From Lupus To Arthritis: New Developments

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This week’s health news round-up highlights some things that are getting better, and some things that are getting worse, and how to be on the right side of both:

New hope for lupus sufferers

Lupus is currently treated mostly with lifelong medications to suppress the immune system, which is not only inconvenient, but also can leave people more open to infectious diseases. The latest development uses CAR T-cell technology (as has been used in cancer treatment for a while) to genetically modify cells to enable the body’s own immune system to behave properly:

Read in full: Exciting new lupus treatment could end need for lifelong medication

Related: How to Prevent (Or Reduce The Severity Of) Inflammatory Diseases

It’s in the hips

There are a lot of different kinds of hip replacements, and those with either delta ceramic or oxidised zirconium head with a highly cross-linked polyethylene liner/cup have the lowest risk of need for revision in the 15 years after surgery. This is important, because obviously, once it’s in there, you want it to be able to stay in there and not have to be touched again any time soon:

Read in full: Study identifies hip implant materials with the lowest risk of needing revision

Related: Nobody Likes Surgery, But Here’s How To Make It Much Less Bad

Sooner is better than later

Often, people won’t know about an unwanted pregnancy in the first six weeks, but for those who are able to catch it early, Very Early Medical Abortion (VEMA) offers a safe an effective way of doing so, with success rate being linked to earliness of intervention:

Read in full: Very early medication abortion is effective and safe, study finds

Related: What Might A Second Trump Presidency Look Like for Health Care?

Increased infectious disease risks from cattle farms

Many serious-to-humans infectious diseases enter the human population via the animal food chain, and in this case, bird flu becoming more rampant amongst cows is starting to pose a clear threat to humans, so this is definitely something to be aware of:

Read in full: Bird flu infects 1 in 14 dairy workers exposed; CDC urges better protections

Related: With Only Gloves To Protect Them, Farmworkers Say They Tend Sick Cows Amid Bird Flu

Herald of woe

Gut health affects most of the rest of health, and there are a lot of links between gut and bone health. In this case, an association has been found between certain changes in the gut microbiome, and subsequent onset of rheumatoid arthritis:

Read in full: Changes in gut microbiome could signal onset of rheumatoid arthritis

Related: Stop Sabotaging Your Gut

Take care!

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  • To tackle gendered violence, we also need to look at drugs, trauma and mental health

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    After several highly publicised alleged murders of women in Australia, the Albanese government this week pledged more than A$925 million over five years to address men’s violence towards women. This includes up to $5,000 to support those escaping violent relationships.

    However, to reduce and prevent gender-based and intimate partner violence we also need to address the root causes and contributors. These include alcohol and other drugs, trauma and mental health issues.

    Why is this crucial?

    The World Health Organization estimates 30% of women globally have experienced intimate partner violence, gender-based violence or both. In Australia, 27% of women have experienced intimate partner violence by a co-habiting partner; almost 40% of Australian children are exposed to domestic violence.

    By gender-based violence we mean violence or intentionally harmful behaviour directed at someone due to their gender. But intimate partner violence specifically refers to violence and abuse occurring between current (or former) romantic partners. Domestic violence can extend beyond intimate partners, to include other family members.

    These statistics highlight the urgent need to address not just the aftermath of such violence, but also its roots, including the experiences and behaviours of perpetrators.

    What’s the link with mental health, trauma and drugs?

    The relationships between mental illness, drug use, traumatic experiences and violence are complex.

    When we look specifically at the link between mental illness and violence, most people with mental illness will not become violent. But there is evidence people with serious mental illness can be more likely to become violent.

    The use of alcohol and other drugs also increases the risk of domestic violence, including intimate partner violence.

    About one in three intimate partner violence incidents involve alcohol. These are more likely to result in physical injury and hospitalisation. The risk of perpetrating violence is even higher for people with mental ill health who are also using alcohol or other drugs.

    It’s also important to consider traumatic experiences. Most people who experience trauma do not commit violent acts, but there are high rates of trauma among people who become violent.

    For example, experiences of childhood trauma (such as witnessing physical abuse) can increase the risk of perpetrating domestic violence as an adult.

    Small boy standing outside, eyes down, hands over ears
    Childhood trauma can leave its mark on adults years later. Roman Yanushevsky/Shutterstock

    Early traumatic experiences can affect the brain and body’s stress response, leading to heightened fear and perception of threat, and difficulty regulating emotions. This can result in aggressive responses when faced with conflict or stress.

    This response to stress increases the risk of alcohol and drug problems, developing PTSD (post-traumatic stress disorder), and increases the risk of perpetrating intimate partner violence.

    How can we address these overlapping issues?

    We can reduce intimate partner violence by addressing these overlapping issues and tackling the root causes and contributors.

    The early intervention and treatment of mental illness, trauma (including PTSD), and alcohol and other drug use, could help reduce violence. So extra investment for these are needed. We also need more investment to prevent mental health issues, and preventing alcohol and drug use disorders from developing in the first place.

    Female psychologist or counsellor talking with male patient
    Early intervention and treatment of mental illness, trauma and drug use is important. Okrasiuk/Shutterstock

    Preventing trauma from occuring and supporting those exposed is crucial to end what can often become a vicious cycle of intergenerational trauma and violence. Safe and supportive environments and relationships can protect children against mental health problems or further violence as they grow up and engage in their own intimate relationships.

    We also need to acknowledge the widespread impact of trauma and its effects on mental health, drug use and violence. This needs to be integrated into policies and practices to reduce re-traumatising individuals.

    How about programs for perpetrators?

    Most existing standard intervention programs for perpetrators do not consider the links between trauma, mental health and perpetrating intimate partner violence. Such programs tend to have little or mixed effects on the behaviour of perpetrators.

    But we could improve these programs with a coordinated approach including treating mental illness, drug use and trauma at the same time.

    Such “multicomponent” programs show promise in meaningfully reducing violent behaviour. However, we need more rigorous and large-scale evaluations of how well they work.

    What needs to happen next?

    Supporting victim-survivors and improving interventions for perpetrators are both needed. However, intervening once violence has occurred is arguably too late.

    We need to direct our efforts towards broader, holistic approaches to prevent and reduce intimate partner violence, including addressing the underlying contributors to violence we’ve outlined.

    We also need to look more widely at preventing intimate partner violence and gendered violence.

    We need developmentally appropriate education and skills-based programs for adolescents to prevent the emergence of unhealthy relationship patterns before they become established.

    We also need to address the social determinants of health that contribute to violence. This includes improving access to affordable housing, employment opportunities and accessible health-care support and treatment options.

    All these will be critical if we are to break the cycle of intimate partner violence and improve outcomes for victim-survivors.

    The National Sexual Assault, Family and Domestic Violence Counselling Line – 1800 RESPECT (1800 737 732) – is available 24 hours a day, seven days a week for any Australian who has experienced, or is at risk of, family and domestic violence and/or sexual assault.

    If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14. In an emergency, call 000.

    Siobhan O’Dean, Postdoctoral Research Associate, The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney; Lucinda Grummitt, Postdoctoral Research Fellow, The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, and Steph Kershaw, Research Fellow, The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • The Disordered Mind – by Dr. Eric Kandel

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    We don’t generally include author bios in these reviews, but it’s worth mentioning that Dr. Kandel won the Nobel Prize in Physiology/Medicine, for studies related to the topics in this book.

    The premise in this book is as per the subtitle: what unusual brains tell us about ourselves. He assumes that the reader has a “usual” brain, but if you don’t, then all is not lost, and in fact he probably talks about your brain in the book too.

    Examining the brains of people with conditions ranging from autism to Alzheimer’s, schizophrenia to Parkinson’s, or even such common things as depression and anxiety and addiction, tells us a lot about what in our brain (anatomically and physiologically) is responsible for what, and how those things can be thrown out of balance.

    By inference, that also tells us how to keep things from being thrown out of balance. Even if the genetic deck is stacked against you, there are still things that can be done to avoid actual disease. After all, famously, “genes load the gun, but lifestyle pulls the trigger”.

    Dr. Kandel writes in a clear and lucid fashion, such that even the lay reader can quite comfortably learn about such things as prion-folding and inhibitory neurons and repressed transcription factors and more.

    Bottom line: if you’d like to understand more about what goes wrong and how and why and what it means for your so-far-so-good healthy brain, this is the book for that.

    Click here to check out The Disordered Mind, and understand more!

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  • Give Your Adrenal Glands A Chance

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    The Hats Of Wrath

    Your adrenal glands are two little hat-shaped glands that sit on top of your kidneys (like your kidneys are wearing them as hats, in fact).

    They produce adrenaline, as you might have guessed, and also cortisol and aldosterone, which you might or might not have known, as well as some miscellaneous corticosteroids that are beyond the scope of today’s article.

    Fun fact! For a long time, doctors thought adrenal glands were much larger than they usually are, because of learning anatomy from corpses that were dissected, but invariably the corpses were those of poor people, especially criminals, whose adrenal glands were almost always overworked and swollen.

    You don’t want yours to be like that.

    What goes wrong

    Assuming you don’t have a rare disorder like Addison’s disease (in which the adrenal glands don’t produce enough of the hormones they’re supposed to), your adrenal glands will usually not have trouble producing enough adrenaline et al.

    However, as we learned from the Victorian vagabonds, they can also have no problems producing too much—much like any organ that gets overworked, however, this has consequences.

    Hopefully you’re not living a life of stressful crime on the streets, but maybe you have other reasons your adrenal glands are working overtime, such as any source of chronic stress, bad sleep (can’t recharge without this downtime), overuse of stimulants (including caffeine and/or nicotine), and, counterintuitively, alcohol. All these things can tax the adrenal glands considerably.

    When this happens, in the extreme we can get Cushing’s syndrome, characterized by the symptoms: hypertension, cortisol-based fat distribution i.e. especially face and abdomen, weakness, fragile easily irritable skin, hair loss and/or hirsutism, paradoxically, and of course general fatigue.

    In the non-extreme, we get all the same symptoms just to a lower level, and experience what the medical profession is begging us not to call “Adrenal Fatigue Syndrome” because that’s not an official diagnosis, whereas if it gets a name then they’ll be expected to treat it.

    What keeps things going right

    Obviously, the opposite of the above, for a start. Which means:

    Manage chronic stress; see: How To Manage Chronic Stress

    Get good sleep; see: Why You Probably Need More Sleep

    Go easy on the caffeine; see: Caffeine Mythbusting

    Skip the nicotine; see: Nicotine Benefits (That We Don’t Recommend)!

    Avoid alcohol; see: How To Reduce Or Quit Alcohol

    There are specific vitamins and minerals that support adrenal health too; they are: vitamins B5, B6, B12, C, & D, and also magnesium and zinc.

    Good dietary sources of the above include green leafy things, cruciferous vegetables*, nuts and seeds, avocados, olive oil, and if you eat fish, then also fatty fish.

    In contrast, it is good to cut down (or avoid entirely) red meat and unfermented dairy.

    *Unsure how to get cruciferous vegetables in more often? Try today’s featured recipe, superfood broccoli pesto

    Want to know more?

    A large part of adrenal health is about keeping cortisol levels down generally (except: for most of us, we can have a little hormesis, as a treat), so for the rest of that you might like to read:

    Lower Your Cortisol! (Here’s Why & How)

    Take care!

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  • From Painkillers To Hunger-Killers
  • The Diabetes Drugs That Can Cut Asthma Attacks By 70%

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Asthma, obesity, and type 2 diabetes are closely linked, with the latter two greatly increasing asthma attack risk.

    While bronchodilators / corticosteroids can have immediate adverse effects due to sympathetic nervous system activation, and lasting adverse effects due to the damage it does to metabolic health, diabetes drugs, on the other hand, can improve things with (for most people) fewer unwanted side effects.

    Great! Which drugs?

    Metformin, and glucagon-like peptide-1 receptor agonists (GLP-1RAs).

    Specifically, researchers have found:

    • Metformin is associated with a 30% reduction in asthma attacks
    • GLP-1RAs are associated with a 40% reduction in asthma attacks

    …and yes, they stack, making for a 70% reduction in the case of people taking both. Furthermore, the results are independent of weight, glycemic control, or asthma phenotype.

    In terms of what was counted, the primary outcome was asthma attacks at 12-month follow-up, defined by oral corticosteroid use, emergency visits, hospitalizations, or death.

    The effect of metformin on asthma attacks was not affected by BMI, HbA1c levels, eosinophil count, asthma severity, or sex.

    Of the various extra antidiabetic drugs trialled in this study, only GLP-1 receptor agonists showed a further and sustained reduction in asthma attacks.

    Here’s the study itself, hot off the press, published on Monday:

    JAMA Int. Med. | Antidiabetic Medication and Asthma Attacks

    “But what if I’m not diabetic?”

    Good news:

    More than half of all US adults are eligible for semaglutide therapy ← this is because they’ve expanded the things that semaglutide (the widely-used GLP-1 receptor agonist drug) can be prescribed for, now going beyond just diabetes and/or weight loss 😎

    And metformin, of course, is more readily available than semaglutide, so by all means speak with your doctor/pharmacist about that, if it’s of interest to you.

    Take care!

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  • Staying Sane In A Hyper-Connected World

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    Staying Sane In A Hyper-Connected World

    There’s a war over there, a genocide in progress somewhere else, and another disease is ravaging the population of somewhere most Americans would struggle to point out on the map. Not only that, but that one politician is at it again, and sweeping wildfires are not doing climate change any favors.

    To borrow an expression from Gen-Z…

    “Oof”.

    A Very Modern Mental Health Menace

    For thousands of years, we have had wars and genocides and plagues and corrupt politicians and assorted major disasters. Dire circumstances are not new to us as a species. So what is new?

    As some reactionary said during the dot-com boom, “the Internet doesn’t make people stupid; it just makes their stupidity more accessible”.

    The same is true now of The Horrors™.

    The Internet doesn’t, by and large, make the world worse. But what it does do is make the bad things much, much more accessible.

    Understanding and empathy are not bad things, but watch out…

    • When soldiers came home from the First World War, those who hadn’t been there had no conception of the horrors that had been endured. That made it harder for the survivors to get support. That was bad.
    • Nowadays, while mass media covering horrors certainly doesn’t convey the half of it, even the half it does convey can be overwhelming. This is also bad.

    The insidious part is: while people are subjectively reporting good physical/mental health, the reports of the symptoms of poor physical/mental health from the same population do not agree:

    Stress in America 2023: A nation grappling with psychological impacts of collective trauma

    Should we just not watch the news?

    In principle that’s an option, but it’s difficult to avoid, unless you truly live under a rock, and also do not frequent any social media at all. And besides, isn’t it our duty as citizens of this world to stay informed? How else can we make informed choices?

    Staying informed, mindfully

    There are steps that can be taken to keep ourselves informed, while protecting our mental health:

    • Choose your sources wisely. Primary sources (e.g. tweets and videos from people who are there) will usually be most authentic, but also most traumatizing. Dispassionate broadsheets may gloss over or misrepresent things more (something that can be countered a bit by reading an opposing view from a publication you hate on principle), but will offer more of an emotional buffer.
    • Boundary your consumption of the news. Set a timer and avoid doomscrolling. Your phone (or other device) may help with this if you set a screentime limit per app where you consume that kind of media.
    • Take (again, boundaried) time to reflect. If you don’t, your brain will keep grinding at it “like a fork in the garbage disposal”. Talking about your feelings on the topic with a trusted person is great; journaling is also a top-tier more private option.
    • If you feel helpless, help. Taking even small actions to help in the face of suffering somewhere else (e.g. donating to relief funds, engaging in advocacy / hounding your government about it), can help alleviate feelings of anguish and helplessness. And of course, as a bonus, it actually helps in the real world too.
    • When you relax, relax fully. Even critical care doctors need downtime, nobody can be “always on” without burning out. So whatever distracts and relaxes you completely, make sure to make time for that too.

    Want to know more?

    That’s all we have room for today, but you might like to check out:

    You also might like our previous main features:

    Take care!

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  • Alzheimer’s may have once spread from person to person, but the risk of that happening today is incredibly low

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    An article published this week in the prestigious journal Nature Medicine documents what is believed to be the first evidence that Alzheimer’s disease can be transmitted from person to person.

    The finding arose from long-term follow up of patients who received human growth hormone (hGH) that was taken from brain tissue of deceased donors.

    Preparations of donated hGH were used in medicine to treat a variety of conditions from 1959 onwards – including in Australia from the mid 60s.

    The practice stopped in 1985 when it was discovered around 200 patients worldwide who had received these donations went on to develop Creuztfeldt-Jakob disease (CJD), which causes a rapidly progressive dementia. This is an otherwise extremely rare condition, affecting roughly one person in a million.

    What’s CJD got to do with Alzehimer’s?

    CJD is caused by prions: infective particles that are neither bacterial or viral, but consist of abnormally folded proteins that can be transmitted from cell to cell.

    Other prion diseases include kuru, a dementia seen in New Guinea tribespeople caused by eating human tissue, scrapie (a disease of sheep) and variant CJD or bovine spongiform encephalopathy, otherwise known as mad cow disease. This raised public health concerns over the eating of beef products in the United Kingdom in the 1980s.

    Human growth hormone used to come from donated organs

    Human growth hormone (hGH) is produced in the brain by the pituitary gland. Treatments were originally prepared from purified human pituitary tissue.

    But because the amount of hGH contained in a single gland is extremely small, any single dose given to any one patient could contain material from around 16,000 donated glands.

    An average course of hGH treatment lasts around four years, so the chances of receiving contaminated material – even for a very rare condition such as CJD – became quite high for such people.

    hGH is now manufactured synthetically in a laboratory, rather than from human tissue. So this particular mode of CJD transmission is no longer a risk.

    Scientist in a lab
    Human growth hormone is now produced in a lab.
    National Cancer Institute/Unsplash

    What are the latest findings about Alzheimer’s disease?

    The Nature Medicine paper provides the first evidence that transmission of Alzheimer’s disease can occur via human-to-human transmission.

    The authors examined the outcomes of people who received donated hGH until 1985. They found five such recipients had developed early-onset Alzheimer’s disease.

    They considered other explanations for the findings but concluded donated hGH was the likely cause.

    Given Alzheimer’s disease is a much more common illness than CJD, the authors presume those who received donated hGH before 1985 may be at higher risk of developing Alzheimer’s disease.

    Alzheimer’s disease is caused by presence of two abnormally folded proteins: amyloid and tau. There is increasing evidence these proteins spread in the brain in a similar way to prion diseases. So the mode of transmission the authors propose is certainly plausible.

    However, given the amyloid protein deposits in the brain at least 20 years before clinical Alzheimer’s disease develops, there is likely to be a considerable time lag before cases that might arise from the receipt of donated hGH become evident.

    When was this process used in Australia?

    In Australia, donated pituitary material was used from 1967 to 1985 to treat people with short stature and infertility.

    More than 2,000 people received such treatment. Four developed CJD, the last case identified in 1991. All four cases were likely linked to a single contaminated batch.

    The risks of any other cases of CJD developing now in pituitary material recipients, so long after the occurrence of the last identified case in Australia, are considered to be incredibly small.

    Early-onset Alzheimer’s disease (defined as occurring before the age of 65) is uncommon, accounting for around 5% of all cases. Below the age of 50 it’s rare and likely to have a genetic contribution.

    Older man places his hands on his head
    Early onset Alzheimer’s means it occurs before age 65.
    perfectlab/Shutterstock

    The risk is very low – and you can’t ‘catch’ it like a virus

    The Nature Medicine paper identified five cases which were diagnosed in people aged 38 to 55. This is more than could be expected by chance, but still very low in comparison to the total number of patients treated worldwide.

    Although the long “incubation period” of Alzheimer’s disease may mean more similar cases may be identified in the future, the absolute risk remains very low. The main scientific interest of the article lies in the fact it’s first to demonstrate that Alzheimer’s disease can be transmitted from person to person in a similar way to prion diseases, rather than in any public health risk.

    The authors were keen to emphasise, as I will, that Alzheimer’s cannot be contracted via contact with or providing care to people with Alzheimer’s disease.The Conversation

    Steve Macfarlane, Head of Clinical Services, Dementia Support Australia, & Associate Professor of Psychiatry, Monash University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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