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Category Archives: Health
Podcast: “Intermittent Fasting” Study Author Mark P. Mattson MD On Diet’s Health Benefits
Intermittent fasting has salutary effects. Listen how Dr. Mark P. Mattson, co-author of a recent NEJM review on the topic, assesses the practice — and how he’s managed to skip breakfast for the past 30 years or so.
Evidence is accumulating that eating in a 6-hour period and fasting for 18 hours can trigger a metabolic switch from glucose-based to ketone-based energy, with increased stress resistance, increased longevity, and a decreased incidence of diseases, including cancer and obesity.
Obesity Risks: “Fatty Liver Disease – The Silent Epidemic” (UCSF Video)
Nonalcoholic fatty liver disease (NAFLD) occurs when fat is deposited in the liver, without other causes of fatty liver identified. Dr. Danielle Brandman explores who is at risk, diagnosis, staging, complications and management.
More from: Organ Failure and Replacement: Why Organs Fail and What Therapies are Available for Organ Replacement (https://www.uctv.tv/organ-failure-rep…)
Healthcare System: “There’s No Dignity In Hospital Gowns” (BMJ)
From a The BMJ Views and Reviews article by David Oliver (February 5, 2020):
Last year the Lancet published a paper on the impact of wearing gowns, surveying 928 adult patients and carrying out structured interviews with 10 patients. Over half (58%) reported wearing the gown despite feeling uncertain that it was a medical necessity. Gown design was considered inadequate, with 61% reporting that they struggled to put it on or required assistance and 67% reporting that it didn’t fit. Most worryingly, 72% felt exposed, 60% felt self-conscious, and 57% felt uncomfortable wearing the gown.
I’ve often wondered why on earth we routinely put so many patients into hospital gowns within minutes of their arrival at hospital.
Sometimes referred to as “dignity gowns,” such dignity as they afford is only in comparison to being stark naked. They don’t come in a wide range of sizes or lengths, and they’re open along the back. You tend to get what you’re given and make do. The effect is to leave patients with lots of exposed flesh, with underwear or buttocks intermittently displayed and a feeling of extreme vulnerability, not to mention being cold if they have no other layers to wear.
Health Infographics: Importance Of “Physical Activity And Ageing” (BMJ)
Healthcare: Mergers & Profit Strategies Force Many Rural And Smaller Hospitals To Close (Video)
In rural towns across the U.S. hospitals are in crisis. Since 2010, 121 rural hospitals have closed. And, the National Rural Health Association says more than one-third of all rural hospitals in the U.S. are at serious risk of shutting down.
But not all hospitals are losing money. A series of mergers and acquisitions that began in the 1990’s has created massive hospital groups. Many of these hospital consortiums are turning huge profits every year by offering high priced services to well insured patients.
Heart Health: “Marine Omega-3s” Are “Greatest Protection Against Arrhythmic Events” (BMJ)
From a British Medical Journal (BMJ) Open Heart online article:
The intake of marine omega-3s has consistently been found to have antiarrhythmic effects. When marine omega-3s are consumed, there is an increase in cellular membrane fluidity, inhibition of L-type calcium channels and a reduction in the chance of arrhythmic events during susceptible times. Prospective data suggest that maintaining an omega-3 index of about 8%, which requires consuming seafood rich in omega-3 up to five times per week or consuming over 3 g of EPA and DHA per day, may provide the greatest protection against arrhythmic events.
Marine omega-3s for the prevention of arrhythmias
Omega-3s have been theorised to increase membrane fluidity by reducing compression of the acyl chains of membrane phospholipid fatty acids, which can lead to a reduction in the ‘spring-like’ tension on membrane ion channels. This spring-like tension can reduce the ability of ions to freely move in and out of the ion channel and hence reduce its conductance. This is known as the ‘Andersen membrane spring-like tension hypothesis’ and is just one way marine omega-3s may prevent arrhythmias.
Dietary omega-3s are mainly consumed as triglycerides, which are absorbed as free fatty acids and monoglycerides. These fats then get rapidly resynthesised in the intestine and liver back to triglycerides with subsequent integration into chylomicrons, very low-density lipoprotein and low-density lipoprotein (LDL) (LDL can actually deliver omega-3s to tissues via LDL receptors).
Health: “High Blood Pressure – What You Should Know” (UCLA)
Join UCLA nephrologist Anjay Rastogi, MD, for an overview of high blood pressure and ways to manage the condition. We will discuss relevant treatment modalities including medications and lifestyle changes.
Top Medical Podcasts: Lung-Cancer Screenings, Placebo Effects (NEJM)
Featuring articles on lung-cancer screening in the NELSON trial, ribociclib and fulvestrant in metastatic breast cancer, vitamin D in pregnancy and asthma, treatment thresholds for neonatal hypoglycemia, and CAR-NK cells in anti-CD19 lymphoid tumors; a review article on placebo and nocebo effects; a Clinical Problem-Solving describing a rapid change in pressure; and Perspective articles on altruism in Extremis, on abuses of FDA regulatory procedures, and on joining forces against delirium.
Intense (VO2peak) Aerobic Exercise Raises Cognition, Alzheimer’s Disease Risks Lowered In Older Adults
From the Brain Plasticity Journal (Dec 26, 2019):
In conclusion, increased CRF (cardiorespiratory fitness) following this six-month intervention was associated with enhanced brain glucose metabolism in the PCC (posterior cingulate cortex), a region linked to AD, and cognition among late-middle-aged individuals at risk for AD. If these findings are supported by a larger-scale study, this would provide strong evidence that adults at risk for AD may enhance brain function and cognition by engaging in aerobic exercise training.
PCC glucose metabolism correlated positively with change in VO2peak (the highest value of VO2 attained upon an incremental or other high-intensity exercise test, designed to bring the sub- ject to the limit of tolerance)…Improvement in executive function correlated with increased VO2peak. Favorable CRF adaptation after 26 weeks of aerobic exercise training was associated with improvements in PCC glucose metabolism and executive function, important markers of AD.
Aerobic exercise has been associated with reduced burden of brain and cognitive changes related to Alzheimer’s disease (AD). However, it is unknown whether exercise training in asymptomatic individuals harboring risk for AD improves outcomes associated with AD. We investigated the effect of 26 weeks of supervised aerobic treadmill exercise training on brain glucose metabolism and cognition among 23 late-middle-aged adults from a cohort enriched with familial and genetic risk of AD.
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