Foetuses yawn in the womb, with more yawns associated with a lower weight at birth
Photo by Mart Production on Pexels
Even in the womb, where all oxygen is provided by the parental placenta, foetuses can – and do – yawn. More yawns during observation were associated with a lower weight at birth – potentially indicating mild foetal stress in the womb, according to a study published February 25, 2026 in the open-access journal PLOS One by Damiano Menin, of the Università degli Studi di Ferrara in Italy, and colleagues.
Yawning is a behaviour found across vertebrates – and no one quite knows why. In humans, foetuses yawn in the womb from about 11 weeks. Even though there is no air to breathe, they slowly open their mouths, make motions similar to inhalation and exhalation, and close their mouths again. To understand more about foetal yawns, the authors of this study used ultrasound to observe 32 healthy foetuses (56% female, 44% male) between 23 and 31 weeks. Each foetus was observed for 22.5 minutes.
The authors found that the foetuses yawned between zero and six times during the observation period, with an average of 3.63 yawns per hour. They also showed that foetuses that yawned more during their observations were more likely to have a low weight at birth, which is considered as an indicator of mild distress – though all foetuses in the study were born healthy.
The researchers did not perform any manipulations to see if they could affect foetal yawning and also did not record measures such as foetal heart rate or maternal temperature which might potentially be associated with the behaviour. Additionally, no high-risk pregnancies were observed. Based on their research, the authors suggest that frequent foetal yawning might be a sign of mild distress in the healthy foetus.
The authors add: “We found that yawning frequencies in the womb are negatively related to birth weight, potentially indicating a stress-related response in healthy fetuses. This suggests that even before birth, yawning may serve as an indicator of a foetus’s well-being.”
Since launching late last year, Össur South Africa’s ‘What’s Your Epic?’ campaign has gained strong traction, with six amputee athletes now deep into training for the 2026 Cape Epic (15–22 March). As preparations intensify, the campaign continues to rally South Africans around a powerful belief: that access to mobility is fundamental to dignity, independence, and opportunity.
Three amputee teams will line up at one of the world’s most demanding mountain biking events, not only to test their physical limits, but to raise awareness and funds for three South African non-profit organisations restoring mobility and independence to people living with limb loss or disability: Jumping Kids, Rejuvenate SA, and Zimele.
Over the past few weeks, the riders have been balancing rigorous training schedules with advocacy, fundraising, and community engagement, using the build-up to the Cape Epic to shine a spotlight on the everyday barriers faced by thousands of South Africans who lack access to basic mobility solutions.
“Since launching ‘What’s Your Epic?’, the response has been incredibly encouraging,” says Blignaut Knoetze, Managing Director of Össur South Africa. “What’s been most powerful is seeing how this campaign has resonated beyond sport. It’s sparked conversations about access, inclusion, and what mobility truly means in people’s lives.”
For the six riders, the road to the Cape Epic is as much mental as it is physical. Long training rides, strength work, and recovery sessions are all undertaken with a deeper purpose in mind.
“Training for the Cape Epic is intense, but every ride reminds me why this matters,” says Rentia Retief, artist and amputee athlete. “With the right prosthetic and support, I’ve been able to reclaim the life I knew before losing my leg. Through this campaign, we’re trying to help make that same freedom possible for others.”
Mhlengi Gwala, international para-triathlete and African champion, adds, “This race is about more than endurance. It’s about representation and showing what’s possible when people are given the tools and support to move forward.”
Representing the third team, Brian Style, a passionate cyclist who rebuilt his life through mountain biking, says, “Preparing for the Cape Epic is both challenging and incredibly rewarding. Being part of this campaign gives real meaning to the training, knowing that every kilometre ridden helps create opportunities for others to regain their independence and confidence.”
Funds raised through the campaign will support:
Jumping Kids, which provides prosthetic limbs, education access, and sport opportunities to children with limb loss.
Rejuvenate SA, which supplies mobility aids to adults who cannot afford them, restoring dignity and independence.
Zimele, which supports adults with physical disabilities to regain independence, reintegrate into society, and build economic self-sufficiency.
Together, these organisations are changing lives every day, from helping a child take their first steps to enabling adults to return to work and participate fully in their communities.
“The riders may be the face of the campaign, but the real heroes are the organisations working on the ground,” says Knoetze. “Our role is to amplify their impact and encourage South Africans to get involved in any way they can.”
As race day draws closer, Össur South Africa is calling on individuals, corporates, and communities to support the campaign through donations, fundraising initiatives, partnerships, or simply by sharing the message.
“‘What’s Your Epic?’ asks a simple but powerful question,” says Knoetze. “How can each of us help remove barriers and create access? When we support mobility, we support inclusion, opportunity, and futures.”
Donate, fundraise, or get involved as an individual or company. Your support can help someone stand, walk, work, play, or believe in possibility again.
Donations: Össur Donations, ABSA Bank, Account number: 4123 215 542, Branch code: 632005, Reference: Company name and contact number. For more information or Section 18A certificates, please contact Amelda Potgieter at apotgieter@ossur.com.
This is more than a race. It’s a movement. What’s your Epic?
Adolescents who use cannabis could face a significantly higher risk of developing serious psychiatric disorders by young adulthood, according to a large new study published in JAMA Health Forum. The longitudinal study followed nearly half a million adolescents ages 13 to 17 through age 26 and found that past-year cannabis use during adolescence was associated with a significantly higher risk of incident psychotic (doubled), bipolar (doubled), depressive and anxiety disorders.
The study was conducted by researchers from Kaiser Permanente, the Public Health Institute’s Getting it Right from the Start, the University of California, San Francisco and the University of Southern California, and was funded by a grant from NIH’s National Institute on Drug Abuse (R01DA0531920).
The study analysed electronic health record data from routine paediatric visits between 2016 and 2023. Cannabis use preceded psychiatric diagnoses by an average of 1.7 to 2.3 years. The study’s longitudinal design strengthens evidence that adolescent cannabis exposure is a potential risk factor for developing mental illness.
“As cannabis becomes more potent and aggressively marketed, this study indicates that adolescent cannabis use is associated with double the risk of incident psychotic and bipolar disorders, two of the most serious mental health conditions,” said Lynn Silver, MD, program director of the Getting it Right from the Start, a program of the Public Health Institute, and a study co-author.
The evidence increasingly points to the need for an urgent public health response — one that reduces product potency, prioritises prevention, limits youth exposure and marketing and treats adolescent cannabis use as a serious health issue, not a benign behaviour.
Lynn Silver, MD, Program Director, PHI’s Getting it Right from the Start
Cannabis is the most used illicit drug among U.S. adolescents. The Monitoring the Future study shows use rising with grade level — from about 8% in 8th grade to 26% in 12th grade — and according to the 2024 National Survey on Drug Use and Health, more than 10% of all U.S. teens aged 12 to 17 report past-year use. At the same time, average THC levels in California cannabis flower now exceed 20%, far higher than in previous decades, and concentrates can exceed 95% THC.
Unlike many prior studies, the research examined any self-reported past-year cannabis use, with universal screening of teens during standard pediatric care, rather than focusing only on heavy use or cannabis use disorder.
“Even after accounting for prior mental health conditions and other substance use, adolescents who reported cannabis use had a substantially higher risk of developing psychiatric disorders — particularly psychotic and bipolar disorders,” said Kelly Young-Wolff, PhD, lead author of the study and senior research scientist at the Kaiser Permanente Division of Research.
This study adds to the growing body of evidence that cannabis use during adolescence could have potentially detrimental, long-term health effects. It’s imperative that parents and their children have accurate, trusted, and evidence-based information about the risks of adolescent cannabis use.
Kelly Young-Wolff, PhD, Lead Study Author and Senior Research Scientist, Kaiser Permanente Division of Research
The study also found that cannabis use was more common among adolescents enrolled in Medicaid and those living in more socioeconomically deprived neighbourhoods, raising concerns that expanding cannabis commercialisation could exacerbate existing mental health disparities.
Magnetic resonance imaging (MRI) is one of medicine’s most powerful diagnostic tools. But certain tissues deep inside the body – including brain regions and delicate structures of the eye and orbit that are of particular relevance for ophthalmology – are difficult to image clearly. The problem is not the scanner itself, but the hardware that sends and receives radio signals.
Now, researchers at the Max Delbrück Center have developed an advanced materials-based MRI antenna that overcomes these limitations – delivering enhanced images more quickly and that can be used in existing MRI machines. The research, led by Nandita Saha, a doctoral student in the Experimental Ultrahigh Field Magnetic Resonance lab of Professor Thoralf Niendorf, was published in Advanced Materials.
Niendorf and his team worked closely with researchers at Rostock University Medical Center, combining expertise in MRI physics with clinical ophthalmology and translational imaging. The Rostock team is also supporting clinical validation of the technology.
“By using concepts from metamaterials, we were able to guide radiofrequency fields more efficiently and demonstrate how advanced physics can directly improve medical imaging,” says Niendorf, senior author of the paper. “This work shows a pathway toward faster, clearer MRI scans that could benefit patients in many clinical areas.”
Rethinking MRI hardware with metamaterials
MRI works by sending radiofrequency (RF) signals into the body and detecting how tissues respond inside a strong magnetic field. The stronger the signal response, the better the image. Conventional MRI antennas – also called RF coils – often struggle to collect enough signal from deep or anatomically complex regions. This leads to images that lack detail and prolongs scan times.
The research team addressed this bottleneck by integrating metamaterials directly into the MRI antenna. Metamaterials are engineered structures that interact with electromagnetic waves in ways not found in natural materials. The engineered RF antenna increases signal strength from targeted tissues, improves spatial resolution and image sharpness and enables faster data acquisition. Crucially, the antenna fits into existing MRI systems, avoiding the need for new infrastructure. The team validated the technology by imaging the eye and orbit region in a group of volunteers at 7.0 Tesla.
“Our research demonstrates clear relevance for ophthalmological applications as it can facilitate anatomically detailed, high-spatial resolution MRI of the eye,” says Professor Oliver Stachs, a co-author of the paper at University Medicine Rostock. “It offers the potential to open a window into the eye and into (patho)physiological processes that in the past have been largely inaccessible.”
“Our goal was to rethink MRI hardware from the modern physics of antenna design,” adds Saha. This technology can also be tuned to protect sensitive areas of the body during MRI, for example, to reduce unwanted heating around medical implants, she adds. It could also be used to focus RF energy more effectively for MRI guided therapies for various cancer treatments, such as gentle heating of tumors (hyperthermia) or thermal ablation of tissue.
Better diagnostics
For patients, MRI scans can be uncomfortable and time-consuming – even more so when images need to be repeated because important details are hard to see. Faster scans mean patients spend less time inside scanners. Clearer images mean doctors can make diagnoses with greater confidence. And because the new antenna is lightweight and compact, it can also be designed to better fit specific parts of the body, improving comfort even further.
The technology could also be adapted to support MRI systems running at magnetic field strengths lower or higher than 7.0T, to image target anatomy other than the eye, orbit or the brain or to track metabolism or drug movement inside the body, says Niendorf. Special MRI scans that use other atoms, such as sodium or fluorine, could also benefit from this technology by producing clearer signals and better images, he adds.
“Innovations in imaging hardware have the potential to transform diagnostics, and this study is an important step toward next-generation MRI technology,” says Dr Ebba Beller, a co-author of the paper at Rostock University Medical Center.
The researchers are already planning larger studies at multiple hospitals and adapting the design for other organs, such as the heart and kidneys. The collaboration will continue to be strengthened by long-standing reciprocal visiting scientist appointments of Stachs and Niendorf.
Rare diseases each affect relatively small numbers of people, but collectively they impact more than 300 million individuals worldwide across over 7000 known conditions, with 70% of these starting in childhood.1 For many patients and families, the reality is often long diagnostic journeys, uncertainty and ongoing challenges in accessing treatment and support.
This year’s global Rare Disease Day theme: “More Than You Can Imagine,” highlights the often unseen challenges faced by rare disease communities and the need for more equitable healthcare systems for people living with rare conditions worldwide.
Ahead of Rare Disease Day 2026, observed globally on 28 February, Sanofi South Africa is reaffirming its commitment to improving outcomes for people living with rare diseases through ongoing research, collaboration to improve access to treatment, and engagement in policy and advocacy discussions that support patients and caregivers.
According to Monique Nel, Medical Adviser for Rare Diseases at Sanofi South Africa, rare diseases demand a long-term mindset. “Patient populations may be small, but that makes every data point even more valuable. Building evidence takes time, yet each insight brings us closer to understanding these conditions and the unique needs of patients – enabling us to deliver better care.”
Research remains essential in rare diseases, where evidence is often limited and every patient experience matters. Global disease registries, such as the Global Gaucher Registry, allow clinicians and researchers to collect real-world data that deepens understanding of how conditions present across different regions and healthcare settings. Participation from South African patients helps ensure local experiences are reflected in global research.
“For me, equity starts with representation,” says Nel. “Patients are not the same everywhere. Genetics, environment, and healthcare systems all shape how a disease presents and progresses. If our research doesn’t reflect the diversity of the populations we serve, we risk missing a critical part of the picture.”
From scientific progress to real-world access
Innovation can transform outcomes for people living with rare diseases, but scientific progress only matters if patients can actually reach and stay on treatment.
Rare disease therapies are often complex and highly specialised, which means access depends on collaboration across clinicians, funders, policymakers and industry. The focus is increasingly on sustainable solutions that support affordability, continuity of care and long-term patient support.
“Access isn’t only about availability,” says Nel. “It’s also about what happens after treatment starts – whether patients can continue therapy, feel supported, and navigate their care with confidence.”
Strengthening policy and advocacy
Policy and legislative frameworks play an important role in shaping diagnosis, treatment pathways and long-term patient support. Ongoing engagement between stakeholders is essential to strengthen South Africa’s rare disease landscape and ensure decisions reflect real patient needs.
Patient voices are becoming increasingly important in policy and reimbursement discussions, offering insights that clinical data alone cannot provide.
“Patients and caregivers become experts through their own lived experiences,” says Nel. “Listening to their voices is what enables us to design better systems and ultimately deliver better care.”
“When we say rare diseases impact lives more than you can imagine, we’re talking about the invisible barriers patients face before they ever receive care,” says Nel. “Healthcare systems matter because they determine how quickly families find answers, how care is funded, and whether patients are truly included.”
She notes that South Africa’s constitutional commitment to healthcare, together with opportunities created through National Health Insurance, presents an important moment to strengthen support for rare disease communities.
South Africa’s support for the May 2025 rare diseases resolution at the World Health Assembly followed advocacy by Rare Diseases South Africa, which engaged the Department of Health and Health Minister Aaron Motsoaledi, calling for rare diseases to be recognised as a national health priority.
“Progress comes from sustained advocacy, partnership and action. Strong policy needs partners who understand that acting for patients means helping build systems that work for them,” says Nel.
Working with patient communities
As part of Rare Disease Day 2026, Sanofi South Africa is once again partnering with Rare Diseases South Africa (RDSA) to raise awareness around rare disease equity and amplify the lived experiences of patients and families. The collaboration focuses on education, awareness and encouraging meaningful dialogue around patient needs.
“Healthcare is a constitutional right in South Africa,” says Kelly du Plessis, CEO & Founder of Rare Diseases South Africa. “The opportunity now is to ensure rare disease patients are fully included in that promise. Equity means policies that don’t simply acknowledge rare diseases but actively prioritise them.”
RDSA remains an independent patient advocacy organisation, while the partnership supports awareness initiatives and responsible collaboration that strengthens patient-centred advocacy.
“We remain committed to working for patients, but we’ve learned to do that more effectively by collaborating with patient societies,” says Nel. “That partnership approach is essential. Equity means ensuring every patient is heard, every voice contributes, and every partnership has the opportunity to drive better care.”
The partnership with RDSA aims to:
Increase understanding of rare diseases and their impact
Support patient-centred advocacy and awareness
Encourage informed dialogue across healthcare stakeholders
Highlight the importance of equity in research, access and policy
Both organisations agree that meaningful progress in rare diseases depends on collective action across patients, healthcare professionals, policymakers and industry partners.
Reference: 1. World Health Organization (WHO). Rare diseases: a global health priority for equity and inclusion. Seventy-eighth World Health Assembly, Draft Resolution A78/51, Fifth report of Committee A, 24 May 2025. Available from: https://apps.who.int/gb/ebwha/pdf_files/WHA78/A78_51-en.pdf
The National Health Insurance (NHI) Act On Friday (20 February), it was reported that President Cyril Ramaphosa had put a halt on putting the NHI Act into effect, amid an array of legal challenges. Four days later, the Pretoria High Court granted an order to the same effect.
The NHI has probably been the most contentious piece of legislation passed in South Africa, and the developments since it was signed into law have been coming thick and fast. The promulgation, that is, putting the law into effect, of the NHI was long predicted to be the hardest part of getting this attempt at universal healthcare to work.
This latest court order restrains President Ramaphosa from any further work in promulgating the NHI Act – something which he had already announced he would do just a few days ago, as reported by BusinessTech. This represents something of a pause in the ongoing legal maelstrom – nothing can be decided until the court cases clear, according to an attorney’s statement on behalf of the President.
Almost as soon as the NHI was signed into law, an array of unions, hospitals, professional organisations and even the Western Cape government launched legal challenges. A ruling compelled the President to provide the records of his decision to sign the NHI into law. One key part governing where healthcare professionals could practice has already been struck down as unconstitutional by a July 2025 High Court ruling.
The lobby group AfriForum last week entered the fray with multiple challenges to the NHI’s constitutionality, aiming to force the government to scrap the NHI completely. A few days later, President Ramaphosa paused the NHI’s promulgation. This all came amidst discussion by the Department of Health into phasing out medical aid tax credits to begin the NHI Fund – which would squeeze many middle-class families out of being able to afford private healthcare. (For now at least, there is good news – just as QuickNews was typing this, it was announced that medical aid tax credits would be increased for 2026).
Experts and even the government itself have acknowledged that these legal challenges will further delay the already decades-long implementation of the NHI, and it appears that this has come to pass. Whether the NHI is modified to a workable version along the lines suggested by industry experts, or whether it is scrapped entirely and South Africa remains stuck with its deeply unequal public/private sector divide remains to be seen.
What is certain is that the NHI as originally envisioned simply isn’t affordable for South Africa – or even a wealthy developed country. The National Treasury seems to be aware of this, as suggested by its minimal allocations to the NHI Fund and medical aid tax credits being updated for this year’s budget.
Ibuprofen is a household name – the go-to remedy for everything from headaches to period pain. But recent research suggests this everyday drug might be doing more than easing discomfort. It could also have anti-cancer properties.
As scientists uncover more about the links between inflammation and cancer, ibuprofen’s role is coming under the spotlight – raising intriguing questions about how something so familiar might offer unexpected protection.
Ibuprofen belongs to the non-steroidal anti-inflammatory drugs (NSAIDs) family. The connection between NSAIDs and cancer prevention isn’t new: as far back as 1983, clinical evidence linked sulindac – an older prescription NSAID similar to ibuprofen – to a reduced incidence of colon cancer in certain patients. Since then, researchers have been investigating whether these drugs could help prevent or slow other cancers too.
NSAIDs work by blocking enzymes called cyclooxygenases (COX). There are two main types. COX-1 helps protect the stomach lining, maintains kidney function, and plays a role in blood clotting. COX-2, on the other hand, drives inflammation.
Most NSAIDs, including ibuprofen, inhibit both, which is why doctors recommend taking them with food rather than on an empty stomach.
Ibuprofen and endometrial cancer
A 2025 study found that ibuprofen may lower the risk of endometrial cancer, the most common type of womb cancer, which starts in the lining of the uterus (the endometrium) and mainly affects women after menopause.
One of the biggest preventable risk factors for endometrial cancer is being overweight or obese, since excess body fat increases levels of oestrogen – a hormone that can stimulate cancer cell growth.
Other risk factors include older age, hormone replacement therapy (particularly oestrogen-only HRT), diabetes, and polycystic ovary syndrome. Early onset of menstruation, late menopause, or not having children also increase risk. Symptoms can include abnormal vaginal bleeding, pelvic pain, and discomfort during sex.
In the Prostate, Lung, Colorectal, and Ovarian (PLCO) study, data from more than 42,000 women aged 55–74 was analysed over 12 years. Those who reported taking at least 30 ibuprofen tablets per month had a 25% lower risk of developing endometrial cancer than those taking fewer than four tablets monthly. The protective effect appeared strongest among women with heart disease.
Interestingly, aspirin – another common NSAID – did not show the same association with reduced risk in this or other studies. That said, aspirin may help prevent bowel cancer returning.
Other NSAIDs, such as naproxen, have been studied for preventing colon, bladder, and breast cancers. The effectiveness of these drugs seems to depend on cancer type, genetics, and underlying health conditions.
Ibuprofen’s broader potential
Ibuprofen’s possible cancer-protective effects extend beyond endometrial cancer. Studies suggest it may also reduce risk of bowel, breast, lung, and prostate cancers.
Inflammation is a hallmark of cancer and ibuprofen is, at its core, anti-inflammatory. By blocking COX-2 enzyme activity, the drug reduces production of prostaglandins, chemical messengers that drive inflammation and cell growth – including cancer cell growth. Lower prostaglandin levels may slow or stop tumour development.
But that’s only part of the story. Ibuprofen also appears to influence cancer-related genes such as HIF-1α, NFκB, and STAT3, which help tumour cells survive in low-oxygen conditions and resist treatment.
Ibuprofen seems to reduce the activity of these genes, making cancer cells more vulnerable. It can also alter how DNA is packaged within cells, potentially making cancer cells more sensitive to chemotherapy.
A word of caution
But not all research points in the same direction. A study involving 7,751 patients found that taking aspirin after an endometrial cancer diagnosis was linked to higher mortality, particularly among those who had used aspirin before diagnosis. Other NSAIDs also appeared to increase cancer-related death risk.
Conversely, a recent review found that NSAIDs, especially aspirin, may reduce the risk of several cancers – though regular use of other NSAIDs could raise the risk of kidney cancer. These conflicting results show how complex the interaction between inflammation, immunity, and cancer really is.
Despite the promise, experts warn against self-medicating with ibuprofen for cancer prevention. Long-term or high-dose NSAID use can cause serious side effects such as stomach ulcers, gut bleeding, and kidney damage.
Less commonly, they may trigger heart problems like heart attacks or strokes. NSAIDs also interact with several medications, including warfarin and certain antidepressants, increasing the risk of bleeding and other complications.
The idea that a humble painkiller could help prevent cancer is both exciting and provocative. If future studies confirm these findings, ibuprofen might one day form part of a broader strategy for reducing cancer risk, especially in high-risk groups.
Everyday medicines may yet hold surprising promise, but until the science is settled, the safest prescription for cancer prevention remains the oldest one: eat well, move often, and listen to your doctor before reaching for the pill bottle.
A second pregnancy changes women’s brains in the same way as a first pregnancy, but in a different way than the first time. This is according to researchers from Amsterdam UMC, published in the scientific journal Nature Communications. The findings of Elseline Hoekzema and her colleagues show that a second pregnancy uniquely changes a woman’s brain, entailing both convergent and distinct neural transformations.
An earlier study by Elseline Hoekzema was the first to demonstrate that pregnancy changes the structure of the human brain. The research group also demonstrated that pregnancy changes the functioning of the brain. For the follow-up study, the results of which have now been published, 110 women were monitored: some were becoming mothers for the first time, others were having their second child, and a third group remained childless. Brain scans before and after pregnancy showed what changes occurred in the brain. “We have shown for the first time that the brain not only adapts during the first pregnancy, but also during the second,” says Hoekzema, head of the Pregnancy Brain Lab at Amsterdam UMC.
Different brain networks
The biggest changes during a first pregnancy occurred in the structure and activity of the so-called Default Mode Network. This part of the brain is important for many functions, including self-reflection and social processes. During a second pregnancy, this network changed again, but less dramatically. However, during a second pregnancy, there were more changes in brain networks related to paying attention and responding to stimuli. “It seems that during a second pregnancy, the brain changes more significantly in networks involved in responding to sensory stimuli and directing your attention,” explains researcher Milou Straathof, who analyzed the data. “These processes can be beneficial when caring for multiple children.”
Mental health of mothers
The researchers also found a connection between the changes in the brain and the bond between mother and child. This link was more prominent in the first pregnancy than during the second pregnancy. In addition, the researchers observed links between structural brain changes and peripartum depression, both during a first and a second pregnancy. This provides the first evidence that the changes that occur in a woman’s cerebral cortex during pregnancy are related to depression. In women who became mothers for the first time, this was particularly noticeable after giving birth. In women who had their second child, this was the case during pregnancy. “This knowledge can help us to better recognize and understand mental health issues in mothers. We must understand how the brain adapts to motherhood.”
The importance of research into the maternal brain
This study provides new insights into how the female brain adapts to motherhood and contributes to closing this important knowledge gap about female biology. Hoekzema: “The majority of women become pregnant one or more times in their lives, but only now are researchers beginning to unravel how this affects the female brain.” The results may also contribute to better care for mothers, for example, in the prevention and treatment of postpartum depression. The study also shows that the brain is flexible and can continually adapt to major changes in life.
Urology departments in England and Wales have reported seeing an increase in the number of 16- to 24-year-olds being admitted for bladder inflammation associated with ketamine use.
This appears to coincide with an increase in ketamine use – with the number of adults and teens entering treatment for ketamine abuse last year jumping substantially compared to even just a few years previously.
Ketamine abuse can have many affects on the bladder, causing frequent urination, night-time urination, sudden urges, leakage, inflammation, pain in the bladder or lower back and blood in the urine. These symptoms can be severe, make daily life very difficult and may even be permanent in some cases.
But a growing number of people are now using ketamine recreationally. It acts as a dissociative drug, causing users to feel detached from themselves and their surroundings. It can produce hallucinogenic, stimulant and pain-relieving effects, which last one to two hours.
Users typically snort or smoke powdered ketamine, or inject liquid ketamine or mix it into drinks in order to experience the drug’s effects. Snorting usually produces stronger effects and more noticeable symptoms than swallowing it.
Ketamine users can develop tolerance to the drug quickly, needing higher doses to get the same effects. This is probably due to the body and brain adapting to become more efficient at breaking down the drug. Frequent users often need to take twice the amount of occasional users to get the same effect.
The first recorded cases of ketamine affecting the bladder were reported in Canada in 2007, where nine people who used ketamine recreationally had severe bladder problems and blood in their urine. Later, a bigger study in Hong Kong found the same issues in 59 people who had used ketamine for more than three months.
Ketamine, as with any other drug, is metabolised in the body where it’s broken down and excreted in urine.
When ketamine is broken down, it turns into chemicals that can seriously harm the bladder. When these by-products stay in contact with the urinary tract for a long time, they irritate and damage the tissue.
The bladder is damaged first, because it holds urine the longest. Later, the ureters (tubes connecting the kidney to the bladder) and the kidneys can also be affected.
Over time, the bladder can shrink and become stiff, causing strong urinary symptoms. The ureters can become narrow and bent, sometimes described as looking like a “walking stick.” This can lead to backed-up urine in the kidneys (hydronephrosis).
Ketamine also increases oxidative stress, which damages cells and causes bladder cells to die. This breaks the protective bladder lining, making it leaky and overly sensitive.
All these changes can make the bladder overactive, extremely sensitive and painful, often causing severe urges to urinate and incontinence.
In the first stage, the bladder becomes inflamed. This can often be reversed by stopping ketamine and taking certain medication – such as anti-inflammatory drugs, pain relievers or prescription drugs that reduce bladder urgency and help the bladder lining heal.
In the second stage, the bladder can shrink or become stiff. In this stage, treatment is similar to stage one, but a bladder wash may also be required. This is where a catheter is used to put liquid medication directly into the bladder. The drug coats the bladder’s inner lining, helping to restore its protective layer and reduce inflammation.
Botulinum toxin injections may also be used to relax the bladder and reduce pain and urgency. Stopping ketamine remains essential to prevent further damage.
In the final stage, permanent damage occurs to the bladder and kidneys. Over time, if the kidneys are affected, it can lead to kidney failure. Dialysis (a treatment where waste products and excess fluid are filtered from the blood) or even surgery may be required to repair kidney function and the urinary system.
Although ketamine has been a class B drug since 2014, it’s unfortunately affordable and accessible – costing as little as £3 per gram in some parts of the UK. Raising awareness about the risks of ketamine use is essential to prevent these serious health problems.
A review by the University of Southampton found that 76% of people worldwide are not meeting recommended intakes of the omega-3s EPA and DHA. The peer-reviewed paper, published in Nutrition Research Reviews, was a collaboration with scientists at the University of East Anglia and Holland & Barrett.
It is the first global review of national and international omega-3 intake recommendations across all life stages for generally healthy people.
Professor of Nutritional Immunology Philip Calder from Southampton, who was part of the study, said: “The omega-3s EPA and DHA are essential for health throughout the life course. But to benefit from these nutrients, people first need to understand how much they should be consuming.
“In this review, we brought together all the recommendations for EPA and DHA intake in healthy populations from authorities around the world to help answer the important question: ‘how much do I need?’ What is clear is that most people are not meeting these recommendations.”
Omega-3 consumption supports a healthy lifestyle throughout all stages of life.
The new review found that the most frequently recommended intake for adults is 250mg per day of combined EPA and DHA, with an additional 100–200mg of DHA advised for pregnant women.
Prof Calder said these targets can be achieved by eating more oily fish, such as salmon, sardines or mackerel, or through supplementation where needed.
The paper also identified challenges that different populations have in achieving current omega-3 recommendations.
These include difficulties in meeting oily fish recommendations due to low seafood consumption, or sustainability concerns, as well as some populations having limited access to supplementation advice.
Dr Abbie Cawood , Science Director at Holland & Barrett and Visiting Research Fellow at the University of Southampton, led the study.
She said: “Omega-3s play such a vital role in health, ensuring people can meet their needs either through diet or with the support of supplementation is essential at every life stage.
In fact, our review highlights that supplementation is often required to meet recommended intakes especially in pregnancy and in those with low fish intakes. We are hopeful that this publication can act as an enabler to inform omega-3 dietary guidelines and shape future nutrition policy and public health strategies.”
