Tag: 21/11/25

Categories : Substance UseTags : Leave a comment

Study Untangles the Complex Relationship Between Cannabis and Binge Drinking

On By ModernMedia
Photo by Pavel Danilyuk on Pexels

Binge drinking is most common among younger adults, and using cannabis during late adolescence or early adulthood is known to increase the risk of engaging in binge drinking. Now, new research from the Arizona State University Department of Psychology shows that this increase in risk of binge drinking from cannabis use varies with age, peaking around age 20.

“We found that during ages 18 to 20, cannabis motivates people to binge drink more often, while later in adulthood, around age 24, it motivates them to binge drink less. This dichotomy has consequences for prevention and treatment efforts,” said Jack Waddell, assistant professor of psychology at ASU and first author on the study.

The study used cannabis use and alcohol consumption data from the National Consortium on Alcohol and Neurodevelopment in Adolescence, a long-term study of over 500 participants with sites in California, Oregon, North Carolina and Pennsylvania. The work was published in Alcohol Clinical and Experimental Research.

Not just one substance

Waddell described the interaction of cannabis use and alcohol consumption as a complex relationship. 

He has previously found that individuals who use both alcohol and cannabis report higher rates of substance use disorder than those who use just one. Yet, he has also found that many individuals who use both alcohol and cannabis perceive using them together as being protective against some of the negative consequences of excessive drinking.

In the current study, he and his collaborators expected using cannabis to consistently increase the likelihood of the study participants engaging in binge drinking, not for it to flip from enabling excessive drinking in late teens and early 20s to blunting it around age 24.

“People are reducing their binge drinking but they’re switching to cannabis. This can be viewed positively from a harm-reduction standpoint, but it is important to understand that there are still a lot of risks associated with cannabis use,” Waddell said.

Digging into the dynamics of substance use

Waddell wants to understand how people end up using more than one substance, and to do this, he plans to study how people think about and use substances on a day-to-day basis.

“What is it that motivates the transition from using one substance to more than one? Is it someone’s affective experiences – their emotions and moods – whenever they’re using alcohol or cannabis that makes them want to add the other? Is it the social environment?” he asked.

Going forward, Waddell plans to use technology-enhanced momentary assessments, which are questionnaires or check-ins delivered by push notification on an app or text message, to study people’s behavior in the moment. 

Having a finer-grained level of access to how different kinds of substance use interact with and influence each other will lead to better treatment and prevention strategies.

Categories : Metabolic Disorders Surgeries & ProceduresTags : Leave a comment

No Increased Safety Risk for Obese Patients Undergoing Shoulder Replacement Surgery

On By ModernMedia

Underweight patients may face higher risk of poor outcomes after surgery

Source: Pixabay CC0

Higher BMI is not linked to increased risk of death or other complications following shoulder replacement surgery, according to a new study by Epaminondas Markos Valsamis from the University of Oxford, UK, and colleagues publishing November 20th in the open-access journal PLOS Medicine.

Joint replacement surgeries – including hip, knee and shoulder replacements – can significantly improve quality of life. Many patients with obesity are denied these procedures despite a lack of formal recommendations from national organisations. Evidence on the risks of joint replacement surgery in patients with obesity is limited and mixed.

In this study, researchers analysed more than 20 000 elective shoulder replacement surgeries performed across the UK and Denmark to see whether BMI was associated with death or other complications.

Compared to patients with a healthy BMI (21.75 kg/m2), patients with obesity (BMI 40 kg/m2) had a 60% lower risk of death within the year following surgery. Those considered underweight (BMI <18.5 kg/m2) had a slightly higher risk of death. The study does not support restricting patients with a high BMI from having elective shoulder replacement surgery, contrary to evidence that some hospitals are starting to restrict patients.

One main limitation of this study was the small sample size of the underweight population (131 for the UK data, 70 for the Denmark data). However, this was a large study that consistently showed a lower risk of death and complications in patients with obesity undergoing shoulder replacement surgery across multiple outcomes and two countries. The results can help patients, surgeons, and policymakers make informed decisions about who should be considered fit for these surgeries.

Lead author Epaminondas Markos Valsamis says, “Shoulder replacements offer patients the opportunity for excellent pain relief and improved quality of life. Our research shows that patients with a higher BMI do not have poorer outcomes after shoulder replacement surgery.”

Senior author Professor Jonathan Rees adds, “While BMI thresholds have been used to limit access to joint replacement surgery, our findings do not support restricting higher BMI patients from accessing shoulder replacement surgery.”

Provided by PLOS

Categories : TransplantsTags : Leave a comment

New Metric Better Predicts Which Drug-induced Liver Injury Patients Need Transplant

On By ModernMedia

Patients who took herbal or dietary supplements found to have lowest likelihood of survival

Photo by Myriam Zilles on Unsplash

A newly developed tool, called the DILI-Inpt prognostic score, can predict patients with drug-induced liver injury who are unlikely to survive without a liver transplant.

In study results published in Clinical Gastroenterology and Hepatology, the DILI-Inpt prognostic score outperformed existing systems in identifying which hospitalised patients with severe idiosyncratic drug-induced liver injury were unlikely to recover on their own.

“We have struggled for many years to identify which patients with severe DILI may need to be evaluated for emergency liver transplantation, versus recovery with supportive care,” said Robert Fontana, MD, Michigan Medicine hepatologist, professor of internal medicine and the study’s senior author.

“The stakes are high. And it is made even more a difficult due to the small number of prior cases we have seen. This study provides important data for all of us to use and help manage our patients.”

The acronym DILI refers to idiosyncratic drug-induced liver injury, an uncommon condition caused by a variety of drugs and herbal and dietary supplements.

While most patients who experience such liver injuries recover after discontinuation of the culprit drugs, some advance to acute liver failure and may require liver transplantation.

The DILI-Inpt prognostic score aims to better assess such patients so that they can be more quickly sent to a liver transplant centre or placed on the waiting list.

This study used data from 305 adults from 1998 to 2019, enrolled in a national database of acute liver failure and acute liver injury patients. The drugs that induced liver injuries in these patients varied and included antimicrobials (42.6%), herbal-dietary supplements (16%) and psychoactive drugs (9.8%).

After 21 days, 110 patients (36%) spontaneously survived – ie, recovered on their own after discontinuing the drug – while 115 required liver transplant and 80 died. For these 305 patients, a variety of tests results were analysed, including total bilirubin, serum ALT and creatinine values.

Using multivariable logistic regression modeling, DILI-Inpt prognostic score was developed to predict which patients were mostly likely to require liver transplant and at highest risk of death. The Area Under the Receiver Operating Characteristic Curve for DILI-Inpt prognostic score was 0.86 and significantly higher than that of MELD (0.79 AUROC score) and King’s College Criteria (0.63).

These results suggest that the DILI-Inpt prognostic score, which is composed of two readily available blood tests (total bilirubin and INR values) and two clinical parameters (encephalopathy grade and use of herbal products), better predicts which patients will not spontaneously survive than these existing scoring systems.

Of note, the diagnosis of drug-induced liver injury is frequently delayed or missed by the need to exclude more common causes of liver injury and its low incidence.

Since DILI patients have a low likelihood of recovery, there is an urgent need to quickly identify which patients might require liver transplant.

“Another important finding in our study was that patients with herbal and dietary supplement hepatotoxicity had the lowest likelihood of survival and that the proportion of herbal cases was increasing over time in the United States,” Fontana said.

“Our data indicates that further research as to why and how botanical products may lead to potentially severe liver injury in otherwise healthy people is needed.”

Source: University of Michigan

Categories : Neurology Regenerative MedicineTags : Leave a comment

Study Reveals the Dual Role for a Protein Critical for Healing Nerve Damage

On By ModernMedia

Sarm1 appears to be essential for regeneration

Source: CC0

Nerve damage can be an unfortunate side effect from an accident, illness or even certain treatments, like chemotherapy. Fortunately, the peripheral nervous system can heal itself to a certain extent, albeit very slowly. Researchers are still trying to understand this natural healing process in order to improve it. A recent study published in Science Translational Medicine sheds new light on this.

This mouse-based study from the University of Michigan adds to the evidence regarding a specific protein inside of the nerves, called Sarm1, that seems key for regeneration. Previous studies have revealed that when Sarm1 is activated, it sets off the degenerative process in nerves. The thinking has been that for conditions like chemotherapy induced peripheral neuropathy, diabetes, or nerve trauma, blocking Sarm1 would beneficially block the breakdown of nerves.

But what else would blocking Sarm1 effect?

“We know that nerve breakdown after an injury is quite efficient, and the breakdown is what Sarm1 controls. So, there must be a biological reason for this breakdown to be so quick and efficient,” said Ligia B. Schmitd, PhD, of the Department of Cell and Developmental Biology, lead author of the study.

Schmidt is a research fellow in the lab of Roman Giger, PhD, co-senior author with Ashley Kalinski of the University of South Carolina.

Using mice bred to lack Sarm1 and subjecting them to peripheral nerve injury, the team could observe drastic changes to the distal nerve environment, including fewer blood-borne immune cells resulting in reduced nerve inflammation.

“These cells are important because they have to enter the injured nerve to clean up all of the debris,” said Schmitd.

More importantly, their study revealed a critical effect on Schwann cells, which line and support the peripheral nerves.

Normally following an injury, Schwann cells will convert to a repair state in which they express different genes and proteins to migrate and proliferate in order to regrow the axon, the long projecting portion of the neuron.

But without Sarm1, “the Schwann cells are just stuck there,” said Schmitd.

In essence, Sarm1 controls both nerve degeneration and regeneration through its effect on Schwann cells.

The team also noted that a lack of Sarm1 seemed to boost the nerve’s efforts to regrow, but without activating the repair Schwann cells, these efforts were much less efficient.

“For a long time, we’ve thought that simply preventing nerve breakdown would be a good thing. What our study now shows is that this early breakdown also sends powerful signals to Schwann cells and immune cells that are needed for efficient repair, so any future therapy that targets Sarm1 will have to preserve that delicate balance between protection and regeneration,” said Giger, professor in the Department of Cell and Developmental Biology.

Schmitd notes that the study needs to be done in other animal models and with other proteins involved in nerve repair, “but if this proves to be an important mechanism for triggering the repair Schwann cell state, then down the road, fixing this response could help humans regenerate peripheral nerves.”

Source: University of Michigan Medicine

Categories : Cancer NeurologyTags : Leave a comment

Study Links Food Insecurity to Tumour Growth in Paediatric Neuroblastoma

On By ModernMedia

How food insecurity may biologically intensify neuroblastoma growth, bridging social determinants of health and cancer biology 

Image Credit: Justine Ross, Michigan Medicine

Neuroblastoma remains one of the deadliest childhood malignancies, accounting for a disproportionate number of paediatric cancer deaths worldwide.

Despite major therapeutic advances, survival rates remain lower for children from socioeconomically disadvantaged families, a pattern long observed and poorly understood at the biological level.

Extending earlier National Institute of Health’s Children’s Oncology Group findings that linked poverty to poorer survival in paediatric cancers, investigators at University of Michigan Health C.S. Mott Children’s Hospital set out to develop the first experimental model to test how social determinants might influence tumour biology itself.

The team led by Erika Newman, MD, Section Head of Pediatric Surgery and Associate Director for Health Equity at the Rogel Comprehensive Cancer Center developed an innovative murine cancer model that simulated food insecurity by intermittently varying chow access, mirroring the unpredictable nutrition many families experience.

The study, recently published in Communications Biology, used established neuroblastoma validated xenograft models to observe how this stressor affected tumour growth and biologic responses.

The results were striking: the experimental group exposed to food insecurity developed significantly larger and bulkier tumours, accompanied by persistent elevation of stress hormones (corticosterone) and activation of tumour survival pathways.

“Our work builds on decades of clinical evidence linking poverty and food insecurity to poorer cancer outcomes,” said Newman.

“We set out to define the biology behind those disparities, to show how social conditions can become embedded in the body and influence how tumours grow.”

The work provides a translational framework linking social determinants of health to molecular pathways of cancer progression, paving the future for studies that explore how interventions addressing nutrition and stress might improve treatment response.

“This model gives us a scientific bridge between social context and cancer biology,” stated Newman.

“It shows that the environments our patients live in, access to food, stability, and safety are not background conditions. They are part of the biology we must confront if we want equitable outcomes.”

The research arrives at a moment of renewed concern over federal nutrition programs, with potential SNAP benefit interruptions amid government budget negotiations.

Newman emphasises that these findings reinforce the urgency of policies ensuring consistent food access for vulnerable children and families.

Newman stresses that health care must account for the realities in which families live.

She calls for systematic screening of social determinants like food insecurity and economic strain within paediatric and oncology practices, ensuring that medical care addresses both biologic and social drivers of outcome disparities.

Source: University of Michigan Medicine