Year: 2022

Categories : Cardiovascular Disease GenderTags :

New Guidelines for CVD Rehabilitation for Women

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Photo by Stephen Andrews on Unsplash

All over the world, women with cardiovascular disease (CVD) generally experience worse outcomes and are less likely to attend prevention and rehabilitation programmes than men. An expert panel has developed a clinical practice guideline endorsed by 24 clinical societies worldwide to provide guidance to the cardiac rehabilitation community on how to deliver more effective women-focused programming. The guideline appears in the Canadian Journal of Cardiology.

“It has long been established that women are significantly less likely to access and complete cardiac rehab (CR), and that their outcomes are often poorer, despite greater need than men,” explained lead author Sherry L. Grace, PhD, a professor at the University of Toronto. “Accordingly, ‘women-focused’ models of CR have been developed to better engage women and optimise their outcomes. There is now sufficient evidence on women-focused CR to make recommendations to the CR community.”

The clinical practice guideline provided by the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR) offers guidance to the CR community on how best to design programs for women with CVD, including stroke and peripheral arterial disease (PAD), and how to increase their engagement, with the goal of optimising women’s health outcomes. Cost, resource implications, feasibility, and patient preferences are foremost considerations in the recommendations.

The ICCPR identified women-focused CR researchers through a review of the scientific literature and programs offering women-focused CR around the world as identified through ICCPR’s Global Audit. Individuals and programs that consented to participate formed a writing and consensus panel including experts with diverse geographic representation who are multidisciplinary healthcare providers, a policymaker, and patient partners. This group drafted and reviewed the recommendations. The draft then underwent external review from CR societies internationally and was posted online for public comment before finalisation. One third of the studies identified in the review that formed the basis for the guideline came from Canada, which is considered to be a leader in women-focused CR.

The guideline presents 15 recommendations relating to referral (ie, automatic plus encouragement), setting (eg, choice of delivery mode, environment, tailoring, and staff training), and delivery (eg, session timing options, preferred form of exercise, psychosocial assessment and care, and education on women and heart disease). When adopted, these recommendations and the associated tools compiled can feasibly support some degree of women-focused CR as part of any program.

Key recommendations are:

  • Women should be systematically referred to CR to reduce bias and encouraged to attend before hospital discharge through two-way fulsome discussion to overcome gender-related barriers.
  • Particular considerations when developing a woman’s tailored rehab plan include considering their contextual and full clinical history, such as any mental health and psychosocial issues, menopausal status, frailty, cancer history, and concerns about urinary incontinence, falls risk/osteoporosis, as well as autoimmune conditions.
  • All programmes should offer women-focused programming, comprising as many of the definitional elements of women-focused CR as possible. Where resources are limited, this could include offering, for example, some women-only virtual education or exercise sessions or peer support programs.
  • Women should be given a choice in participating in a centre-based (clinical or community) or home-based setting, delivered in a women-friendly environment, and their needs/preferences should be taken into consideration when formulating their programs.
  • Programs should include a strong psychosocial component, choice of exercise modalities, as well as specific education on women and CVD. The psychosocial needs of women should be assessed and addressed in an evidence-based manner (eg, social support, relationship health, depression, anxiety, stress, socioeconomic issues, informal caregiving activities).

“For the first time, there are a consensus definition and recommendations for women-focused CR, so it is hoped now that many programmes will incorporate these elements into their programmes,” said Prof Grace. “If implemented, more women may engage in CR, and as a result have significantly greater quality and quantity of life.”

Source: Elsevier

Categories : Cancer Obstetrics & GynaecologyTags :

Possible Cancer Risk for Children Born from Frozen Embryos

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Photo by Pavel Danilyuk

A new study suggests the possibility that children born after use of a fertility procedure known as frozen-thawed embryo transfer may have a slightly higher risk of cancer than children born through other means. The researchers presented their findings in PLOS Medicine.

In assisted reproductive technology (ART) a doctor may immediately transfer a fertilised embryo to the uterus, or, in a practice that is increasing worldwide, the embryo might be frozen and later thawed before implantation. Prior research suggests that children born after frozen-thawed transfer may have higher short-term risk of certain medical issues than children born after fresh embryo transfer. However, potential long-term medical risks have been less clear.

To better understand these risks, Nona Sargisian of the University of Gothenburg, Sweden, and colleagues analysed medical data from nearly 8 million children in Denmark, Finland, Norway, and Sweden. Of these, 171 744 were born after the use of ART, and of these, 22 630 were born after frozen-thawed transfer.

Analysis showed that children born after frozen-thawed embryo transfer were at higher risk of cancer than children born after fresh embryo transfer and those without ART. When analysed as a single group (ie, those born after frozen-thawed transfer and fresh embryo transfer), however, the use of any type of ART did not have an increased risk of cancer. The most common types of cancer seen in this study were leukaemia and tumours of the central nervous system.

The researchers stress caution in interpreting the results due to the low number of cancer cases (48) in children born from frozen-thawed embryo transfer.

Nonetheless, the findings may raise concerns about frozen-thawed embryo transfer. Future research will be needed to confirm a possible link between the procedure and increased risk of cancer, as well as any biological mechanisms that may underlie such risk.

Coauthor Ulla-Britt Wennerholm added, “A higher risk of cancer in children born after frozen-thawed embryo transfer in assisted reproduction, a large study from the Nordic countries found. The individual risk was low, while at a population level it may have an impact due to the huge increase in frozen cycles after assisted reproduction. No increase in cancer was found among children born after assisted reproduction techniques overall.”

Source: EurekAlert!

Categories : HospitalsTags :

Operation Dudula Harasses Immigrants outside Kalafong Hospital

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Police were present at Kalafong Hospital in Tshwane on Wednesday after the Gauteng Health Department obtained an interdict to prevent members of Operation Dudula from threatening immigrants. Photo: Mosima Rafapa

Members of Operation Dudula were outside Kalafong provincial hospital in Tshwane on Wednesday, shouting at immigrant patients and employees. Police were present, enforcing the court interdict obtained last week by the Gauteng Health Department against the threats.

A security guard who did not want to give his name said for most of August Operation Dudula members had been operating outside the hospital, until the Gauteng Department of Health obtained a court interdict last Friday.

“They greeted patients who were of a dark skin colour one by one, to check which language they spoke and to listen to their accent. The local language here is Tswana or Pedi. If they found that you don’t know those languages, they turned you away,” said the security officer, whose station is not far from the pedestrian entrance.

Since 4 August, Operation Dudula has been trying to deny access to patients and employees from other countries.

“I’m here at 5:30 in the morning. Just before 8am this morning, a member of Operation Dudula was speaking through a loudspeaker saying they don’t want makwerekwere. On Monday, they checked their ID documents before people could enter the hospital. Today, they were about five or six of them outside. I think they wanted to scare people away because they just stood there until the police arrived,” he added.

Last Friday, the Gauteng MEC for Health obtained a court interdict against the members from threatening or denying access to patients and employees. The interdict was pinned to the notice board outside the hospital.

When GroundUp arrived just after 10am, a handful of Operation Dudula members were still gathered outside. Some were shouting that foreigners should leave.

Chairperson of Operation Dudula in Atteridgeville and regional coordinator in Greater Tshwane Elias Makgwadi said they were picketing outside the hospital entrance to get management to enforce the hospital’s admission rules and not admit “illegal foreign nationals”.

“We are saying, enforce your own rules. If illegal foreign nationals have been admitted to hospitals they must be discharged to law enforcement officers and immigration officers. That’s why we’re here, ” said Makgwadi.

Members of the Economic Freedom Fighters (EFF) put up a tent outside the hospital entrance and started chanting songs. Provincial spokesperson Phillip Makwala told the crowd: “Operation Dudula is acting as doctors, they are interfering with the process of the South African Police Service and the immigration office.”

Police officers were stationed outside the hospital.

Verrah Frace, from Zomba in Malawi, condemned the xenophobia. She works as a domestic worker in Laudium, west of Pretoria. Frace, who had come to visit her sick sister, said it was painful to see what Operation Dudula was doing.

“I came to South Africa in 2019 to look for a job because we are very poor back in Malawi. We are in South Africa to earn a living,” said Frace.

GroundUp heard a hospital employee wearing a pharmacy tag praising the Operation Dudula members. “These people get our medicine for free. They get everything for free. You guys are helping us. You are doing a great job,” said the employee before going back inside the hospital.

James Chasiya, from Magochi in Malawi, was at the hospital to see his wife who had given birth to a premature baby. He arrived in South Africa in 2014 and works as a plumber, living in one room in Laudium with his wife.

“Sometimes the piece jobs are hard to come by so I sell some of the furniture I have in order to pay rent. It’s not as easy living here as people think. We struggle. My wife works at a creche but it’s still hard. I’m undocumented so I can’t find a real job. There’s no way I can pay for a private hospital,” said Chasiya.

Head of Communication for the Gauteng Department of Health Motalatale Modiba had not responded to GroundUp’s questions by the time of publication.

The health department’s Motalatale Modiba said that the facility reported that operations are continuing as normal with no change in the number of patients.

“There is now increased police monitoring the situation. Patients are no longer obstructed from coming into the facility. The Department would like to assure patients that the hospital continues to render services to all who need such care,” he said.

Modiba said the department will not hesitate “to call law enforcement agencies to act against those that put the lives of patients and staff at risk”. He said the Department obtained a court interdict on 26 August from the High Court in Pretoria “to prevent a group of people from threatening, preventing and denying patients (deemed to be non-South African) and employees at Kalafong Hospital from accessing the facility to receive medical attention and to administer care respectively”.

Written by Mosima Rafapa

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Categories : Medical Research & Technology Metabolic DisordersTags :

Breakthrough in Development of an Oral Insulin Tablet

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Source: Danilo Alvesd on Unsplash

A team of researchers working on developing oral insulin tablets as a replacement for daily insulin injections have made a game-changing discovery, which they published in Scientific Reports. The University of British Columbia team found that it’s not so much the composition of the pill so much as where it’s absorbed.

Researchers have discovered that insulin from the latest version of their oral tablets is absorbed by rats in the same way that injected insulin is.

“These exciting results show that we are on the right track in developing an insulin formulation that will no longer need to be injected before every meal, improving the quality of life, as well as mental health, of more than nine million Type 1 diabetics around the world.” said Professor Anubhav Pratap-Singh, the principal investigator.

He said the inspiration behind the search for a non-injectable insulin comes from his diabetic father, who has had to inject insulin for the past 15 years.

According to Dr Alberto Baldelli, they are now seeing nearly 100% of the insulin from their tablets go straight into the liver. In previous attempts to develop a drinkable insulin, most of the insulin would accumulate in the stomach.

“Even after two hours of delivery, we did not find any insulin in the stomachs of the rats we tested. It was all in the liver and this is the ideal target for insulin – it’s really what we wanted to see,” said PhD candidate Yigong Guo, first author of the study.

Changing the mode of delivery

When it comes to insulin delivery, injections are not the most comfortable or convenient for diabetes patients. But with several other oral insulin alternatives also being tested and developed, the UBC team worked to solve where and how to facilitate a higher absorption rate.

The team instead developed a different kind of tablet that isn’t made for swallowing, but instead dissolves when placed between the gum and cheek.

This method makes use of the buccal mucosa to deliver all the insulin to the liver without wasting or decomposing any insulin along the way.

“For injected insulin we usually need 100iu per shot. Other swallowed tablets being developed that go to the stomach might need 500iu of insulin, which is mostly wasted, and that’s a major problem we have been trying to work around,” explained Yigong.

Most swallowed insulin tablets in development tend to release insulin slowly over two to four hours, while fast-release injected insulin can be fully released in 30–120 minutes.

“Similar to the rapid-acting insulin injection, our oral delivery tablet absorbs after half an hour and can last for about two to four hours long,” said Dr Baldelli.

Potential broad benefits

The study is yet to go into human trials, and for this to happen Prof Pratap-Singh says they will require more time, funding and collaborators. But beyond the clear potential benefits to diabetics, he says the tablet they are developing could also be more sustainable, cost-effective and accessible.

“More than 300 000 Canadians have to inject insulin multiple times per day,” Prof Pratap-Singh said. “That is a lot of environmental waste from the needles and plastic from the syringe that might not be recycled and go to landfill, which wouldn’t be a problem with an oral tablet.”

He explains that their hope is to reduce the cost of insulin per dose since their oral alternative could be cheaper and easier to make. Pills would be easier for diabetics as well, since currently their doses need to be kept cool.

Source: University of British Columbia

Categories : CancerTags :

Neurofeedback Could Help Alleviate ‘Chemo Brain’

On By ModernMedia

Using neurofeedback to restore normal functioning in the brains of cancer patients could potentially alleviate the mental fogginess that many report after treatment, according to a new pilot study published in the Journal of Complementary and Integrative Medicine.

The UCLA study is one of the first to indicate that neurofeedback, or electroencephalogram (EEG) biofeedback, could help address cognitive deficits of cancer patients experiencing ‘chemo brain’, a constellation of symptoms that could include problems with memory, concentration and organisation, as well as other symptoms like trouble sleeping and emotional difficulties. In previous studies, neurofeedback, in which brain waves are trained to operate in optimal frequency patterns, has been shown to help improve cognitive function in patients with cognitive impairments like attention-deficit/hyperactivity disorder, stroke and seizures, as well as helped regulate brain activity in patients with substance use and post-traumatic stress disorders.

“The history of neurofeedback shows that it’s helpful for a whole range of disorders and symptoms. This study was an opportunity for seeing whether neurofeedback is something that could be helpful with chemo brain,” said study leader Stephen Sideroff, a UCLA professor who has used neurofeedback training with patients for over 20 years.

The study by Sideroff and UCLA colleagues David Wellisch and Valerie Yarema included nine female breast cancer patients between the ages of 21 and 65 who had completed chemotherapy at least one year earlier and complained of debilitating symptoms of chemo brain, which brought significant disruptions to their work and personal lives. A clinical nurse practitioner conducted a brief mental status interview with each patient to confirm that they had persistent difficulties with concentration, memory, organization and confusion. The patients selected for the study did not have a current breast cancer diagnosis, a present or recent diagnosis of a major depressive disorder or other mental illness, or used cognitive-altering medications that might confound study results.

Before the neurofeedback training sessions began, the study participants received neurocognitive and psychological tests, as well as a quantitative EEG to measure brain wave frequencies that could be compared to normative data. The pre-training quantitative EEGs shows that each study participant had abnormal brain waive activity compared to healthy adult brains.

The study participants received a series of 18 neurofeedback sessions, scheduled for 30 minutes each over a six-week period. During these sessions, sensors were placed on the scalp and earlobe to monitor brain wave frequencies. Patients were shown a monitor displaying these frequencies in bar graphs, and they were told their goal was to increase or decrease the amplitude of specific frequency ranges to turn each bar green. They received audio and visual feedback when they successfully shifted these amplitudes.

Quantitative EEGs taken after completion of the 18 neurofeedback sessions found that brain wave frequencies had significantly normalised in seven of the nine study participants, and significantly improved in the other two.

Neurocognitive tests also showed substantial improvements in the study participants’ information processing, executive set shifting and sustained visual attention. There was improvement for all in everyday functioning and overall psychological.

Study limitations include a small sample size and lack of a control group, and some were unable to complete the study in the allotted period.

“Our results are more impressive given we were not able to have subjects stick to the schedule,” Prof Sideroff said.

Prof Sideroff said the study results were strong enough to support further research into whether neurofeedback is an effective approach for addressing chemo brain and determining the ideal protocols for conducting neurofeedback training sessions.

Source: University of California – Los Angeles

Categories : Diet and Nutrition Injury & TraumaTags :

Increased Risk of Hip Fractures for Women on Vegetarian Diets

On By ModernMedia
Source: Unsplash

Middle-aged women on vegetarian diets have a significantly higher risk of hip fractures than those on diets that include fish or meat, according to a long-term study publish in BMC Central. This risk remained even after accounting for the differences in available nutrient intake and body mass index.

Hip fractures greatly impact quality of life and and health outcomes, and carry a significant financial burden, with an average of $44 000 estimated to spent in the 12 months following a hip fracture. The growing trends of meat-free diets have prompted concern over their impact on hip fracture rates.

While increased intake of vegetable proteins has been associated with lower hip fracture risk, vegetarian diets have also been characterised by lower dietary intakes of nutrients that boost bone mineral density (BMD) and which are more abundant in animal products. Examples include total protein, calcium, vitamin D, vitamin B12, and ω-3 fatty acids, though the relationship with BMD is complex.

The researchers drew on data from the United Kingdom Women’s Cohort Study (UKWCS), and included 26 318 participants aged 35–69 who were classed into regular meat-eaters (> 5 servings/week), occasional meat-eaters (< 5 servings/week), pescatarians (eating fish but no meat) and vegetarians.

On average, vegetarians and pescetarians had a lower BMI (23.3 for both) than regular meat-eaters (25.2). At recruitment, regular meat-eaters had the highest prevalence of CVD, cancer, or diabetes (10.2%), and vegetarians the lowest (5.8%). A higher proportion of vegetarians reported never drinking alcohol. Regular meat-eaters reported the highest absolute dietary intakes of protein, vitamin D, and vitamin B12, whilst vegetarians reported the lowest. Calcium intakes were similar across the diet groups.

Before adjustments, compared with regular meat-eaters, vegetarians (hazard ratio 1.40) but not occasional meat-eaters (1.03) or pescatarians (1.04) had a greater hip fracture risk. Adjustment for confounders slightly attenuated these associations in the adjusted model, but the higher risk in vegetarians remained and was statistically significant: vegetarians 1.33; occasional meat-eaters 1.00; pescatarians 0.97.

However, even after adjustment for factors such as reported differences in nutrient intake and lower BMI, which is a known risk factor in hip fractures, the relative risk difference remained. This suggests that other, as yet unknown, factors related to the diets may be involved.

Categories : Dentistry Environmental EffectsTags :

Study Gives Water Fluoridation a Green Thumbs Up

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Teeth and toothbrush
Photo by Diana Polekhina on Unsplash

For the first time, researchers have demonstrated the low environmental footprint of water fluoridation compared to other preventive measures for tooth decay while still retaining effectiveness. The study is published in the British Dental Journal.

Water fluoridation is regarded as one of the most significant public health interventions of the twentieth century. But as the climate crisis worsens, the contribution of healthcare and the prevention of disease to the crisis must be considered.

Influenced by this urgency, Trinity College Dublin researchers collaborating with University College London quantified the environmental impact of water fluoridation for an individual five year-old child over a one-year period and compared this to the traditional use of fluoride varnish and toothbrushing programmes, which take place in selected schools across the UK, and internationally.

Over 35% of the world’s population has access to water fluoridation, with studies showing significant reductions in dental caries. Whilst data on the clinical effectiveness and cost analysis of water fluoridation are available, there has been no data regarding its environmental impact up to now.

To quantify this impact, the research team performed a Life Cycle Assessment by carefully measuring the combined travel, the weight and amounts of all products and the processes involved in all three preventive programmes (toothbrushing, fluoride varnish programmes and water fluoridation). Data was inputted into specialised environmental software and the team used the Ecoinvent database, enabling them to calculate environmental outputs, including the carbon footprint, the amount of water used for each product and the amount of land use.

The results of the study, led by Brett Duane, Associate Professor in Dental Public Health at Trinity College, concluded that water fluoridation had the lowest environmental impact in all categories studied, and had the lowest disability-adjusted life years impact when compared to all other community-level caries prevention programmes. The study also found that water fluoridation gives the greatest return on investment.

Considering the balance between clinical effectiveness, cost effectiveness and environmental sustainability, researchers believe that water fluoridation should be the preventive intervention of choice.

This research strengthens the case internationally for water fluoridation programmes to reduce dental decay, especially in the most vulnerable populations.

Assoc Prof Duane said: “As the climate crisis starts to worsen, we need to find ways of preventing disease to reduce the environmental impact of our health systems. This research clearly demonstrates the low carbon impact of water fluoridation as an effective prevention tool.”

Source: Trinity College Dublin

Categories : COVID ExerciseTags :

Returning to Sport after COVID Infection

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Rugby players
Photo by Olga Guryanova

A first-of-its-kind study published in Scientific Reports has investigated how the immune system of elite student-athletes responded to the COVID virus. Unlike older adults with comorbidities, American Football players who were diagnosed with COVID were able to have their immune system back to its baseline after their CDC-recommended isolation period.

“When COVID really started moving out of control, we met with Neil Johannsen, an exercise physiologist at LSU, and the athletic trainers Derek Calvert and Jack Marucci, and we discussed what we could do to make sure our athletes remained healthy. We especially wanted to make sure that athletes were not at risk for secondary infections when they came back from isolation,” said Guillaume Spielmann, associate professor in LSU’s School of Kinesiology.

Isolation effective after COVID infection

“When the idea started for the research, we discussed why not turn something negative into a positive, and assist with the research to find some answers. If we can do things to understand the virus better, let’s do it,” said Jack Marucci, LSU’s Director of Athletic Training. “The student-athletes were willing to be a part of it.”

During that time at the start of the COVID pandemic, the CDC had recommended 14 days of isolation.

“There was a lot unknown during this time. We are looking at a population that are extremely close to each other during plays and during games. We wanted to make sure that since they are literally face-to-face with other players, that their salivary defences, their oral defences were pretty much intact and that that part of their immune system was not affected by the disease; that there were no long-lasting effects of the disease,” Assoc Proff Spielmann said.

Saliva samples were collected from 29 student-athletes in 2020, before a COVID vaccine. Fourteen were COVID positive and 15 had no history of infection. Of the 14, only six reported mild symptoms from the virus, the other eight were asymptomatic throughout the isolation period.

“Salivary immunity is extremely important to ensure that people don’t contract secondary infections, so when athletes are coming back we need to make sure they are as healthy as can be. We found that the isolation period was sufficient to restore the athletes’ salivary immunity to the level seen in non-infected players,” Assoc Prof Spielmann said.

Safely return to play after COVID

These findings suggested the student-athletes could safely return to practice and play football without a risk of secondary infection; that their immune system wasn’t at risk when playing the close contact sport.

“I was worried a bit about long-haulers and other more significant outcomes like the concerns for the development of myocarditis. Engaging in athletic activities at an elite level can be stressful on the body and you would want to arm yourselves with the best scientific information to help understand potential outcomes. This data helped to validate some of these decisions that were made. Providing a safe environment for your student-athletes is paramount and this helped that process along,” said Shelly Mullenix, LSU’s Senior Associate Athletics Director for Health & Wellness.

For this study, three graduate students also participated in the research.

“This kind of access is unique in Division I sports. You typically don’t have access to football players, so the fact that we have access is hugely instrumental as well,” Assoc Prof Spielmann said. “LSU is a great place for this field.”

“I think this COVID research is something that we are really proud to be a part of and contribute to finding answers to such a devastating virus,” Marucci said.

Assoc Prof Spielmann, an immunologist, researches the impact of stress on the immune system of elite and tactical athletes, including astronauts and fire fighters. But this study isn’t the first for Spielmann and LSU Athletics. They have worked together to study psychological and physiological health, along with performance measures in other student-athletes and sports teams. A new study will take a closer look at female athletes’ mental, physiological and immune resilience to stress.

Source: Louisiana State University

Categories : AllergiesTags :

A New Guideline for Pollen Food Syndrome

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Photo by Daria Shevtsova on Pexels

Pollen Food Syndrome (PFS) – also known as oral allergy syndrome or pollen food allergy syndrome – causes affected individuals to experience an allergic reaction when consuming raw plant foods, and triggers can vary depending on an individual’s pollen sensitisation, which in turn is affected by geographical location. A guideline, published in Clinical & Experimental Allergy, has been developed for the diagnosis and management of PFS.

The guideline was drafted by the British Society of Allergy & Clinical Immunology Standards of Care Committee. The correct diagnosis of PFS ensures the avoidance of a misdiagnosis of a primary peanut or tree nut allergy or confusion with another plant food allergy to non-specific lipid transfer proteins. The characteristic foods involved, and rapid-onset oropharyngeal symptoms, mean PFS can often be diagnosed from the clinical history alone. Management focuses on avoiding known trigger foods, which may appear to be simple, but can be difficult if coupled with a pre-existing food allergy, or for individuals following a vegetarian/vegan diet.

“More studies on the effect of PFS on health-related quality of life are needed to dispel the myth that because it usually manifests with mild symptoms, PFS is easily managed, and does not adversely affect the individual,” the authors wrote. “The number of foods and concern about new food triggers means dietary restrictions are often overly strict, so more research on novel treatments of PFS, including food immunotherapy, needs to be undertaken.”

Source: Wiley

Categories : Cardiovascular DiseaseTags :

A Simple Low-cost Method to Identify Aortic Valve Stenosis

On By ModernMedia
Source: CC0

In the Journal of Applied Physics, researchers developed a method to identify aortic valve stenosis using complex network analysis that is accurate, simple to use, and low-cost.

Aortic valve stenosis occurs when the aortic valve narrows, constricting blood flow from the heart through the artery and to the entire body. In severe cases, it can lead to heart failure. Identifying the condition can be difficult in remote areas because it requires sophisticated technology, and diagnoses at early stages are challenging to obtain.

“Many rural health centres don’t have the necessary technology for analysing diseases like this,” said author M.S. Swapna, of the University of Nova Gorica and the University of Kerala. “For our technique, we just need a stethoscope and a computer.”

The diagnostic tool works based on the sounds produced by the heart. The organ creates a “lub” noise as it closes the mitral and tricuspid valves, pauses as ventricular relaxation occurs and the blood fills in, then makes a second noise, “dub,” as the aortic and pulmonary valves close.

Swapna and her team used heart sound data, collected over 10 minutes, to form a graph. This was then split into sections, with each part representing with a node on the graph. If the sound in that portion of the data was similar to another section, a line was drawn between the two nodes.

In a healthy heart, the graph showed two distinct clusters of points, with many nodes unconnected. In contrast, a heart with aortic stenosis contained many more correlations and edges.

“In the case of aortic stenosis, there is no separation between the ‘lub’ and ‘dub’ sound signals,” explained Swapna.

The researchers used machine learning to examine the graphs and identify those with and without disease, achieving a classification accuracy of 100%. Their method takes the correlation of each point under consideration, making it more accurate than others that only consider the strength of the signal, and it does so in less than 10 minutes. As such, it could be useful for early-stage diagnoses.

So far, the method has only been tested with data, not in a clinical setting. The authors are developing a mobile application that could be accessed worldwide. Their technique could also be used to diagnose other conditions.

“The proposed method can be extended to any type of heart sound signals, lung sound signals, or cough sound signals,” said Swapna.

Source: American Institute of Physics