Medical Bulletin 12/November/2022

Metastasis-directed treatment has emerged as a potential alternative for men with "oligorecurrent" prostate cancer - a state of disease with a limited number of metastatic lesions after initial treatment. In the MDT approach, surgery or radiation therapy (steretotactic body radiation therapy, or SBRT) is used to specifically target the area of cancer spread.

That's in contrast to ADT, systemic therapy to block testosterone and other male sex hormones, which promote the growth of prostate cancer. Androgen deprivation therapy with or without other systemic therapy is the standard treatment for metastatic prostate cancer, but has numerous adverse effects that can decrease quality of life - including sexual dysfunction, bone thinning, and loss of muscle strength, among others. If MDT is effective in controlling limited recurrences, it may avoid or delay the need for ADT.

Reference:

Jack R. Andrews et al, JOURNAL, The Journal of Urology, DOI: 10.1097/JU.0000000000002898

Repeat COVID-19 infections increase risk of organ failure, death

A new study from Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care system shows the health consequences of reinfection with SARS-Cov-2. The researchers found that repeat SARS-CoV-2 infections contribute significant additional risk of adverse health conditions in multiple organ systems.

Such outcomes include hospitalization; disorders affecting the lungs, heart, brain, and the body's blood, musculoskeletal and gastrointestinal systems; and even death. Reinfection also contributes to diabetes, kidney disease and mental health issues.

The findings are published Nov. 10 in Nature Medicine.

Reference:

Ziyad Al-Aly et al,Acute and post-acute sequelae associated with SARS-CoV-2 reinfection, Nature Medicine, DOI 10.1038/s41591-022-02051-3

Light physical activity linked to milder symptoms from intracerebral hemorrhage

Intracerebral hemorrhage is the most serious type of stroke with few treatment options. About one in ten cases of stroke is an intracerebral hemorrhage, a condition caused by bleeding within the brain tissue, with high risk of death and disability.

In the current register-based study researchers from Sahlgrenska Academy at the University of Gothenburg shows a clear link, although not causality, between physical activity and protection agains severe sympthoms of intracerebral hemorrhage.

Four hours of light physical activity per week can now be linked to milder symptoms from intracerebral hemorrhage, and also to better survival rates, a University of Gothenburg study shows.

Reference:

ADAM VIKTORISSON et al,Associations of Prestroke Physical Activity With Stroke Severity and Mortality After Intracerebral Hemorrhage Compared With Ischemic Stroke, Neurology, DOI 10.1212/WNL.0000000000201097

Dementia prevalence is declining among older Americans, study finds

In 2021, about 6.2 million U.S. adults aged 65 or older lived with dementia. Because age is the strongest risk factor for dementia, it has been predicted that increasing life expectancies will substantially increase the prevalence of Alzheimer's disease and related dementias from about 50 million to 150 million worldwide by 2050.

The prevalence of dementia in the U.S. is declining among people over age 65, dropping 3.7 percentage points from 2000 to 2016, according to a new RAND Corporation study. The findings are published in the latest edition of the journal Proceedings of the National Academy of Sciences.

The age-adjusted prevalence of dementia declined from 12.2% of people over age 65 in 2000 to 8.5% of people over age 65 in 2016, a nearly one-third drop from the 2000 level. The prevalence of dementia decreased over the entire period, but the rate of decline was more rapid between 2000 and 2004.

Reference:

Dementia prevalence is declining among older Americans, study finds; RAND CORPORATION JOURNAL Proceedings of the National Academy of Sciences; DOI: 10.1073/pnas.2212205119.