Medical Bulletin 17/ September/ 2024

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.

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