Medical Bulletin 31/March/2023

Here are the top medical news for the day:

Negative effects of unhealthy sleep duration on longevity may be reduced by exercise

Both sufficient exercise and healthy sleep contribute to prolonged life expectancy. However, it has been unclear how physical activity may interact with sleep duration to promote health.

Sleeping too little or too long is linked with a shorter life, but scientists have found that physical activity counteracts some of these negative effects. The research in more than 90,000 adults is published today in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).

“The study showed that increased physical activity levels weakened the mortality risks associated with short or long sleep duration,” said study author Dr. Jihui Zhang of The Affiliated Brain Hospital of Guangzhou Medical University, China.

Reference:

Joint association of physical activity and sleep duration with risk of all-cause and cause-specific mortality: A population-based cohort study using accelerometry,European Journal of Preventive Cardiology,doi 10.1093/eurjpc/zwad060

Hope for heart failure patients in novel drug

When a person has a heart attack and subsequent heart failure, the brain responds by activating the sympathetic system, the ‘fight or flight’ response, as a way to stimulate the heart to pump blood. However, the brain persists with this activation of the nervous system, even when it is no longer required, and this together with the consequent sleep apnoea, contributes to the patient’s reduced life expectancy. Most patients die within five years of a heart failure diagnosis.

A novel drug is showing promise for alleviating heart failure, a common condition associated with sleep apnoea and a reduced lifespan.

Reference:

P2X3 receptor antagonism attenuates the progression of heart failure,Nature Communications,doi 10.1038/s41467-023-37077-9

Key risk factors for surgical site infection following commonly performed surgery identified in study

Surgical site infections or SSIs are infections that occur at a surgical incision site within 30 days after the incision is made. According to the Centers for Disease Control and Prevention, SSI accounts for 20% of all healthcare-associated infections (HAIs) and is associated with a 2-to 11-fold increase in the risk of mortality. SSI is also the most costly type of HAI with an estimated annual cost of $3.3 billion.

Findings from an analysis of more than 66,000 abdominal hysterectomies performed in New York hospitals reveal key risk factors for surgical site infections (SSIs) following these procedures, including open surgery, obesity, diabetes, gynecological cancer, and age under 45. Published today in the American Journal of Infection Control (AJIC), the data can help inform surgical and clinical decisions to reduce post-operative infections.

Reference:

Risk Factors for Surgical Site Infection after Total Abdominal Hysterectomy, New York State 2015-2018,American Journal of Infection Control,doi 10.1016/j.ajic.2023.01.016

Some melanoma patients with leptomeningeal disease benefit from novel immunotherapy delivery approach

Leptomeningeal disease is a complication of cancer that occurs when cancer cells from primary tumors migrate into the cerebrospinal fluid (CSF) and leptomeninges, the outer lining of the brain and spinal cord. These cells can quickly spread throughout the CSF and cause a wide variety of neurological symptoms. Roughly 10% of patients with stage IV melanoma will be diagnosed with LMD, which also commonly derives from metastatic lung cancer and breast cancer.

A novel approach to administer intrathecal (IT) immunotherapy (directly into the spinal fluid) and intravenous (IV) immunotherapy was safe and improved survival in a subset of patients with leptomeningeal disease (LMD) from metastatic melanoma, according to interim analyses of a Phase I/Ib trial led by researchers at The University of Texas MD Anderson Cancer Center.

Reference:

Isabella Glitza Oliva et al,UNIVERSITY OF TEXAS M. D. ANDERSON CANCER CENTERJOURNAL: Nature Medicine