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Having Ideal Heart Health May Lessen the Risk for Brain Vessel Disease

Title: Having Ideal Heart Health May Lessen the Risk for Brain Vessel Disease
Category: Health News
Created: 8/17/2022 12:00:00 AM
Last Editorial Review: 8/18/2022 12:00:00 AM




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AHA News: New Report Details What to Know About Cardiovascular Disease Symptoms

Title: AHA News: New Report Details What to Know About Cardiovascular Disease Symptoms
Category: Health News
Created: 8/18/2022 12:00:00 AM
Last Editorial Review: 8/19/2022 12:00:00 AM




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What Are the 4 Stages of Congestive Heart Failure?

Title: What Are the 4 Stages of Congestive Heart Failure?
Category: Diseases and Conditions
Created: 6/24/2020 12:00:00 AM
Last Editorial Review: 8/26/2022 12:00:00 AM




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What Causes Congestive Heart Failure?

Title: What Causes Congestive Heart Failure?
Category: Diseases and Conditions
Created: 6/12/2020 12:00:00 AM
Last Editorial Review: 8/26/2022 12:00:00 AM




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Congestive Heart Failure (CHF)

Title: Congestive Heart Failure (CHF)
Category: Diseases and Conditions
Created: 12/31/1997 12:00:00 AM
Last Editorial Review: 8/26/2022 12:00:00 AM




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Scientists Create Synthetic Mouse Embryo With Brain, Beating Heart

Title: Scientists Create Synthetic Mouse Embryo With Brain, Beating Heart
Category: Health News
Created: 8/26/2022 12:00:00 AM
Last Editorial Review: 8/26/2022 12:00:00 AM




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U.S. Government Extends Baby Formula Waivers, Rebates for WIC Families

Title: U.S. Government Extends Baby Formula Waivers, Rebates for WIC Families
Category: Health News
Created: 8/25/2022 12:00:00 AM
Last Editorial Review: 8/26/2022 12:00:00 AM




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Does Coffee Raise Cholesterol?

Title: Does Coffee Raise Cholesterol?
Category: Health News
Created: 5/11/2022 12:00:00 AM
Last Editorial Review: 5/12/2022 12:00:00 AM




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Common Diabetes Drug May Contain Traces of Carcinogen

Title: Common Diabetes Drug May Contain Traces of Carcinogen
Category: Health News
Created: 8/12/2022 12:00:00 AM
Last Editorial Review: 8/12/2022 12:00:00 AM




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Certain Painkillers Raise Heart Failure Risk in People With Type 2 Diabetes

Title: Certain Painkillers Raise Heart Failure Risk in People With Type 2 Diabetes
Category: Health News
Created: 8/24/2022 12:00:00 AM
Last Editorial Review: 8/24/2022 12:00:00 AM




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Exercise, Puzzles, Games: How Do They Help Aging Brains?

Title: Exercise, Puzzles, Games: How Do They Help Aging Brains?
Category: Health News
Created: 7/21/2022 12:00:00 AM
Last Editorial Review: 7/21/2022 12:00:00 AM




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Diets Heavy in 'Ultra-Processed' Foods Could Harm the Brain

Title: Diets Heavy in 'Ultra-Processed' Foods Could Harm the Brain
Category: Health News
Created: 7/28/2022 12:00:00 AM
Last Editorial Review: 7/29/2022 12:00:00 AM




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Brain Zaps Give Month-Long Memory Boost

Title: Brain Zaps Give Month-Long Memory Boost
Category: Health News
Created: 8/22/2022 12:00:00 AM
Last Editorial Review: 8/23/2022 12:00:00 AM




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Too Much TV Time May Really Harm Your Brain

Title: Too Much TV Time May Really Harm Your Brain
Category: Health News
Created: 8/23/2022 12:00:00 AM
Last Editorial Review: 8/24/2022 12:00:00 AM




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3 Big Pharmacy Chains Must Pay $650 Million to Ohio Counties for Role in Opioid Crisis

Title: 3 Big Pharmacy Chains Must Pay $650 Million to Ohio Counties for Role in Opioid Crisis
Category: Health News
Created: 8/18/2022 12:00:00 AM
Last Editorial Review: 8/18/2022 12:00:00 AM




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Too Few Psychiatric Beds: Psychiatrists' Group Takes Aim at Ongoing Crisis

Title: Too Few Psychiatric Beds: Psychiatrists' Group Takes Aim at Ongoing Crisis
Category: Health News
Created: 8/17/2022 12:00:00 AM
Last Editorial Review: 8/18/2022 12:00:00 AM




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Brain-Eating Amoeba From River May Have Caused Child's Death

Title: Brain-Eating Amoeba From River May Have Caused Child's Death
Category: Health News
Created: 8/19/2022 12:00:00 AM
Last Editorial Review: 8/19/2022 12:00:00 AM




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Want to Maintain Muscle? Frequency of Workouts Is Key

Title: Want to Maintain Muscle? Frequency of Workouts Is Key
Category: Health News
Created: 8/22/2022 12:00:00 AM
Last Editorial Review: 8/22/2022 12:00:00 AM




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Nerve Block Plus Lidocaine Clears Psoriasis in Small Study

Title: Nerve Block Plus Lidocaine Clears Psoriasis in Small Study
Category: Health News
Created: 8/15/2022 12:00:00 AM
Last Editorial Review: 8/16/2022 12:00:00 AM




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What Are the Main Parts of the Male Reproductive System?

Title: What Are the Main Parts of the Male Reproductive System?
Category: Diseases and Conditions
Created: 7/7/2022 12:00:00 AM
Last Editorial Review: 7/7/2022 12:00:00 AM




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What Causes Lower Abdominal Pain in Men?

Title: What Causes Lower Abdominal Pain in Men?
Category: Diseases and Conditions
Created: 7/15/2022 12:00:00 AM
Last Editorial Review: 7/15/2022 12:00:00 AM




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Cheaper Over-the-Counter Hearing Aids Should Be in Stores by October, FDA Says

Title: Cheaper Over-the-Counter Hearing Aids Should Be in Stores by October, FDA Says
Category: Health News
Created: 8/16/2022 12:00:00 AM
Last Editorial Review: 8/17/2022 12:00:00 AM




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How Did AIDS Start?

Title: How Did AIDS Start?
Category: Diseases and Conditions
Created: 6/3/2022 12:00:00 AM
Last Editorial Review: 6/3/2022 12:00:00 AM




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What Happens If We Get AIDS?

Title: What Happens If We Get AIDS?
Category: Diseases and Conditions
Created: 6/10/2022 12:00:00 AM
Last Editorial Review: 6/10/2022 12:00:00 AM




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What Therapeutic Options Are Available for Treating an Antiretroviral Naive Patient?

Title: What Therapeutic Options Are Available for Treating an Antiretroviral Naive Patient?
Category: Diseases and Conditions
Created: 6/16/2022 12:00:00 AM
Last Editorial Review: 6/16/2022 12:00:00 AM




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COVID Crisis Has Stalled Fight Against HIV/AIDS

Title: COVID Crisis Has Stalled Fight Against HIV/AIDS
Category: Health News
Created: 7/28/2022 12:00:00 AM
Last Editorial Review: 7/29/2022 12:00:00 AM




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Does Menopause Make You More Sensitive to Pain?

Title: Does Menopause Make You More Sensitive to Pain?
Category: Diseases and Conditions
Created: 5/11/2022 12:00:00 AM
Last Editorial Review: 5/11/2022 12:00:00 AM




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Menopause Might Worsen Jaw Pain in Women

Title: Menopause Might Worsen Jaw Pain in Women
Category: Health News
Created: 5/17/2022 12:00:00 AM
Last Editorial Review: 5/17/2022 12:00:00 AM




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Will Joint Pain From Menopause Go Away?

Title: Will Joint Pain From Menopause Go Away?
Category: Diseases and Conditions
Created: 5/24/2022 12:00:00 AM
Last Editorial Review: 5/24/2022 12:00:00 AM




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Moving Away From Opioids to Treat Dental Pain

Title: Moving Away From Opioids to Treat Dental Pain
Category: Health News
Created: 8/19/2022 12:00:00 AM
Last Editorial Review: 8/19/2022 12:00:00 AM




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Kids With ADHD Have Differences in 'Neural Flexibility,' Brain Study Shows

Title: Kids With ADHD Have Differences in 'Neural Flexibility,' Brain Study Shows
Category: Health News
Created: 7/29/2022 12:00:00 AM
Last Editorial Review: 8/1/2022 12:00:00 AM




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Your Brain Gets Tired, and Scientists Now Know Why

Title: Your Brain Gets Tired, and Scientists Now Know Why
Category: Health News
Created: 8/12/2022 12:00:00 AM
Last Editorial Review: 8/15/2022 12:00:00 AM




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cocaine

Title: cocaine
Category: Medications
Created: 8/15/2022 12:00:00 AM
Last Editorial Review: 8/15/2022 12:00:00 AM




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You Could Live 9 Years Longer in Hawaii Than in Mississippi, New Data Shows

Title: You Could Live 9 Years Longer in Hawaii Than in Mississippi, New Data Shows
Category: Health News
Created: 8/23/2022 12:00:00 AM
Last Editorial Review: 8/23/2022 12:00:00 AM




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What Is the Main Cause of Leaky Gut, and How Do You Fix It?

Title: What Is the Main Cause of Leaky Gut, and How Do You Fix It?
Category: Diseases and Conditions
Created: 8/23/2022 12:00:00 AM
Last Editorial Review: 8/23/2022 12:00:00 AM




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Treating central sleep apnoea in heart failure: progressing one step at a time

Extract

We read with great interest the correspondence by T. Bitter and co-workers in the European Respiratory Review, about our recently published review entitled "Central sleep apnoea: not just one phenotype" [1]. We first want to express our gratefulness to the authors for their support and appreciation of our work, particularly regarding the urgent need for an increasingly differentiated view of central sleep apnoea (CSA) in the context of precision medicine.




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Treating central sleep apnoea in heart failure: is positive airway pressure and adaptive servo-ventilation in particular the gold standard?

Extract

We read with great interest the review article by Randerath et al. [1] recently published in the European Respiratory Review. We would like to congratulate the authors on this clearly structured review, which emphasises the urgent need for an increasingly differentiated view of central sleep apnoea (CSA) in the context of precision medicine.




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Impaired lung function and associated risk factors in children born prematurely: a systematic review and meta-analysis

Background

Immature lung development and respiratory morbidity place preterm-born children at high risk of long-term pulmonary sequelae. This systematic review and meta-analysis aims to quantify lung function in preterm-born children and identify risk factors for a compromised lung function.

Methods

We searched MEDLINE, Embase, Cochrane Library, Web of Science and Scopus for relevant studies published on preterm cohorts born since 1990. Studies comparing forced expiratory volume in 1 s (FEV1) in preterm-born children aged ≥5 years to term-born controls or normative data were included. Study quality was assessed using the Newcastle–Ottawa Scale for cohort studies. Standardised mean differences in FEV1 and secondary spirometry outcomes per study were pooled using meta-analysis. The impact of different demographic and neonatal variables on studies’ FEV1 effect sizes was investigated by meta-regression analyses. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations framework.

Results

We identified 42 studies with unique cohorts including 4743 preterm children and 9843 controls. Median gestational age in the studies was 28.0 weeks and age at assessment ranged from 6.7 to 16.7 years. Preterm children had lower FEV1 than controls (–0.58 sd, 95% CI –0.69– –0.47 sd, p<0.001) resulting in a relative risk of 2.9 (95% CI 2.4–3.4) for abnormal outcome, with high certainty of evidence. FEV1 was significantly associated with gestational age, birthweight, bronchopulmonary dysplasia and invasive mechanical ventilation in univariate meta-regression analyses (R2=36–96%).

Conclusion

This systematic review shows robust evidence of impaired lung function in preterm-born children with a high certainty of evidence.




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Antibody-mediated protection against respiratory syncytial virus in children

Respiratory syncytial virus (RSV) is a major global pathogen, causing lower respiratory tract disease in at-risk populations including young children. Antibodies form a crucial layer of protection from RSV disease, particularly in immunologically naïve infants. Such antibodies are derived from the mother via transplacental transfer and breast milk, but may be particularly low in high-risk infants such as those born preterm. Maternally derived antibodies can now be supplemented by the administration of anti-RSV monoclonal antibodies, while a rising wave of maternal and paediatric vaccine strategies are approaching. The implementation of these prophylactics may profoundly decrease the healthcare burden of RSV. In this article, we review the role of antibody-mediated immunity in protecting children from RSV. We focus on maternally derived antibodies as the main source of protection against RSV and study factors that influence the scale of this transfer. The role of passive and active prophylactic approaches in protecting infants against RSV are discussed and knowledge gaps in our understanding of antibody-mediated protection against RSV are identified.




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Mutational scanning of CRX classifies clinical variants and reveals biochemical properties of the transcriptional effector domain [RESEARCH]

The transcription factor (TF) cone-rod homeobox (CRX) is essential for the differentiation and maintenance of photoreceptor cell identity. Several human CRX variants cause degenerative retinopathies, but most are variants of uncertain significance. We performed a deep mutational scan (DMS) of nearly all possible single amino acid substitutions in CRX using a cell-based transcriptional reporter assay, curating a high-confidence list of nearly 2000 variants with altered transcriptional activity. In the structured homeodomain, activity scores closely aligned to a predicted structure and demonstrated position-specific constraints on amino acid substitution. In contrast, the intrinsically disordered transcriptional effector domain displayed a qualitatively different pattern of substitution effects, following compositional constraints without specific residue position requirements in the peptide chain. These compositional constraints were consistent with the acidic exposure model of transcriptional activation. We evaluated the performance of the DMS assay as a clinical variant classification tool using gold-standard classified human variants from ClinVar, identifying pathogenic variants with high specificity and moderate sensitivity. That this performance could be achieved using a synthetic reporter assay in a foreign cell type, even for a highly cell type-specific TF like CRX, suggests that this approach shows promise for DMS of other TFs that function in cell types that are not easily accessible. Together, the results of the CRX DMS identify molecular features of the CRX effector domain and demonstrate utility for integration into the clinical variant classification pipeline.




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Cannabis and Pain Management

Family physicians are fielding questions about cannabis --particularly for the use of cannabis for treatment of pain. Like about every substance ingested to treat medical conditions, cannabis has risks and benefits. But regarding evidence-based practice and practice-based recommendations for patients about cannabis use, the cart is in front of the horse. Cannabis use is still illegal at a federal level and a Schedule 1 drug, but most states have challenged federal law by decriminalizing or legalizing cannabis for a variety of uses. Research is difficult due to this federal status as a Schedule 1 drug since federal funding is not readily available to support research. As a result, physicians have little to no guidance about the clinical usefulness of the product. This article explores what we know and what we are learning about cannabis, and the authors provide clinical guidance for patient care based on this evidence.




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Be SMART About Asthma Management: Single Maintenance and Reliever Therapy

Single maintenance and reliever therapy (SMART) is an asthma treatment approach that utilizes combined inhaled corticosteroids and long-acting β-agonists for maintenance and quick relief therapy. Despite the evidence for its benefits in asthma treatment and its adoption into American and international asthma guidelines and recommendations, SMART remains a practice of some debate. This article reviews the available evidence for SMART and offers guidance for its integration into comprehensive asthma management. Overall, short-acting β-agonist-only asthma therapy regimens should be avoided, regardless of condition severity (SOR A Recommendation). Family medicine clinicians should start SMART for patients requiring either GINA Step 3 or 4 therapy, especially if they have signs of poor adherence (SOR B Recommendation). Finally, use budesonide-formoterol over other inhaled corticosteroid/long-acting β-agonist combinations when implementing SMART (SOR B Recommendation).




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Performance Evaluation of the Generative Pre-trained Transformer (GPT-4) on the Family Medicine In-Training Examination

Objective:

In this study, we sought to comprehensively evaluate GPT-4 (Generative Pre-trained Transformer)’s performance on the 2022 American Board of Family Medicine’s (ABFM) In-Training Examination (ITE), compared with its predecessor, GPT-3.5, and the national family residents’ performance on the same examination.

Methods:

We utilized both quantitative and qualitative analyses. First, a quantitative analysis was employed to evaluate the model's performance metrics using zero-shot prompt (where only examination questions were provided without any additional information). After this, qualitative analysis was executed to understand the nature of the model's responses, the depth of its medical knowledge, and its ability to comprehend contextual or new information through chain-of-thoughts prompts (interactive conversation) with the model.

Results:

This study demonstrated that GPT-4 made significant improvement in accuracy compared with GPT-3.5 over a 4-month interval between their respective release dates. The correct percentage with zero-shot prompt increased from 56% to 84%, which translates to a scaled score growth from 280 to 690, a 410-point increase. Most notably, further chain-of-thought investigation revealed GPT-4’s ability to integrate new information and make self-correction when needed.

Conclusions:

In this study, GPT-4 has demonstrated notably high accuracy, as well as rapid reading and learning capabilities. These results are consistent with previous research indicating GPT-4's significant potential to assist in clinical decision making. Furthermore, the study highlights the essential role of physicians' critical thinking and lifelong learning skills, particularly evident through the analysis of GPT-4's incorrect responses. This emphasizes the indispensable human element in effectively implementing and using AI technologies in medical settings.




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Comparing Highs and Flows in Patients With COPD With Chronic Hypercapnic Respiratory Failure




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Simulation in Mechanical Ventilation Training: Integrating Best Practices for Effective Education




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Home Respiratory Strategies in Patients With COPD With Chronic Hypercapnic Respiratory Failure

BACKGROUND:Home noninvasive ventilation (NIV) may improve chronic hypercarbia in COPD and patient-important outcomes. The efficacy of home high-flow nasal cannula (HFNC) as an alternative is unclear.METHODS:We searched MEDLINE, Embase, Cochrane CENTRAL, Scopus, and ClinicalTrials.gov for randomized trials of subjects from inception to March 31, 2023, and updated the search on July 14, 2023. We performed a frequentist network meta-analysis and assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. We analyzed randomized controlled trials (RCTs) comparing NIV, HFNC, or standard care in adult subjects with COPD with chronic hypercapnic respiratory failure. Outcomes included mortality, COPD exacerbations, hospitalizations, and quality of life (St George Respiratory Questionnaire [SGRQ]).RESULTS:We analyzed 24 RCTs (1,850 subjects). We found that NIV may reduce the risk of death compared to standard care (relative risk 0.82 [95% CI 0.66–1.00]) and probably reduces exacerbations (relative risk 0.71 [95% CI 0.58–0.87]). HFNC probably reduces exacerbations compared to standard care (relative risk 0.77 [0.68–0.88]), but its effect on mortality is uncertain (relative risk 1.20 [95% CI 0.63–2.28]). HFNC probably improves SGRQ scores (mean difference −7.01 [95% CI −12.27 to −1.77]) and may reduce hospitalizations (relative risk 0.87 [0.69–1.09]) compared to standard care. No significant difference was observed between HFNC and NIV in reducing exacerbations.CONCLUSIONS:Both NIV and HFNC reduce exacerbation risks in subjects with COPD compared to standard care. HFNC may offer advantages in improving quality of life.




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Effects of Ultrasonic Use on Hearing Loss in Dental Hygienists: A matched pairs design study

Purpose Dental professionals are exposed to hazardous noise levels on a daily basis in clinical practice. The purpose of this study was to compare the hearing status of dental hygienists who utilize ultrasonic scalers in the workplace compared to age-matched control participants (non-dental hygienists) who were not exposed to ultrasonic noise.Methods A convenience sample of nineteen dental hygienists (experimental) and nineteen non-dental hygienists (control) was recruited for this study. A matched pairs design was utilized; participants in each group were matched based on age and gender to eliminate confounding variables. The testing procedure consisted of an audiologist performing a series of auditory tests including otoacoustic emissions test, pure-tone audiometry, and tympanometry on the experimental and control groups.Results In the right ear, there were notable differences from 1000 Hz – 10,000 Hz and in the left ear from 6000 Hz – 10,000 Hz, with higher hearing thresholds in the experimental group of dental hygienists. While 56% of the univariate tests conducted on how many days were worked per week showed statistical significance, the regression line slope indicated those that worked more days had better hearing statuses. The variables for years in practice for dental hygienists, how many of those years were full-time employment, and how many years the dental hygienist had used an ultrasonic scaling device, also had many significant univariate tests for the experimental group only. These variables were more likely to serve as proxies representing true noise exposure. The paired t-test between the groups demonstrated statistically significant differences between the experimental and control group at 9000 Hz in both ears.Conclusion While results from this study demonstrated various qualitative differences in hearing status of the control group (non-dental hygienists) and experimental group (dental hygienists), age was found to be the most critical variable. Furthermore, this data demonstrated differences in hearing status based on various frequencies between dental hygienists and age-matched controls that should be further explored with a larger population.




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YY1 knockout in pro-B cells impairs lineage commitment, enabling unusual hematopoietic lineage plasticity [Research Papers]

During B-cell development, cells progress through multiple developmental stages, with the pro-B-cell stage defining commitment to the B-cell lineage. YY1 is a ubiquitous transcription factor that is capable of both activation and repression functions. We found here that knockout of YY1 at the pro-B-cell stage eliminates B lineage commitment. YY1 knockout pro-B cells can generate T lineage cells in vitro using the OP9-DL4 feeder system and in vivo after injection into sublethally irradiated Rag1–/– mice. These T lineage-like cells lose their B lineage transcript profile and gain a T-cell lineage profile. Single-cell RNA-seq experiments showed that as YY1 knockout pro-B cells transition into T lineage cells in vitro, various cell clusters adopt transcript profiles representing a multiplicity of hematopoietic lineages, indicating unusual lineage plasticity. In addition, YY1 KO pro-B cells in vivo can give rise to other hematopoietic lineages in vivo. Evaluation of RNA-seq, scRNA-seq, ChIP-seq, and scATAC-seq data indicates that YY1 controls numerous chromatin-modifying proteins leading to increased accessibility of alternative lineage genes in YY1 knockout pro-B cells. Given the ubiquitous nature of YY1 and its dual activation and repression functions, YY1 may regulate commitment in multiple cell lineages.




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Harnessing brain-body communication to understand cancer [Special Section: Symposium Outlook]

Solid tumors that arise in the body interact with neurons, which influences cancer progression and treatment response. Here, we discuss key questions in the field, including defining the nature of interactions between tumors and neural circuits and defining how neural signals shape the tumor microenvironment. This information will allow us to optimally target neural signaling to improve outcomes for cancer patients.




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Temperature matters: the potential impact of thermoregulatory mechanisms in brain-body physiology [Special Section: Symposium Outlook]

Thermoregulation, responsible for maintaining a stable core temperature during wide fluctuations in external and internal thermal environments, is an iconic homeostatic process. However, we suggest that despite its fundamental physiological significance, the potential for required cool housing temperatures and thermoregulatory mechanisms to influence the interpretation of experimental data is not sufficiently appreciated. Moreover, although it is generally assumed that the major thermoregulatory pathways are well understood, here we discuss new research that suggests otherwise and reveals the emergence of a new wave of exciting ideas for this "old" field of research.