A selection of three essential articles read aloud from the latest issue of The Economist. This week, covid-19 presents grim choices between life, death and, ultimately, the economy (11:02), lockdowns in Asia have sparked a stampede home (17:52) And, Formula 1 comes up with a breathing machine for covid-19 patients.
Category Archives: Health
Study: Middle-Aged Knees With Meniscal Tears – No Benefits To Surgery Over Exercise Therapy (BMJ)
Conclusion: The study was inconclusive with respect to potential differences in progression of individual radiographic features after surgical and non-surgical treatment for degenerative meniscal tear. Further, we found no strong evidence in support of differences in development of incident radiographic knee osteoarthritis or patient-reported outcomes between exercise therapy and arthroscopic partial meniscectomy.
Objective: To evaluate progression of individual radiographic features 5 years following exercise therapy or arthroscopic partial meniscectomy as treatment for degenerative meniscal tear.
Design: Randomized controlled trial including 140 adults, aged 35-60 years, with a magnetic resonance image verified degenerative meniscal tear, and 96% without definite radiographic knee osteoarthritis. Participants were randomized to either 12-weeks of supervised exercise therapy or arthroscopic partial meniscectomy. The primary outcome was between-group difference in progression of tibiofemoral joint space narrowing and marginal osteophytes at 5 years, assessed semi-quantitatively by the OARSI atlas. Secondary outcomes included incidence of radiographic knee osteoarthritis and symptomatic knee osteoarthritis, medial tibiofemoral fixed joint space width (quantitatively assessed), and patient-reported outcome measures. Statistical analyses were performed using a full analysis set. Per protocol and as treated analysis were also performed.
Results: The risk ratios (95% CI) for progression of semi-quantitatively assessed joint space narrowing and medial and lateral osteophytes for the surgery group were 0.89 (0.55-1.44), 1.15 (0.79-1.68) and 0.77 (0.42-1.42), respectively, compared to the exercise therapy group. In secondary outcomes (full-set analysis) no statistically significant between-group differences were found.
Personal Health: “Singing The Praises Of Prevention” (The Scientist Magazine)
From Bob Grant, The Scientist Magazine (April 1, 2020):
Prevention has been playing a growing role in other diseases, infectious and 
otherwise, long before this latest global pandemic. Cancer, the focus of this issue, is ubiquitous, and one would be hard pressed to find a person anywhere on Earth whose life wasn’t in some way touched by the complex and vexing malady.
This cancer-focused issue features a cover story in which we explore one facet of cancer prevention: exercise. In this feature story, Danish researcher Bente Klarlund Pedersen explains that studies have shown frequent exercise to be useful in avoiding cancer as well as in helping cancer patients lessen the side effects of their cancers and treatments. Her research and that of others is seeking to enumerate the molecular and cellular mechanisms that underlie the benefits exercise seems to offer cancer patients.
But when one considers the practical ripples that biology sends through societies—issues of public health and the shared goal of minimizing the impact of diseases on a global scale—human behavior and prevention become vitally important.
Coronavirus (COVID-19): Safe Shopping at Stores and Pharmacies (JAMA)
Food and medicine shopping is essential during the COVID-19 pandemic, but requires getting out and standing close to strangers at a time when social distancing and sheltering-in-place are recommended to slow spread of disease.
David Aronoff, MD, director of the Division of Infectious Diseases at Vanderbilt University in Nashville, explains how to minimize COVID-19 risk while shopping.
Health Study: Older Adults With High Glucose Levels (A1C) Have Greater Cognitive Decline
From a MedPage Today online article (April 2, 2020):
This relationship between higher glucose levels and poorer cognitive functioning extended beyond just CASI z-score, as well, Cukierman-Yaffe noted. Higher HbA1c levels were also tied to significantly poorer performance in other psychological tests, including the clock making test of executive functioning, test of discriminative ability, and for the test of verbal fluency.
Poorer glycemic control was tied to cognitive decline following a lacunar stroke in a prospective cohort study.
Among 942 individuals with type 2 diabetes who had a lacunar stroke, every 1% higher HbA1c was tied to a 0.06 drop in cognitive function at baseline measured by Cognitive Assessment Screening Instrument (CASI) z-score (95% CI -0.101 to -0.018), reported Tali Cukierman-Yaffe, MD, MSc, of Sheba Medical Center and the Sackler School of Medicine of Tel Aviv University in Israel.
Coronavirus: “Can Masks Stop You From Getting Covid-19?” (April 3, 2020)
William Schaffner, M.D., Professor of Preventive Medicine and Health Policy at Vanderbilt University, answers if masks can stop a person from contracting COVID-19.
Health: Wear “Cloth Face Mask” In Public To Prevent Spread Of Coronavirus
New research suggests that face masks may offer more protection against coronavirus infection than previously thought. It suggests that coughs and sneezes may be projected much further than scientists had thought possible. The World Health Organisation is considering whether to update its guidance on face masks and the White House may recommend that Americans wear them. Meanwhile in the UK hospitality companies are turning their skills to help those in need. And for the second week in a row, applause has rung out from members of the public showing gratitude to NHS staff and other workers helping to keep the country going. Sophie Raworth presents BBC News at Ten coverage from Science Editor David Shukman and Social Affairs Correspondent Alison Holt.
Obesity Study: “Late Night Snacking” Older Adults – Higher Fat Levels Than Early Eaters On Same Diet
From a PLOS Biology Journal study (Feb 20, 2020):
The major finding of this study is that the timing of feeding over the day leads to significant differences in the metabolism of an equivalent 24-h nutritional intake. Daily timing of nutrient availability coupled with daily/circadian control of metabolism drives a switch in substrate preference such that the late-evening Snack Session resulted in significantly lower LO compared to the Breakfast Session.
Developed countries are experiencing an epidemic of obesity that leads to many serious health problems, foremost among which are increasing rates of type 2 diabetes, metabolic syndrome, cardiovascular disease, and cancer. While weight gain and obesity are primarily determined by diet and exercise, there is tremendous interest in the possibility that the daily timing of eating might have a significant impact upon weight management [1–3]. Many physiological processes display day/night rhythms, including feeding behavior, lipid and carbohydrate metabolism, body temperature, and sleep.
These daily oscillations are controlled by the circadian clock, which is composed of an autoregulatory biochemical mechanism that is expressed in tissues throughout the body and is coordinated by a master pacemaker located in the suprachiasmatic nuclei of the brain (aka the SCN [1,4]). The circadian system globally controls gene expression patterns so that metabolic pathways are differentially regulated over the day, including switching between carbohydrate and lipid catabolism [1,3,5–9]. Therefore, ingestion of the same food at different times of day could lead to differential metabolic outcomes, e.g., lipid oxidation (LO) versus accumulation; however, whether this is true or not is unclear.
Coronavirus / Covid-19: “When Will We Have A Vaccine?” (Podcast)
Scientists around the world are racing to develop a vaccine for COVID-19. But experts have said it could take a year to 18 months for one to hit the market. The process for testing and approving a vaccine is long and complicated.
That can be frustrating when the coronavirus is taking more and more lives every day. But cutting corners to push a vaccine through faster can lead to devastating consequences. We know that, because it’s happened before.
Boomers Daily 