Medical Bulletin 17/ September/ 2024

Here are the top news for the day:
Gastrointestinal Problems May Increase
Parkinson’s Risk by 76%: JAMA Study Finds
Digestive problems, including ulcers in one’s food
pipe or stomach, could increase the risk of Parkinson’s
disease by 76 per cent, according to a new study. Analysing endoscopy
reports of 9,350 patients, the authors found that people having upper
gastrointestinal conditions — specifically, ulcers or other types of damage to
the lining of the oesophagus, stomach, or upper part of the
small intestine — were far more likely to develop
Parkinson’s disease later in life.
These findings, published in the Journal of the American
Medical Association Network Open Researchers add to a growing body of
evidence that ageing-related or neurodegenerative disease, long thought to
originate in the brain, could begin in the gut.
Gastrointestinal problems are known to be common in patients suffering from
neurodegenerative disorders, the authors said.
The researchers at the Beth Israel Deaconess Medical Center, US, said that
gastrointestinal troubles experienced by patients of Parkinson’s disease often
appear up to two decades before symptoms such as tremors or stiffness in arms
or legs, which interfere with one’s movement and are usually the grounds for
diagnosis.
They said that digestive issues can involve constipation, drooling, difficulty
in swallowing and a delayed emptying of the stomach.
Constipation and difficulty in swallowing were strong risk factors related with
a more than doubling of Parkinson’s disease risk, the authors said.
One of the possible biological mechanisms underlying
these relationships between the gut and risk of Parkinson’s disease could be
problems in regulating dopamine, a brain chemical known to play a key role in
digestion, they said.
The authors also proposed that gastrointestinal conditions could trigger the
building up of the protein ‘alpha-synuclein’, which is how Parkinson’s disease
presents in the brain.
Future research could help understand these mechanisms better, they added.
Reference: Chang JJ, Kulkarni S, Pasricha
TS. Upper Gastrointestinal Mucosal Damage and Subsequent Risk of Parkinson
Disease. JAMA Netw Open. 2024;7(9):e2431949.
doi:10.1001/jamanetworkopen.2024.31949
Monkeypox Outbreak: High Alert at
Bengaluru Airport, Will Implement 21-Day Quarantine for Monkeypox Cases
Passengers arriving from African countries are
undergoing thorough monitoring at Bengaluru airport until they depart, due to
multiple recorded cases of Mpox.
Kempegowda International Airport in Bengaluru is on
high alert following the detection of India’s first monkeypox case in New
Delhi. Screening tests for international passengers are now in progress. The
infected individual, a 26-year-old man from Haryana, contracted the virus,
which is known to spread between people.
In an announcement, Bangalore International Airport
Limited (BIAL) said, “Keeping the global Mpox situation in mind, Bengaluru
airport is fully prepared with all safety protocols. We are conducting
screening and temperature checks of international passengers, and if anyone is
found with the symptoms, we send them for a 21-day quarantine.”
Passengers arriving from African countries are being
closely monitored throughout their time at the airport due to several reported
cases of Mpox.
Meanwhile, the Karnataka health department also said
that the state government has implemented comprehensive measures to manage any
potential outbreak. Speaking to news agency ANI earlier, Karnataka Medical
Education minister Sharan Prakash Patil said, “There’s no need for alarm; we
have implemented the necessary measures. The Union Health Department has
already issued guidelines, and the Centre has provided advisories regarding
Mpox. We have organised testing and screening facilities at Victoria Hospital and
set up isolation beds. Tests will be conducted free of charge.”
The Union Health Ministry announced that the man who
tested positive for the Mpox virus has been isolated, and efforts are ongoing
to trace contacts and determine the potential source of the infection.
Cow Slime Can Help Disc Herniation Patients
After Surgery: Study
Researchers at Uppsala University have developed a gel
inspired by cow slime for patients suffering from disc herniation. By adding
the mucin gel immediately after surgery, it is possible to create a protective
barrier around the discs to prevent the immune system from attacking their
nucleus pulposus. This keeps the discs intact and reduces the risk of further
damage.
“This new approach offers hope for those suffering
from back pain caused by disc herniation and may prevent further damage after
removing herniated discs, potentially improving the quality of life for the
patients,” says Hongji Yan, researcher at the Department of Medical Cell
Biology at Uppsala University and AIMES (Center
for the Advancement of Integrated Medical and Engineering Sciences) at
Karolinska Institutet, whose study was recently published in Advanced
Science.
In a new study, researchers explored an innovative
solution for post-surgery care aimed at preventing further damage after the
surgical removal of herniated discs. They developed a synthetic mucin gel,
inspired by the mucus coating of certain parasites, which suppresses immune
cell activation at infection sites to prevent immune cell recognition. When
applied to the surgical site, this gel prevents further disc damage by stopping
immune cells from attacking the nucleus pulposus of intervertebral discs, thanks
to its immune-suppressive properties. In contrast, traditional physical
barriers like alginate gels failed to provide this level of protection, as
demonstrated in the study.
“This approach could have a major impact on surgical
procedures, as a simple injection of mucin gels at the surgical site could
improve patient outcomes, reduce the risk of long-term complications, and
increase the overall success rate of disc surgery,” Hongji Yan concludes.
Reference: Wang, H., Chen, S., Liu, Z., Meng, Q.,
Sobreiro-Almeida, R., Liu, L., Haugen, H. J., Li, J., Mano, J. F., Hong, Y.,
Crouzier, T., Yan, H., & Li, B. (2024). Preserving the immune-privileged
niche of the nucleus pulposus: Safeguarding intervertebral discs from
degeneration after discectomy with synthetic mucin hydrogel injection. Advanced
Science. https://doi.org/10.1002/advs.202404496
Meta-analysis Finds Significant Reduction
in Insulin Resistance with Hormone Therapy
Menopausal women are at greater risk of insulin
resistance as a result of declining estrogen levels. Previous studies
evaluating the potential benefits of hormone therapy on insulin resistance have
produced mixed results. However, a new meta-analysis of 17 different
randomized, controlled trials suggests hormone therapy can be beneficial. Results
of the meta-analysis were presented at the 2024 Annual Meeting of The Menopause
Society in Chicago September 10-14.
In this new meta-analysis of 17 unique
randomized, controlled trials that covered more than 29,000 participants
between 1998 and 2024, it was found that hormone therapy significantly reduced
insulin resistance in healthy postmenopausal women without metabolic diseases
including diabetes, hypertension, and cardiovascular diseases.
Cumulative totals of the 17 different trials included
15,350 participants who were randomized to hormone therapy including estrogen
alone or estrogen plus progestogen and 13,937 who were randomized to placebo.
The mean age of the study population ranged from 47 to 75 years, and treatment
duration ranged from eight weeks to two years.
“Our analysis showed that both types of hormone
therapy, including oral and transdermal routes, significantly reduced insulin
resistance in healthy postmenopausal women, although estrogen alone was
associated with a more prominent reduction when compared to a combination
hormone therapy,” says Dr. Xuezhi (Daniel) Jiang, lead researcher from Reading
Hospital Tower Health and Drexel University College of Medicine in
Pennsylvania.
“Hormone therapy is an effective treatment for many
bothersome menopause symptoms, including hot flashes,” says Dr. Stephanie
Faubion, medical director for The Menopause Society. “This new metaanalysis is
important as declining estrogen levels in menopausal women put them at greater
risk for insulin resistance and hormone therapy could be beneficial in reducing
insulin resistance in these women.”
Reference: “Effect of hormone therapy on insulin resistance
in healthy postmenopausal women: A systematic review and meta-analysis of
randomized placebo-controlled trials.” presented at 2024 Annual Meeting of The
Menopause Society in Chicago September 10-14.
New Wearable Brain Imaging Headgear Provides
Clearer Picture Of Baby’s Brain Activity
A technology which uses harmless light waves to
measure activity in babies’ brains has provided the most complete picture to
date of brain functions like hearing, vision and cognitive processing outside a
conventional, restrictive brain scanner, in a new study led by researchers at
UCL and Birkbeck.kjh
The wearable brain imaging headgear, which was
developed in collaboration with UCL spin-out Gowerlabs, found unexpected
activity in the prefrontal cortex, an area of the brain that processes
emotions, in response to social stimuli, appearing to confirm that babies start
processing what is happening to them in social situations as early as five
months old.
This latest technology can measure neural activity
across the whole outer surface of a baby’s brain. An earlier version developed
by the same team could only measure activity in one or two parts of a baby’s
brain at a time.
The researchers say this technology could help to map
the connections between different brain regions and establish what
distinguishes typical and atypical neurodevelopment in the crucial early stages
of childhood and shed light on conditions of neurodiversity such as autism,
dyslexia and ADHD.
The development of the new device and the results of
early tests are documented in a new study, published in Imaging
Neuroscience.
Dr Liam Collins-Jones, first author of the study from
UCL Medical Physics & Biomedical Engineering and the University of
Cambridge, said: “Previously we developed a wearable imaging approach that
could map activity in specific areas of the brain.
“But this made it difficult to get a complete
picture as we could only focus on one or two areas in isolation, whereas in
reality different parts of the brain work together when navigating real-world
scenarios.
“The new method allows us to observe what’s
happening across the whole outer brain surface underlying the scalp, which is a
big step forward. It opens up possibilities to spot interactions between
different areas and detect activity in areas that we might not have known to
look at previously.
“This more complete picture of brain activity
could enhance our understanding of how the baby brain functions as it interacts
with the surrounding world, which could help us optimise support for
neurodiverse children early in life.”
The researchers observed differences in brain activity
between the two scenarios. As well as the unexpected findings in the
pre-frontal cortex observed in response to social stimuli, the researchers
found that activity was more localised in response to social stimuli compared
to non-social stimuli, validating previous findings from optical neuroimaging
and MRI studies.
In the new study, the researchers developed a high-density
diffuse optical tomography (HD-DOT) optical neuroimaging method capable of
scanning the whole of the infant’s head.
Dr Rob Cooper, senior author of the study from UCL
Medical Physics & Biomedical Engineering, said: “This device is a
great example of academic research and commercial technological development
working hand-in-hand.”
Reference: Liam H. Collins-Jones, Louisa K. Gossé,
Borja Blanco, Chiara Bulgarelli, Maheen Siddiqui, Ernesto E. Vidal-Rosas, Nida
Duobaitė, Reuben W. Nixon-Hill, Greg Smith, James Skipper, Tim Sargent, Samuel
Powell, Nicholas L. Everdell, Emily J.H. Jones, Robert J. Cooper. Whole-head
high-density diffuse optical tomography to map infant audio-visual responses to
social and non-social stimuli. Imaging Neuroscience, 2024; 2: 1
DOI: 10.1162/imag_a_00244