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Thursday, December 15, 2022 | Kaiser Health News

Thursday, December 15, 2022 | Kaiser Health News

10 Yrs Just after Sandy Hook: How Gun Violence Has — And Hasn’t — Adjusted The united states

In a assertion Wednesday marking the Dec. 14, 2012, massacre of 20 elementary university learners and six educators at Sandy Hook Elementary University, President Joe Biden claimed People have a “moral obligation to go and enforce legal guidelines that can protect against these items from going on once more.” In the meantime, the mother and father of those killed push by means of their unspeakable grief with the hope that their kids will never be overlooked.


NBC Information:
10 Yrs Immediately after Sandy Hook, Biden Says Individuals Should really Have ‘Societal Guilt’ More than Gun Violence

Marking a ten years considering the fact that the Sandy Hook faculty massacre, President Joe Biden mentioned Wednesday the United States need to do much more to tackle the nation’s gun violence epidemic and folks ought to have “societal guilt” for taking far too extensive to tackle it. Biden mentioned in a assertion that 10 several years back, on Dec. 14, 2012, “the unthinkable occurred,” when 20 younger young children and 6 educators had been killed at the elementary college in Newtown, Connecticut. Survivors “nevertheless have the wounds of that day,” he mentioned. (Shabad, 12/14)


The Hill:
On Sandy Hook’s Anniversary, ATF Director Calls Range Of Shootings In US ‘Wholly Un-American’ 

Steve Dettelbach, the director of the Bureau of Alcoholic beverages, Tobacco, Firearms and Explosives (ATF), in marking the 10th anniversary of the Sandy Hook Elementary School tragedy on Wednesday, termed the sum of gun violence in the United States “un-American” and vowed to continue to keep up the do the job of the Biden administration in blocking gun violence. “It is wholly illegal and it is wholly un-American for this stage of firearm violence to be heading on. So, what I say to … people out there who are railing versus this, continue to keep applying your voices, we’re with you on this. We have to do greater,” he said in an interview with The Hill at ATF headquarters. (Gangitano, 12/14)


AP:
A 10 years Immediately after Sandy Hook, Grief Continues to be But Hope Grows

They would have been 16 or 17 this 12 months. Substantial university juniors. The kids killed at the Sandy Hook Elementary Faculty on Dec. 14, 2012 ought to have put in this 12 months contemplating about college or university, using their SATs and finding their driver’s licenses. It’s possible attending their very first prom. Rather, the people of the 20 learners and 6 educators slain in the mass capturing will mark a 10 years without them Wednesday. December is a difficult thirty day period for numerous in Newtown, the Connecticut suburb in which getaway time pleasure is tempered by heartbreak all over the anniversary of the nation’s worst grade college capturing. For previous Sandy Hook college students who survived the massacre, guilt and anxiety can intensify. For the moms and dads, it can indicate renewed grief, even as they carry on to fight on their dropped children’s behalf. (Collins, 12/13)


CNN:
Sandy Hook Mom and dad Continue To Thrust For Adjustments In The 10 years Due to the fact The Faculty Capturing

They have been living ordinary and complete lives in the tiny New England town of Newtown, Connecticut, unprepared for the devastation that would unfold and occupy the rest of their days. … A thirty day period right after the shooting, Mark Barden, Nicole Hockley and other mother and father who shed small children that working day launched Sandy Hook Assure, an corporation dedicated to guarding little ones from gun violence. (Simon, 12/14)


NBC Information:
10 A long time Immediately after Sandy Hook Capturing, Gun Security Motion Highlights Important Wins

As killing sprees have turn into additional recurrent and community assist for more durable firearm regulations has developed, the clear invincibility of the gun lobby on Capitol Hill has proven cracks. Congress passed the very first federal gun safety regulation in 30 a long time in June to tighten qualifications checks and give “purple flag” grants for states that allow people and law enforcement to try to hold guns out of the palms of possibly unsafe folks right before they dedicate violence. On the condition amount, 525 “significant gun safety laws” have been adopted in the decade considering the fact that Sandy Hook, in accordance to a new report by the Giffords Law Center to Prevent Gun Violence, the advocacy group led by previous Rep. Gabby Giffords, D-Ariz., who survived a shooting in January 2011. (Kapur, 12/13)


United states Right now:
Sandy Hook School Psychologist Died Confronting Gunman. 10 Many years Later on, Her Partner Nonetheless Fights For Improve

Bill Sherlach realized his spouse for 36 decades and three times. He very first laid eyes on her at a faculty Xmas bash, and the holiday seasons became their specific time. But a gunman shattered it all the early morning of Dec. 14, 2012, when he stormed into Sandy Hook Elementary University and fatally shot 20 youthful kids and six employees users, which includes Sherlach’s spouse, Mary Sherlach, a school psychologist. A decade later, Sherlach nonetheless lives in the similar home. He works the same career. He sits in a equivalent business. (Hauck, 12/14)


NPR:
10 Years Soon after Sandy Hook, A Spouse and children Finds Bits Of Joy Amid Shards Of Pain

To Jen Hensel, one particular of the major factors about marking 10 many years, is producing it 10 several years. “Yeah, we’re listed here,” she sighs. “I truthfully consider which is really a amazing accomplishment. I come to feel like I am dwelling once more, which I was not for a really lengthy time. And I essential to do that for my young children.” It can be a selection Hensel will make over and about once more just about every day — to hone in amid her damage on what she calls the bits of magnificence. (Smith, 12/14)

In related information about gun violence —

KHN:
Mass Shootings Reopen The Debate Above Regardless of whether Crime Scene Pics Prompt Alter Or Trauma

John Lites was one particular of the 1st police officers to answer to a 911 phone from Mom Emanuel African Methodist Episcopal Church in Charleston, South Carolina, on June 17, 2015, when a white gunman murdered nine Black individuals attending a Bible review. Lites arrived at the scene only minutes following the very first crisis contact was put. He held a single of the victim’s fingers as the male died. Lites then stood guard inside of the fellowship corridor all night — remaining even by a bomb risk — to protect against men and women who did not need to have to be there from moving into the space. “I didn’t want any one else to see it,” Lites explained. “I was fully traumatized.” (Sausser, 12/15)


The 19th:
Club Q Survivors Tie Anti-LGBTQ+ Rhetoric To Taking pictures In Residence Testimony

Matthew Haynes, founding co-operator of Club Q in Colorado Springs, says he’s witnessed various kinds of anti-LGBTQ+ hate in the wake of the mass capturing there past thirty day period that remaining five men and women dead. There’s visceral loathe, which he states the club, a longtime queer local community place, has received by hundreds of vitriol-crammed emails and letters since the shooting took area. Then there’s the “subtle hate” — which he identifies as laws and leaders not respecting LGBTQ+ people today or family members, and in Republicans who did not vote for the just-signed Respect for Relationship Act. (Rummler, 12/14)

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New oral anticoagulants may have lower bleeding risk

New oral anticoagulants may have lower bleeding risk

  • Cardiovascular sickness is the top bring about of dying globally, according to the World Wellbeing Organization (WHO).
  • As a consequence, tens of millions of sufferers all around the earth are treated with anticoagulants in the hope of stopping daily life threatening cardiovascular activities these kinds of as strokes, pulmonary embolisms, and heart assaults.
  • Anticoagulants made use of in scientific apply include things like warfarin, heparin, and direct oral anticoagulants (DOACs), this kind of as thrombin and issue Xa inhibitors. Even so, there may perhaps be a increased threat of bleeding in some clients acquiring DOACs.
  • Verseon, a corporation based in California, has designed a future-technology oral anticoagulant that has the likely to protect against undesired clots although preserving the body’s ability to prevent too much bleeding.

The main perform of anticoagulants is to reduce blood clots from forming. These drugs interfere with blood things the proteins accountable for the coagulation, or thickening, system.

There are numerous blood factors and diverse anticoagulants goal distinctive variables.

Sadly, anticoagulant prescription drugs do lead to facet results that might direct to severe difficulties, this sort of as abnormal bleeding.

To deal with this dilemma, Verseon, a company centered in California, has made numerous novel drug candidates for cardiovascular disorder. In their new investigate, posted in the European Journal of Medicinal Chemistry, the exploration workforce describes compounds from a novel course referred to as N-acylpyrazoles.

Their merchandise have been termed “Precision Oral Anticoagulants” (PROACs) and according to Verseon, they have “optimized several physicochemical homes — including efficiency, selectivity, and in vivo stability.”

“Verseon has made precision oral anticoagulants (PROACs) that can reduce possibly existence threatening blood clots devoid of escalating the hazard of bleeding,” Walter Jones, Head of Corporate Growth at Verseon, told Health care Information Right now.

“Hundreds of millions of cardiovascular condition patients globally need to have this sort of anticoagulants urgently,” Jones mentioned.

“The medicinal chemists at Verseon optimized the various qualities of the drug candidates to make them a lot more strong, secure, and selective. Although potency of a drug is important to its motion on the ailment, balance would make it probable to administer the drug with much less daily doses. Boosting the selectivity of a drug is vital in steering clear of adverse side effects.”

– Walter Jones

“Verseon’s drug belongs to a novel class of drug molecules that act by a various system on its focus on in the system. This system preserves hemostasis and is crucial to the reduced bleeding possibility demonstrated in ‘in vivo’ exams,” Jones spelled out.

The scientists note that PROACs do not inhibit platelet purpose which could clarify the reduce bleeding threat that may well be connected with these drug candidates. The enterprise highlights that these attributes make them excellent candidates for future anticoagulant therapies.

The thrombin inhibitors described in this paper are productive at preventing clots in animal models. In addition, they do not inhibit the thrombin-mediated activation of platelets. This is a crucial step to end damage-induced bleeding, that means these drug candidates have proven significantly reduced bleeding dangers in animal styles.

Whilst these solutions will need to be absolutely analyzed in human medical trials, Jones highlighted their prospective future applications.

“Patients with a heart issue identified as non-valvular atrial fibrillation, a extremely common type of [arrhythmia], are at danger of suffering strokes. At this time promoted anticoagulants have large bleeding chance. Verseon’s PROAC drug candidates, with their novel pharmacology, can potently cut down the chance of strokes with out elevating bleeding threat,” Jones explained.

“Another extremely huge client population who suffer from acute coronary syndrome can profit from lifelong simultaneous administration of antiplatelet prescription drugs and anticoagulants. Unfortunately, these types of twin remedy with at the moment marketed anticoagulants carries an unacceptable total of bleeding possibility,” he claimed.

“Verseon’s PROACs, with their exceptional mechanism of motion, intention to present a secure selection for lengthy-term twin treatment with antiplatelets. In excess of 51 million people in significant-revenue nations would reward from secure extensive-time period anticoagulant-antiplatelet twin treatment,” he extra.

Dr. Jayne Morgan, a cardiologist at the Piedmont Medical center/Healthcare, not involved in this investigation, highlighted the worries that sufferers expertise when obtaining anticoagulation therapies:

“Errors could lead to hemorrhage on one particular stop, or thrombosis on the other. Bleeding is the big issue which include rare problems this sort of as intracranial hemorrhage, or large GI bleeds.”

Dr. Mark Goldin, director of scientific trials at the Feinstein Institutes for Medical Investigation, also not aspect of this review, agreed and told MNT that “when medical practitioners prescribe anticoagulants, they must always harmony the have to have for therapy with the risks of bleeding that can take place.”

“The anticoagulants in this pre-clinical review are promising as they could have even lower bleeding hazard than normal solutions, these types of as issue Xa inhibitors (like Xarelto and Eliquis), which by now have fantastic basic safety profiles and do not commonly call for blood exam checking,” Dr. Goldin discussed.

Mellanie Real Hills, founder & CEO of the American Basis for Women’s Health and fitness and StopAfib.org, claimed that “patients who get anticoagulants have to harmony the risk of bleeding with the risk of stroke.”

“Patients now on anticoagulants must be very careful with their daily activities, such as making use of household knives in the kitchen, reducing applications for property get the job done, and collaborating in hazardous sporting activities and hobbies that can result in bleeding accidents,” she stated. “Some people today on anticoagulants have so substantially bruising from them that they have to go over up their torso and extremities due to humiliation around the bruising.”

While this new exploration is promising, Dr. Goldin urged caution:

“It is significant to be extremely careful in deciphering this early data, as these drugs have however to be analyzed in humans and will want to exhibit efficacy and security in massive clinical trials.”

Hills advocates for clients getting anticoagulant therapy. She said the novel anticoagulants “appear to have the very best of the two worlds,” potentially producing it attainable to prevent strokes devoid of the draw back of bleeding concerns.

“The fear of strokes and bleeds requires a mental and emotional toll on afib sufferers. This included stress worsens afib and boosts the toll afib will take on clients. Consequently, staying equipped to reside their life devoid of these problems would substantially increase their excellent of lifetime in so quite a few approaches,” Hills included.

When questioned how soon this new class of anticoagulant could be permitted for use in patients, Jones claimed:

“The initially drug candidate in our method is now going through stage I scientific trials. Our next candidate is about to enter medical trials. We hope our drug candidates to get acceptance in the subsequent 3 to 4 several years.”

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Low carb, high fat diet may help manage weight, A1c

Low carb, high fat diet may help manage weight, A1c

A cup of blueberries, two fried eggs in a plate and a cucumber salad placed on a wooden table counter.Share on Pinterest
Research suggests that a low carb, high fat diet is more beneficial for people with type 2 diabetes to help manage weight and glucose. Joscha Malburg/EyeEm/Getty Images
  • More than 462 million adults around the world have type 2 diabetes.
  • Although type 2 diabetes is not curable, the condition is sometimes reversible through medications and lifestyle changes, such as diet.
  • Researchers from the University of Southern Denmark say low carb, high fat diet can help people with type 2 diabetes lose weight and control glucose levels.

More than 462 million adults globally are currently living with type 2 diabetes. And over one million people die each year from diabetes.

While there is no cure for type 2 diabetes, the condition is sometimes reversible through a combination of medications and lifestyle changes, including diet.

Researchers from the University of Southern Denmark, Odense, Denmark, found new evidence suggesting a low-carbohydrate, high fat, calorie-unrestricted diet helps people with type 2 diabetes lose weight and keep glucose levels under control better than a high-carbohydrate, low fat diet.

The study appears in the journal Annals of Internal Medicine.

Of the two types of diabetes, type 2 diabetes is the most common — more than 95{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of people with diabetes have type 2 diabetes.

Type 2 diabetes occurs when a person’s body becomes insulin resistant and no longer responds to insulin correctly. The hormone insulin regulates the amount of glucose allowed into the body’s cells, giving them energy.

Unlike type 1 diabetes, type 2 diabetes happens through a combination of genetics and certain lifestyle factors, including obesity, age, sedentary lifestyle, and family history.

In the United States, research shows certain ethnic groups, including African American, Latinx, American Indian, and Alaska Native, are at a higher risk for developing type 2 diabetes.

Treatment for type 2 diabetes may include medications and lifestyle changes, including weight loss, exercise, and dietary changes.

For this study, researchers conducted a study with 165 people with type 2 diabetes. Participants were randomly assigned to follow either a low-carbohydrate, high fat diet or a high-carbohydrate, low fat diet for six months. Researchers also asked the participants to eat the same number of calories equal to the energy they burned each day.

Upon conclusion of the study, researchers found people on the low-carbohydrate, high fat diet lowered their hemoglobin A1c levels by 0.59{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} compared to those on the high-carbohydrate, low fat diet. And those on the low carb diet also lost more body fat and reduced their waist circumference compared to the high carb group.

“Diet is very important in the management of type 2 diabetes,” said Camilla Dalby Hansen, an MD and Ph.D. student at the Department of Clinical Research at the University of Southern Denmark in Odense, Denmark, and the Department of Medical Gastroenterology and Hepatology at Odense University Hospital. Hansen is also the first author of this study.

“The patients have the possibility to control the diet themselves. This gives them a feeling of control and the feeling that they can do something themselves in the management of their disease,” Hansen told Medical News Today.

“We were very surprised to see that participants on the (low-carbohydrate, high-fat) diet improved their glycemic control by 9.5mmol/mol (0.88{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}) and lost 5.5 kg even though they were eating the same amount of calories as they were used to.

This will hopefully mean that long-term compliance will be more successful because patients will be full and do not have to starve.”

– Camilla Dalby Hansen

“We were very surprised to see that participants on the (low-carbohydrate, high-fat) diet improved their glycemic control by 9.5mmol/mol (0.88{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}) and lost 5.5 kg even though they were eating the same amount of calories as they were used to,” she told Medical News Today. “This will hopefully mean that long-term compliance will be more successful because patients will be full and do not have to starve.”

At the conclusion of the study, the researchers also found participants did not sustain the changes they experienced during the study once they went back to their typical eating patterns.

“This shows us that this diet approach needs to be considered as a long-term lifestyle choice and not only sustained for a short period of time,” Hansen said.

Lauren Pelehach Sepe, a clinical nutritionist at the Kellman Wellness Center in New York, agreed:

“It is important for people who are dealing with diabetes to implement lifelong diet and lifestyle changes. There is a significant amount of research out there to show that diet and lifestyle can often allow [people with type 2 diabetes] to control their blood sugar, even without medications. However, these changes need to be sustained.

Managing our health is a lifelong process — there are no short-term fixes.”

Upon reviewing this study, Sepe commented she was not surprised by the results as people with diabetes are often recommended a diet focused on low carbohydrate intake, as well as increased protein.

“When we consume carbohydrates, our body breaks them down and converts them into sugar molecules or glucose,” she explained. “This results in an increase in blood sugar, which stimulates the body to release insulin to facilitate the storage of glucose into the cells, where they can be used as a source of energy, as needed.”

“For diabetics, this process is not functioning properly, meaning they continue to maintain high circulating levels of blood sugar despite the release of insulin,” Sepe continued. “Therefore, lowering the intake of carbohydrates naturally helps to control blood sugar levels.”

In regards to the high fat portion of the low-carbohydrate, high fat diet some study participants were on, Sepe mentioned conventional research has only recently opened up to the idea of a higher fat intake is beneficial, particularly for diabetics.

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Fear-dampening mechanism may point to better treatments

Fear-dampening mechanism may point to better treatments

person covering their eyes with their handsShare on Pinterest
Scientists are investigating irrespective of whether blocking serotonin in the mind could assist handle PTSD and anxiety ailments. Impression credit: Producciones Visualix/Stocksy.
  • Folks with write-up-traumatic anxiety problem (PTSD) stay with terrifying reminiscences of traumatic functions.
  • Psychotherapy is the key type of treatment supplied to folks with PTSD and other acute fears. Medicines may perhaps dietary supplement these treatment plans.
  • A new analyze in mice indicates that blocking serotonin receptors may possibly assist individuals unlearn fears.

A new analyze in mice performed by scientists at Ruhr University Bochum in Germany may perhaps supply a novel insight into how anxiety can be neutralized.

The review identifies a neurological pathway that could, in the future, aid people today with publish-traumatic tension problem (PTSD) and other fears unlearn the terror they associate with a past traumatic knowledge.

PTSD affects about 6 out of 100 people, and it is a response to a traumatizing experience of their very own, or one that they witnessed.

The new exploration zeroes in on serotonin, a neurotransmitter and hormone that sends messages through the entire body and amongst nerve cells in the mind.

Psychological and physiological conditions have been joined to abnormally substantial or reduced degrees of serotonin, and research suggests it is implicated in PTSD and anxiety issues.

The outcomes of the recent review look in Translational Psychiatry.

PTSD’s debilitating indications typically look in 3 months of a traumatic experience, but can be brought on a long time immediately after the occasion.

Individuals with PTSD may perhaps come across on their own reliving a trauma when they are actually harmless. They could also be frequented by terrifying feelings and desires. At the exact time, they might have issues remembering the information of their traumatic expertise.

As a result, a host of behavioral improvements are common with PTSD, which includes feeling on edge, staying simply startled, experiencing bursts of anger, and getting issue sleeping.

PTSD may perhaps result in emotions of negativity or guilt. Men and women with PTSD could unfairly blame other people for perceived failings, and eliminate fascination in pursuits they have previously relished.

Whilst PTSD stems from a one traumatic party, individuals who have knowledgeable recurring or prolonged trauma may have intricate PTSD.

In the analyze, researchers worked with knockout mice specifically bred to absence serotonin 2C receptors (5-HT2CRs) that are distributed commonly via the mind. Ordinary mice served as a manage team.

Just before trials commenced, mice gained injections with tracing dyes to allow for the authors of the review to detect brain spots of neurological activity soon after trials.

Scientists gave mice a 1-2nd electrical shock accompanied by an auditory tone frequently more than the system of a working day. By the upcoming working day, the mice demonstrated that they experienced learned to affiliate the tone with a shock, straight away freezing in anxiety upon hearing it even without the need of the tone.

Following repeated playings of the tone without a shock, the mice at some point acquired not to freeze when listening to the seem.

The mice without the 2C receptors unlearned their dread of the tone far more quickly than the command group. This suggested that the absence of serotonin receptors permitted them to a lot more very easily split the connection amongst the tone and their fear.

Healthcare News Nowadays spoke with Dr. Joseph Dunsmoor, assistant professor in the Section of Psychiatry and Behavioral Sciences at the College of Texas at Austin’s Dell Health care School about the worth of these experiments involving mice.

Dr. Dunsmoor was not associated in the analyze, and he cautioned that his feedback were being on PTSD procedure and investigate, in normal, somewhat than this examine in certain.

He explained to us that “[o]f all the products for any psychiatric ailment, I would say the animal styles of PTSD are some of the better ones since PTSD depends on getting some variety of occasion that occurs.”

“Obviously, when you get into humans, you are going to commence working with points like subjective emotions, outcomes on declarative memory, effects on our social cognition, items that animal designs have a harder time knowing. But when it comes to the pressure and dread aspect of it, they are really great styles,” he described.

After the second working day of trials, the researchers deeply anesthetized the mice, euthanized them, and froze and sliced their brains into cross-sections for evaluation.

Co-writer Dr. Sandra Süβ notes that two brain locations unexpectedly showed dye evidence of increased activity:

“In the knock-out mice, we initial located an amplified basal exercise in sure serotonin-making cells of the dorsal raphe nucleus. In a subsequent move, we showed that the absence of the receptor also alters neuronal activity in two subnuclei of the BNST [bed nucleus of the stria terminalis, part of the amygdala] which supports extinction learning.”

Whether or not the outcome lasts is an open up problem.

“What tends to occur is that offered some sort of upcoming stress, or plenty of time passes, the initial response tends to appear again, which Pavlov mentioned 100 decades in the past. That is called ‘spontaneous recovery’ or ‘fear renewal’,” Dr. Dunsmoor mentioned.

Amid the medication utilised in the therapy of PTSD along with psychotherapy there are selective serotonin reuptake inhibitors, or SSRIs.

The analyze notes that extended-term use of SSRIs is affiliated with 2CR desensitization, suggesting an possibility for the outcome noticed in knockout mice to carry around into individuals.

“The discussion,” stated Dr. Dunsmoor, “is whether or not [SSRIs] must be a initial-line treatment or extra of a next-line therapy. Meta-analyses of what common SSRSs — like Zoloft or Paxil or Prozac — on their have with PTSD implies that they are not [first-line treatments].”

Drug-based therapies “on their own never appear to be to be greatly productive,” he reported, although no just one is familiar with particularly why. The study’s findings suggest that SSRIs might aid secondary understanding for people today with PTSD in conjunction with psychotherapy.

The first line of these types of cure, Dr. Dunsmoor spelled out, is exposure treatment, “the gold standard.” Continue to, reliving a traumatic function is challenging — even for a therapeutic goal — and not everyone tolerates it.

“It is efficient,” stated Dr. Dunsmoor, “but that does not signify it’s powerful for every person, and that does not signify it’s productive endlessly. It can get the job done for some men and women, but that’s an place of, you know, ‘how can we make it superior,’ like all sorts of mental wellness therapies.”

“But I would say, in conditions of other psychological wellbeing disorders, PTSD is certainly a person of the a lot more treatable ones.”

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Extreme temperatures linked to greater mortality risk

Extreme temperatures linked to greater mortality risk

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Extreme heat as well as extreme cold can affect people with heart conditions. Alexi Rosenfeld/Getty Images
  • A multinational analysis of more than 32 million deaths from cardiovascular disease found that more people died on days with extreme temperatures— both hot and cold.
  • For every 1,000 cardiovascular deaths, 2.2 excess deaths were associated with extreme hot days, and 9.1 were associated with extreme cold days.
  • The researchers now want to see guidelines developed to help mitigate the impact of extreme temperatures.

The planet is enduring more frequent intense heat waves due to climate change, which is mostly caused by humans burning fossil fuels such as coal, oil, and gas. The last eight years have been the hottest on human record, according to the World Meteorological Organization.

Some research studies indicate that climate change may also be linked to severe winter weather, like that experienced in Texas in February of 2021.

An international consortium of researchers recently joined forces to study how climate change impacts cardiovascular health.

A paper about their efforts, which is published in Circulation, a flagship journal of the American Heart Association (AHA), explains that the researchers found more deaths on days when temperatures were at their highest and lowest.

The study suggests both extreme hot and extreme cold temperatures increase the risk of death among individuals with cardiovascular disease (CVD), like ischemic heart disease, stroke, heart failure, and arrhythmia.

On extremely hot days, the heart shifts blood from major organs to underneath the skin, where it is cooler.

“Sweating also happens,” Dr. Barrak Alahmad, lead author of the study as well as a research fellow at the Harvard T.H. Chan School of Public Health and mission scholar at the College of Public Health at Kuwait University in Kuwait City, explained to Medical News Today.

“This could lead to volume depletion that increases heart rate. Increased core body temperature will also increase the metabolic state and oxygen consumption. Then you might also [experience] fluid shifts and electrolytes imbalance (specifically, potassium, magnesium). All of these [cascade] in susceptible individuals…” he further explained.

In hot weather, people who are older, obese, have high blood pressure, or have a history of heart disease need to take precautions like avoiding the outdoors in the early afternoon and staying hydrated, according to the AHA.

Cold weather also causes problems for humans.

“Blood vessels will constrict, and skeletal muscles will increase tone to preserve and generate heat. This will increase blood pressure. Some researchers suggested that cold makes cholesterol crystals deposit in blood vessels and causes heart attacks. Other researchers showed that cold makes your blood more sticky, and that also increases the risk of heart attacks,” said Dr. Alahmad.

For this study, the team of researchers led by D. Alahmad used data collected by the Multi-County Multi-City Collaborative Research Network, an international collaboration of scientists looking for epidemiological evidence of associations “between environmental stressors, climate, and health.”

They analyzed more than 32 million cardiovascular deaths that occurred in 567 cities in 27 countries on five continents between 1979 and 2019. Researchers obtained city-specific daily temperatures from weather stations and climate reanalysis models.

For their analysis, researchers compared cardiovascular deaths on the hottest and coldest 2.5{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of days for each city with cardiovascular deaths on the days that had the optimal temperature (the temperature associated with the least rates of deaths) in the same city.

For every 1,000 deaths from CVD, the researchers found that extreme hot days resulted in 2.2 additional deaths, and extreme cold days accounted for 9.1 additional deaths.

“We now learned that for every 100 cardiovascular deaths, at least 1 additional death is from extreme cold and hot days. Considering that cardiovascular disease is the leading cause of death globally, this essentially translates into a very large burden,” Dr. Alahmad said.

Of all the types of heart disease, heart failure caused the greatest number of deaths from extreme temperatures, the researchers found.

Meanwhile, ischemic heart disease accounted for 37{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of CVD deaths studied by researchers. They estimate that about 1{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of all ischemic heart diseases “are attributed to extreme temperatures alone.”

The researchers did not find a significant association between extreme heat and death from arrhythmia. The researchers write that this may be caused by arrhythmia being misclassified as the cause of death when the death was actually caused by ischemia or cardiomyopathy.

Dr. Don Pham, interventional cardiologist at Memorial Hermann in Houston, Texas applauded the study for providing “a new and interesting approach to prevention.”

“I think this serves as a good reminder to patients during the winter or summer months [that] when the weather has drastically [changed] in your region to pay attention to any new symptoms that occur,” he told MNT.

Although the study looked at cities in many countries, some parts of the world received less attention.

“Readers must be cautioned when interpreting our findings as global estimates since some regions were underrepresented in our data such as South Asia, the Middle East and Africa,” Dr. Alahmad told MNT.

“Extreme temperatures might have a larger impact in these underrepresented regions,” he added.

Future research needs to look at the social determinants of health and climate change, said Dr. Martha Gulati, director of preventive cardiology at the Smidt Heart Institute at Cedars-Sinai in Los Angeles, California, and president of the American Society for Preventive Cardiology.

“[T]he persons most vulnerable already for CVD may be the persons living without [air-conditioning] or without heat. Perhaps having jobs that expose them to these extreme temperatures too.”
— Dr. Martha Gulati

Dr. Gulati would also like to see research that collects data on incident cardiovascular disease.

“[T]he cost to global health systems is affected by more than just mortality. Additionally, on a population level, the number of people living with cardiovascular disease, if increasing as a result of climate change, is important when creating predictive models for cardiovascular disease burden,” she told MNT.

Professional cardiology organizations need to draft guidelines about extreme temperatures and cardiovascular health, Dr. Alahmad argued.

“We can provide exact directions to healthcare providers on what they should advise their patients,” he told MNT.

Dr. Gulati, on the other hand, believes more data needs to be collected before this step can be taken.

“But I do think that cardiologists and our national and international societies need to take a stand about climate change and also lead and advocate for our countries to address climate change in order to protect human health,” she said.

In September, Dr. Gulati argued in a piece for The American Journal of Preventive Cardiologythat the cardiology community must work to affect public policy to offset the impact of climate change.

“Rising temperatures, extreme weather, increases in greenhouse gasses (GHG), and rising sea levels are threatening human lives and dramatically impacting cardiovascular health,” she wrote.

Heart disease is the leading cause of death globally, according to the World Health Organization. That said, death rates from cardiovascular disease (CVD) have declined since the 1960s.

In the United States, that can be contributed to public health interventions that reduced smoking and the consumption of dietary fat along with improvements in medical care, according to the Centers for Disease Control and Prevention.

“It [is] a great public health success story,” Dr. Alahmad told MNT.

Cardiologists and public health officials now need to look at the risk climate change poses to cardiovascular health, Dr. Alahmad stressed.

“We need to be on top of emerging environmental exposures. In this rapidly changing climate and [at an unprecedented] pace of warming, it is not the time to be asleep at the driving wheel.”
— Dr. Alahmad

It’s past time to set alarm bells ringing, agreed Dr. Gulati.

“If we do not reverse the course urgently, the impact on human health, particularly heart health, will be dire,” she told MNT.

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Depression and gut bacteria: What is the link?

Depression and gut bacteria: What is the link?

collage showing a portrait of a pensive young Black man and microscopic slides of bacteriaShare on Pinterest
Could the gut microbiota influence depression symptoms? Image design by MNT; Photography by Klaus Vedfelt/Getty Images & Debbie Marshall via Wellcome Collection.
  • Depression is a common mental health disorder and a leading cause of disability around the world, according to the World Health Organisation (WHO).
  • Research shows gut microbiota may play a role in depressive disorders and that depressive symptom levels vary across ethnic groups.
  • Now, researchers from the United Kingdom and the Netherlands have demonstrated that 13 types of bacteria found in the gut are associated with depression symptoms.

A new study, published in Nature Communications, shows how gut bacteria may play a role in depression through the production of neurotransmitters, such as serotonin and glutamate.

Depression is a chronic feeling of sadness, emptiness, or an inability to feel pleasure. The causes of depression are still not fully understood, however, it is likely that various factors are involved, such as:

  • genetics
  • changes to neurotransmitter levels in the brain
  • environmental factors such as exposure to trauma
  • psychological and social factors.

In this study, researchers at Oxford Population Health, working with colleagues in the Netherlands, investigated the relationship between the composition and diversity of the gut microbiota with symptoms of depression.

They examined data from 1,133 participants in the Rotterdam Study. As part of their analysis, they made sure to control for lifestyle factors and medication use. For example, they only included individuals who were not taking antidepressants.

This was to avoid measuring changes in the gut microbiota that are a consequence of the depression — or the medication — rather than a cause.

Various bacteria identified showed a potential involvement in the way people produce neurotransmitters, particularly those linked to depression such as glutamate.

The researchers then replicated and validated these findings using data from another observational study, called the HELIUS study.

The results of this research may one day lead to the development of novel treatments for conditions such as depression.

Dr. Najaf Amin, study author and senior research associate at Oxford Population Health, highlighted the key findings to Medical News Today, saying that the research team has “identified 13 types of bacteria [12 genera and one family] associated with depression.”

“Eggerthella, Hungatella, Sellimonas, and Lachnoclostridium are more abundantly found, while Coprococcus, Lachnospiraceae UCG001, Ruminococcusgauvreauii group, Eubacterium ventriosum, Subdoligranulum, Ruminococcaceae (UCG002, UCG003, UCG005), and [the] family Ruminococcaceae were less abundant in individuals with higher symptoms of depression,” she specified.

“These bacteria are known to be involved in the metabolism of some key molecules including glutamate and butyrate through which these bacteria can influence depression.”

– Dr. Najaf Amin

Dr. Amin said that “large and carefully conducted studies on the association of gut microbiome with depression were missing.” According to her, “[s]uch studies are the first step towards understanding the pathogenesis, providing biomarkers and therapeutic targets for the disease.”

“Since gut microbiome is primarily determined by the lifestyle factors, diet in particular, once causality is established, the therapy would be as simple as modification of diet or the use of probiotics,” she noted.

“Further, depression is both an underdiagnosed and overdiagnosed disease. A biomarker will enable an objective measurement for depression, which is currently lacking, thus improving the diagnosis,” Dr. Amin explained.

New York-based anti-aging and regenerative medicine doctor, Dr. Neil Paulvin, not involved in the study, told MNT that “we know that the microbiome affects our mood.”

“The microbiome produces neurotransmitters such as nana, serotonin, and norepinephrine. This is part of the future of mental health,” he added.

“We need to find the specific combination of gut bacteria that are good and bad for anxiety. For example, which bacteria can activate GABA [gamma-aminobutyric acid, a neurotransmitter] to help anxiety, which can affect serotonin to help with depression, and if fecal microbiota transplant will be an answer for depression and anxiety.”

– Dr. Neil Paulvin

Dr. Paulvin highlighted that “there are pill psychobiotics [probiotics that affect mood] currently in development.”

“We are now cultivating the information to develop programs in the future,” Dr. Paulvin said.

Dr. James Giordano, Pellegrino professor of Neurology and Biochemistry at Georgetown University Medical Center, also not involved in this research, commented that “this is a very well done study that controlled for several potentially interfering variables, and in so doing, demonstrated the role of certain gut microbiome species in providing chemical modulators that are known to have both direct and indirect effect on brain chemistry involved in cognitive and emotional function.”

“Namely, these gut species, Eggerthella and Eubacterium ventriosum, have been shown to produce butyrate — an important precursor molecule to GABA, a brain chemical that functions in regulatory control of glutamate,” he explained.

“Additionally, these species were shown to produce serotonin, which has direct effects upon the enteric nervous system, the gut-brain axis, and in these ways, can affect serotonin levels and activity in the brain, which in turn, are important to aspects of cognitive, emotional, and behavioral function.”

“Overactivity of glutamate transmission in the brain has been shown to contribute to several features of depressive and anxiety disorders, and thus, gut microbiome contribution to GABA-mediated and serotonin-mediated control of brain glutamate activity (primarily via modulation of the vagus nerve) may be an important mechanism for maintaining mental health.”

– Dr. James Giordano

“[T]he study [also] revealed that certain other species of gut [bacteria] can exert disruptive effects on the microenvironment of the gut, the enteric nervous system, the gut-brain axis, brain chemistry, and the expression of signs and symptoms of depressive and anxiety disorders.”

“Thus, overgrowth of these species, and undergrowth or underactivity of beneficial species can produce local and systemic inflammatory states, which can disrupt the biochemical and physiological stability of the brain, and contribute to the development and exacerbation of neuro-psychiatric conditions,” Dr. Giordano explained.

Dr. Amin noted that “it is possible to alter the composition of these [populations of] bacteria. This is possible through the use of prebiotics and probiotics. For instance, the butyrate-producing bacteria can be altered by the consumption of high-fiber diets, e.g. fresh fruits, whole grains, and vegetables.”

Dr. Giordano agreed, telling MNT that “an important take-away message afforded by this study’s findings is that gut health via [the] stability of the gut microbiome is important to maintaining brain functions that are involved in thought, mood and behavior.”

“The increasing knowledge about the gut microbiome and the gut-brain axis fortifies that the prudent use of pre- and probiotics can be of value in sustaining both gut and brain health,” he said.