Latest news with #Researchers
Medscape
a day ago
- Health
- Medscape
Older Breast Cancer Patients Face Inconsistent Bone Care
TOPLINE: Bone health management for older women with breast cancer receiving aromatase inhibitors (AIs) varied substantially across five UK hospitals. Despite the higher risk for fractures, women older than 80 years were less likely to receive DEXA scans or bisphosphonates, highlighting the urgent need for standardised bone monitoring and treatment in frail older patients. METHODOLOGY: This secondary analysis of the multicentre Age Gap study included 529 women (age, ≥ 70 years) with oestrogen receptor-positive early breast cancer who received AIs, either as primary or adjuvant treatment, at five hospitals in the UK. Researchers collected comprehensive data including the type of endocrine therapy, DEXA scan results, bisphosphonate usage, calcium and vitamin D supplementation, and the incidence of fractures during or after AI therapy. Frailty was assessed using a modified Rockwood Frailty Index, with scores being calculated across 75 variables to categorise patients as robust (< 0.08), prefrail (0.08-0.25), or frail (> 0.25). TAKEAWAY: Overall, 67% of patients had baseline DEXA scans. Of these, 42% were osteopenic and 18% osteoporotic. Scans were more common in 70- to 79-year-olds than in those aged 80 years or older and in women undergoing surgery than in those undergoing primary endocrine therapy, with marked variation across centres (P < .001 for all). Among patients receiving AI therapy, 43% were prescribed bisphosphonates, especially those who had surgery (hazard ratio [HR], 1.36; P = .04) and those aged 70-79 years (HR, 1.31; P = .02); 33% had vitamin D plus calcium along with bisphosphonates. During follow-up, 23% of patients had fractures, with significant variation across centres (P = .02), and 38% of these patients had received prior bisphosphonates. Although 94% of patients were frail or prefrail, frailty did not correlate with baseline hip (P = .10) or spine (P = .89) T scores. Bisphosphonates plus AIs were prescribed in 70% of non-frail participants vs 43% of prefrail and 47% of frail participants (P = .02). IN PRACTICE: "Patient's age and general health influence bone health decision making, with older and frailer patients often receiving non-standard care. Despite national and international recommendations, there is still wide variation in bone health management, highlighting the need for further education and standardised bone health care in older women with breast cancer," the authors wrote. SOURCE: This study was led by Elisavet Theodoulou, University of Sheffield, Sheffield, England. It was published online on July 18, 2025, in the Journal of Geriatric Oncology. LIMITATIONS: The study's inclusion of only five hospital sites limited the ability to draw broader conclusions about bone health management practices across a wider range of centres. Additionally, the interpretation of the results was complicated by the introduction of adjuvant bisphosphonates during the study period, making the cohort unstable in terms of bisphosphonate usage indications. DISCLOSURES: The Age Gap study was supported by the National Institute for Health and Care Research Programme Grants for Applied Research. The authors declared having no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Telegraph
4 days ago
- Health
- Telegraph
Covid vaccines ‘saved far fewer lives than first thought'
Covid vaccines saved far fewer lives than first thought, a major new analysis has concluded, with researchers criticising 'aggressive mandates'. In 2024, the World Health Organisation (WHO) claimed that jabs prevented the deaths of 14.4 million globally in the first year alone, with some estimates putting the figure closer to 20 million. However, new modelling by Stanford University and Italian researchers suggests that while the vaccine did undoubtedly save lives, the true figure is 'substantially more conservative' and closer to 2.5 million worldwide over the course of the entire pandemic. The team estimated that nine of 10 prevented deaths were in the over-60s, with jabs saving just 299 youngsters aged under 20, and 1,808 people aged between 20 and 30 globally. Overall 5,400 people needed to be vaccinated to save one life but in the under-30s this figure rose to 100,000 jabs, the paper suggests. Researchers criticised 'aggressive mandates and the zealotry to vaccinate everyone at all cost', adding that the findings had implications for how future vaccine rollouts are handled. John Ioannidis, Professor of Medicine at Stanford University and the first author, said: 'I think early estimates were based on many parameters having values that are incompatible with our current understanding. 'In principle, targeting the populations who would get the vast majority of the benefit and letting alone those with questionable risk-benefit and cost-benefit makes a lot of sense. 'Aggressive mandates and the zealotry to vaccinate everyone at all cost were probably a bad idea.' Since 2021, more than 13 billion Covid-19 vaccine doses have been administered. But there have been mounting concerns that vaccines could be harmful for some people, particularly the young, and that the risk was not worth the benefit for a population at little risk from Covid. More than 17,500 Britons have applied to the Government's vaccine damage payment scheme believing they or loved ones were injured by the jab. In June, manufacturers added warnings for myocarditis and pericarditis to Covid-19 messenger RNA (mRNA) vaccines' prescribing information. For the new study, experts used worldwide population data, alongside vaccine effectiveness and infection fatality rates, to estimate how many people died from a Covid infection before or after the periods of vaccination. The team believes earlier modelling may have used overly pessimistic infection fatality rates and overly optimistic vaccine effectiveness, while failing to consider how quickly protection waned. Based on fewer assumptions Earlier studies may also have underestimated how many people had already been unknowingly infected by the time they had the vaccine. Dr Angelo Maria Pezzullo, researcher in general and applied hygiene at the Catholic University of the Sacred Heart, in Milan, said: 'Before ours, several studies tried to estimate lives saved by vaccines with different models and in different periods or parts of the world, but this one is the most comprehensive because it is based on worldwide data. it also covers the omicron period. 'It also calculates the number of years of life that was saved, and it is based on fewer assumptions about the pandemic trend.' The team calculated that around 14.8 million life-years were saved, one life-year saved per 900 vaccine doses administered. Researchers concluded that although vaccines had a 'substantial benefit' on global mortality, it was 'mostly limited' to older people. The over-70s made up nearly 70 per cent of the lives saved, while the 60 to 70s accounted for a further 20 per cent. In contrast, under-20s made up just 0.01 per cent of lives saved and 20 to 30s were 0.07 per cent. Professor Stefania Boccia, of the Catholic University of the Sacred Heart, added: 'These estimates are substantially more conservative than previous calculations that focused mainly on the first year of vaccination, but clearly demonstrate an important overall benefit from Covid-19 vaccination over the period 2020-2024. 'Most of the benefits, in terms of lives and life-years saved, have been secured for a portion of the global population who is typically more fragile, the elderly.' Sir David Davis, the former Brexit secretary who fought against vaccine mandates, said: 'Frankly it's a good cautionary tale that if we have another pandemic we should be far more clinical about the risk-benefit ratio. 'We knew pretty quickly who the most susceptible groups were and we should have focused very strictly on them, rather than placing people who were at little risk in hazard's way. 'The level of aggression of trying to force people to become vaccinated and shutting down people who were raising concerns, the reasons for those concerns are all validated in this report.'
Medscape
5 days ago
- Health
- Medscape
Mindfulness Therapy Aids IBD Patients With Mental Distress
TOPLINE: Mindfulness-based cognitive therapy reduced psychological distress and improved well-being of patients with inflammatory bowel disease (IBD), and it may offer benefits for sleep quality and inflammation. METHODOLOGY: Even in remission, many patients with IBD experience anxiety, depression, fatigue, and poor sleep, which can lower their quality of life, undermine self-care, and drive up healthcare use. Researchers conducted this trial in the Netherlands between July 2021 and May 2022 to strengthen the evidence for the effectiveness of mindfulness-based cognitive therapy in reducing psychological distress in patients with IBD who had been in remission for at least 3 months and experienced at least mild levels of distress. They randomly assigned 142 patients (mean age, 48.6 years; 64.1% women) to receive either mindfulness therapy plus usual treatment (n = 70; intervention group) or only usual treatment (n = 72; control group); the follow-up period lasted 12 months. The mindfulness therapy program included eight weekly group sessions of 2.5 hours, 30-45 minutes of daily home practice, and a 6-hour silent retreat day between sessions six and seven. Usual treatment included pharmacologic and surgical disease control treatments and the prevention of complications. The primary outcome was psychological distress post-intervention (3 months from baseline), measured using the Hospital Anxiety and Depression Scale (HADS) total score. Secondary outcomes included well-being, sleep, self-compassion, mindfulness skills, and disease activity. TAKEAWAY: Patients in the intervention group vs the control group showed reduced psychological distress (Cohen d [d], -0.61) and an improvement in the HADS total score (unstandardized coefficient B, -3.4; P < .001) at 3 months from baseline. The HADS total scores remained lower in the intervention group vs the control group during the entire 12-month follow-up duration. Compared with patients in the control group, those in the intervention group showed improved well-being (d, 0.41) and increases in mindfulness skills (d, 0.46) and self-compassion (d, 0.42). Patients in the intervention group vs the control group had a reduced total sleep time (d, -0.67) but an increased proportion of deep sleep (d, 0.7). No between-group difference was observed in the occurrence of disease flares, but patients in the control group showed a significant reduction in fecal calprotectin levels, an indicator of intestinal inflammation compared with patients in the control group (d, -0.49). IN PRACTICE: 'Our results demonstrate that MBCT [mindfulness-based cognitive therapy] could be a valuable addition to the currently limited number of psychological treatment options for patients with IBD with psychological distress. The group format of MBCT allows for the simultaneous treatment of more patients, potentially making it more cost-effective than individual therapy. Additionally, group therapy provides opportunities for peer support,' the authors of the study wrote. SOURCE: This study, led by Milou M. ter Avest, MD, Department of Psychiatry, Centre for Mindfulness, Radboud University Medical Centre, Nijmegen, the Netherlands, was published online in Inflammatory Bowel Diseases. LIMITATIONS: This study was limited by its unblinded design, risking expectation bias in self-reports. Mindfulness teachers had varied competence levels, which may have introduced bias. The study did not assess sleep disorders such as obstructive sleep apnea, narcolepsy, or restless legs syndrome that may have affected the sleep metrics. Additionally, electroencephalography headbands were not available for all patients, and technical and self-application issues may have led to unusable nights and data loss. DISCLOSURES: This trial was supported by ZonMw (the Netherlands Organisation for Health Research and Development) and the MindMore Foundation. Two authors reported serving on the advisory boards of various pharmaceutical companies, and one of them also reported receiving a grant from Royal DSM. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
6 days ago
- Health
- Medscape
AF in Chronic Aortic Regurgitation Tied to Mortality Risk
TOPLINE: Atrial fibrillation (AF) was present in 1 in 6 patients with chronic aortic regurgitation — either moderate-to-severe or severe — and was independently associated with an increased risk for mortality and more severe symptoms. METHODOLOGY: Researchers conducted a retrospective cohort study to determine the prevalence and prognostic significance of AF in patients with hemodynamically significant aortic regurgitation. The study included 1006 patients (mean age, 59 years; 82% men) with moderate-to-severe chronic aortic regurgitation between March 2004 and April 2019. AF was identified using ECG and episodes were recorded by implanted cardiac devices. The primary endpoint was all-cause mortality. Inclusion was halted for patients who received an aortic valve replacement. TAKEAWAY: AF was present in 16% of patients at the time of diagnosis of chronic aortic regurgitation. Those with AF were more likely to be older (adjusted odds ratio [aOR] per year increase, 1.06), men (aOR, 3.55), and have a diagnosis of congestive heart failure (aOR, 2.11; P ≤ .001 for all). AF was independently associated with a significantly elevated risk for mortality in all three multivariable models even after adjusting for comorbid conditions and left ventricular systolic and diastolic function, with hazard ratios ranging from 1.61 to 2.21 (P < .05 for all). Patients with AF had more severe symptoms and a higher risk for death than those with sinus rhythm (P < .05 for both). The median duration between the diagnoses of AF and aortic regurgitation was 2.1 years, and AF was usually paroxysmal. IN PRACTICE: The findings 'highlight the need for a more comprehensive evaluation of cardiac function, including assessment of AF, in patients with chronic, hemodynamically significant [aortic regurgitation] rather than focusing solely' on left ventricle systolic function, the researchers reported. The results also underscore the need for prospective studies 'to validate risk factors for the development of AF in chronic [aortic regurgitation] and to assess whether the onset of AF could aid in risk stratification, including the timing of intervention,' they added. SOURCE: This study was led by Giordano M. Pugliesi, MD, of the University of Milan-Bicocca in Milan, Italy. It was published online on July 16, 2025, in Heart. The findings were previously presented as a poster at the American College of Cardiology (ACC) Scientific Session 2025 in Chicago. LIMITATIONS: The retrospective analysis had incomplete data on comorbidities, cerebral embolic events, hospitalizations for heart failure, and causes of death. Lack of systematic screening may have underestimated the prevalence of AF. This study was conducted at a single tertiary center, potentially introducing referral bias. DISCLOSURES: This study received support through an intramural grant by Mayo Clinic. The authors declared having no competing interests. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Yahoo
6 days ago
- Health
- Yahoo
Can't Sleep? These 4 Exercises Could Help, New Study Suggests
Reviewed by Dietitian Emily Lachtrupp, M.S., RD Sleep can feel elusive sometimes. Stress, poor sleep hygiene—like not having a healthy bedtime routine—and even medications can interfere with sleep quality and quantity. If you struggle with getting enough quality sleep, you're not alone. About 12% of Americans have been diagnosed with insomnia. Defined as trouble falling asleep, staying asleep or getting good quality sleep, insomnia can be short-term or chronic. Besides causing exhaustion and daytime sleepiness, chronic insomnia can also affect memory and concentration, as well as increase the risk of heart disease, high blood pressure, diabetes and cancer. Healthy sleep habits and cognitive behavioral therapy (CBT) can be effective treatments for insomnia. CBT can help calm the nervous system and prepare it for sleep. Healthy sleep habits include things like creating a healthy sleep environment, avoiding alcohol or caffeine near bedtime and maintaining a consistent sleep routine. Of course, there are also sleep medications, but they can have unwanted side effects. In an attempt to find drug-free interventions, there is evidence that suggests that exercise may act as a sleep aid. Researchers from China wanted to take a closer look at this possibility and examine more specifically what types of exercise may be most effective. They conducted a systematic review and meta-analysis and published their findings in BMJ Evidence-Based Medicine. How Was This Study Conducted? This was a systematic review and meta-analysis, so researchers searched for previously conducted studies that met their criteria. This included studies using participants with insomnia diagnoses and organized exercise as an intervention. After initially finding almost 10,500 studies that met their criteria, researchers rigorously weeded out those that didn't meet all their standards. They settled on 22 randomized controlled trials, which is considered the gold standard in evaluating cause-and-effect relationships between factors. The total number of participants included in all 22 studies was 1,348. The exercise interventions included yoga, tai chi, walking or jogging, aerobic/cardio exercise plus strength training, strength training alone, aerobic exercise combined with therapy (i.e. CBT) and mixed aerobic exercises. What Did This Study Find? RCTs analyze the data in the studies, including running statistical analyses. In this study, many different criteria were tested, based on various aspects of sleep. These researchers concluded that: Yoga may be helpful for those who want to increase total sleep time. Yoga and tai chi may offer benefits for specific clinical symptoms of insomnia, including low sleep efficiency (the actual amount of time you spend asleep while in bed), difficulty falling asleep and frequently waking up in the middle of the night. Tai chi may extend sleep time, both in the short-term and long-term (after one or two years of follow-up). Walking or jogging may help mitigate daytime sleepiness. Though researchers used rigorous standards when choosing the studies to include in this meta-analysis, there are still a few limitations. First, some of the studies tested at moderate or high levels regarding bias. There was also an absence of exercise 'dose'—including frequency and intensity—in some of the studies, so researchers are unable to say how much and at what intensities these exercise types may be most helpful. How Does This Apply to Real Life? If you're having sleep issues, one of the first things to consider is your sleep hygiene. What does your bedtime routine look like? Ideally, you want to spend an hour before your head hits the pillow preparing your body for sleep. This includes getting off devices, dimming the lights and engaging in relaxing activities, like reading, journaling or listening to calming music. Having a bedtime routine that feels familiar is a healthy trigger for your brain to start preparing for sleep. That routine may be as simple as washing up, flossing and brushing your teeth and getting into pajamas. Your sleep environment is key, too. Having a dark room allows your body to produce melatonin, the hormone that signals your body that it's time to go into sleep mode. It's also important to have your bedroom on the cool side, as being too warm inhibits sleep, and make sure your pillows, mattress and sheets are comfortable for you. Many people also find that white noise, like a fan or the sound of rain, helps with sleep. As this study suggests, it's not just what you do at bedtime that influences sleep; what you do during the day matters, too. Yoga, tai chi, walking and jogging all seem to improve sleep quality and quantity. Even getting outside into natural light during the afternoon may help you sleep better. But what about the timing of exercise? Recent research suggests that vigorous exercise done within four hours of bedtime may disrupt sleep quality and length. This research suggests opting for light, relaxing exercise if done in the evening, or making sure your vigorous workouts are reserved for earlier in the day and are no closer than four hours before bedtime. It's also important to avoid caffeine, nicotine, alcohol and large meals too close to bedtime, and try to keep a consistent bedtime, even on the weekends. If you nap in the afternoon, limit its length if you find it prevents you from falling asleep at bedtime. And if you find you get up at night to pee, take a break from the fluids earlier in the evening. While eating a large meal too close to bedtime can interrupt sleep, a rumbling belly sure doesn't help either. If you're hungry before bedtime, choose a sleep-friendly snack. Some ideas include banana with almond butter, Greek yogurt with sprouted pumpkin seeds and tart cherries or a turkey and apple roll-up. Our Expert Take This systematic review and meta-analysis suggests that yoga, tai chi, walking and jogging may help you sleep better. While this study can't say how much or at what intensity of each activity helps the most, you can experiment with that. The important thing is that whichever activities you choose, do them consistently over a long period of time for the greatest benefits. Read the original article on EATINGWELL
