Medical Bulletin 14/November/2023

Here are the top medical news of the day:

Blood clotting risk quickly drops after stopping hormonal contraceptives

Using birth control pills and other hormone-based contraceptives is known to elevate the risk of blood clots about three-fold, but a new study suggests that this risk largely goes away within two to four weeks after one stops using these contraceptives, according to recent research.

For the study, researchers collected blood samples from 66 women on hormone-based birth control at six timepoints before and after the women stopped using their contraceptives. Participants voluntarily stopped using hormonal contraceptives for personal reasons. Dr. Blondon and team then compared the samples with blood from a control group of 28 women who were not using hormone-based birth control.

The researchers measured several biomarkers that are associated with combined hormonal contraceptives and clotting activity. These include global markers of coagulation activation due to hormones and individual coagulation factors (factor VIII and factors that inhibit clotting)

As expected, participants showed elevated levels of clotting markers before they stopped using their contraceptives. However, these coagulation markers dropped precipitously within one to two weeks after they stopped taking birth control, and by week 12, all markers were similar to the control group.

Overall, around 80% of the total drop in clotting markers seen in these women occurred within two weeks of stopping their birth control and 85% of the drop occurred within four weeks. This suggests that the likelihood of developing clots due to birth control returns to nearly normal levels within the first few weeks of stopping birth control.

Ref: AMERICAN SOCIETY OF HEMATOLOGY JOURNAL Blood

Artificial intelligence may help predict – possibly prevent – sudden cardiac death

Predicting sudden cardiac death, and perhaps even addressing a person’s risk to prevent future death, may be possible through artificial intelligence (AI) and could offer a new move toward prevention and global health strategies, according to preliminary research to be presented at the American Heart Association’s Resuscitation Science Symposium 2023.

The research team analyzed medical information with AI from registries and databases in Paris, France and Seattle for 25,000 people who had died from sudden cardiac arrest and 70,000 people from the general population, with data from the two groups matched by age, sex and residential area. The data, was gathered from medical records up to ten years prior to each death. Using AI to analyze the data, researchers built nearly 25,000 equations with personalized health factors used to identify those people who were at very high risk of sudden cardiac death. Additionally, they developed a customized risk profile for each of the individuals in the study.

The personalized risk equations included a person’s medical details as well as mental and behavioral disorders including alcohol abuse. The analysis identified those factors most likely to decrease or increase the risk of sudden cardiac death at a particular percentage and time frame, for example, 89% risk of sudden cardiac death within three months.

The AI analysis was able to identify people who had more than 90% of risk to die suddenly, and they represented more than one fourth of all cases of sudden cardiac death.

Ref:American Heart Association Resuscitation Science Symposium 2023, Abstract 347

Link Between Mediterranean Diet, Gut Microbiome, and PTSD

Post-traumatic stress disorder (PTSD) is a debilitating psychiatric condition often stemming from exposure to traumatic events. While the microbiota-gut-brain axis's role in mental health has garnered attention, a recent study has unveiled a fascinating connection between diet, gut microbiome, and PTSD symptoms.

In an analysis involving 191 individuals participating in a longitudinal cohort study, researchers delved into trauma exposure, PTSD symptoms, gut microbiome data, and dietary habits. The study indicated that higher levels of PTSD symptoms were linked to reduced adherence to the Mediterranean diet pattern, suggesting a potential influence of dietary choices on the severity of PTSD symptoms. This observation raises the possibility of dietary interventions to mitigate PTSD symptoms.

Additionally, the research uncovered that certain gut microbiome species, such as Eubacterium eligens, held promise as protective factors against PTSD. These microbial protectors appeared to be intertwined with the Mediterranean diet's benefits.

Notably, the study delved into the microbial pathways involved in pantothenate and coenzyme A biosynthesis, revealing their potential role as protective elements in PTSD. These pathways were primarily associated with beneficial microbial species like Akkermansia muciniphila.

Ref: Ke, S., Wang, XW., Ratanatharathorn, A. et al. Association of probable post-traumatic stress disorder with dietary pattern and gut microbiome in a cohort of women. Nat. Mental Health 1, 900–913 (2023). https://doi.org/10.1038/s44220-023-00145-6