10/02/17

Monday, October 2, 2017

Mayo Clinic Minute: Lyphedema risk is not just about the surgery

From: Mayo Clinic https://www.youtube.com/watch?v=aFeo3UoKl80

Heart study is more reason not to skip breakfast

About a third of adults usually skip breakfast, but research suggests that could backfire

From: http://www.cbsnews.com/news/skipping-breakfast-heart-health-study/

Could Skipping Breakfast Feed Heart Disease?

Forgoing morning meal may reduce cardiac health and boost odds for diabetes, study suggests

From: http://www.webmd.com/heart-disease/news/20171002/could-skipping-breakfast-feed-heart-disease?src=RSS_PUBLIC

Reassuring Kids After Another Las Vegas Massacre

Psychiatrists urge parents to stress to young concertgoers that events like Las Vegas shooting remain rare

From: http://www.webmd.com/mental-health/news/20171002/reassuring-kids-after-another-las-vegas-massacre?src=RSS_PUBLIC

How hospitals respond to mass shooting events

To save as many lives as possible following an event like the Las Vegas shooting, first responders and ER doctors must act quickly and make difficult decisions

From: http://www.cbsnews.com/news/las-vegas-shooting-how-hospitals-respond-mass-casualty-events/

Nobel Prize Winners Unlocked Your Sleep Secrets

Winners in Medicine studied circadian rhythm.

From: http://www.webmd.com/sleep-disorders/news/20171002/nobel-prize-winners-unlocked-your-sleep-secrets?src=RSS_PUBLIC

Think Whole Food, Not ‘Out of the Box’ for Heart Healthy Diet

From: Mayo Clinic https://www.youtube.com/watch?v=WY0OipsNtCA

Lipid-Based Nutrient Supplements During Pregnancy and Lactation Did Not Affect Human Milk Oligosaccharides and Bioactive Proteins in a Randomized Trial [Nutrient Physiology, Metabolism, and Nutrient-Nutrient Interactions]

Background: Human milk oligosaccharides (HMOs) and bioactive proteins are beneficial to infant health. Recent evidence suggests that maternal nutrition may affect the amount of HMOs and proteins in breast milk; however, the effect of nutrient supplementation on HMOs and bioactive proteins has not yet been well studied.

Objective: We aimed to determine whether lipid-based nutrient supplements (LNSs) affect milk bioactive protein and HMO concentrations at 6 mo postpartum in women in rural Malawi. These are secondary outcomes of a previously published randomized controlled trial.

Methods: Women were randomly assigned to consume either an iron and folic acid capsule (IFA) daily from ≤20 wk gestation until delivery, followed by placebo daily from delivery to 6 mo postpartum, or a multiple micronutrient (MMN) capsule or LNS daily from ≤20 wk gestation to 6 mo postpartum. Breast milk concentrations of total HMOs, sialylated HMOs, fucosylated HMOs, lactoferrin, lactalbumin, lysozymes, antitrypsin, immunoglobulin A, and osteopontin were analyzed at 6 mo postpartum (n = 647). Between-group differences in concentrations and in proportions of women classified as having low concentrations were tested.

Results: HMO and bioactive protein concentrations did not differ between groups (P > 0.10 for all comparisons). At 6 mo postpartum, the proportions of women with low HMOs or bioactive proteins were not different between groups except for osteopontin. A lower proportion of women in the IFA group had low osteopontin compared with the LNS group after adjusting for covariates (OR: 0.5; 95% CI: 0.3, 0.9; P = 0.016).

Conclusion: The study findings do not support the hypothesis that supplementation with an LNS or MMN capsule during pregnancy and postpartum would increase HMO or bioactive milk proteins at 6 mo postpartum among Malawian women. This trial was registered at clinicaltrials.gov as NCT01239693.

From: Jorgensen, J. M., Arnold, C., Ashorn, P., Ashorn, U., Chaima, D., Cheung, Y. B., Davis, J. C., Fan, Y.-M., Goonatilleke, E., Kortekangas, E., Kumwenda, C., Lebrilla, C. B., Maleta, K., Totten, S. M., Wu, L. D., Dewey, K. G. http://jn.nutrition.org/cgi/content/short/147/10/1867?rss=1

Moderate Walking Enhances the Effects of an Energy-Restricted Diet on Fat Mass Loss and Serum Insulin in Overweight and Obese Adults in a 12-Week Randomized Controlled Trial [Nutrient Physiology, Metabolism, and Nutrient-Nutrient Interactions]

College-Aged Males Experience Attenuated Sweet and Salty Taste with Modest Weight Gain [Nutrient Physiology, Metabolism, and Nutrient-Nutrient Interactions]

Background: Human and animal studies report a blunted sense of taste in people who are overweight or obese, with heightened sensitivity also reported after weight loss. However, it is unknown if taste changes concurrently with weight gain.

Objective: This study investigated the association of weight gain with changes in suprathreshold taste intensity perception in a free-living population of young adults.

Methods: Taste response, anthropometric measures, and diet changes were assessed with a longitudinal study design in first-year college students 3 times throughout the academic year. At baseline, 93 participants (30 males, 63 females) were an average of 18 y old, with a body mass index (in kg/m²) of 21.9. Sweet, umami, salty, sour, and bitter taste intensities were evaluated at 3 concentrations by using the general Labeled Magnitude Scale. Ordinary least-squares regression models assessed the association of weight gain and within-person taste change, adjusting for sex, race, and diet changes.

Results: Participants gained an average of 3.9% in weight, ranging from –5.7% to +13.8%. With each 1% increase in body weight, males perceived sweet and salty as less intense, with taste responses decreasing by 11.0% (95% CI: –18.9%, –2.3%; P = 0.015) and 7.5% (95% CI: –13.1%, –1.5%; P = 0.015) from baseline, respectively. Meanwhile, females did not experience this decrement, and even perceived a 6.5% increase (95% CI: 2.6%, 10.5%; P = 0.007) in sour taste with similar amounts of weight gain. Changes in the consumption of meat and other umami-rich foods also negatively correlated with umami taste response (–39.1%; 95% CI: –56.3%, –15.0%; P = 0.004).

Conclusions: A modest weight gain is associated with concurrent taste changes in the first year of college, especially in males who experience a decrement in sweet and salty taste. This suggests that young-adult males may be susceptible to taste loss when gaining weight.

From: Noel, C. A., Cassano, P. A., Dando, R. http://jn.nutrition.org/cgi/content/short/147/10/1885?rss=1

Dietary Methionine Restriction Alleviates Hyperglycemia in Pigs with Intrauterine Growth Restriction by Enhancing Hepatic Protein Kinase B Signaling and Glycogen Synthesis [Nutrient Physiology, Metabolism, and Nutrient-Nutrient Interactions]

Background: Individuals with intrauterine growth restriction (IUGR) are prone to developing type 2 diabetes mellitus (T2DM). Dietary methionine restriction (MR) improves insulin sensitivity and glucose homeostasis in individuals with normal birth weight (NBW).

Objective: This study investigated the effects of MR on plasma glucose concentration and hepatic and muscle glucose metabolism in pigs with IUGR.

Methods: Thirty female NBW and 60 same-sex spontaneous IUGR piglets (Landrace x Yorkshire) were selected. After weaning (day 21), the piglets were fed diets with adequate methionine (NBW-CON and IUGR-CON) or 30% less methionine (IUGR-MR) (n = 6). At day 180, 1 pig with a body weight near the mean of each replication was selected for biochemical analysis.

Results: The IUGR-CON group showed 41.6%, 68.6%, and 67.1% higher plasma glucose concentration, hepatic phosphoenolpyruvate carboxykinase activity, and glucose-6-phosphatase activity, respectively, than the NBW-CON group (P < 0.05). Muscle glycogen content and glycogen synthase activity were 36.9% and 38.8% lower, respectively, in the IUGR-CON than the NBW-CON group (P < 0.05), respectively, and there was decreased hepatic and muscle protein kinase B phosphorylation in the IUGR-CON group (P < 0.05). Compared with the IUGR-CON pigs, the IUGR-MR pigs had 28.7% lower plasma glucose concentrations (P < 0.05), which were similar to those of the NBW-CON pigs (P ≥ 0.05). The hepatic glycogen content and glycogen synthase activity of the IUGR-MR pigs were 62.9% and 50.8% higher than those of the IUGR-CON pigs (P < 0.05) and 53.5% and 84.3% higher than the NBW-CON pigs (P < 0.05), respectively. The IUGR-MR pigs’ hepatic and muscle protein kinase B phosphorylation was higher than that of the IUGR-CON pigs (P < 0.05) and similar to that of the NBW-CON pigs (P ≥ 0.05).

Conclusion: MR attenuates hyperglycemia in IUGR pigs by enhancing hepatic protein kinase B signaling and glycogen synthesis, implying a potential nutritional strategy to prevent type 2 diabetes mellitus in IUGR offspring.

From: Ying, Z., Zhang, H., Su, W., Zhou, L., Wang, F., Li, Y., Zhang, L., Wang, T. http://jn.nutrition.org/cgi/content/short/147/10/1892?rss=1

Fructo-oligosaccharide-Induced Transient Increases in Cecal Immunoglobulin A Concentrations in Rats Are Associated with Mucosal Inflammation in Response to Increased Gut Permeability [Nutrient Physiology, Metabolism, and Nutrient-Nutrient Interactions]

Background: The mechanism underlying transient increases in immunoglobulin (Ig) A concentrations in the cecal contents of rats fed fructo-oligosaccharide (FOS) is unclear.

Objective: This study was designed to test whether increased IgA concentrations represent one aspect of the inflammatory response to increased permeability induced by FOS in the cecum.

Methods: Seven-week-old male Wistar rats were fed a fiber-free semipurified diet (FFP) with or without supplemental FOS (60 g/kg diet) for 9 or 58 d [experiment (expt.) 1], 7 d (expt. 2), or 7 or 56 d (expt. 3). In addition to measuring IgA concentrations in cecal content, we assessed gut permeability, inflammatory responses (expt. 1), the number of IgA plasma cells in the cecal lamina propria, polymeric Ig receptor (pIgR) expression in the cecal mucosa (expt. 2), and the condition of the cecal mucus layer (expt. 3).

Results: The cecal IgA concentration in the FOS-fed rats was 15-fold higher than that of the rats fed FFP for 9 d (P < 0.05). Gut permeability estimated by urinary chromium-EDTA excretion, bacterial translocation to mesenteric lymph nodes, myeloperoxidase activity, and expression of inflammatory cytokine genes in the cecal mucosa was greater in the FOS-fed rats than in the rats fed FFP for 9 d. These effects were not observed in the rats fed FOS for 58 d (expt. 1). Accompanying the higher cecal IgA concentration, pIgR protein and the number of IgA plasma cells in the cecal mucosa were higher in the FOS-fed rats than in the rats fed FFP for 7 d (expt. 2). Destruction of the mucus layer on the epithelial surface, as evidenced by Alcian blue staining in the cecal sections, was evident in the rats fed FOS for 7 d, but the mucus layer appeared normal in the rats fed FOS for 56 d (expt. 3).

Conclusions: These findings suggest that transient increases in cecal IgA concentrations induced by FOS in rats are associated with mucosal inflammation in response to increased gut permeability; these are presumably evoked by disruption of the cecal mucus barrier. The observed responses could contribute to the maturation of the gut immune system.

From: Genda, T., Sasaki, Y., Kondo, T., Hino, S., Nishimura, N., Tsukahara, T., Sonoyama, K., Morita, T. http://jn.nutrition.org/cgi/content/short/147/10/1900?rss=1

The Mayo Clinic Heart Rhythm Experience

From: Mayo Clinic https://www.youtube.com/watch?v=qP6Rkez7rlc

Revascularization with PCI or CABG in the Post SYNTAX Era

From: Mayo Clinic https://www.youtube.com/watch?v=6zACXI-4-Jw

The 10 Most Frequently Asked Questions with Regard to Robotic Heart Surgery

From: Mayo Clinic https://www.youtube.com/watch?v=r7GYBfbB478

Carcinoid Heart Disease – Mayo Clinic

From: Mayo Clinic https://www.youtube.com/watch?v=5gq4_j7x0cU

Adult Congenital Heart Disease: Anomalous Pulmonary Veins

From: Mayo Clinic https://www.youtube.com/watch?v=mdArrNyAPoE

Adult Congenital Heart Disease: Bicuspid Aortic Valve

From: Mayo Clinic https://www.youtube.com/watch?v=7INWriBGDEs

Adult Congenital Heart Disease: The Fontan Operation

From: Mayo Clinic https://www.youtube.com/watch?v=lt1clXikNYc

Adult Congenital Heart Disease: Eisenmenger Syndrome

From: Mayo Clinic https://www.youtube.com/watch?v=Npo38ZCr_YY

Adult Congenital Heart Disease Pregnancy and CHD

From: Mayo Clinic https://www.youtube.com/watch?v=1jowxHcIDwI

Assessing and Managing Stroke Risk in Adult Congenital Heart Disease

From: Mayo Clinic https://www.youtube.com/watch?v=pK1dSjCPUhg

Why Colorado is banning pot gummy bears

The change is aimed at decreasing the likelihood small children will mistake the drug-infused products for a favorite treat

From: http://www.cbsnews.com/news/colorado-bans-pot-gummy-bears-other-edibles-shapes/

Study: Go Wider When Having Suspect Moles Removed

Goal is to only perform one procedure, skin cancer specialist says

From: http://www.webmd.com/melanoma-skin-cancer/news/20171002/study-go-wider-when-having-suspect-moles-removed?src=RSS_PUBLIC

ADA Foundation distinguishes GKAS award recipients

The president of the Hawaii Dental Association’s Young Dentist Group and the head of Premier Dental Products Co. are the recipients of the ADA Foundation’s Smile Champion Awards for Give Kids A Smile, the Foundation announced in September.

From: By Matt Carey http://www.ada.org/en/publications/ada-news/2017-archive/september/ada-foundation-distinguishes-gkas-award-recipients

American Association of Oral and Maxillofacial Surgeons joins project to reduce opioid abuse

Parsippany, N.J. — The American Association of Oral and Maxillofacial Surgeons joined a research project in September with Pacira Pharmaceuticals and Aetna in a national program aimed at reducing the amount of opioids prescribed to patients undergoing third molar extractions.

From: By David Burger http://www.ada.org/en/publications/ada-news/2017-archive/september/american-association-of-oral-and-maxillofacial-surgeons-joins-project-to-reduce-opioid-abuse

Dr. Joe Crowley’s core values are close to home

ow many people are lucky enough to love the place they’ve called home since they were born? Lucky enough to grow up knowing the neighbors because they shopped at your dad’s store and later, knowing them as their dentist — and finding that being called “Joey” by patients who’ve watched you grow up made perfect sense.

From: http://www.ada.org/en/publications/ada-news/2017-archive/september/dr-joe-crowleys-core-values-are-close-to-home

Get ready for Give Kids A Smile 2018

The ADA Foundation is reminding Give Kids A Smile program coordinators to register their events by Nov. 6 to be eligible to receive donated product kits.

From: http://www.ada.org/en/publications/ada-news/2017-archive/september/get-ready-for-give-kids-a-smile-2018

Help Atlanta family violence victims during ADA 2017

Atlanta – Two local philanthropic organizations will benefit thanks to the Alliance of the American Dental Association’s service project at ADA 2017 – America’s Dental Meeting, and ADA members are invited to join in the effort.

From: by Michelle Manchir http://www.ada.org/en/publications/ada-news/2017-archive/september/help-atlanta-family-violence-victims-during-ada-2017

Pulmonary Balloon Angioplasty for Medical Professionals

From: Mayo Clinic https://www.youtube.com/watch?v=AyJwbdCHt2Y

Pulmonary Balloon Angioplasty

From: Mayo Clinic https://www.youtube.com/watch?v=W894miqGfPM

The mysterious rise in knee osteoarthritis

Follow me on Twitter @RobShmerling

While there are more than 100 types of arthritis, osteoarthritis is by far the most common.

Osteoarthritis is the form of joint disease that’s often called “wear-and-tear” or “age-related,” although it’s more complicated than that. While it tends to affect older adults, it is not a matter of “wearing out” your joints the way tires on your car wear out over time. Your genes, your weight, and other factors contribute to the development of osteoarthritis. Since genes don’t change quickly across populations, the rise in prevalence of osteoarthritis in recent generations suggests an environmental factor, such as activity, diet, or weight.

Osteoarthritis of the knee will affect at least half of people in their lifetime, and is the main reason more than 700,000 people need knee replacements each year in the US.

The obesity-arthritis connection

To explain the rise in the prevalence of osteoarthritis in recent decades, most experts proposed that it was due to people living longer and the “epidemic of obesity,” since excess weight is a known risk factor for osteoarthritis. Studies have shown not only that the risk of joint disease rises with weight, but also that even modest weight loss can lessen joint symptoms and in some cases allow a person to avoid surgery.

But a remarkable new study suggests there is more to the story.

Challenging a common assumption

Researchers publishing in the Proceedings of the National Academy of Sciences examined skeletons from people who had died and donated their bodies to research. Information regarding presence of knee osteoarthritis, age at death, body mass index (BMI), cause of death, and other data were compared for more than 1,500 people who died between 1905 and 1940 (the “early industrial group”) and more than 800 people who died between 1976 and 2015 (the “post-industrial group”).

A third group of skeletons obtained from archeological sites were also assessed for osteoarthritis of the knee. They came from prehistoric hunter-gatherers living hundreds to thousands of years ago. and early farmers living between 900 and 300 BP. BMI could not be determined for these individuals, but gender could be determined and age was estimated based on features of their skeletons.

The findings were intriguing:

The prehistoric skeletons and early 1900s cadavers had similar rates of knee osteoarthritis: 6% for the former and 8% for the latter.
With a prevalence of 16%, the more recent skeletons had at least double the rate of knee osteoarthritis as those living in centuries past.
Even after accounting for age, BMI, and other relevant information, those in the post-industrial group had more than twice the rate of knee osteoarthritis as those in the early industrial group.

Limitations of this study include BMI estimates at the time of death that might not reflect body weight during most of the person’s life, a study population (bodies donated for medical research or from archeological digs) that might not be representative of the population at large, and lack of accurate information regarding diet, activity, and other important factors. Even so, the findings shake some long-held assumptions and make the rise in osteoarthritis in recent years more mysterious than before.

So what?

These findings call into question assumptions about the reasons osteoarthritis is becoming more common. And they suggest that slowing or reversing the dramatic increase in obesity in recent years may not have as much of an impact on knee osteoarthritis as we’d thought. Finally, if longevity and excess weight do not account for the rising rates of knee osteoarthritis, what does? The list of possibilities is long, and as suggested by the authors of this study includes:

injury
wearing high-heeled shoes (yes, there is at least one study suggesting that the altered forces in the knee among those wearing high-heeled shoes might contribute to the development of osteoarthritis)
inactivity
walking on hard pavement
inflammation (worsened by inactivity, modern diets, and obesity)

The bottom line

As is so often the case in medical research, this new study raises more questions than it answers. We’ll need a better understanding of why and how osteoarthritis develops before we can prevent it or improve its treatment. There are already many dedicated researchers exploring these important questions.

The post The mysterious rise in knee osteoarthritis appeared first on Harvard Health Blog.

From: Robert H. Shmerling, MD https://www.health.harvard.edu/blog/the-mysterious-rise-in-knee-osteoarthritis-2017100212504