Mammography screening saves lives also in older age

 Mammography, which is an x-ray picture of the breast, is efficient also for women over the age of 70. For women invited to regular mammography screening over the age of 70, the reduction in mortality rate was significant. This according to a vast new study from Sweden.

"The results confirm that the Swedish assessment of setting the upper age limit for mammography screening to 74 was justified," says Håkan Jonsson, docent at the Department of Epidemiology and Global Health at Umeå University.

This new Swedish study builds upon twenty years of follow ups and over 2,000 breast cancer deaths. It turned out that the breast cancer mortality rate was 20 per cent lower for women invited to partake in mammography between the ages of 70 and 74 compared to those who were only invited up until the age of 69. For those who actually took part in screening, the mortality rate reduction was a full 27 per cent.

Mammography screening was introduced in the late 1980s after positive results from a number of randomised controlled trials of which several were conducted in Sweden. However, there have previously been uncertainties regarding what age groups should be included. As a result, countries have made different assessments and the recommendations have varied.

Currently, most countries offer screening for women up until the age of 69, but some countries - Sweden included - have chosen to set the upper age limit to 74. In Sweden, the screening programmes are decentralised which has meant that the upper age limit of 74 has been introduced at different points in the various parts of the country. This not least as the early recommendations from the Swedish National Board of Health and Welfare allowed regional exceptions of an upper age limit of 69.

In the current study, the breast cancer mortality rate in women in the areas of Sweden that used an upper age limit of 74 were compared to those regions that used an age limit of 69 between the years 1986 and 2012. The Cancer Register was used to identify women diagnosed with breast cancer aged 70-74 and the National Cause of Death Register was used to gain data on cause of death for those who died from breast cancer aged 70-89. Cause of death may be difficult to decide - particularly for older women. Consequently, the excess mortality in breast cancer cases was measured in conjunction with the underlying cause of death.

"Given that we live longer and remain active in old age, it is also valuable to screen for cancer in order to start treatment in time," says Håkan Jonsson.

Most randomised controlled trials were conducted about 40 years ago. Only one of those trials included women aged 70 to 74. Nevertheless, this group was too small to provide any clear evidence. Observational studies are rare in this age group as few countries have invited these women to screening. This also means that the evidence of the importance of mammography in women aged 70 to 74 has been scarce until now.

Those with mild or no symptoms may be infectious for no more than about 10 days, serious Covid cases: 20 days.

 A review of dozens of studies by researchers at Oregon Health & Science University and Oregon State University suggests that people may shed virus for prolonged periods, but those with mild or no symptoms may be infectious for no more than about 10 days. People who are severely ill from COVID-19 may be infectious for as long as 20 days.

That's in line with guidance provided by the U.S. Centers for Disease Control and Prevention, confirming recommendations for the length of time people should isolate following infection with SARS-CoV-2.

The review published in the journal Infection Control and Hospital Epidemiology.

"Detection of viral RNA may not correlate with infectivity since available viral culture data suggests shorter durations of shedding of viable virus," the authors write. "Additional data is needed to determine the duration of shedding of viable virus and the implications for risk of transmission."

Researchers decided to conduct the review to gain more information on transmission and to help inform infection control practices, said co-author Monica Sikka, M.D., assistant professor of medicine (infectious diseases) in the OHSU School of Medicine.

"Even though people can shed virus for a prolonged period of time, the studies we reviewed indicated that live virus, which may predict infectiousness, was only detected up to nine days in people who had mild symptoms," Sikka said.

The researchers identified 77 studies worldwide, including 59 that had been peer-reviewed, and combed through the results. All studies reported assessments of viral shedding using standard methods to identify the virus by replicating it through a process called polymerase chain reaction, or PCR.

"Although PCR positivity can be prolonged, culture data suggests that virus viability is typically shorter in duration," the authors write.

Improved mental and physical condition is directly linked to nutrition

 Researchers at the University of Illinois, Urbana-Champaign, Abbott and, the U.S. Air Force Research Lab announced today the results of a new study that found a direct link between physical fitness, cognitive performance, and optimal nutrition. The scientists revealed that getting the right nutrition not only fuels our bodies and improves fitness, but gives us an edge mentally, too.

The double-blind study, published this week in the journal Scientific Reports, examined the effectiveness of optimal nutrition and exercise to enhance fitness and cognitive performance among a population of active-duty men and women in the U.S. Air Force. Researchers divided the 148 study participants into two groups for 12 weeks. Both groups performed the same training program, which included a balanced exercise program comprised of aerobic and resistance training performed five days per week. In addition to the training program, one group was given a prototype nutritional drink, the other group received a placebo.

The study showed that exercise, along with the addition of a high-protein nutrition drink containing lutein, omega-3 fatty acids, phospholipids, vitamin D, and beta-hydroxy-beta-methylbutyrate (HMB), led to statistically significant changes to the following compared to exercise alone.

• Improved working memory by 11% (i.e., information processing and problem-solving), which predicts multitasking and is often impaired under stress
• Improved reaction time by 6% - participants became faster and more accurate
• Increased muscle mass by more than two pounds
• Lowered resting heart rate by 8% - a sign of increased cardiovascular fitness. Resting heart rate improved from 71 beats per minute to 65 beats per minute

"The physical and mental health benefits of exercise are well known, but this study demonstrates how optimal nutrition can help boost brain function as well," said lead study author, Chris Zwilling, Ph.D, a postdoctoral researcher working with the study's principal investigator Aron Barbey, Ph.D. at the Beckman Institute for Advanced Science and Technology at the University of Illinois. "We are excited by the results because they provide critical insights into how simple dietary changes can make a big difference in helping people be as efficient and productive as possible in today's world. "

Mouthwashes, oral rinses may inactivate human coronaviruses

 

PENN STATE

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HERSHEY, Pa. -- Certain oral antiseptics and mouthwashes may have the ability to inactivate human coronaviruses, according to a Penn State College of Medicine research study. The results indicate that some of these products might be useful for reducing the viral load, or amount of virus, in the mouth after infection and may help to reduce the spread of SARS-CoV-2, the coronavirus that causes COVID-19.

Craig Meyers, distinguished professor of microbiology and immunology and obstetrics and gynecology, led a group of physicians and scientists who tested several oral and nasopharyngeal rinses in a laboratory setting for their ability to inactivate human coronaviruses, which are similar in structure to SARS-CoV-2. The products evaluated include a 1% solution of baby shampoo, a neti pot, peroxide sore-mouth cleansers, and mouthwashes.

The researchers found that several of the nasal and oral rinses had a strong ability to neutralize human coronavirus, which suggests that these products may have the potential to reduce the amount of virus spread by people who are COVID-19-positive.

"While we wait for a vaccine to be developed, methods to reduce transmission are needed," Meyers said. "The products we tested are readily available and often already part of people's daily routines."

Meyers and colleagues used a test to replicate the interaction of the virus in the nasal and oral cavities with the rinses and mouthwashes. Nasal and oral cavities are major points of entry and transmission for human coronaviruses. They treated solutions containing a strain of human coronavirus, which served as a readily available and genetically similar alternative for SARS-CoV-2, with the baby shampoo solutions, various peroxide antiseptic rinses and various brands of mouthwash. They allowed the solutions to interact with the virus for 30 seconds, one minute and two minutes, before diluting the solutions to prevent further virus inactivation. According to Meyers, the outer envelopes of the human coronavirus tested and SARS-CoV-2 are genetically similar so the research team hypothesizes that a similar amount of SARS-CoV-2 may be inactivated upon exposure to the solution.

To measure how much virus was inactivated, the researchers placed the diluted solutions in contact with cultured human cells. They counted how many cells remained alive after a few days of exposure to the viral solution and used that number to calculate the amount of human coronavirus that was inactivated as a result of exposure to the mouthwash or oral rinse that was tested. The results were published in the Journal of Medical Virology.

The 1% baby shampoo solution, which is often used by head and neck doctors to rinse the sinuses, inactivated greater than 99.9% of human coronavirus after a two-minute contact time. Several of the mouthwash and gargle products also were effective at inactivating the infectious virus. Many inactivated greater than 99.9% of virus after only 30 seconds of contact time and some inactivated 99.99% of the virus after 30 seconds.

According to Meyers, the results with mouthwashes are promising and add to the findings of a study showing that certain types of oral rinses could inactivate SARS-CoV-2 in similar experimental conditions. In addition to evaluating the solutions at longer contact times, they studied over-the-counter products and nasal rinses that were not evaluated in the other study. Meyers said the next step to expand upon these results is to design and conduct clinical trials that evaluate whether products like mouthwashes can effectively reduce viral load in COVID-19-positive patients.

"People who test positive for COVID-19 and return home to quarantine may possibly transmit the virus to those they live with," said Meyers, a researcher at Penn State Cancer Institute. "Certain professions including dentists and other health care workers are at a constant risk of exposure. Clinical trials are needed to determine if these products can reduce the amount of virus COVID-positive patients or those with high-risk occupations may spread while talking, coughing or sneezing. Even if the use of these solutions could reduce transmission by 50%, it would have a major impact."

Future studies may include a continued investigation of products that inactive human coronaviruses and what specific ingredients in the solutions tested inactivate the virus.

High fructose intake may drive aggressive behaviors, ADHD, bipolar

 

New research suggests that conditions such as attention deficit hyperactivity syndrome (ADHD), bipolar disorder, and even aggressive behaviors may be linked with sugar intake, and that it may have an evolutionary basis.

The research, out today from the University of Colorado Anschutz Medical Campus and published in Evolution and Human Behavior, presents a hypothesis supporting a role for fructose, a component of sugar and high fructose corn syrup, and uric acid (a fructose metabolite), in increasing the risk for these behavioral disorders.

"We present evidence that fructose, by lowering energy in cells, triggers a foraging response similar to what occurs in starvation," said lead author Richard Johnson, MD, professor at the University of Colorado School of Medicine on the CU Anschutz Medical Campus.

Johnson outlines research that shows a foraging response stimulates risk taking, impulsivity, novelty seeking, rapid decision making, and aggressiveness to aid the securing of food as a survival response. Overactivation of this process from excess sugar intake may cause impulsive behavior that could range from ADHD, to bipolar disorder or even aggression.

"While the fructose pathway was meant to aid survival, fructose intake has skyrocketed during the last century and may be in overdrive due to the high amounts of sugar that are in the current Western diet," Johnson adds.

The paper looks at how excessive intake of fructose present in refined sugars and high fructose corn syrup may have a contributory role in the pathogenesis of behavioral disorders that are associated with obesity and Western diet.

Johnson notes, "We do not blame aggressive behavior on sugar, but rather note that it may be one contributor."

Johnson recommends further studies to investigate the role of sugar and uric acid, especially with new inhibitors of fructose metabolism on the horizon.

"The identification of fructose as a risk factor does not negate the importance of genetic, familial, physical, emotional and environmental factors that shape mental health," he adds.

Loss of interest a sign of dementia risk

 Older adults with severe apathy, or lack of interest in usual activities, may have a greater chance of developing dementia than people with few symptoms of apathy, according to a study published in the October 14, 2020, online issue of Neurology®, the medical journal of the American Academy of Neurology.

"Apathy can be very distressing for family members, when people no longer want to get together with family or friends or don't seem interested in what they used to enjoy," said study author Meredith Bock, M.D., of the University of California, San Francisco. "More research is needed, but it's possible that these are signs that people may be at risk for Alzheimer's disease and could benefit from early interventions and efforts to reduce other risk factors."

The study involved 2,018 adults with an average age of 74. None had dementia. At the start of the study, researchers measured apathy using a survey with questions such as "In the past four weeks, how often have you been interested in leaving your home and going out?" and "In the past 4 weeks, how often have you been interested in doing your usual activities?" Participants were then divided into three groups: those with low, moderate and severe apathy. After nine years, researchers determined who had dementia by looking at medication use, hospital records and results on cognitive tests.

By the end of the study, 381 participants, or almost 19%, developed dementia. In the low apathy group, 111 out of 768 people, or 14%, developed dementia, compared to 143 out of 742 people, or 19%, in the moderate apathy group. In the severe apathy group, 127 out of 508 people, or 25%, developed dementia. After adjusting for age, education, cardiovascular risk factors and other factors that could affect dementia risk, they found that people with severe apathy were 80% more likely to develop dementia than people with low apathy.

Greater apathy was also associated with worse cognitive score at the beginning of the study.

"While depression has been studied more extensively as a predictor of dementia, our study adds to the research showing that apathy also deserves attention as an independent predictor of the disease," Bock said. "In fact, we believe that apathy may be a very early sign of dementia and it can be evaluated with a brief questionnaire."

A limitation of the study is that an algorithm was used to diagnose dementia, which may not be as sensitive as an in-depth evaluation by a doctor.

Urban daycare yards outfitted with natural forest floor boosted children's immune systems

 

Biodiversity intervention enhances immune regulation and health-associated commensal microbiota among daycare children

AMERICAN ASSOCIATION FOR THE ADVANCEMENT OF SCIENCE

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Children who played in formerly gravel-covered urban daycare center yards renovated with natural forest floor, sod, and vegetation developed more diverse microbiomes and signs of a better-regulated immune system within one month, according to a new study with 75 children between 3 and 5 years old. The findings suggest it may be possible to improve immune systems in urban communities simply by granting young children daily access to green spaces. Previous studies have shown that urban populations are more susceptible to immune-mediated diseases, with the prominent "biodiversity hypothesis" blaming a lack of exposure to diverse microbiota. To test the biodiversity hypothesis, Marja Roslund and colleagues performed an intervention in the yards of 4 standard Finnish daycare centers, transferring natural forest floor rich with dwarf shrubs, blueberries, crowberry, and mosses to the bare spaces. Children spent an average of 1.5 hours per day over 28 days planting, crafting natural materials, and playing games in the renovated green spaces. Roslund et al. found that children in the 4 centers that received the intervention maintained a high diversity of commensal skin microbiota over the study period and developed a higher ratio of the anti-inflammatory cytokine IL-10 to the pro-inflammatory cytokine IL-17A, suggesting that playing in the forest dirt stimulated their immunoregulatory pathways. These results agreed with findings from 3 nature-oriented daycare centers that served as a positive control. In contrast, microbiotic diversity declined in children at 3 standard centers without the intervention, and they did not experience a similar immune boost. The researchers also found that a high abundance of the bacteria Faecalibacterium prausnitzii was associated with decreased expression of IL-17A in healthy children, noting that previous studies reported a decreased abundance associated with immune disorders.