Medical Bulletin 05/ September/2024
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Here are Top Medical News of the Day
Bengaluru Reports Highest Dengue Cases in India, Declared Epidemic by Karnataka Govt
With dengue fever cases rising quickly across the state, the Karnataka government has declared it an epidemic. The state government has directed health officials to take strong actions to stop the spread of dengue in Bengaluru and other towns in the state.
According to health department data, Karnataka has had 25,408 cases of dengue and 12 deaths. Bengaluru has the highest number, with over 11,000 cases and three deaths. Other places like Mandya, Hassan, Mysuru, and Kalaburgi also have many cases.
The health department has warned that homeowners will be fined if mosquitoes are found breeding around their homes. The fines are ₹400 in cities and ₹200 in rural areas if homes are not kept clean. For businesses, the fines are ₹1,000 in cities and ₹500 in rural areas. Construction sites where mosquitoes can breed will face fines of ₹2,000 in cities and ₹1,000 in rural areas.
They should ensure to cover or secure the water storage containers, sumps or overhead tanks with a lid or any material to prevent mosquito breeding. They should also dispose of solid waste material to prevent water accumulation & mosquito breeding," according to the notification.
20-fold Higher risk of Sudden Cardiac Death between 30 and 40 years with Type 1 Diabetes: ESC Congress 2024
Data from a Danish study presented at the European Society of Cardiology (ESC) Congress 2024 reveals that patients with either type of diabetes, particularly type 1, experience higher rates of sudden cardiac death (SCD) across all age groups. This increased risk highlights the need for better risk assessment for these individuals.
Their latest study investigates the impact of sudden cardiac death (SCD) on people with diabetes within the general population. It also explores how much life expectancy is reduced due to sudden cardiac death in individuals with both type 1 and type 2 diabetes.
The researchers used 2010 data from the entire Danish population, which includes about 5.5 million people. They found 6,851 cases of sudden cardiac death (SCD) and matched these cases with individuals who had type 1 and type 2 diabetes based on prescription records. They then determined the loss of life years for each group of diabetes diagnoses.
For individuals with type 1 diabetes, the average age was 50 years, with 57% being men and 5.5% having arrhythmia. For those with type 2 diabetes, the average age was 65 years, 52% were men, and 11% had arrhythmia.
Sudden cardiac death rates were consistently higher across all age groups (from 0 to 90 years) for people with diabetes compared to the general population.
The incidence of sudden cardiac death (SCD) per 100,000 person-years indicated that type 1 diabetes is associated with a higher risk of sudden cardiac death (SCD) across all ages up to 90 years compared to the general population. Specifically, individuals with type 1 diabetes had nearly a 10-fold higher risk of sudden cardiac death (SCD) at age 30 or younger, a 20- fold higher risk between ages 30 and 40 years (95% CI, 11.8-80.0), and this risk decreases with age up to 90 years.
For type 2 diabetes, the relative risk of SCD was nearly six times higher for those up to 30 years old, about 5.6 times higher for ages 30-40 years (95% CI, 2.7-14.0), and the risk decreased with age up to 90 years.
New Findings: Mobile Phone Use and Increased Risk of Cardiovascular Diseases
A new study has found that regular mobile phone use was positively associated with incident cardiovascular diseases risk, especially in current smokers and individuals with diabetes. In addition, this association was partly attributed to poor sleep, psychological distress, and neuroticism.
The article in the Canadian Journal of Cardiology, details the results of this large-scale prospective cohort study.
The study included 444,027 individuals from the UK Biobank without a history of cardiovascular diseases who self-reported on the frequency of their mobile phone use from 2006 to 2010. Regular mobile phone use was defined as at least one call per week. Using linked hospital and mortality records, the composite outcome of incident stroke, coronary heart disease, atrial fibrillation, and heart failure was ascertained over a median followup time of 12.3 years. Researchers also investigated the role of sleep patterns, psychological distress, and neuroticism.
An editorial that comes with the study helps explain its results in a broader context. It points out that the study was done between 2006 and 2010, a time when smartphones weren't as common as they are now. Back then, people mainly used mobile phones for calls and texts, not for things like social media or streaming videos. Because of this, we need to be cautious when applying these results to today's situation, where smartphones are used in many more ways. The findings might not fully reflect the risks associated with the way people use phones now.
Reference: Canadian Journal of Cardiology. (2024). Regular mobile phone use and incident cardiovascular diseases: Mediating effects of sleep patterns, psychological distress, and neuroticism. https://doi.org/10.1016/j.cjca.2024.06.006
New Study Highlights Key Indicators for Dentists to Identify Sleep Apnea
In a research review published in the Journal of the American Dental Association, Rutgers Health researchers identified dentists as an unexpected player in the battle against life-threatening sleep disorders.
A patient dozes off in a dental chair despite the anxiety of an impending procedure. A seemingly unremarkable act but — for dentists versed in the latest sleep research — this red flag hints at a life-threatening condition.
The review suggests dental professionals have unique opportunities to screen for conditions such as obstructive sleep apnea, a disorder that affects millions of Americans and is linked to serious health risks, including cardiovascular disease and neurodegeneration.
It also challenges dentists to look beyond teeth and gums to the broader landscape of patient health.
Sleep disorders such as obstructive sleep apnea affect more than half of people at some point in their lives. Many cases go undiagnosed, but dentists can play an important role in reducing those numbers.
The review outlines several key indicators that dental clinicians should look for during examinations, including enlarged jaw muscles, scalloped tongue edges, white lines on the cheeks, restricted visibility of the throat, dental wear patterns and tiny cracks on teeth.
These physical signs, combined with patient history and simple screening tools, can help dentists identify at-risk patients with up to 80 percent accuracy.
Another sign of concern, according to the review authors, is bruxism, commonly known as teeth grinding. Contrary to long-held beliefs, the studies suggest teeth griding is often a symptom of underlying sleep issues rather than a standalone problem caused by dental misalignment.
This shift in perspective could have far-reaching implications. By identifying patients at risk for sleep disorders, dentists can facilitate early intervention, potentially preventing complications such as hypertension, heart disease and stroke.
To implement these findings, scientists propose a simple protocol for dental practices: Incorporate sleep-related questions into patient history forms. Other recommendations include training dental staff to recognise physical signs of sleep disorders and using validated screening tools like the STOP-BANG (snoring, tiredness, observed apnea, blood pressure, body mass index, age, neck size, gender) questionnaire, which screens for obstructive sleep apnea and establish referral networks with sleep medicine specialists.
Scientists recommends that dentists looking to incorporate sleep screening into their practices start with education.
Reference: Thomas, D. C., Somaiya, T., Meira E. Cruz, M., Pitchumani, P. K., Ardeshna, A., Ravi, A., & Prabhakar, S. (2024). The enigma of sleep: Implications of sleep neuroscience for the dental clinician and patient. The Journal of the American Dental Association. https://doi.org/10.1016/j.adaj.2024.05.007
False-Positive Mammograms May Deter Women from Future Screenings: Research Finds
A major, new study led by the UC Davis Comprehensive Cancer Center has found that women who received a false-positive result that required additional imaging or biopsy were less likely to return for that follow-up screening.
The research was published in the Annals of Internal Medicine analyzed data on more than 3.5 million screening mammograms nationwide performed between 2005-2017 on over 1 million patients aged 40 to 73.
The study found that 77% of women with a negative result from a mammogram returned for subsequent screening. But this percentage dropped to 61% after a false-positive finding requiring another mammogram in six months to confirm the results and 67% if a biopsy was recommended. The impact was even more pronounced for women who received false-positive results on two consecutive mammograms recommending short-interval follow-up --only 56% returned their next screening mammogram.
The high rate of women who don't return for future screening is concerning to the research team.
The research also showed that Asian and Hispanic/Latinx women were the least likely to return for future screening mammograms after a false positive result, which may contribute to existing health disparities.
False-positive results are common, especially among younger women. They occur in 10-12% of mammograms in women 40-49 years of age. After 10 years of annual screenings, 50-60% of women can expect at least one false-positive and 7-12% at least one false-positive with a biopsy recommendation.
It is important for women to understand that about 10% of the time, additional imaging is necessary to get a better look at a finding on a screening mammogram.
Reference: Miglioretti, D. L., Abraham, L., Sprague, B. L., Lee, C. I., Bissell, M. C. S., Ho, T.-Q. H., Bowles, E. J. A., Henderson, L. M., Hubbard, R. A., Tosteson, A. N. A., & Kerlikowske, K. (2024). Association between false-positive results and return to screening mammography in the Breast Cancer Surveillance Consortium cohort. Annals of Internal Medicine. https://doi.org/10.7326/M24-0
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