Smoking cannabis associated with increased risk of heart attack, stroke

Frequent cannabis smoking may significantly increase a person’s risk for heart attack and stroke, according to an observational study supported by the National Institutes of Health. The study, published in the Journal of the American Heart Association, uses data from nearly 435,000 American adults, and is among the largest ever to explore the relationship between cannabis and cardiovascular events.

The study, funded by the National Heart, Lung, and Blood Institute (NHLBI), part of NIH, found that daily use of cannabis-predominately through smokingwas associated with a 25% increased likelihood of heart attack and a 42% increased likelihood of stroke when compared to non-use of the drug. Less frequent use was also associated with an increased risk of cardiovascular events. Weekly users showed a 3% increased likelihood of heart attack and a 5% increased likelihood of stroke.

Around 75% of the study respondents reported that they mainly used cannabis by smoking the drug. Approximately 25% of the respondents reported using cannabis by some method other than smoking, such as vaping, drinking, or eating the drug.

“We know that toxins are released when cannabis is burned, similar to those found in tobacco smoke,” said corresponding author Abra Jeffers, Ph.D., a data analyst at Massachusetts General Hospital in Boston and formerly a researcher at the Center for Tobacco Control Research and Education at the University of California, San Francisco, where she conducted the study as part of her postdoctoral work.

“We’ve known for a long time that smoking tobacco is linked to heart disease, and this study is evidence that smoking cannabis appears to also be a risk factor for cardiovascular disease, which is the leading cause of death in the United States,” Jeffers said. “Cannabis use could be an important, underappreciated source of heart disease.”

Researchers note that while the exact mechanisms linking cannabis to heart disease are unclear and were not explored in the current study, multiple factors could play a role. In addition to toxins, endocannabinoid receptors — the part of cells responsible for recognizing tetrahydrocannabinol (THC), the main psychoactive ingredient in cannabis — are widespread in the body’s cardiovascular tissues and might facilitate heart risks.

Cannabis consumption has increased significantly within the past 20 years nationwide as negative perceptions of its use have declined, according to government surveys of drug use and health. In the United States, cannabis is now legal in 38 states for medicinal use and in 24 states for recreational use. Some studies have linked its regular use to impaired brain development and lung damage, as well as to certain cardiovascular diseases. However, there are gaps in knowledge about the adverse effect of cannabis on the heart.

To look more closely at associations between cannabis use and health, Jeffers and her research team used 2016–2020 data from the Behavioral Risk Factor Surveillance Survey of the Centers for Disease Control and Prevention. The national cross-sectional survey, performed annually by the CDC, included 434,104 adults ages 18-74 from 27 U.S. states and 2 territories. Most of the respondents were white (60%), while about 12% were Black, 19% Hispanic, and 9% other race/ethnicity.

The researchers evaluated the association of cannabis smoking (the number of days participants said they smoked the drug in the past 30 days) with self-reported cardiovascular outcomes, including coronary heart disease, heart attack, stroke, and a composite measure of all three. They adjusted for the participants’ use of tobacco and other characteristics, including their age, sex, race, body mass index or BMI, obesity, diabetes, physical activity levels, and socioeconomic status.

“This is an important public health finding, particularly given our ongoing efforts to reduce the burden of heart disease in this country,” said David C. Goff, M.D., Ph.D., director of the NHLBI’s Division of Cardiovascular Sciences.

“Asking patients about their cannabis use during routine medical exams or physicals in much the same way they might be asked about tobacco use will help us learn more about the long term effect of marijuana on the body,” Jeffers said.

Reference:

Abra M. Jeffers, Stanton Glantz, Amy L. Byers and Salomeh Keyhani, Association of Cannabis Use With Cardiovascular Outcomes Among US Adults, Journal of the American Heart Association, https://doi.org/10.1161/JAHA.123.030178.

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Scientists develop simple blood test to quickly diagnose sarcoidosis

A research project supported by the National Institutes of Health has developed a tool to rapidly and inexpensively diagnose sarcoidosis, a chronic inflammatory disease marked by the growth of tiny lumps called granulomas in the lungs and other organs in the body. The tool, which uses a simple blood test, could allow for selective use of more invasive diagnostic tests often used to identify the disease. The findings published in the American Journal of Respiratory and Critical Care Medicine.

“Currently, diagnosing sarcoidosis isn’t a straightforward process, and requires tissue removal and testing with additional screenings to rule out other diseases, such as tuberculosis or lung cancer,” said James Kiley, Ph.D., Director of the Division of Lung Diseases at the National Heart, Lung, and Blood Institute, part of NIH. “Using a blood test will help diagnose faster, particularly in those organs that are more challenging to biopsy and with less harm to the patient.”

Though the exact cause of sarcoidosis is unknown, researchers suspect it is an immune disorder triggered by a group of specific antigens, which are generally foreign substances that incite an immune response in the body. In the United States, an estimated 8-11 people per 100,000 are affected by sarcoidosis each year, according to previous research.To identify antigens and determine which might be linked to sarcoidosis, scientists collected lung fluid samples and blood cells from patients with pulmonary sarcoidosis, then extracted the genetic material. Using a combination of molecular techniques, the researchers homed in on two newly described disease-specific antigen biomarkers that only bind to the antibodies of sarcoidosis positive patients.

They next designed a highly specific blood test, which only requires a small amount of blood, to determine if they could accurately detect sarcoidosis. To verify the test, researchers compared blood samples from 386 people, which included patients with sarcoidosis, patients with tuberculosis, patients with lung cancer, and healthy individuals. The researchers confirmed that their test was able to differentiate patients who had sarcoidosis from those with other respiratory diseases.

“More testing needs to be completed before this screening method is ready for clinical use, but it’s possible that could be a reality within a few years,” said Lobelia Samavati, M.D., of Wayne State University and senior author on the study.

Reference:

Peng C, Talreja J, Steinbauer B, et al. (2024) Discovery of two novel immunoepitopes and development of peptide-based sarcoidosis immunoassay. Am J Respir Crit Care Med. www.atsjournals.org/doi/abs/10.1164/rccm.202306-1054OC.

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New study identifies five ferroptosis-related genes which may be a novel therapeutic target for focal segmental glomerulosclerosis

China: Ferroptosis-related genes could be a novel therapeutic target for focal segmental glomerulosclerosis, a recent study published in BMC Nephrology has shown.

This study identified the Hub ferroptosis-related genes (FRGs) and transcriptomic molecules from focal segmental glomerulosclerosis (FSGS) in renal tubules, thus providing novel diagnostic and therapeutic targets for FSGS.

Focal segmental glomerulosclerosis is characterized by partial glomerular (focal) or partial glomerular capillary loops (segmental) sclerosis. In most world parts, FSGS is one of the main causes of glomerulopathy in end-stage renal disease (ESRD).

FSGS treatment primarily includes immunosuppressive therapy, corticosteroids, and kidney transplantation. However, FSGS patients have become resistant to immunosuppressive therapy and corticosteroids, thus showing a limited response to FSGS. The existing treatment modalities and efficacy of FSGS are inadequate in delaying ESRD progression, necessitating more effective treatment for FSGS management.

Recent studies have suggested ferroptosis participation in various renal diseases. However, no clarity exists on its effect on focal segmental glomerulosclerosis. Therefore, Lan Chen, Fujian Medical University, Fuzhou, China, and colleagues analyzed the GSE125779 and GSE121211 datasets to identify the differentially expressed genes (DEGs) in renal tubular samples with and without FSGS.

The research team used the Cytoscape to construct the protein–protein interaction network. Moreover, they obtained ferroptosis-related genes from the ferroptosis database, while ferroptosis-related DEGs were obtained by intersection with DEGs. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis and Gene Ontology (GO) were used for target genes analysis.

The GSE108112 dataset was used to confirm the expression of target FRGs. Besides, the tea built the mRNA-miRNA network regarding FRGs using the NetworkAnalyst database, and circRNAs corresponding to key miRNAs were predicted in the ENCORI database.

The key findings of the study were as follows:

  • 16 ferroptosis-related DEGs were identified between FSGS and healthy subjects, while five co-expressed genes were obtained by three topological algorithms in Cytoscape. These included the most concerned Hub genes JUN, HIF1A, ALB, DUSP1 and ATF3.
  • The KEGG enrichment analysis indicated that FRGs were associated with mitophagy, renal cell carcinoma, and metabolic pathways.
  • The co-expressed hub genes were analyzed to construct the mRNA-miRNA interaction network, and important miRNAs such as hsa-mir-155-5p, hsa-mir-1-3p, and hsa-mir-124-3p were obtained.
  • 75 drugs targeting 54 important circRNAs and FRGs were predicted.

The study identified five ferroptosis-related genes, which may be potential novel diagnostic markers for renal tubulointerstitial injury in FSGS.

“Our prediction of several miRNAs will provide valuable reference information for the ferroptosis-related pathological mechanism of FSGS, and the prediction of targeted drugs provides direction for clinical treatment,” the researchers wrote.

“There is a need for further clinical and basic studies to elucidate the specific mechanistic details of ferroptosis in FSGS-associated tubulointerstitial damage in the future,” they concluded.

Reference:

Lin, Y., He, J., Mou, Z. et al. Ferroptosis-related genes, a novel therapeutic target for focal segmental glomerulosclerosis. BMC Nephrol 25, 58 (2024). https://doi.org/10.1186/s12882-024-03490-5

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Living near pubs, bars and fast-food restaurants could be bad for heart health

Living close to pubs, bars and fast-food restaurats may lead to a higher risk of heart failure, according to new research published today in Circulation: Heart Failure, an  American Heart Association journal.

These kinds of ready-to-eat food environments typically provide unhealthy foods and drinks, and have been linked to cardiovascular diseases, said study senior author Lu Qi, M.D., Ph.D., a professor in the epidemiology department at Tulane University in New Orleans.

Heart failure is a condition in which the heart muscle can’t pump enough blood to meet the body’s needs for blood and oxygen. Few studies have assessed the relationship between heart failure and food environment, the authors noted. This study is likely the first to assess the association between food environment and heart failure with long-term observation.

“Most previous research on the relation between nutrition and human health has been focused on food quality, while neglecting the impact of food environment,” Qi said. “Our study highlights the importance of accounting for food environment in nutrition research.”

Researchers evaluated the association using data from the UK Biobank-a large-scale database containing health information for more than 500,000 adults in the United Kingdom. They measured enrollees’ exposure to three types of food environments-pubs or bars, restaurants or cafeterias and fast-food restaurants. Exposure was determined by proximity (living within 1-kilometer/0.62 miles-or a within a 15-minute walk) and density (the number of ready-to-eat food outlets within the predefined 1-kilometer/0.62 miles).

The study documented nearly 13,000 heart failure cases during a 12-year follow-up period, recorded through national electronic health-related datasets.

The analysis found that a closer proximity and a greater density of ready-to-eat food outlets were associated with an elevated risk of heart failure.

Specifically, the results include:

  • Overall, participants in the highest density of ready-to-eat food outlets-defined as 1 kilometer/.62 mile area with 11 or more ready-to-eat outlets — had a 16% greater risk of heart failure compared to those with no ready-to-eat food environments near their homes.
  • Those in the highest density areas of pubs and bars showed a 14% higher risk for heart failure; while those in the highest density areas for fast-food outlets had a 12% higher risk.
  • Participants who lived closest to pubs and bars-less than 500 meters (.31 miles)-had a 13% higher risk of heart failure; while those closest to fast-food outlets had a 10% higher risk compared to those who lived the farthest away (more than 2,000 meters or 1.24 miles.
  • Heart failure risk was stronger among participants without a college degree and adults in urban areas without access to formal physical activity facilities such as gyms.

The findings were in line with expectations, Qi said, “because previous studies have suggested that exposure to ready-to-eat food environments is associated with risks of other disorders, such as Type 2 diabetes and obesity, which may also increase the risk of heart failure.”

Authors noted the findings suggest that improving access to healthier food environments and physical fitness facilities in urban areas, along with helping more people attain higher levels of education, could reduce the increased risk of heart failure linked to quick-meal options.

An accompanying editorial by Elissa Driggin M.D., M.S., and Ersilia M. DeFilippis, M.D., both of Columbia University Medical Center in New York, notes that more detailed analyses are needed in communities with more racially and ethnically diverse populations.

“Given the clear association between Black race and high incidence of heart failure as compared to white patients, as well as associations with worse heart failure outcomes, attention to food environment in this high-risk population is of the utmost importance,” they wrote.

“It has already been demonstrated that compared to predominantly white neighborhoods, there are significantly fewer supermarkets in predominantly Black neighborhoods, which are likely to be inversely associated with ready-to-eat food environments.”

The American Heart Association is working to improve access to healthy food among patients receiving treatment for chronic health conditions and people at high risk for such conditions. The Association’s Health Care by Food TM initiative is investing in research, advocacy and education to show clinical benefit and cost effectiveness of interventions that use food as medicine so that such interventions are covered by public and private health insurance.

A 2023 Association Presidential Advisory reviewing the landscape for food is medicine practice and research noted that one of the major challenges to eating healthier is the lack of a systemic focus on improving food environments and the food system. With few exceptions, taxes and financial incentives are not directed toward encouraging the purchase of healthy foods, improving the healthfulness of local food environments or ensuring the health of children and future generations, according to the advisory.

“Consuming a healthy diet is too hard for too many people,” said Eduardo Sanchez, M.D., M.P.H., FAHA, the Association’s chief medical officer for prevention. “Structural racism and factors that contribute to poverty mean that historically excluded people suffer the consequences of poor-quality diets at disproportionate levels. For over a century, we’ve saved and improved lives at the American Heart Association and will continue to focus on initiatives like this in our next 100 years by ensuring everyone, everywhere enjoys their healthiest lives.”

Study background and details:

  • Data came from UK Biobank entries for more than 500,000 adults, ages 37-73 years old recruited from 22 assessment centers in England, Scotland and Wales between March 2006 and October 2010, followed through May 2021.
  • Heart Failure was based on self-reported information and hospital inpatient records.
  • Participants, on average, were 56 years old, more than half were women and 94% were of white European ancestry. Participants had completed extensive questionnaires detailing personal information, such as age, sex, race, education, lifestyle habits and medical history.
  • Within the 1-kilometer range of where participants lived, there were 3.57 ready-to-eat food outlets on average.
  • The average street distance to pubs and bars was 692 meters (0.43 miles); 820 meters (0.50 miles) to restaurants and cafeterias; and 1,135 meters (0.70 miles) to fast-food restaurants. Participants included in the analysis were exposed to the highest density category of composite ready-to-eat food environments.

Although the research used a large sample size, it may not represent the general population because most participants were white, skewed older and lived in the U.K. Other limitations include potential for exposure misclassification because of participants’ movements among neighborhoods during the follow-up period. The study did not rule out other factors that may involve a particular food environment that could affect heart failure and did not include nutrition insecurity data. In addition, it cannot show causality because the research is observational based on previously collected data.

The study emphasizes the importance of improving food environments to prevent heart failure, and the researchers noted that more studies are needed, particularly assessing nutrition insecurity, to enhance the robustness and applicability of this study’s conclusions.

Reference:

Qiaochu Xue, Xiang Li, Hao Ma, Xuan Wang, Yoriko Heianza and Lu Qi, Ready-to-Eat Food Environments and Risk of Incident Heart Failure: A Prospective Cohort Study, Circulation Heart Failure, https://doi.org/10.1161/CIRCHEARTFAILURE.123.010830.

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Study confirms benefits of auricular acupuncture to treat depression

Auricular acupuncture, recommended by the World Health Organization (WHO) and offered as an integrative practice since 2006 by the SUS (Sistema Única de Saúde), Brazil’s national health service, is safe for patients with depression and effectively reduces symptoms of this mental health disorder, according to a study conducted by researchers at the University of São Paulo (USP) and the University of Southern Santa Catarina (UNISUL).

The results of the study are reported in an article published in the journal JAMA Network Open. They confirm the efficacy of auricular acupuncture as an alternative treatment for depression, a mood disorder for which rising numbers are seeking care from the SUS, judging from data provided by the Ministry of Health.

Depression is one of the leading causes of disability worldwide, according to the WHO. In Brazil, lifetime prevalence of depression is 15.5%, one of the highest globally, and depressive disorders account for 10.3% of years of life lost (YLL), a measure of premature mortality calculated by subtracting the age at death from the longest possible life expectancy for a person at that age.

However, fewer than half the people affected globally receive treatment considered adequate, including psychotherapy and medication. In some countries, the proportion is less than 10%. The reasons include the high cost of antidepressants and their adverse side effects, such as gastric discomfort and decreased libido. Interest in non-pharmacological and more affordable options is growing as a result. In the United States, for example, a third of the population prefers alternative treatments for depression.

One such alternative is auricular acupuncture, an ancient Chinese technique in which thin needles are inserted into points on the outer ear with the aim of stimulating various organs, including the brain and vagus nerve. The needles are inexpensive: a pack of 50 (enough for ten sessions) costs less than BRL 10.00 (now about USD 2.00). Simple and quick (a session lasts between 5 and 15 minutes), the technique does not require long periods of training and can be applied by nurses or physical therapists, unlike full-body acupuncture, which can only be offered by licensed practitioners. On the downside, its efficacy and safety to treat depression have not yet been completely established.

The researchers sought evidence of this kind in the study, which was funded by FAPESP and took place between March and July 2023, involving 74 patients whose scores on Patient Health Questionnaire 9 (PHQ9) indicated moderate or moderately severe depression. Prospective participants were not included if they had previously undergone auricular acupuncture or were severely depressed and at risk of suicide. They were given 12 sessions of 15 minutes each during a period of six weeks.

The average age of the participants was 29. Most of them (84%) were women. They were divided into two groups of 37. One received specific auricular acupuncture (SA) to treat depression according to traditional Chinese medicine, stimulating six points on the outer ear corresponding to shenmen (spirit), subcortex, heart, lung, liver, and kidney. The other received non-specific treatment (NSA) using non-points or auricular points not associated with symptoms of mental illness: pinna, cheek, face, and four points on the helix. For ethical reasons, all participants continued with their usual treatment. The efficacy and safety of the acupuncture were assessed after four weeks, six weeks and three months.

At the end of the follow-up period, the PHQ9 scores of 58% of the patients in the SA group were found to have improved by at least 50%. The proportion for the NSA group was 43%. This difference was not considered statistically significant. Nevertheless, the authors note, some of the results were promising: for example, the proportion of patients with depression recovery and remission was higher in the SA group after four weeks, and a statistically significant difference in favor of the SA group was observed in remission after three months.

“Our results showed almost 60% recovering from depression thanks to specific auricular acupuncture. This is similar to the recovery rate for treatment with drugs, according to other published studies on this topic,” said Daniel Maurício de Oliveira Rodrigues, first author of the article and a professor of naturology at UNISUL. “Moreover, 46% of these participants reported cessation of symptoms, in contrast with 13% of the NSA group. For comparison, the proportion is about 35% in patients treated with drugs.”

Another promising result was a lack of severe adverse effects, with no significant differences between the groups. A large majority of participants (94% in the SA group and 91% in the NSA group) reported only mild pain at the needle application site. “This evidences the safety of the intervention for more than six weeks,” Rodrigues said.

More safety

“We’re witnessing a veritable epidemic of mood disorders. I believe there has never been so much anxiety and depression as has been the case since the Covid pandemic. Acceptance of the gold standard for treatment is far from ideal,” said Alexandre Faisal Cury, a researcher in the Department of Preventive Medicine at the University of São Paulo’s Medical School (FM-USP). “In clinical practice, we see patients with chronic depression who have been taking medication for a long time and have side effects and relapses, so we need complementary options with proven benefits.”

Three important lessons can be learned from the study, Faisal added. For the SUS, it validates a technique that is already in widespread use, and is in fact the most frequently practiced integrative method in the public system. For patients, it confirms that auricular acupuncture is a safe option for treatment of mental illness. And for health workers, it destigmatizes a non-allopathic therapy.

Despite the encouraging results, the researchers pointed out that the study had noteworthy limitations and that longer studies with more participants are needed to investigate the efficacy of this treatment in greater depth. “I believe participation by more people would produce results even more favorable to the intervention,” Faisal said.

Reference:

de Oliveira Rodrigues DM, Menezes PR, Machado Ribeiro Silotto AE, et al. Efficacy and Safety of Auricular Acupuncture for Depression: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(11):e2345138. doi:10.1001/jamanetworkopen.2023.45138.

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Exclusive breastfeeding for four months protects against psoriasis development through early adulthood: Study

Sweden: A recent study published in the British Journal of Dermatology for the first time has highlighted the potential role of early diet on psoriasis development and suggests a protective effect of breastfeeding.

The prospective longitudinal birth cohort study from Sweden revealed an association between longer breastfeeding duration and a lowered risk of psoriasis development in early adulthood.

“Babies introduced to infant formula before the age of 4 months were almost twice as likely to develop psoriasis later in life,” the researchers reported. ” Also, earlier consumption of larger amounts of dairy milk was also associated with an increased psoriasis risk.”

Psoriasis is a genetically determined systemic skin disease, although environmental trigger factors are needed for disease manifestation Some of these triggers, such as infections, stress, and drug exposure, have been identified. Johnny Ludvigsson, Linköping University, Linkoping, Sweden, and colleagues aimed to explore the role of early nutrition as a risk factor for psoriasis development.

Parents in the ABIS (All Babies in Southeast Sweden) (n= 16145) prospective birth cohort were included. They answered questionnaires at birth and by the child’s age of 1 and 3 years. Psoriasis diagnosis was received from the Swedish National Patient Register and National Drug Prescription Register. Custom-written R scripts were used for conducting statistical analyses.

The study led to the following findings:

  • Individuals breastfed for less than four months and receiving infant formula before four months were associated with a higher risk of psoriasis (OR 1.84 and OR 1.88, respectively).
  • At the 3-year follow-up, the increased fish consumption, especially from the Baltic Sea, increased the risk of psoriasis (OR9.61).
  • The risk of psoriasis increased following large milk consumption (OR2.53).

“Our study underscores, for the first time, the effect of very early nutrition on the manifestation of psoriasis through early adulthood. Exclusive breastfeeding for four months seems protective,” the researchers wrote.

Reference:

Das, D., Thimjo, J., Lebena, A., Guo, A., Enerbäck, C., & Ludvigsson, J. Breast-feeding decreases the risk of developing psoriasis through early adulthood. British Journal of Dermatology. https://doi.org/10.1093/bjd/ljae043

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Yoga provides unique cognitive benefits to older women at risk of Alzheimer’s disease, study finds

A new UCLA Health study found Kundalini yoga provided several benefits to cognition and memory for older women at risk of developing Alzheimer’s disease including restoring neural pathways, preventing brain matter decline and reversing aging and inflammation-associated biomarkers-improvements not seen in a group who received standard memory training exercises.

The findings, published in the journal Translational Psychiatry, are the latest in a series of studies led by UCLA Health researchers over the past 15 years into the comparative effects of yoga and traditional memory enhancement training on slowing cognitive decline and addressing other risk factors of dementia.

Led by UCLA Health psychiatrist Dr. Helen Lavretsky of the Jane and Terry Semel Institute for Neuroscience and Human Behavior, this latest study sought to determine whether Kundalini yoga could be used early on to prevent cognitive decline and trajectories of Alzheimer’s disease among postmenopausal women.

Women have about twice the risk of developing Alzheimer’s disease compared to men due to several factors including longer life expectancy, changes in estrogen levels during menopause and genetics.

In the new study, a group of more than 60 women ages 50 and older who had self-reported memory issues and cerebrovascular risk factors were recruited from a UCLA cardiology clinic. The women were divided evenly into two groups. The first group participated in weekly Kundalini yoga sessions for 12 weeks while the other one group underwent weekly memory enhancement training during the same time period. Participants were also provided daily homework assignments.

Kundalini yoga is a method that focuses on meditation and breath work more so than physical poses. Memory enhancement training developed by the UCLA Longevity center includes a variety of exercises, such as using stories to remember items on a list or organizing items on a grocery list, to help preserve or improve long-term memory of patients.

Researchers assessed the women’s cognition, subjective memory, depression and anxiety after the first 12 weeks and again 12 weeks later to determine how stable any improvements were. Blood samples were also taken to test for gene expression of aging markers and for molecules associated with inflammation, which are contributing factors to Alzheimer’s disease. A handful of patients were also assessed with MRIs to study changes in brain matter.

Researchers found the Kundalini yoga group participants saw several improvements not experienced by the memory enhancement training group. These included significant improvement in subjective memory complaints, prevention in brain matter declines, increased connectivity in the hippocampus which manages stress-related memories, and improvement in the peripheral cytokines and gene expression of anti-inflammatory and anti-aging molecules.

“That is what yoga is good for-to reduce stress, to improve brain health, subjective memory performance and reduce inflammation and improve neuroplasticity,” Lavretsky said.

Among the memory enhancement training group, the main improvements were found to be in the participants’ long-term memory.

Neither group saw changes in anxiety, depression, stress or resilience, though Lavretsky stated this is likely because the participants were relatively healthy and were not depressed.

While the long-term effects of Kundalini yoga on preventing or delaying Alzheimer’s disease require further study, Lavretsky said the study demonstrates that using yoga and memory training in tandem could provide more comprehensive benefits to the cognition of older women.

“Ideally, people should do both because they do train different parts of the brain and have different overall health effects,” Lavretsky said. “Yoga has this anti-inflammatory, stress-reducing, anti-aging neuroplastic brain effect which would be complimentary to memory training.”   

Reference:

Grzenda, A., Siddarth, P., Milillo, M.M. et al. Cognitive and immunological effects of yoga compared to memory training in older women at risk for alzheimer’s disease. Transl Psychiatry 14, 96 (2024). https://doi.org/10.1038/s41398-024-02807-0.

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Exposure to UV radiations of sun may have positive effect on fertility in women aged 30-40

A research team from Tel Aviv University and the Sheba Medical Center at Tel Hashomer conducted investigation of seasonal fluctuations in AMH (anti-Müllerian hormone) levels. Their pioneering study revealed that during the summer, women of late reproductive age-between the ages of 30 and 40-experience increased secretion of the hormone from their ovaries. This phenomenon is suggested to be attributed to heightened exposure to ultraviolet (UV) radiation from the sun. The groundbreaking research was led by Prof. Carmit Levy of the Department of Human Genetics and Biochemistry, in a team effort of Ph.D. student Roma Parikh and Prof. Yftach Gepner of the School of Public Health, all from the Faculty of Medicineat Tel Aviv University and Dr. Ruth Percik from the Institute of Endocrinology at Sheba Medical Center. The results of the study were published in the journal Steroids.

“The ovaries secrete the anti-Müllerian hormone, and its level in the bloodstream is linked to ovarian function,” explains Dr. Percik. “While the hormone level is specific to an individual woman at a given point in time and does not provide a definitive assessment of the status of her fertility, evaluating its value, trend, and comparison to the age group is the best indicator of fertility that we have. For this reason, every woman who wants to get pregnant, or is trying to, is sent for an AMH test. In Israel, all of these tests are directed to the central laboratory in Sheba. Our research group investigated the seasonal variability of the AMH tests in order to gauge how the ovaries respond to UV radiation.”

The researchers compared the AMH results of 2,235 Israeli women to the recorded levels of UV radiation. For younger women, aged 20-29, no statistical relationship was found between UV exposure and AMH level. On the other hand, among older fertile women, aged 30 to 40, a statistically significant seasonal pattern emerged: These women, whose egg reserves are in decline, responded positively to sun exposure.

“Based on our prior studies, we can affirm that sun exposure increases metabolism, sexual appetite and behavior, and, at least in animal models, enlarges the ovaries and extends the estrus period,” explains Prof. Levy. “This is a preliminary, pioneering human epidemiological study, and we need to be cautious about inferring a causal relationship between fertility in women and exposure to UV radiation. Humans are not the same as mice. However, we are also animals, our hairless nature makes us even more sensitive to solar radiation. Our research suggests that the female reproductive system is indeed more fertile in the summer, but we still have no information on the mechanism or actual success rates.”

Particularly interesting is the absence of this effect among younger women in their 20s. According to Dr. Percik, this may be attributed to the ample egg reserve found in young women. “Based on my interpretation of the findings, women at the onset of their reproductive age are less in need of signals from the sun, which affect hormonal pathways that have not yet been sufficiently studied. They are less impacted or dependent on the forces of nature in the context of fertility. In contrast, older ovaries need optimal environmental factors in order to function. In fact, this effect was even more pronounced among women aged 35 and older. Of course, there are caveats: Exposure to the sun’s UV radiation should always be done in moderation, and further research is required in order to determine whether such exposure actually helps fertility, and how much exposure is needed.”

Reference:

Roma Parikh, Shivang Parikh, Rina Hemi, Nadav Elkoshi, Yftach Gepner, Carmit Levy, Ruth Percik, Seasonal AMH variability implies a positive effect of UV exposure on the deterioration of ovarian follicles, Steroids, https://doi.org/10.1016/j.steroids.2023.109307.

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Vitamin D Deficiency Linked to Higher Risk of Oral Candidiasis in HIV Patients, finds study

In a groundbreaking case-control study, researchers have
unveiled a compelling association between vitamin D deficiency and the
prevalence of oral candidiasis in individuals living with human
immunodeficiency virus (HIV). Oral candidiasis, a common opportunistic
infection in HIV patients, has long been a concern, and this study sheds new
light on the role of vitamin D levels in its occurrence.


The study results were published in the journal BMC Infectious
diseases.

Also Read: High prevalence and persistence of vitamin D deficiency revealed over time in patients with acute MI: Study

Oral candidiasis, a prevalent opportunistic
infection affecting individuals with human immunodeficiency virus (HIV), is now
under the spotlight as a new study reveals a potential connection with vitamin
D deficiency. Hence researchers conducted a study on a cohort of 206 individuals, including 104
cases diagnosed with oral candidiasis and 102 age- and sex-matched controls
without the condition, to investigate the link between vitamin D levels and the
incidence of oral candidiasis in HIV-infected patients.


Findings:

  • The findings are striking.

  • Patients with oral candidiasis exhibited markedly lower levels
    of 25-OH vitamin D3 compared to their counterparts without the infection.

  • Furthermore, CD4 counts, a key indicator of immune function,
    were significantly lower in the group with oral candidiasis, suggesting a
    potential link between immune status and the occurrence of this opportunistic
    infection.


  • Viral load, another critical parameter in HIV management, was
    notably higher in patients with oral candidiasis, emphasizing the complex
    interplay between viral activity and the development of opportunistic
    infections.

  • The researchers employed multivariate logistic regression
    analysis to explore various factors influencing the risk of oral candidiasis.

  • Educational status, current Highly Active Antiretroviral Therapy
    (HAART), history of oral candidiasis, CD4 count, viral load, and vitamin D
    level emerged as significant factors associated with the likelihood of
    developing oral candidiasis.


  • Notably, the study found a staggering association between
    hypovitaminosis D and an increased risk of oral candidiasis in HIV patients.
Also Read: Higher Vitamin D Levels prior to Methotrexate initiation may Lower Mortality in RA, study finds

Individuals with lower vitamin D levels were found to be at a significantly
higher risk of developing oral candidiasis compared to those with sufficient
vitamin D levels.

The implications of this research are substantial. Given the
prevalence of vitamin D deficiency among individuals living with HIV,
especially those grappling with oral candidiasis, the study suggests that
vitamin D supplementation could play a pivotal role in improving oral health
and preventing the onset of this opportunistic infection.

This groundbreaking research not only deepens our understanding
of the intricate connections between vitamin D, immune function, and
opportunistic infections in HIV patients but also opens avenues for potential
interventions to enhance the overall well-being of individuals living with HIV.

Further reading: Tehrani, S., Abbasian, L., Dehghan Manshadi, S.A. et al. Vitamin D deficiency and oral candidiasis in patients with HIV infection: A case‒control study. BMC Infect Dis 24, 217 (2024). Doi: https://doi.org/10.1186/s12879-024-09065-x

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Asymptomatic Bradyarrhythmias may not require any treatment, needless pacemaker therapy: JAMA

A groundbreaking post hoc analysis of the Implantable Loop
Recorder Detection of Atrial Fibrillation (AF) to Prevent Stroke (LOOP) trial
has unearthed a previously underestimated prevalence of bradyarrhythmias in
individuals aged 70 and above with cardiovascular risk factors. The study
concluded that one in five individuals over 70
years old with cardiovascular risk factors may have bradyarrhythmias when
subjected to long-term continuous monitoring for AF.

The study results were published in the journal
JAMA Cardiology.

Also Read: Low Serum Albumin Levels Related to Increased Risks Post Cardiac Surgery

Growing attention is directed towards heart rhythm monitoring
and technologies aimed at identifying subclinical atrial fibrillation (AF),
potentially resulting in the inadvertent discovery of bradyarrhythmias. Hence,
researchers conducted a Post Hoc analysis of the LOOP randomized trial to investigate
the impact of long-term continuous monitoring for atrial fibrillation (AF)
using an implantable loop recorder (ILR) compared to standard care across four
sites in Denmark.


Between January 2014 and May 2016, the trial enrolled 6004
participants, all aged 70 or older, with conditions such as hypertension,
diabetes, heart failure, or prior stroke. The focus was on evaluating
bradyarrhythmia diagnoses, pacemaker implantations, syncope events, and sudden
cardiovascular deaths over a median follow-up period of 65 months.


Findings:


  • Intriguingly, the ILR screening group, comprising 1501
    participants, exhibited a staggering 6.21-fold increase in bradyarrhythmia
    diagnoses compared to the control group (4503 participants), where only 3.8%
    received such a diagnosis.

  • Significantly, a large proportion of bradyarrhythmia cases in
    the ILR group (79.8%) were asymptomatic, highlighting the potential value of
    continuous monitoring in capturing silent cardiac irregularities.


  • The most prevalent types of bradyarrhythmias identified were
    sinus node dysfunction and high-grade atrioventricular block.

    Age, male gender, and a history of prior syncope were identified
    as risk factors associated with bradyarrhythmias.


  • Notably, the ILR screening group experienced a noteworthy
    increase in pacemaker implantations (4.5%) compared to the control group
    (2.9%).

  • However, there was no discernible difference in the occurrence
    of syncope or sudden cardiovascular death between the two groups.


  • Bradyarrhythmias, identified through continuous monitoring, were
    found to be correlated with subsequent syncope, cardiovascular death, and
    all-cause mortality.

  • Crucially, the impact of bradyarrhythmia on these outcomes
    remained consistent across both the ILR and control groups.
Also Read: Automatic mechanical ventilation feasible and comparable to manual ventilation method during CPR: Study


In conclusion, this study suggests that more than one in five
individuals over 70 years old with cardiovascular risk factors may have
bradyarrhythmias when subjected to long-term continuous monitoring for AF. The
utilization of ILR screening significantly heightened the detection of
bradyarrhythmias and led to more pacemaker implantations compared to standard
care. While shedding light on this hidden aspect of cardiac health, the study
underscores the need for comprehensive heart rhythm monitoring, offering
invaluable insights for diagnostic and therapeutic considerations in managing
cardiovascular health in the elderly.

Further reading: Diederichsen SZ, Xing LY, Frodi DM, et al. Prevalence and Prognostic Significance of Bradyarrhythmias in Patients Screened for Atrial Fibrillation vs Usual Care: Post Hoc Analysis of the LOOP Randomized Clinical Trial. JAMA Cardiol. 2023;8(4):326–334. doi:10.1001/jamacardio.2022.5526

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