Tag: 29/10/25

Categories : AgeingTags : Leave a comment

New Research Reveals Longevity Gains Slowing, Life Expectancy of 100 Unlikely

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Photo by Tim Kilby on Unsplash

A new study co-authored by a University of Wisconsin-Madison professor finds that life expectancy gains made by high-income countries in the first half of the 20th century have slowed significantly, and that none of the generations born after 1939 will reach 100 years of age on average.

Published in the journal Proceedings of the National Academy of Sciences, the study by Héctor Pifarré i Arolas of the La Follette School of Public Affairs, José Andrade of the Max Planck Institute for Demographic Research, and Carlo Giovanni Camarda of the Institut national d’études démographiques analysed life expectancy for 23 high-income and low-mortality countries using data from the Human Mortality Database and six different mortality forecasting methods.

“The unprecedented increase in life expectancy we achieved in the first half of the 20th century appears to be a phenomenon we are unlikely to achieve again in the foreseeable future,” according to Pifarré i Arolas. “In the absence of any major breakthroughs that significantly extend human life, life expectancy would still not match the rapid increases seen in the early 20th century even if adult survival improved twice as fast as we predict.”

From 1900 to 1938, life expectancy rose by about five and a half months with each new generation. The life expectancy for an individual born in a high-income country in 1900 was an average of 62 years. For someone born just 38 years later in similar conditions, life expectancy had jumped to 80 years on average.

For those born between 1939 and 2000, the increase slowed to roughly two and a half to three and a half months per generation, depending on the forecasting method. Mortality forecasting methods are statistical techniques that make informed predictions about future lifespans based on past and current mortality information. These models enabled the research team to estimate how life expectancy will develop under a variety of plausible future scenarios.

“We forecast that those born in 1980 will not live to be 100 on average, and none of the cohorts in our study will reach this milestone. This decline is largely due to the fact that past surges in longevity were driven by remarkable improvements in survival at very young ages,” according to corresponding author Andrade.

At the beginning of the 20th century, infant mortality fell rapidly due to medical advances and other improvements in quality of life for high-income countries. This contributed significantly to the rapid increase in life expectancy. However, infant and child mortality are now so low that the forecasted improvements in mortality in older age groups will not be enough to sustain the previous pace of longevity gains.

While mortality forecasts can never be certain as the future may unfold in unexpected ways – by way of pandemics, new medical treatments or other unforeseen societal changes – this study provides critical insight for governments looking to anticipate the needs of their healthcare systems, pension planning and social policies.

Although a population-level analysis, this research also has implications for individuals, as life expectancy influences personal decisions about saving, retirement and long-term planning. If life expectancy increases more slowly as this study shows is likely, both governments and individuals may need to recalibrate their expectations for the future.

Source: La Follette School of Public Affairs

Categories : Respiratory DiseasesTags : Leave a comment

Study Reveals How a Stubborn Lung Infection Evolves Inside Patients over Years

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Researchers wanted to know what allows the infection to hang on or come back, and whether it develops new tricks or resistances while living inside the lungs.

Photo by Anna Shvets

Researchers at Trinity Translational Medicine Institute (TTMI) and the Irish Mycobacterial Reference Laboratory at St James’s Hospital have uncovered how the bacterium Mycobacterium avium – a leading cause of difficult-to-treat chronic lung infections – changes and adapts inside patients over many years of illness. Their findings, published in Genome Medicine, could help doctors understand why M. avium infections come back and why antibiotics sometimes fail.

The team undertook this research to understand how M. avium manages to survive for years in people’s lungs, even during long courses of antibiotics. This bacterium causes a type of chronic lung infection that’s becoming more common around the world. By looking closely at its genetic code, the team hoped to see how it changes inside the body and why it can be so difficult to clear.

Treating M. avium lung disease is difficult – patients often need 12 months or more of several antibiotics, and treatment still fails in up to half of cases. Many patients get sick again even after therapy.

The team used whole-genome sequencing to analyse nearly 300 bacterial samples from patients in Ireland, the UK and Germany, including 20 Irish patients treated at St James’s Hospital. By reading the DNA of these bacteria over time, the scientists tracked how M. avium evolves, swaps strains and develops resistance while living in the human lung.

They found that infection is often not caused by one single long-term strain, but by repeated reinfection with new ones, sometimes closely related to strains seen in other European countries—hinting at shared environmental sources. The bacterium acquires roughly one new genetic change per year, and most importantly, the team found that thirteen specific genes showed signs of adaptation to antibiotics, immune attack and low-oxygen stress.

Lead author Dr Aaron Walsh, researcher in the Trinity Translational Medicine Institute said:

 “Our study shows that M. avium can evolve in real time inside the lung. Understanding which genes help it survive may point us towards new treatment targets for this increasingly common and stubborn infection.”

This is the first study to use whole-genome sequencing to follow M. avium infections inside patients over many years, revealing how the germ evolves within the lungs.

Key findings from study

  1. Reinfection is common: Many patients picked up new strains over time, suggesting they were reinfected from the environment rather than suffering relapse of the same infection.
  2. International connections: Some Irish strains were genetically almost the same as ones from UK and Germany.
  3. Thirteen key genes changed under pressure: These genes help the bacterium cope with antibiotics, low oxygen, or attack by the immune system.
  4. Resistance can appear during treatment: We saw changes in a gene linked to rifampicin resistance in two patients receiving that drug.

Uniquely, in this study researchers found that thirteen genes under “positive selection” was new for M. avium.

Dr Emma Roycroft, Specialist Medical Scientist in the Irish Mycobacterial Reference Laboratory. “Some of those genes weren’t previously linked to survival of M. avium inside the body. For example, one involved in handling oxidative stress and another in forming biofilms. This has highlighted important pathways that could be targeted with new treatments. It was also striking that Irish, British and German samples were so closely related, even though the patients had never met.”

The team’s next steps are:

  • Test in the lab how those thirteen genes help the bacterium survive.
  • Use long-read sequencing to see genetic changes that short-read methods miss.
  • Study environmental samples to find where reinfections come from.
  • Expand their research to other patient groups to see if the same patterns occur.

Source: Trinity College Dublin

Categories : Mental HealthTags : Leave a comment

Ketamine no Benefit for Patients Hospitalised with Depression

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Researchers from Trinity College, St Patrick’s Mental Health Services, Queen’s University Belfast, Ireland, investigate use of twice-weekly ketamine infusions as an add-on treatment for inpatients with serious depression

Photo by Sydney Sims on Unsplash

Findings from a randomised and blinded clinical trial investigating repeated ketamine infusions for treating depression have revealed no extra benefit for ketamine when added onto standard care for people admitted to hospital for depression. The paper is published in the journal JAMA Psychiatry.

The KARMA-Dep (2) Trial involved researchers from St Patrick’s Mental Health Services, Trinity College Dublin, and Queens University Belfast, Ireland. It was sponsored by Trinity College Dublin  and led by Declan McLoughlin, Research Professor of Psychiatry at Trinity College Dublin and Consultant Psychiatrist at St Patrick’s Mental Health Services.

Depression has been recognised by the World Health Organization as a leading cause of disability globally.  According to the Health Research Board’s most recent report, there were 15 631 adult admissions to psychiatric services in Ireland in 2023. Similar to previous years, depressive disorders accounted for the highest proportion (about 24%) of all admissions.

Studies show that about 30% of people with depression do not respond sufficiently well to conventional antidepressants, which mostly target monoamine neurotransmitters, for example serotonin, dopamine and noradrenaline.  There is thus a need for new treatments.  One such novel treatment is the dissociative anaesthetic ketamine when given intravenously in low sub-anaesthetic doses. Ketamine works differently to other antidepressants and is believed to mediate its effects in the brain through the chemical messenger glutamate.

Single infusions of ketamine have been reported to produce rapid antidepressant effects, but these disappear within days. Nonetheless, ketamine is increasingly being adopted as an off-label treatment for depression even though the evidence to support this practice is limited. One possibility is that repeated ketamine infusions may have more sustained benefit. However, this has so far been evaluated in only a small number of trials that have used an adequate control condition to mask the obvious dissociative effects of ketamine, e.g. altered consciousness and perceptions of oneself and one’s environment. 

KARMA-Dep 2 is an investigator-led trial, sponsored by Trinity College Dublin and  funded by the Health Research Board. The randomised trial was developed to assess antidepressant efficacy, safety, cost-effectiveness, and quality of life during and after serial ketamine infusions when compared to a psychoactive comparison drug midazolam. Trial participants were randomised to receive up to eight infusions of either ketamine or midazolam, given over four weeks, in addition to all other aspects of usual inpatient care. 

 The trial findings revealed that:

  • There was no significant difference between the ketamine and midazolam groups at the end of the treatment course on the trial’s primary outcome, which was an objective measurement of depression. This was assessed with the commonly used Montgomery-Åsberg Depression Rating Scale (MADRS).
  • There was no significant difference between the two groups at the end of the treatment course on a subjective, patient-rated, scale for depression.  This was assessed with the commonly used Quick Inventory of Depressive Symptoms, Self-Report scale (QIDS-SR-16). 
  • No significant differences were found between the ketamine and midazolam groups on secondary outcomes for cognitive, economic or quality-of-life outcomes. 
  • Despite best efforts to keep the trial patients and researchers blinded about the randomised treatment, the vast majority of patients and raters correctly guessed the treatment allocation. This could lead to enhanced placebo effects.

Speaking about the impact of the findings, Declan McLoughlin, Research Professor of Psychiatry at Trinity College Dublin and Consultant Psychiatrist at St Patrick’s Mental Health Services, said:

“Our initial hypothesis was that repeated ketamine infusions for people hospitalised with depression would improve mood outcomes. However, we found this not to be the case. Under rigorous clinical trial conditions, adjunctive ketamine provided no additional benefit to routine inpatient care during the initial treatment phase or the six-month follow-up period. Previous estimates of ketamine’s antidepressant efficacy may have been overstated, highlighting the need for recalibrated expectations in clinical practice.” 

Lead author of the study, Dr Ana Jelovac, Trinity College Dublin, said:

“Our trial highlights the importance of reporting the success, or lack thereof, of blinding in clinical trials. Especially in clinical trials of therapies where maintaining the blind is difficult, e.g. ketamine, psychedelics, brain stimulation therapies. Such problems can lead to enhanced placebo effects and skewed trial results that can over-inflate real treatment effects.”.

Source: Trinity College Dublin

Categories : Obstetrics & Gynaecology Substance UseTags : Leave a comment

Study Explores How Prenatal Cannabis Exposure May Affect Foetal Brain Development

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Source: Pixabay CC0

Researchers at UTHealth Houston are examining the biological effects of prenatal cannabis exposure and its potential impact on foetal brain development. Supported by a $3.7 million grant from the National Institutes of Health and the National Institute on Drug Abuse, the study aims to improve screening tools, public health guidance, and prenatal care strategies for pregnant people who use cannabis.

Led by Laura Goetzl, MD, MPH, a professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at McGovern Medical School at UTHealth Houston, the five-year grant will fund the study, “Foetal neuronal extracellular vesicle biomarkers of in-utero effects of maternal cannabinoid use and human foetal brain development and neurobehavioral outcomes.”

“In recent years, cannabis use among pregnant women has increased, either recreationally or to help relieve nausea and vomiting during pregnancy,” Goetzl said. “Despite this rise, the effects on a baby’s brain are not well understood. Our hope through this research is that we can better identify risk factors and help health care providers give expecting mothers the best possible guidance.

The study will explore early biological signs, or biomarkers, to show how cannabis exposure influences a baby’s developing brain.

“During pregnancy, small bubbles called neuronal extracellular vesicles travel from the foetus into the mother’s bloodstream,” Goetzl said. “Through studying these small particles, we hope to gain valuable insight into foetal brain development without invasive testing.”

In collaboration with the University of Colorado, the research study will focus on how prenatal cannabis exposure may influence brain growth and neurobehavioral outcomes in children, including their potential for developing attention-deficit/hyperactivity disorder (ADHD) or autism later in life.

The project is supported by the National Institute on Drug Abuse of the National Institutes of Health under award number R01DA060319.

Source: UTHealth Houston

Categories : Lab Tests and Imaging Skeletal SystemTags : Leave a comment

When a Limp Isn’t Just a Sprain in Adolescents

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A timely X-ray can save young hips

Frog leg lateral view of the hips. Widening of the growth plate (physis) with blurring and irregularity of the femoral neck (metaphysis). Inferior offset of the head in relation to the neck (early slip).

Slipped Capital Femoral Epiphysis (SCFE) is the most common adolescent hip disorder. It occurs when the ball at the top of the thigh bone (femoral head) slips off the neck of the bone through the growth plate (physis). A bit like an ice cream sliding off a cone… Dr Ryno du Plessis, a renowned orthopaedic and joint replacement surgeon in the Western Cape, talks about what it is and why it is often misdiagnosed.

SCFE usually happens during growth spurts in children aged 9 to 16 years and is more common in boys and in children with obesity, endocrine disorders, or other risk factors.

Why is this problem often missed?

AP view of the hips. ‘Melting ice cream sign’: Femoral head (epiphysis) slipping off the femoral neck (metaphysis) though the growth plate (physis) like an ice cream melting from the cone.

Despite its frequency, SCFE is routinely misdiagnosed or diagnosed late – unfortunately, sometimes months after symptoms start. Studies show that over 50% of SCFE cases are not diagnosed at the first medical visit.

Here’s why:

  • Pain felt in the knee or thigh: Physicians often focus on the wrong joint and the hip is never X-rayed
  • Labeled as a groin strain: Adolescents in sports may be diagnosed with muscle strains or ‘growing pains’
  • Symptoms develop gradually: Children may limp without severe pain, leading to delayed concern
  • Physiotherapy prescribed early: Instead of imaging – patients are referred to physio – delaying diagnosis
  • Lack of hip-specific X-rays: It requires a frog-leg lateral X-ray.

Why does delay matter?

The longer the slip is left untreated, the more serious the outcome. Every week or month of delay increases the severity of the deformity, often silently.

Late diagnosis risks:

  • More severe deformity
  • Loss of bloody supply to the femoral head. This is known as avascular necrosis and can lead to pain, limited movement and eventually, hip collapse and osteoarthritis
  • Early-onset hip arthritis
  • Complex surgery

Children diagnosed early often need just one screw to stabilise the hip. Those who are diagnosed late may face major reconstructive surgery, longer recovery, and reduced hip function for life.

Red flags for parents, teachers and coaches

If you notice any of the following signs in a child or teen – especially those who are overweight – take it seriously and ask for a hip X-ray:

  • Limping for more than a week
  • Complaints of pain in the knee, thigh, groin, or buttock
  • Walking with the foot turned outwards
  • Stiffness or loss of motion in the hip
  • Sudden inability to walk or stand after a minor stumble (may indicate an unstable SCFE)

Radiology – diagnostic challenges

Dr Jaco Greyling, a radiologist from SCP Radiology, says SCFE diagnoses can be delayed due to several factors, including

  • Hip X-rays not ordered by the initial healthcare provider (eg, GP or physiotherapist)
  • Only a single anterior-posterior pelvis projection is performed, whereas a frog-leg lateral view must also be specifically requested by the referring physician. Radiologists should ensure the child returns for this view if it was not initially ordered
  • Findings in the pre-slip phase are subtle and may be missed, even by experienced radiologists

He says, ’the recommended imaging is an anterior-posterior pelvic view which shows malalignment and widening of the growth plate and a frog-leg lateral view, the most sensitive for detecting early or subtle slips.’

‘Key radiological signs,’ says Dr Greyling are:

  • Widening of the growth plate
  • Loss of height of the femoral head
  • Loss of alignment of the anatomical lines that intersect with the femoral head
  • ‘Melting ice cream sign’ slipping off the femoral neck at the growth plate (epiphysis).

Follow-up recommendations:

Dr Greyling suggests repeat imaging within two weeks if symptoms persist, and an early referral to a paediatric orthopaedic surgeon and an MRI for patients with risk factors and ongoing pain.

Who’s at risk?

  • Children aged 9-16 years
  • Boys are at greater risk than girls
  • BMI in the overweight/obese range
  • Family history of hip disorders
  • Endocrine disorders: Hypothyroidism, growth hormone treatment, kidney disease

Treatment

Early SCFE is usually treated with in-situ fixation using one or two screws. The goal is to stabilise the rounded end of a long bone to prevent further slippage.

In cases where both hips are at risk (especially in young or overweight patients), pinning of the opposite hip as well is sometimes recommended to prevent it from occurring.

Severe or late cases have a high risk of AVN, which is the death of bone tissue caused by a disruption in its blood supply, leading to pain, stiffness, and potential bone collapse or joint destruction over time and permanent disability.

The take-home message

SCFE is treatable and preventable if recognised early.

If a child has an unexplained limp, especially with thigh or knee pain, don’t assume it’s just a strain. Ask the doctor directly: “Could this be SCFE? Should we get hip X-rays done?”

One simple question. One X-ray. It could save a child’s hip.