Categories : General InterestTags :

Med Student’s Stellar Academic Record Paves Way for Elective Abroad

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By NIÉMAH DAVIDS

Photo: Supplied

Fifth-year Bachelor of Medicine and Surgery (MBChB) student Moses Malebana’s stellar academic record has paved the way for a special international elective at the University of Graz – making him the maiden recipient of this golden opportunity – and galvanising ties between the University of Cape Town’s (UCT) Department of Medicine and the Medical University of Graz (Med Uni Graz) in Austria.

Malebana will depart in November and return to UCT’s Faculty of Health Sciences in January 2024. And with just a few short weeks before he boards his flight, he said he is excited for what awaits, and plans to absorb every detail of the experience.

“I plan on becoming a giant sponge while there. I am excited and feel privileged that I’ve been selected for this opportunity. I look forward to learning all there is to learn and flying UCT’s and the Department of Medicine’s flag[s] high at Med Uni Graz,” he said.

Tough grind

But this opportunity didn’t just fall into his lap. To be considered for the elective abroad, the application and selection criteria was clear – the candidate needed to prove an unmatched academic record. Each applicant was also tasked with supplying a motivational letter that highlighted why they felt they deserved the opportunity. It’s safe to say that Malebana passed the test with flying colours.

He said he used the motivational letter to reflect and relay personal anecdotes that focused on the sacrifices that led him to study medicine at UCT, and he enjoyed documenting his story.

“I remember seeing the email and thinking that this is my opportunity to reflect on my journey and to just tell my story. It was interesting because I don’t often reflect on things. But when I started, I realised that my whole life up to this point was about making the most of the opportunities that have come my way,” he said.

First-class motivation

In his motivation, Malebana touched on the events in his life that moulded him into the man he is today. And the list is endless – walking for more than an hour to and from school every day in rural Limpopo, contending with a lack of in-school resources, and a shortage of skilled teachers were just some of the challenges he experienced. These hurdles, he added, provided the impetus he needed to give his high school education and his medical studies his all.

“All of this taught me resilience; it motivated me to work even harder to reap the rewards later in life. I worked very hard to get to UCT, and now that I’m here, I’m working even harder to attain success in my degree,” he said. “I don’t take any opportunities for granted. I’m humbled that I’ve been chosen to represent the faculty and the university in Austria,” he said.

As he prepares for his big trip, Malebana said he’s looking forward to understanding the Austrian health system and gaining some valuable insight into how medical doctors practice medicine in that country and how it compares to South Africa.

A whole new world

The elective will consist of several rotations in different areas of internal medicine and Malebana will be based at a teaching hospital affiliated to Med Uni Graz. He said he is most excited about his oncology rotations after developing a keen interest in this area of medicine.

“I have always enjoyed studying and learning more about the management of different cancers. So, I really look forward to seeing how things are done in Austria. I know each day will be filled with something new to learn, whether it’s in oncology or a different area of medicine. I’m eager to get going,” he said.

But over and above the work, Malebana said he is thrilled to have the opportunity to travel outside of South Africa’s borders for the first time, to experience diverse cultures and cuisines, gain insight into a new way of life, and build new, lasting friendships.

“It’s going to be an adventure, that’s for sure – one that I’ve already embraced with my arms wide open. I’m grateful that it has come my way,” he said.

Republished from the University of Cape Town under a Creative Commons Attribution-NoDerivatives 4.0 International Licence.

Source: University of Cape Town

Categories : Gastrointestinal Immune SystemTags :

Atopic Dermatitis Increases Risk of New-onset IBD

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Source: CC0

Adults with atopic dermatitis (AD) have a 34% increased risk of developing new-onset inflammatory bowel disease (IBD) compared to those without the skin condition, according to a new recently published in JAMA Dermatology. The study also shows for children, the risk increase is 44%. Additionally, as the severity of AD increased, the risk of developing IBD rose.

These findings clear up ambiguity from previous research, especially among populations of children and between the different types of IBD: ulcerative colitis and Crohn’s disease. While IBD is located in the gut and AD affects the skin, both diseases are driven by the immune system and are categorised by severe inflammation. Insight offered from this study from the Perelman School of Medicine at the University of Pennsylvania could lead to new treatments for both IBD and AD.

“It is imperative for clinicians to understand atopic dermatitis and the trajectory of our patients with it in order to provide the best standard of care,” said senior author Joel M Gelfand, MD, dermatology professor at Penn. “There are new and better treatments for AD today, and there will likely continue to be more. But providers have to understand how those treatments could impact other autoimmune diseases. For patients with AD and another autoimmune disease, some currently available medications can exacerbate symptoms of their other disease or can help treat two immune diseases at the same time.”

While this is not the first study to explore AD and IBD, its size, with one million adult and child participants with AD drawn from a UK medical database, and its separation between ulcerative colitis and Crohn’s disease advances previous research.

When looking at ulcerative colitis and Crohn’s disease separately, AD was not linked to higher ulcerative colitis in children unless the kids had severe AD. Children with AD, however, had a 54–97% increased relative risk of Crohn’s disease, and among children with severe AD, their risk was roughly five times higher. Results among adults were more straightforward. Adults with AD had a 32% increased relative risk of ulcerative colitis and a 36% increased relative risk of Crohn’s disease. Gelfand notes that the absolute extra risk of developing IBD in individuals with AD is still quite small, but the association is meaningful in better understanding health outcomes in AD. Moreover, since millions of people have AD, this small increase in risk spread among many people is likely important from a public health perspective.

Although Penn researchers did not look at the root cause of IBD linked to AD, they have strong hypotheses about the links.

“AD and IBD can cause changes in the microbiome, chronic inflammation, and the dysfunction in the skin and gut barrier respectively,” said Gelfand, who is also the director of the Center for Clinical Sciences in Dermatology at Penn. “There are also specific cytokines, certain kinds of proteins, that play a role in immune system activity and that seem to be related to AD and IBD. For example, we think dysfunction of types of T cells common to both AD and IBD, could be the culprits. Those need to be explored further to uncover both what’s happening at a microscopic level and what proteins or structures could be targeted to treat one or both conditions.”

As a leading expert on psoriasis, a disease known to be tied to IBD genetically, Gelfand is well aware of how closely skin health can affect other parts of the body. He and his colleagues are also studying AD’s relationship to infections, neurologic and psychiatric disorders, and cardiovascular disease.

“Investigating the relationship between skin diseases and other diseases doesn’t just offer new insight into how these diseases can affect a patient with both, but these studies are especially powerful because they also highlight unique characteristics of each disease and how they behave individually,” Gelfand shared.

Source: University of Pennsylvania School of Medicine

Categories : CancerTags :

New Online Tool for Hard-to-identify Breast Cancer

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A new diagnostic scoring system, developed by renowned breast cancer experts, is now available as an easy-to-use online tool through Susan G. Komen®, the world’s leading breast cancer organisation. This tool will help health care providers recognise and effectively diagnose a rare and aggressive breast cancer, inflammatory breast cancer.

The new Inflammatory Breast Cancer (IBC) Scoring System online tool is available at https://www.komen.org/ibc and may help to increase diagnostic accuracy, predict outcomes, guide treatment decisions and inclusion in clinical trials.  

Before the development of the proposed IBC Scoring System, IBC lacked a formal, objective medical definition and diagnosis was often delayed, misdiagnosed or missed altogether. The new online tool is intended to provide the proposed IBC diagnostic criteria in a convenient tool to help more quickly and effectively recognize IBC in the clinic. 

IBC often develops rapidly and can easily be confused with a breast infection because of symptoms such as redness and swelling, and the frequent lack of a breast lump. IBC can be hard to see on a mammogram as it may only show up as skin thickening. This results in approximately 30% of IBC patients being first diagnosed at stage IV (de novo metastatic breast cancer), meaning their breast cancer has already spread to other parts of the body. 

“IBC has historically been difficult to diagnose and no changes to diagnostic approach have been made since the 1960s,” said Dr Reshma Jagsi, Komen Scholar and Lawrence W. Davis Professor and Chair of the Department of Radiation Oncology at Emory University School of Medicine. “This first-of-its-kind tool may help health care providers recognise and diagnose IBC and may also enable researchers to study the biology of IBC, making discoveries to advance progress toward personalized care for all IBC patients in the future.”

The proposed IBC Scoring System was developed through a collaborative effort between Susan G. Komen, the Inflammatory Breast Cancer Research Foundation (IBCRF) and the Milburn Foundation, which brought together a team of leading breast cancer experts including clinicians, researchers, and IBC patients.  It is now being validated by a team of researchers at two of the largest IBC centres in the world led by Dr Filipa Lynce at Dana-Farber Cancer Institute, and Dr Wendy A. Woodward at MD Anderson Cancer Center. This work validating the scoring system is supported by a grant awarded by Susan G. Komen and is part of the groups’ collaborative efforts to advance IBC research and care through innovative approaches.

“I encourage my fellow health providers to use the IBC Scoring System when addressing patients having concerns about changes in their breast, such as swelling and redness. Using this tool may accelerate the diagnosis of IBC and start treatment at an earlier stage for those who have a confirmed diagnosis of invasive breast cancer,” said Dr Lynce.

“The creation of this tool reflects the deep commitment of Komen, the Inflammatory Breast Cancer Research Foundation and the Milburn Foundation to accelerate progress in detecting and treating inflammatory breast cancer. With the help of leading scientists and medical providers across the US, we will help thousands of patients receive an earlier and more accurate diagnosis of this aggressive disease and get the high-quality care they need to survive,” said Senior Vice President of Mission for Susan G. Komen, Victoria Wolodzko Smart. “I have no doubt this tool will improve outcomes for all IBC patients in the future.”

Source: EurekAlert!

Categories : Cancer GastrointestinalTags :

Gastric Reflux without Oesophagitis does not Increase Cancer Risk

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Reflux disease manifests as acid regurgitation and heartburn and is a known risk factor for oesophageal cancer. However, a new study published in The BMJ by researchers at Karolinska Institutet now reports that the majority of patients do not have a higher risk of cancer. A large-scale study from three Nordic countries shows that the cancer risk is only elevated in patients whom gastroscopy reveals to have changes in the oesophageal mucosa.

“This is a gratifying result since reflux disease is a very common condition and most patients are found to have a completely normal mucus membrane on gastroscopic examination,” says the study’s first author Dag Holmberg, Karolinska Institutet researcher and resident doctor of surgery at Karolinska University Hospital in Sweden.

In reflux disease, acidic stomach contents leak into the oesophagus. This can sometimes cause oesophagitis, inflammation in the oesophageal mucus membrane, which is diagnosed via gastroscopy. It is common knowledge that reflux disease increases the risk of oesophageal cancer, but what the cancer risk is for patients with normal mucosa has remained unknown.

Symptoms generally persist

The symptoms of reflux disease can come and go but generally persist, which means that many patients frequently seek medical attention and often undergo repeated gastroscopies to detect mucosal lesions or prodromal cancer.

“Our study suggests that these repeated gastroscopies are probably unnecessary for people with reflux disease who have a normal oesophageal mucosa,” says Dr Holmberg. “These findings should be reassuring for this large patient group and can guide GPs who often treat them.”

The present study is based on national health data registries in Sweden, Denmark and Finland, and included over 285 000 individuals with reflux disease and no gastroscopic evidence of oesophagitis. The patients were followed for up to 31 years and the researchers registered all cases of oesophageal cancer.

The cancer risk was then compared with that for individuals from the general population matched by age and sex and at the same period in the three countries. No increased risk of oesophageal cancer was observed in patients with reflux disease and a normal mucus membrane.

Increased risk in patients with oesophagitis

By way of comparison, the researchers also analysed the cancer risk in over 200 000 individuals with reflux disease and oesophagitis. These people were at a clearly increased relative risk of developing oesophageal cancer.

“We now intend to examine what factors other than oesophagitis can be linked to tumour growth in people with reflux disease,” says the study’s last author Jesper Lagergren, professor of surgery at Karolinska Institutet.

Source: Karolinska Institutet

Categories : Diseases, Syndromes and Conditions Obstetrics & GynaecologyTags :

Prescribed Oestrogen and Factor V Leiden Mutation More than Double Blood Clot Risk

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Source: Wikimedia CC0

New research from Queen Mary University of London, published in iScience, shows an increased risk of blood clots in women who have any combination of Factor V Leiden gene mutation, oestrogen use, or common medical conditions – specifically: obesity, high blood pressure, high cholesterol, and kidney disease.

Women with the Factor V Leiden (FVL) gene mutation who had been prescribed oestrogen had more than double the risk of blood clotting compared to women who did not have this mutation. And almost 20% of the women who carry FVL, were prescribed oestrogen and had two medical conditions suffered a blood clot. The presence of the FVL gene made a substantial difference to risk, with only around 5% of women taking oestrogen and having two conditions suffering a clotting event.

The study also found that a woman with obesity, hypertension, high cholesterol, and kidney disease (not uncommon in a clinical setting) had an 8 times greater chance of blood clotting compared to a woman with none of these conditions. This amounted to roughly one in every six women with the four conditions in the study suffering a blood clot. Three medical conditions meant a five times greater chance of blood clotting, and two medical conditions meant a two times greater chance.

One in three women who had the FVL gene mutation and three of the medical conditions examined also suffered a blood clotting event.

The researchers examined the health data of 20 048 British-Bangladeshi and British-Pakistani women from the Genes & Health project, a large community-based genetics study. While oestrogen use, FVL, and common medical conditions are all known risk factors of blood clots, studies have not looked at the combined risk of these factors together on blood clot prevalence.

Women are commonly prescribed oestrogen, both through oral contraception containing the hormone and as part of post-menopausal hormone replacement therapy.

Professor Sir Mark Caulfield, from Queen Mary University of London, said: “Our study gives a more complete picture of blood clotting in Bangladeshi and Pakistani communities who have previously been underrepresented in research.

“Genetic testing of the FVL gene mutation could give a clearer sense of someone’s personalised risk of this potentially fatal complication if they were prescribed oestrogen.”

Source: Queen Mary University London

Categories : Mental HealthTags :

‘All Work and no Play’ Really does Make ‘Jack a Dull Boy’

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Photo by Tim Gouw on Unsplash

A Journal of Personality-published study across three countries discovered people who prioritised achievement over enjoyment were less happy on the next day. Whereas those who aimed for freedom said they had a 13% increase in well-being, recording better sleep quality and life satisfaction.

And participants who tried to relax and follow their hobbies recorded an average well-being boost of 8% and a 10% drop in stress and anxiety.

Dr Paul Hanel from the University of Essex worked with colleagues at the University of Bath on the study, which explored for the first time how following various values impacts happiness. “We all know the old saying ‘All work and no play makes Jack a dull boy’ and this study shows it might actually be true,” Dr Hanel said. “There is no benefit to well-being in prioritising achievement over fun and autonomy.

“This research shows that there are real benefits to having a balanced life and taking time to focus on enjoying ourselves and following individual goals. Ironically by doing this, people could in fact be more successful as they will be more relaxed, happier and satisfied.”

The study, called Value Fulfilment and Well-being: Clarifying Directions Over Time, examined more than 180 people in India, Turkey and the UK.

They filled in a diary across nine days and recorded how following different values affected them.

Interestingly all nationalities reported the same results with the following of ‘hedonism’ and ‘self-direction’ values leading to increased happiness.

‘Achievement’ and ‘conformity’ values had no impact on happiness whatsoever.

However, the researchers believe achievement could impact on happiness when linked to job satisfaction or the amount of days worked.

Professor Greg Maio, University of Bath, said: “This multination project was an exciting foray into questions about how values affect well-being in day-to-day life.

“People often spend most of their days working hard for their daily income, studies, and careers.

“Against this backdrop, where achievement-oriented values have ring-fenced a great portion of our time, we found that it helps to value freedom and other values just enough to bring in balance and recovery.

“In the future, it will be interesting to consider how this pattern interacts with relevant traits, such as conscientiousness, and situational contexts, such as type of employment.”

It is hoped the research will now influence mental health provision and influence therapeutic give to clients.

Dr Hanel added: “Our research further shows that it might be more important to focus on increasing happiness rather than reducing anxiety and stress, which is of course also important, just not as much.”

Source: University of Essex

Categories : Genetics PaediatricsTags :

Genetics can Make Paediatric Medicines Taste Sweeter

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Photo by cottonbro studio

Paediatric medicines often come in a sweetened liquid form for compliance in ingesting it, but if it’s too palatable, a child may empty an entire bottle and poison themselves. But children can perceive taste in different ways. A new study published in the International Journal of Molecular Sciences uncovers genetic variations in how sweetness of medicine is perceived, with adult participants of African descent finding it than those of European descent.

A multidisciplinary research group specialising in paediatrics, genetics, and psychophysics, co-led by Julie A. Mennella, PhD, Principal Investigator at the Monell Chemical Senses Center, has identified wide variation in the sensory perception of a paediatric formulation of ibuprofen. Some were tied to genetic ancestry, and some were not. These findings indicate that a range of factors come into play in determining how a medicine tastes to an individual. Their work is the first in a series of studies funded by the National Institutes of Health to look at variation in the taste of medicines.

“Taste is personal and determining how individuals differ and why is critical to understanding medication adherence and personal risks,” said Mennella. Bitter taste and irritating sensations in the throat are the top reasons for non-compliance, as a child (or adult) is less likely to ingest a medicine that is unpleasant (or tastes bad). However, if a child finds the medicine bottle uncapped and finds it tastes sweet like candy, they may ingest too much. Discovering how individuals differ in sensory perception is especially key when it comes to liquid ibuprofen, which accounts for many unintentional poison exposures among children younger than six years old in the US, according to the US Poison Centers.

“Sweetening medicines like ibuprofen is a delicate balance between having it taste good enough that kids take it, but bitter enough that, should they get unguarded access to it, it’s irritating enough that they stop drinking it and don’t poison themselves,” said Mennella. “We found genetic markers, both ancestry-related and independent of it, that could predict if someone would find a medication irritating or pleasantly sweet. If we get to the point of tailor-making medications in the future, knowing these associations could help us design taste specifically for each child in the not-so-distant future.”

The study included 154 adult panellists from Philadelphia, who represented the diversity of their city. According to a genome-wide association study, 63 had African ancestry, 51 European, 13 South Asian, seven East Asian, and seven American. They underwent training in sensory methods and then rated the sweetness, irritation, bitterness, and palatability of a paediatric formulation of a berry-flavoured ibuprofen after swallowing, and also after just tasting it without swallowing.

Researchers found that panellists of African genetic ancestry had fewer chemaesthetic sensations such as tingling or an urge to cough, rated the medicine as tasting sweeter and more palatable than those of European genetic ancestry. Researchers also found a novel association between the TRPA1rs1198875 genetic variation and tingling sensations, independent of ancestry. This is significant as TRPA1 is a family of neuron receptors that are involved in sensory neural response to a variety of chemical irritants found in foodstuff and other medicines.

Discovering both an ancestry-related link and non-ancestry-related genetic variation to taste and irritation perception shows that who perceives a medicine as palatable or not is a complicated picture and must consider a variety of factors.

This first study was conducted with adults because the sensory measures were complex and included several hour-long test sessions. That does not mean future tests should not include children, Mennella said, adding that this is just the first in a line of studies on the taste of paediatric medicines and methods need to be developed to measure sensory irritation in children. “This is a small study, but it is the first step in showing how research on diverse populations is needed to be able to unravel the genetic, cultural, dietary, and developmental paths that underlie medicine adherence and also risk for poisoning,” said Mennella. “It’s looking at both sides of the same, very important coin.”

Findings from this research will affect how sensory tests can be designed in the future. Since participants did both swallow and sip-and-spit tests, the team was able to determine that just tasting medicine allowed predictions and perceptions after swallowing, which could simplify future studies in different age groups. Other studies as part of this National Institutes of Health grant are ongoing, including determining the variation and acceptance of medicines in children.

Source: Monell Chemical Senses Center

Categories : Obstetrics & GynaecologyTags :

New Intrauterine Device Rapidly Controls Postpartum Haemorrhage

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Photo by Jonathan Borba on Unsplash

A study led by Columbia University obstetricians has shown that a new intrauterine device can rapidly control postpartum haemorrhage, a major cause of severe maternal morbidity and death, in real-world situations.

“Our findings show that the device is an important new tool in managing postpartum bleeding,” says Dena Goffman, MD, professor of obstetrics and gynaecology at Columbia University and senior author of the study, which is published in the journal Obstetrics & Gynecology.

“We had previously shown that the device worked well with patients who were experiencing relatively minor bleeding, so it’s really reassuring to see that the device worked almost as well among a wider range of patients and when used by many different doctors.”

Overall, the device succeeded in controlling haemorrhage in 93% of vaginal deliveries and 84% of caesarean deliveries.

Major cause of severe maternal morbidity and death

Shortly after birth and delivery of the placenta, the uterus contracts and closes off the blood vessels that nourished the placenta. Failure of the uterus to contract after delivery can result in prolonged and excessive blood loss, which may necessitate blood transfusions, ICU admission, or surgery to try to stop the bleeding and, if needed, removal of the uterus.

“Less than 10% of people who give birth will have excessive postpartum bleeding, but when it happens, it can get really serious really fast,” says Goffman, who co-authored the most recent guidelines from the American College of Obstetrics and Gynecology for the treatment of postpartum haemorrhage.

Current treatment options not ideal for all patients

To stop excessive bleeding, clinicians usually start by manually stimulating the uterus and giving medications that help the uterus contract, but some of these drugs are not safe for patients with hypertension or asthma. When medication fails or isn’t an option, patients may be treated with a balloon-like tamponade device that is inserted into the uterus and controls bleeding by placing pressure on the uterine wall.

Balloon tamponade devices have a high success rate, but this treatment has an impact on the patient and family experience. “The balloon often stays in the uterus for 12 to 24 hours until the uterus is well-contracted, and during that time the patient can’t sit up in bed, can’t walk around, can’t easily care for the baby,” Goffman says.

New device approved in 2020

In 2020, the FDA approved a new intrauterine device to control postpartum bleeding that uses low-level suction to promote uterine contractions.

“With postpartum haemorrhage being one of the most preventable causes of maternal morbidity and mortality, practice-changing innovation was needed to better equip our teams and care for our patients,” says Mary D’Alton, MD, chair of the Department of Obstetrics & Gynecology at Columbia University Vagelos College of Physicians and Surgeons and national leader of the clinical trial that first tested the safety and efficacy of the device.

In that initial trial, which led to FDA approval, the device controlled bleeding in a median of 3 minutes among 106 patients experiencing relatively minor blood loss after childbirth and was removed about 3 hours after insertion. Most patients in the trial delivered vaginally. The trial also excluded patients with preterm births < 34 weeks.

Highly effective in real-world conditions

The current study, which included more than 800 patients giving birth at 16 hospitals, was designed to study the effectiveness of the new device outside of a controlled clinical trial. One third of the patients in the new study had a caesarean, and 50 patients had a preterm birth < 34 weeks.

Median blood loss volume before device insertion was also higher in the new study, reflecting a greater range in blood loss, with some patients losing substantial amounts of blood (up to 3000mL). Most patients had been treated with medications to manage postpartum bleeding prior to device insertion.

Treatment with the new device was successful in 93% of patients who had a vaginal birth and 84% of patients who had a caesarean birth (similar to efficacy with intrauterine balloon devices). For most patients, the device brought bleeding under control in five minutes. Treatment success rates were higher in patients with less blood loss prior to device insertion.

Next steps

The researchers say that early recognition of postpartum hemorrhage and timely intervention are crucial in managing the condition and preventing potentially life-threatening complications.

“Postpartum haemorrhage is a treatable condition,” Goffman says. “Delivery teams need to be attuned to recognising it quickly and managing it in a seamless and sequential manner before a patient experiences significant blood loss.”

Additional studies comparing the new device with other treatments for postpartum haemorrhage are being planned to determine if using the device earlier produces better outcomes.

“Until we have more data, we’re using the new intrauterine device after medications have been tried,” Goffman says. “But for patients with underlying conditions who cannot be treated with one or more of our available medications, the device is a critically important tool to have.”

Source: Columbia University Irving Medical Center

Categories : GastrointestinalTags :

Silent but Violent: Taurine-consuming Bacteria Protects the Gut with Toxic Gas

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Photo by Pablo Stanic on Unsplash

Researchers have discovered a new intestinal bacterim that feeds exclusively on taurine and produces the foul-smelling gas hydrogen sulfide. The results, currently published in Nature Communications, show that Taurinivorans muris protects against Klebsiella and Salmonella, two important pathogens.

Chemical warfare in the gut

One of the ways the gut microbiome helps regulated health is in contributing to the levels of hydrogen sulfide – the toxic gas responsible for foul-smelling farts. Having small amounts of hydrogen sulfide in the gut is a good thing; in fact, it’s essential for a number of physiological processes, and can even protect against pathogens. Hydrogen sulfide-producing microbes in the gut may help “choke out” oxygen-dependent pathogens such as Klebsiella, making it harder for them to colonise. However, excessive levels can have negative consequences and have been associated with gut inflammation and damage to the intestinal lining.

Taurine plays yet another a role

The bacterium Bilophila wadsworthia is one of the most important taurine utilizers in humans. In the current study, researchers led by Alexander Loy at CeMESS, the Centre for Microbiology and Environmental Systems Science of the University of Vienna, have discovered a new genus of hydrogen sulfide-producing bacteria in the mouse intestine. “The bacterium we described has a rather unbalanced diet,” explains Loy, “it specialises in consuming taurine.” Taurine is a semi-essential amino acid, synthesised in small amounts in the liver but mostly obtained through the diet – especially meat, dairy and seafood. 

Like hydrogen sulfide, taurine is implicated in a plethora of physiological processes. Recent studies have found a link between taurine and healthy ageing – it seems this nutrient may stave away age-related disease. In light of these findings, the discovery of a new gut microbe that feeds exclusively on taurine (aptly named Taurinivorans muris) is another piece of an exciting puzzle. “By isolating the first taurine degrader in the mouse gut, we’re one step closer to understanding how these gut microbes mediate animal and human health” explains Huimin Ye, lead author of the study. 

To access sufficient taurine in the gut, however, Taurinivorans muris needs the help of other gut microbes to release it from bile acids. Taurine-containing bile acids are produced in the liver and are increasingly released into the intestine during a high-fat diet to help our body digest fats. The activities of the bacteria in the intestine in turn influence the bile acid metabolism in the liver. The results of the Viennese researchers therefore also contribute to a better understanding of these complex interactions in bile acid metabolism, which has an impact on processes and diseases throughout the body.

Taurine-degrading microbes choke out pathogens

One of the most important functions of the symbiotic microbes in the gut is to defend against pathogens. The microbiome has a versatile arsenal of protective mechanisms – and utilising taurine to create hydrogen sulfide is one of them. “Hydrogen sulfide may suppress the oxygen-dependent metabolism of some pathogens,” explains Ye. In the present study, the researchers found that Taurinivorans muris has a protective role against Klebsiella and Salmonella, two important gut pathogens. “The protective mechanism of Taurinivorans muris against pathogens may be via hydrogen sulfide but is essentially not yet fully understood” adds Alexander Loy. Taurine is one of the most important sources of hydrogen sulfide production in the gut. The study thus generates basic knowledge on the physiological interactions between the different gut microbes and their hosts, which is necessary to develop new microbiome-based therapies.

Source: EurekAlert!

Categories : Mental Health PaediatricsTags :

ADHD Medication Errors have Increased Nearly 300%

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In a new study published in Pediatrics, researchers investigated the characteristics and trends of out-of-hospital attention-deficit/hyperactivity disorder (ADHD) medication errors among children and teenagers reported to US poison centres from 2000 through 2021. Their results showed that the number of medication errors increased by nearly 300%, with over half resulting from an accidental double dosage.

ADHD is among the most common paediatric neurodevelopmental disorders. In 2019, nearly 10% of children in the US had a diagnosis of ADHD, roughly half of whom currently have a prescription for ADHD medication.

According to the study by at the Center for Injury Research and Policy and Central Ohio Poison Center at Nationwide Children’s Hospital, the annual number of ADHD-related medication errors increased 299% from 2000 to 2021. During the study period, there were 87 691 medication error cases involving ADHD medications as the primary substance among this age group reported to poison centres, yielding an average of 3985 individuals annually. In 2021 alone, 5235 medication errors were reported. The overall trend was driven by males, accounting for 76% of the medication errors and by the 6–12-year-old age group, accounting for 67% of the errors. Approximately 93% of exposures occurred in the home.

Among medication errors involving ADHD medications as the primary substance, the most common scenarios were:

  • 54% – “Inadvertently taken/given medication twice”
  • 13% – “Inadvertently taken/given someone else’s medication”
  • 13% – “Wrong medication taken/given”

“The increase in the reported number of medication errors is consistent with the findings of other studies reporting an increase in the diagnosis of ADHD among US children during the past two decades, which is likely associated with an increase in the use of ADHD medications,” said Natalie Rine, PharmD, co-author of the study and director of the Central Ohio Poison Center at Nationwide Children’s Hospital.

In 83% of cases, the individual did not receive treatment in a health care facility; however, 2.3% of cases resulted in admission to a health care facility, including 0.8% to a critical care unit. In addition, 4.2% of cases were associated with a serious medical outcome. Some children experienced agitation, tremors, seizures, and changes in mental status. Children under age 6 were twice as likely to experience a serious medical outcome and were more than three times as likely to be admitted to a health care facility than 6–19-year-olds.

“Because ADHD medication errors are preventable, more attention should be given to patient and caregiver education and development of improved child-resistant medication dispensing and tracking systems,” said Gary Smith, MD, DrPH, senior author of the study and director of the Center for Injury Research and Policy at Nationwide Children’s Hospital. “Another strategy may be a transition from pill bottles to unit-dose packaging, like blister packs, which may aid in remembering whether a medication has already been taken or given.”

Although prevention efforts should focus on the home setting additional attention should be given to schools and other settings where children and adolescents spend time and receive medication.

Source: Nationwide Children’s Hospital