rate of rise being several times greater for non-survivors. This should be validated to help provide a better prognosis for COVID-19 patients. The extensive range of obesity among critically ill patients indicates that weight-adjusted dosage is critical in achieving the correct therapeutic levels. Moreover, AZM is an independent contributor to improved survival. Most importantly, this is the first clinical study to demonstrate the remarkable benefit of using cumulative doses of HCQ>3g/AZM>1g, compared to those not treated with this combination. Why did such a large effect miss observation? For one thing, HCQ produces its benefit by cumulative effects on the target cells, which is weight-dependent. The failure to treat patients with weight-adjusted doses leads to ineffective treatment and outcomes biased towards lighter patients. HCQ is both safe and tolerable at higher doses, as shown in studies of rheumatoid arthritis or lupus. Such high doses for such long durations have not been used to treat COVID-19. The earlier studies claiming prolongation of the QTc duration with HCQ in COVID-19 treatment are shown to be flawed. Indeed, available data suggests that this finding is due to the underlying illness itself. The investigators also point out: “On April 24, 2020, the FDA issued a warning about the possible effects of low HCQ on QTc interval (47). Since 2010, the FDA has approved over 150 clinical trials, which include HCQ treatment. The FDA did and does not require monitoring for cardiotoxicity. In each of these trials, the total HCQ dose and expected tissue levels are markedly higher than used or seen in Covid patients. This discrepancy lacks logic or explanation.” In this startling study, the investigators carefully re-examined the data, showing that among critically ill COVID-19 patients on IMV, less than 4% “walk out of hospital.” In contrast, the survival benefit of combined HCQ/AZM at a cumulative dosage of >80 mg/kg and >1g, respectively, is shown to be both clear and significant. The safety at such doses is obvious, since survival is increased by almost 130% in this very high-risk population. Moreover, it appears that AZM is an important component of this therapy in terms of mortality reduction. *Important Notice medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information. To read the original article click here.

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Overweight or Obesity Amplifies Harmful Effects of Alcohol on the Liver

AHA Publisher — Fri, 04 Jun 2021 07:00:55 +0000

University of Sydney via News-Medical – Led by the University of Sydney’s Charles Perkins Centre, the study looked at medical data from nearly half a million people and found having overweight or obesity considerably amplified the harmful effects of alcohol on liver disease and mortality. “People in the overweight or obese range who drank were found to be at greater risk of liver diseases compared with participants within a healthy weight range who consumed alcohol at the same level. Even for people who drank within alcohol guidelines, participants classified as obese were at over 50 percent greater risk of liver disease.” (Professor Emmanuel Stamatakis, senior author and research program director, Charles Perkins Centre and the Faculty of Medicine and Health) The researchers drew upon data from the UK Biobank – a large-scale biomedical cohort study containing in-depth biological, behavioural, and health information from participants in the United Kingdom (UK). According to the researchers, this is one of the first and largest studies looking at increased adiposity (overweight or obesity) and level of alcohol consumption together, in relation to future liver disease. Information was examined from 465,437 people aged 40 to 69 years, with medical and health details collected over an average of 10.5 years. The findings were published in the European Journal of Clinical Nutrition. Lead author Dr Elif Inan-Eroglu, a postdoctoral research fellow with the Charles Perkins Centre, said the results suggest people carrying excess weight may need to be more aware of risks around alcohol consumption. “With the most recent data suggesting two in three people – or 67 percent of the Australian population are in the overweight or obesity range, this is obviously a very topical issue.” Key Findings The researchers reviewed data on participants classified as overweight/obese based on their body mass index (BMI) and waist circumference, self-reported alcohol consumption according to UK alcohol guidelines, and liver disease incidence and liver disease as cause of death. BMI is based on both weight and height. A BMI of over 25 denotes overweight, and over 30 denotes obesity. For waist circumference, researchers used the World Health Organization (WHO) classification: normal (<80 cm for women, <94 cm for men), overweight (>80 cm for women, >94 cm for men), and obese (>88 cm for women, >102 cm for men). The level of risk was given a number called a ‘hazard ratio’. The higher the number than 1, the higher the risk. People who drank above UK alcohol guidelines had, compared to within guideline drinkers: oA nearly 600 percent higher risk of being diagnosed with alcoholic fatty liver disease(5.83 hazard ratio). oA nearly 700 percent higher risk of death caused by alcoholic fatty liver disease (6.94 hazard ratio). People with overweight or obesity who drank within or above alcohol guidelines had over 50 percent greater risk of developing liver disease compared to normal weight participants who consumed alcohol at the same level. To read the original article click here.

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Drinking This Nitrate-Rich Juice Offers POWERFUL Benefits to People With Heart Failure

AHA Publisher — Tue, 01 Jun 2021 07:00:56 +0000

Lori Alton via NaturalHealth365 – Heart disease, a condition in which the heart can’t pump enough blood to meet the body’s demands, currently affects 5.7 million people in the United States, with roughly 550,000 new cases diagnosed each year. Unfortunately, heart failure – often triggered by coronary artery disease and ischemic heart disease – features a high mortality rate. The ability to undertake medically supervised, appropriate physical activity is key to the survival of heart failure patients, especially in the early stages. But shortness of breath and fatigue – classic symptoms of the condition – can make exercise difficult. And this is where a particular nitrate-rich juice comes in. A study from researchers at Indiana University suggested that dietary nitrates from beet juice could improve the ability of heart failure patients to exercise. CATCH 22 – While Heart Failure Symptoms Make Exercise Difficult, Inactivity Worsens Survival Rate Not only is inactivity a major risk factor for heart failure, but it has been shown in studies to worsen the survival rate once the condition has developed. In one study, only 25 percent of heart failure patients with a sedentary lifestyle were still alive two and a half years after being admitted to the hospital – compared with 75 percent of physically active patients. Scientists report that medically supervised regular activity that provokes mild-to-moderate shortness of breath can improve quality of life, increase functional capacity, promote endothelial function and reduce the production of pro-inflammatory cytokines in heart patients. Most important of all, it reduces both hospitalizations and deaths. Nitrate-Rich Juice Enhances Exercise Capability of Heart Failure Patients and Elite Athletes Alike Noting that heart failure patients exhibit lower exercise efficiency, shortness of breath, and diminished peak oxygen uptake (VO peak) during exercise, researchers wanted to see if dietary nitrates from beet juice could help. Nitrates, found in great supply in beetroot and beet juice, are converted during exercise into beneficial nitric oxide. Earlier studies had shown that nitrates improve muscle contractile function and physical performance. In the double-blind, placebo-controlled study published in Journal of Cardiac Failure, the team found that beet juice supplementation caused significant increases in exercise duration, peak power, and peak oxygen uptake in heart failure patients. As a result, the participants could exercise longer without becoming fatigued. The scientists concluded that dietary nitrates could be a valuable means of enhancing exercise capability in patients with heart failure. But Wait, There Is More! Heart Failure Patients Can Also Expect Increased Muscle Power From Beet Juice, According to Study In research conducted at Washington University School of Medicine in St. Louis, MO., and published in Circulation: Heart Failure, scientists built upon earlier research showing that dietary nitrates improve muscle performance for elite athletes. To conduct the study, researchers gave heart failure patients either beet juice or a placebo version – identical, except that the nitrates had been removed. Those who had received the “live” beet juice showed a 13 percent increase in muscle power over those who received the nitrate-depleted juice. Particularly, power increased in the muscles that extend the knee, which obviously has great relevance to walking and running. The researchers compared the “magnitude of improvement” in the heart failure patients to that of patients who had performed two to three months of resistance training – a remarkable result. Lead study author Dr. Linda R. Peterson, associate professor of medicine at the Washington University School of Medicine, commented that many everyday activities in life – even those as simple as climbing stairs or getting in and out of a bathtub – are “power-based.” The goal, she said, is to make people more powerful. In addition to benefiting the quality of life, power is an important indication of how well patients will do when battling health conditions such as heart failure or cancer. Beet Juice May Help Prevent Life-Threatening Chronic Diseases Increased exercise capacity is not the only gift of beet juice to the heart. The increased production of nitric oxide helps dilate blood vessels and combats high blood pressure, a risk factor for heart attacks, heart failure, and stroke. One study showed that drinking 250 ml (about eight ounces) of nitrate-rich beet juice a day significantly lowered blood pressure, leading the researchers to advise eating high-nitrate vegetables as a low-cost way to help treat hypertension. (Of course, never reduce or eliminate prescribed medication unless advised to do so by your doctor). Beets may also help fight type 2 diabetes with their content of alpha-lipoic acid. This powerful antioxidant has been shown to increase insulin sensitivity and lower blood sugar. In addition, beets contain natural plant pigments known as betalains, which can disrupt potentially cancer-causing mutations of cell DNA. While more study is needed, researchers are intrigued by betalains’ potential for acting against cancer. If you choose to get your beets in the form of the cooked root vegetable rather than the juice, you will be benefiting from a hefty 3.81 grams of fiber per cup. Dietary fiber has been shown in numerous studies to help prevent colon cancer. Clearly, it is not just heart failure patients that may be helped by beet juice. Older individuals without heart failure could benefit – along with the rest of the general population, many of whom don’t take in enough nutrient-rich, antioxidant-laden healthy fare. By the way, other promising natural interventions for heart failure include hawthorn, CoQ10, and fish oil. Naturally, check with your doctor before supplementing. Whether you are a heart disease patient, an athlete in training, or just someone looking to improve their health, it looks like lifting a glass (of nitrate-rich beet juice) is a wise move. Sources for this article include: ScienceDaily.com MedicalNewsToday.com LifeExtension.com MedicalNewsToday.com To read the original article click here. For more articles from NaturalHealth365 click here.

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Vitamin D Levels in the Blood Can Predict Future Health Risks & Death

AHA Publisher — Wed, 09 Sep 2020 07:00:13 +0000

European Society of Endocrinology via EurekAlert – Free, circulating vitamin D levels in the blood may be a better predictor of future health risks in aging men, according to a study being presented at e-ECE 2020. These data suggest the free, precursor form of vitamin D found circulating in the bloodstream is a more accurate predictor of future health and disease risk, than the often-measured total vitamin D. Since vitamin D deficiency is associated with multiple serious health conditions as we get older, this study suggests that further investigation into vitamin D levels and their link to poor health may be a promising area for further research. Vitamin D deficiency is common in Europe, especially in elderly people. It has been associated with a higher risk for developing many aging-related diseases, such as cardiovascular disease, cancer and osteoporosis. However, there are several forms, or metabolites, of vitamin D in the body but it is the total amount of these metabolites that is most often used to assess the vitamin D status of people. The prohormone, 25-dihydroxyvitamin D is converted to 1,25-dihydroxyvitamin D, which is considered the active form of vitamin D in our body. More than 99% of all vitamin D metabolites in our blood are bound to proteins, so only a very small fraction is free to be biologically active. Therefore, the free, active forms may be a better predictor of current and future health. Dr Leen Antonio from University Hospitals Leuven in Belgium and a team of colleagues investigated whether the free metabolites of vitamin D were better health predictors, using data from the European Male Ageing Study, which was collected from 1,970 community-dwelling men, aged 40-79, between 2003 and 2005. The levels of total and free metabolites of vitamin D were compared with their current health status, adjusting for potentially confounding factors, including age, body mass index, smoking and self-reported health. The total levels of both free and bound vitamin D metabolites were associated with a higher risk of death. However, only free 25-hydroxyvitamin D was predictive of future health problems and not free 1,25-dihydroxyvitamin D. Dr Antonio explains, “These data further confirm that vitamin D deficiency is associated with a negative impact on general health and can be predictive of a higher risk of death.” As this is an observational study, the causal relationships and underlying mechanisms remain undetermined. It was also not possible to obtain specific information about the causes of death of the men in the study, which may be a confounding factor. “Most studies focus on the association between total 25-hydroxyvitamin D levels and age-related disease and mortality.” “As 1,25-dihydroxyvitamin D is the active form of vitamin D in our body, it was possible it could have been a stronger predictor for disease and mortality. It has also been debated if the total or free vitamin D levels should be measured. Our data now suggest that both total and free 25-hydroxyvitamin D levels are the better measure of future health risk in men,” says Dr Antonio Dr Antonio and her team are currently finalising the statistical analysis and writing a manuscript on these findings. To read the original article click here.

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6 Reasons You’re Not Getting Good Sleep & Why It’s Dire

AHA Publisher — Sat, 25 Jul 2020 07:00:07 +0000

Dr. Don Colbert – It’s estimated that 50 to 70 million Americans have problems with getting good sleep. Are you one of them? Or, are you getting enough sleep each night; at least 7 hours, with much of it being deep sleep? If not, here’s what you need to know. A new study was recently published about the effects of insufficient sleep and rapid eye movement (REM). Plus, we have 6 reasons you may not be getting enough, and what you can do about it. Not Getting Good Sleep? It May Be a Dire Situation It’s no secret that lack of sleep has negative effects on your body. If you’re not getting good sleep each night, at least 7 hours, you likely also get less REM. This can increase cortisol levels, depressed moods, and irritability while decreasing reaction times, focus, and overall wellness. But, do these effects have dire consequences? New Study Links REM and Mortality A new study published in July in JAMA found an association with less REM percentage and an increased risk for death in middle-aged and older adults (1). Investigators at the University of California, San Diego, studied insufficient REM percentage and its consequences. They found that each 5% reduction of REM over a 12-year period was associated with a 13% increase in mortality rate. The primary study included 2675 men (mean age, 76.3 years), and followed them for approximately 12 years. A cohort study included 1386 individuals (54.3% men, mean age 51.5 years), with a follow-up of approximately 21 years. The investigators followed the sleep scores and mortality throughout the study. Self-report sleep measures were collected using the Pittsburgh Sleep Quality Index and the Functional Outcomes of Sleep Questionnaire. This study did not show cause and effect but did establish the association of low REM percentage and increased mortality. Causes of Death in the Study The causes of death in the study were categorized as cardiovascular, cancer, or other. Approximately half (53%) of the participants in the primary study died during follow-up. The highest percentage of deaths was recorded among those in the lowest REM sleep percentage. After analysis adjustments, it was determined that there was a 13% higher mortality rate for every 5% reduction in REM sleep among participants. These findings were similar and significant for cardiovascular and “other causes of death” but not cancer-related death. Findings were similar in the cohort study. REM Percentage The percentage of REM was calculated throughout the study using polysomnography and evaluation with the Epworth Sleepiness Scale. A “healthy” percentage of REM for most adults is approximately 20-25% (2). The mean percentage of REM sleep in the study was 19.2%. Within all causes of death, the mortality rate was greater for those participants who had <15% REM sleep per night than those with 15% or more. Those with <15% REM were generally older and also had higher rates of antidepressant use, cardiac events and conditions, and engaged in less physical activity. Dire Consequences Unfortunately, the answer is “yes,” the consequences of insufficient sleep and REM percentage may be dire. While this study shows increased mortality, the investigators are not sure exactly what connects it to REM. They do know insufficient REM percentage and sleep negatively affect the cardiovascular system, metabolism, brain, and overall quality of life. How can you get more REM and avoid the effects? 6 Reasons You’re Not Getting Good Sleep and REM 1. Stress Stress affects individuals in many different ways. It can affect digestion, emotional stability, the cardiovascular system, brain function, and for many, sleep quality (3). And there’s more. Recent studies have shown it may be associated with lower brain volume and memory issues in mid-life (5). If you’re going to bed with lots on your mind and feel that stress is negatively affecting your sleep, it’s important to take stress relief-steps. What to do: Do your best to get some stress relief before bed. Try exercising earlier in the day or getting outside with a walk after dinner. Take time to write in a journal before bed, prepare for your next day, and pray. For more tips to reduce stress and cortisol, see this post. 2. Artificial Light & Circadian Rhythms Many of us live in an artificial light world. We’re inside too much of the day, especially in the winter. Our circadian rhythms depend on the natural cycle of light in order to promote good sleep cycles. If we’re inside all day without much exposure to natural sunlight, this rhythm can suffer. If we experience excessive nighttime exposure to artificial light, our brains are signals that it is still daytime, and our rhythms suffer. A combination of lack of daylight, and too much artificial evening light, can lead to poorer sleep patterns. What to do: Make every effort to get out into natural sunlight in the morning, and throughout the day. Turn lights down and power screens off an hour before bedtime. 3. Busy Schedules and Late Nights The more we do, the less we likely sleep. And unfortunately, many families have very busy schedules. For those with kids and teens, scheduled activities can reach far into the evening, disrupting dinner and downtime. In fact, many kids and teens get inadequate sleep. What’s more, American adults often reach for their computers and put in work hours during the evening. Or, they spend time on screens, delaying sleep. What to do: If your schedule or your family’s schedule is negatively affecting sleep, it’s time to cut down on activities or choose those that can be finished early in the evening. Keep kids and teens at a consistent bedtime. Do your best to prioritize the whole family’s sleep schedule. 4. Too Much Caffeine If you’re not getting good sleep and feel fatigued during the day, you may start increasing your caffeine intake to perk up. This is often a band-aid used by sleepy adults, but it just makes the issue of insufficient sleep worse. In fact, if you feel you “need” caffeine after the morning hours to function well, it’s a strong indicator that you simply need more sleep. One study from Australia found that poor sleepers drank ~70-295 mg caffeine per day, while those who self-reported as “good sleepers” only drank ~60-190 gm per day. This study only included 80 people, but may indicate that >200 mg caffeine was associated with poorer sleep in this group (6). What to do: If caffeine is affecting your sleep, trying capping your caffeine intake at 200 mg or less per day, or 12 ounces strong coffee. Avoid caffeine after 2 pm. 5. Unhealthy Weight If you are overweight, it may negatively affect your sleep. Unfortunately, obstructive sleep apnea (OSA), a common sleep disorder, affects 17% of the total population and 40–70% of the obese population (7, 8). Studies have found that sleep apnea is associated with metabolic diseases and weight gain, and being overweight is associated with sleep apnea (9,10). Sleep apnea may affect glycemic control, insulin, and leptin levels (11). This is a problematic cycle for getting good sleep. What to do: If you are overweight or obese, consider reducing carbohydrates and getting into the Keto Zone. A ketogenic diet is associated with improved weight and fat percentage (11, 12). It also supports healthy blood sugars (13, 14). If you need help, try the FREE Keto Zone 21-Day-Challenge and check out the Keto Zone Starter Kit including Dr. Colbert’s Keto Zone Diet Book. 6. Too Hot to Sleep If your environment is too warm at night, you may have trouble sleeping. In fact, many adults report waking up due to feeling overly warm. It may be due to the environment, or your own hormones. If you are experiencing hot flashes or warming at night, try these tips for natural hot flash relief. What to do: Ensure that your room is cool when you go to be by reducing any heat, using a fan, open window or air conditioning, and removing excess covers. If you are suffering from hot flashes, take steps listed in this post to find relief. Bottom Line Getting good sleep is important. And, an insufficient percentage of REM each night can have serious consequences. Thankfully, there are many steps we can all take to improve our hours of sleep and REM percentage. Take a look at your own lifestyle. What can you do to ensure you’re getting good sleep? To read the original article click here. For more articles by Dr. Colbert click here.

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Study Claims Eating Vegetables Lower COVID-19 Death Rates

AHA Publisher — Tue, 21 Jul 2020 07:00:20 +0000

Sally Robertson, B.Sc. via News-Medical – A preliminary study by researchers in Europe claims that coronavirus disease 2019 (COVID-19) mortality rates may be lower in countries where people consume high amounts of cabbage and cucumber. The findings lend support to two other studies published earlier this year that were headed by the same lead researcher, Jean Bousquet, from Charité, Universitätsmedizin Berlin. The first study reported that COVID–19 mortality rates seemed to be low in countries with high consumption of traditional fermented foods. At the same time, the second narrowed down the beneficial food type to fermented vegetables. The authors had proposed that this protective effect may be associated with the antioxidant activity of the foods acting on insulin resistance since many vegetables have been shown to have antioxidative effects against diabetes and cardiovascular disease. For the current study, the team hypothesized that a high intake of antioxidant-rich Brassica vegetables such as broccoli, cauliflower, and head cabbage (white, red, and savoy cabbage) might be associated with the low COVID-19 mortality seen in some countries. “Now, Bousquet and colleagues say the “the negative ecological association between COVID-19 mortality and the consumption of cabbage and cucumber supports the a priori hypothesis previously reported.” The team recommends testing the hypothesis further by conducting individual studies in countries where a high vegetable intake is typical. A pre-print version of the paper is available on the server medRxiv*. A pre-print paper is a preliminary report that is yet to be evaluated by the scientific community. This means the information presented may be erroneous and should not be regarded as conclusive or established information. It will be interesting to see if this paper passes the peer review process and gets published. Striking Geographical Variation in COVID-19 Mortality Since the COVID-19 outbreak began in Wuhan, China, late last year, one striking finding has been the highly variable death rate between and within countries, say Bousquet and team. Although many factors may be involved, diet is one potentially relevant factor that has been largely overlooked, they add. Earlier this year, a study led by Bousquet showed that some countries with low COVID-mortality rates seemed to be ones that have diets rich in traditional fermented foods, and the team proposed that this was due to the foods’ antioxidative effects on insulin resistance. In another pre-print paper published on 7th July, Bousquet and colleagues describe a study of the consumption of fermented vegetables, pickled/marinated vegetables, fermented milk, yogurt, and fermented sour milk. That study claimed that of all the foods included, only the consumption of fermented vegetables had a significant effect on the COVID-19 mortality rate by country. Investigating the Protective Effect of Brassica Vegetables Now, for the current study, the authors proposed that “vegetables such as Brassica – with an antioxidant activity reducing insulin resistance – may also be associated with low COVID-19 mortality in countries.” To investigate, the team used data extracted from the European Food Safety Authority (EFSA) Comprehensive European Food Consumption Database to compare the consumption of Brassica vegetables including broccoli, cauliflower, head cabbage (white, red and savoy cabbage) and leafy brassica with the consumption of spinach, cucumber, courgette, lettuce, and tomato. Data on COVID-19 mortality were downloaded from the Johns Hopkins Coronavirus Resource Center, and the mortality per number of inhabitants was used to estimate death rates. Data downloaded from EuroStat were used to adjust for potential confounders by country, including gross domestic product, population density, the proportion of people older than 64 years, unemployment rate, and obesity prevalence. The team reports that of all the variables and confounders considered, only the consumption of head cabbage and cucumber had any significant impact on the COVID-19 mortality rate by country. For each gram per day increase in the amount of head cabbage consumed, the risk of dying from COVID-19 decreased by 13.6 %. For each gram per day increase in the amount of cucumber consumed, this death risk fell by 15.7%. Which Mechanisms Might Underly the Protective Effect? Many natural compounds derived from vegetables are potent activators of the transcription factors related to antioxidant effects such as Nrf2. “Cruciferous vegetables such as Brassicaceae contain high amounts of sulforaphane, a potent activator of Nfr2,” say Bousquet and colleagues. Although cucumber does not belong to the Brassicaceae family, it is rich in a compound called Cucurbitacin B that exerts anti-inflammatory and hypoglycemic effects through the activation of Nrf2, says the team. “These results and those of the recent study on fermented foods suggest a strong link between Nrf2 and the protection against severe forms of COVID-19,” write the researchers. “Another Piece of the Hypothesis” “Thus, although this study is only indicative of the role of diet in COVID-19, it is however, another piece of the hypothesis proposing that some vegetables with antioxidant properties may be involved in the prevention of severe COVID-19 at a country level,” writes the team. The researchers acknowledge that since the study was restricted to European counties, the findings cannot be extrapolated to other regions. “The hypothesis needs to be tested in individual studies performed in countries where the consumption of vegetables is common,” they conclude. *Important Notice medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information. To read the original article click here.

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New Plasma Cancer Treatment Designed to Kill Malignant Cells

AHA Publisher — Tue, 14 Jul 2020 07:00:58 +0000

Brian Blum via Israel21c – CAPS Medical’s delivery system sends high-energy ionized gas to kill malignant cells inside a tumor. The first indication is bladder cancer. “The holy grail of all cancer treatments is how to maximize damage to tumors while minimizing damage to the healthy tissue around the tumors,” says Ilan Uchitel, CEO of CAPS Medical. Uchitel believes his small startup may have found the med-tech version of the fabled chalice. The Or Yehuda-based company has developed a small disposable catheter that can reach deep inside the body to deliver cold atmospheric plasma (CAP). The company is addressing non-muscle invasive bladder cancer (NMIBC) first, reaching the bladder via the urethra. Uchitel says the device will be applicable for other types of solid organ tumors, as well. CAP has been around for 15 years but only to treat superficial tumors outside the body or during surgery. CAPS Medical is enabling it to reach deep into the body. The plasma in CAP is not the plasma in blood. Rather it’s the plasma found in stars and lightning – the fourth fundamental state of matter, alongside solids, liquids and gases. CAP is a stream of high-energy ionized gas (“It sort of glows,” Uchitel points out) consisting of reactive oxygen and nitrogen. When applied to a tumor, CAP “causes cancer cell death, then triggers an immune response in the body that specifically targets additional cancer cells in the surrounding area,” Uchitel explains. In this way, only one tumor spot needs to be reached; the body does the rest. Nor is healthy tissue bombarded as with a toxic treatment such as chemotherapy. “The side effects are minimal” using CAP, Uchitel tells ISRAEL21c. Cold as in Room Temperature The “cold” in “cold atmospheric plasma” does not mean that CAP is a type of cryoablation, where a tumor is killed by freezing. That’s the approach of Vessi Medical, another Israeli tech startup addressing NMIBC. Cryoablation has a similar problem to chemotherapy, Uchitel says. “It will destroy the tissue in the surrounding area. It is not selective.” (Vessi is addressing the issue by developing a cryotherapy “spray” that is more targeted and minimizes physical contact with the delicate bladder mucosa.) CAP, on the other hand, is not so much cold as it is “non-thermal,” Uchitel explains – closer to room temperature; neither too cold nor too hot, like radiation. If you’ve heard of “hot plasma,” that’s because it’s a technique used during surgery as a kind of super scalpel – a surgical lightsaber, so to speak – that makes cutting extremely precise. Non-thermal plasma combined with CAPS Medical’s catheter delivery device ultimately means less damage to healthy tissue. Prototype Stage CAPS Medical (formerly known as Plasmed) began as a collaboration between researchers at the Rambam Healthcare Campus in Haifa and the plasma lab at the Technion – Israel Institute of Technology. The technology was spun out into a company that joined the MEDX technology accelerator in Or Yehuda. MEDX is backed by Boston Scientific, Intellectual Ventures, MEDX Ventures and Sheba Medical Center. CAPS Medical chose to start with NMIBC for several reasons. While treatable, this type of cancer has a high recurrence rate and no definitive cure. Moreover, the current treatment standard –transurethral resection of bladder tumor (TURBT) — is unpleasant and expensive, averaging about $120,000 per patient, the highest cost per patient of any cancer type. With more than half a million people suffering from NMIBC in the United States alone, the costs to the healthcare system quickly add up. “Once we prove our ability to treat NMIBC, we will extend our technology to more complicated indications, such as lung, liver, pancreatic, brain and breast cancer,” Uchitel says. CAPS Medical’s prototype device has been tested in laboratory and animal models. The next step is to develop a clinical-grade system that will allow testing on humans. Uchitel hopes that will start in a year. Pricing will ultimately be in line with other laparoscopic devices doctors are familiar with, he says. CAPS Medical is still a small company, with just a half dozen full- and part-time employees, and is working on a post-accelerator funding round. In 2018, the company won first place at a pitch competition for ITTN, Israel’s technology transfer organization. Last January, the company added two prominent opinion leaders to its scientific advisory board: Dr. Yair Lotan, chief of urologic oncology at UT Southwestern Medical Center in Dallas, and Dr. Zohar Dotan, head of urologic oncology at Sheba Medical Center. “They will help CAPS Medical define our clinical strategy aimed towards FDA clearance,” Uchitel says. To read the original article click here. For more articles from Israel21c click here.

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