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Insulin Pump Therapy Slashes Death Risk from Heart Disease by Nearly 50 Percent

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Insulin Pump Therapy Slashes Death Risk from Heart Disease by Nearly 50 Percent

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People who use insulin pump therapy to manage type 1 diabetes have a nearly 50 percent lower risk of dying from heart disease than people who take insulin through daily injections, according to a new study published in The British Medical Journal.

The study included 18,168 patients with type 1 diabetes from Sweden. A total of 2,441 participants used insulin pump therapy while the rest used daily injections.

“There is a rationale for insulin pump treatment resulting in more stable blood glucose concentrations than multiple daily injections,” said researcher Dr. Isabelle Steineck. ”Previous studies have shown that insulin pump can reduce the frequencies of severe hypoglycemic episodes. Severe hypoglycaemia can be a risk factor for cardiovascular events, particularly among high risk individuals.”

More convenient, more safe?

Insulin pump therapy may also be more safe in the long run as patients usually receive more extensive training for use, Steineck said.

Pumps are safe and effective, the researchers explained, and they may make managing diabetes easier on a daily basis.

Whether patients use a pump or daily injections, however, consistent glucose monitoring is still the main concern for both blood sugar control and overall heart health, the researchers concluded.

Source: University of Gothenburg
Image courtesy of PANPOTE/FreeDigitalPhotos.net

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Blood test to detect dehydration in the elderly

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Equation including sodium, potassium, urea and glucose levels provides reliable information on older people.

Dehydration is a common problem among older people and could, in future, be diagnosed more easily using a simple blood test. This requires putting the results of routine tests into a mathematical equation. The study was published in “BMJ Open”.

Researchers from the University of East Anglia (Norwich) looked for an alternative to the time-consuming and expensive osmolarity test, currently the best method to determine dehydration. When someone has not had enough to drink, the blood becomes more concentrated and the levels of sodium, potassium, urea and glucose rise.

There are a number of mathematical equations that link these four variables. But it was unclear which one is most useful for elderly people. The researchers tested the accuracy of 39 different equations in 595 people over the age of 65. Participants included healthy people who lived independently, frail people living in residential care, people in hospital care and people with poor kidney function as well as diabetes.

The osmolarity equation by Khajuria and Krahn demonstrated the greatest accuracy for all participants, regardless of sex and health status. “We propose that clinical laboratories use this equation to report on the hydration status of older people when reporting blood test results that include sodium, potassium, urea and glucose. We hope our findings will lead to pragmatic screening in older people to allow early identification of dehydration. This would help doctors nurses and carers support older people to increase their fluid intake,” said study author Lee Hooper.

IMRT associated with fewer adverse effects in lung cancer

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Study: lung toxicity is significantly lower using this treatment method.

Using intensity modulated radiation therapy (IMRT) instead of 3-D conformal radiation therapy (3-D CRT) in locally advanced non-small cell lung cancer (NSCLC) may be beneficial for patients. According to a study presented at the annual meeting of the “American Society for Radiation Oncology” (ASTRO) in San Antonio (Texas), lung toxicity is reduced and chemotherapy is better tolerated.

The study conducted by the University of Texas MD Anderson included 482 patients with locally advanced non-small cell lung cancer (NSCLC). All patients underwent concurrent chemotherapy and either IMRT or 3-D CRT. The findings result from a secondary analysis of the original study in which different IMRT radiation doses had been tested.

Comparing the standard treatment of 3-D CRT and IMRT showed significantly fewer cases of pneumonitis in IMRT patients. There were 44 per cent fewer cases – this affected 3.5 per cent of IMRT patients, compared to 7.9 per cent of 3-D CRT patients. The reduction of pneumonitis cases was particularly pronounced in larger tumours. In addition, IMRT patients were more likely to complete chemotherapy – 37 versus 29 per cent of the 3-D CRT group.

IMRT is more time-intensive and costly, say the authors, but toxicity reduction proved to be “dramatic”. The study therefore suggests considering routine use of IMRT in locally advanced non-small lung cancer, said study author Stephen Chun.

El riesgo de cáncer de mama y de ovario puede tener relación con el sentido del olfato (PLoS ONE)

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El ovario, independientemente de la nariz, intercede en las señales olfativas.

La asociación entre la actividad del ciclo menstrual y el riesgo de cáncer de mama y de ovario puede tener un intermediario inesperado: los olores. Científicos de la University of Southern California Los Angeles (USC), en Estados Unidos, han descubierto que el ciclo estral (el equivalente del ciclo menstrual humano) en ratones que portan una mutación conocida por causar predisposición familiar al cáncer de mama y de ovario en seres humanos se estimula más fácilmente por el olor que en ratones normales. Incluso, hallaron que el ovario, independientemente de la nariz, intercede en las señales olfativas.

“Esta investigación indica que un mejor sentido del olfato puede contribuir al riesgo elevado de cáncer de las mujeres con mutaciones BRCA1 –afirma uno de los autores de este trabajo, el Dr. Louis Dubeau, profesor de Patología y director médico de Patología Molecular en el Norris Comprehensive Cancer Center de la USC–. Hemos encontrado que la presencia de la mutación en el ovario media en una respuesta más fuerte de olor, lo que implica que la mutación puede influir en el ciclo menstrual, que a su vez es un factor de riesgo establecido para el cáncer de mama y de ovario”.

Partiendo de la observación de que los ciclos menstruales a menudo se sincronizan entre compañeras de clase, lo que indica la existencia de algún tipo de comunicación con señales ambientales, los científicos compararon ratones hembras genéticamente modificadas que tenían la mutación BRCA1 con roedores normales o de tipo salvaje. Los expertos aislaron las hembras de los machos, provocando que el ciclo estral se detuviera en las hembras. Cuando se expuso a las hembras al lecho del macho, aquellas con la mutación BRCA1 iniciaron el ciclo estral más rápido que las de tipo salvaje.

Para confirmar que los resultados estaban influidos por el ovario independientemente de la nariz, los científicos trasplantaron ovarios de ratones con la mutación BRCA1 en roedores de tipo salvaje y ovarios de ratones normales en ratones genéticamente modificados que llevaban la mutación, como se detalla en un artículo sobre el trabajo que se publica en “PLoS ONE”. Los ratones hembra de tipo salvaje con la mutación BRCA1 presente en sus trasplantes ováricos respondieron más rápidamente cuando se les presentó el aroma masculino que los ratones mutantes con trasplante de ovario de tipo salvaje que llevan la mutación en todos los tejidos excepto en el ovario.

“Hemos sabido durante mucho tiempo que los receptores del olor se expresan en todo tipo de tejidos, pero sabemos muy poco acerca de lo que estos receptores hacen fuera de la nariz –dice Dubeau–. Sólo ciertos tejidos en la mama y los órganos reproductivos tienen un riesgo elevado de cáncer en las mujeres que portan una mutación BRCA1. Encontramos que las mutaciones BRCA1 no sólo influyen en estos tejidos directamente, sino también indirectamente cambiando la forma en que se comunican con otras células”.

“Esta investigación es uno de varios ejemplos que muestran en mi laboratorio dónde BRCA1 controla cómo diferentes células se comunican a distancia. Si podemos entender cómo la interrupción de estas comunicaciones conduce a un riesgo elevado de cáncer en portadoras de la mutación BRCA1, podemos desarrollar terapias para controlar estos tipos de cáncer, incluyendo quizás terapias basadas en el olor”, concluye.

El aceite de oliva virgen extra es fundamental en la prevención del deterioro cognitivo en la vejez

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Los polifenoles contribuyen a retrasar la oxidación y, con ello, a alargar la vida celular.

Los polifenoles contribuyen a retrasar la oxidación y, con ello, a alargar la vida celular.

La segunda sesión del ciclo Diálogos Saludables se ha centrado en el Estudio Predimed y el Dr. Emilio Ros ha desgranado los resultados de la investigación destinada a conocer los efectos de la dieta mediterránea, suplementada con aceite de oliva virgen extra, en la evolución de las capacidades cognitivas de los 450 participantes de mayor edad y ha subrayado el efecto de los antioxidantes naturales, los polifenoles, que contribuyen a retrasar la oxidación y, con ello, a alargar la vida celular.

Por su parte, la Dra. Elena Urdaneta, coordinadora del proyecto internacional SIforAGE, se ha mostrado a favor de poner en marcha políticas de promoción, “a partir de evidencias científicas”, de hábitos saludables entre la población, “para no medicalizar la vejez”.

El Diálogo de Sevilla también ha contado con la participación del Dr. Antonio Escribano, experto en nutrición del deporte, que ha desterrado mitos como el efecto del consumo de los aceites de oliva en la obesidad apuntando que “mucho más determinante es el efecto de los azúcares”.

Escribano ha recomendado el consumo de aceites de oliva entre los deportistas al ser “las grasas más saludables. “Su precio, si caro o barato, es intrascendente. Es el mejor”, ha subrayado.

El ciclo divulgativo Diálogos Saludables está impulsado por Aceites de Oliva de España, marca de promoción de la Interprofesional del Aceite de Oliva de España. Tras las ediciones de Madrid, Sevilla, en breve se desarrollarán nuevas ediciones en Bilbao, Santiago de Compostela y Barcelona.

Se trata, según ha explicado el tesorero de la Interprofesional del Aceite de Oliva Español, Luis Miguel Martínez, de un evento con el que “poner un granito de arena en la divulgación de alimentación saludables, fundamentalmente entre el colectivo de la salud”. “Lo queremos hacer con el aval de la ciencia, de todos aquellos que llevan décadas trabajando para desentrañar la relación que existe entre alimentación y salud”, ha subrayado.

How to avoid the post-surgery “weekend effect”

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US researchers identified five factors handled differently by hospitals which overcame the “weekend effect”.

The so-called “weekend effect”, which many studies have found to be associated with longer hospital stays and increased mortality rates, could be avoided or completely prevented by addressing five factors, says a US study. The research was published in the “Annals of Surgery”.

Over a five-year period, scientists from Loyola University Chicago (Illinois) analysed data of 126,666 patients from 166 hospitals in Florida. The patients had undergone appendectomies, hernia repairs or gall bladder removals. In some hospitals, the weekend effect was observed over the entire study period, other hospitals developed the effect during the course of the study and 17 hospitals were able to overcome the weekend effect.

The researchers then analysed 21 hospital resources in these 17 hospitals and identified five factors that seemingly helped eliminate the weekend effect. Fully implemented electronic medical records had the strongest impact – making it 4.74 times more likely that the weekend effect would be overcome.

Home health programmes also had a strong impact (likelihood increased 2.37 times), in which, after hospital discharge, skilled caregivers visited patients and cared for them at home. With the help of pain management programmes, the hospital was 1.48 more likely to overcome the weekend effect.

In addition, increased nurse-to-bed ratios raised the chances of eliminating the effect 1.44 times – hospitals with a persistent weekend effect had a median ratio of 1.1, clinics that overcame the effect had a ratio of 1.3. In comparison, a relative weak effect was found in hospitals with inpatient physical rehabilitation – they were 1.03 times more likely to overcome the weekend effect.

Helmeted bicycle riders have less severe injuries after accidents

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US study shows that bicycle riders wearing a helmet have a 60 per cent lower risk of severe head injuries than riders without helmets.

Wearing a helmet when riding a bicycle effectively prevents severe head injuries. According to a US study presented at the Clinical Congress of the American College of Surgeons in Chicago (Illinois), helmeted bicycle riders suffer significantly fewer severe head injuries.

Physicians from the University of Arizona (Tucson) analysed data from more than 6,200 patients who had experienced traumatic brain injury after a bicycle-related accident. They found that helmets provided a significant protective effect.

Risk of severe traumatic brain injury or even death was 60 per cent lower among helmeted bicycle riders. The same applied to severe injuries that required temporary removal of cranial bone due to a swelling of the brain. Helmets also reduced the likelihood of injury to the upper part of the face by 25 per cent.

“When you look closely at that group that developed brain injury, the helmet really made a difference”, emphasised study author Bellal Joseph. But only one-fourth of those who had an accident were wearing helmets. The lowest helmet use was found in the group of ten to 20 year-olds, but the percentage of helmet use increased with every 10 years of age. The study authors call for stricter laws on helmet use for bicycle riders.