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Having A-Fib Might Raise Odds for Dementia

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By Steven Reinberg 

HealthDay Reporter

MONDAY, March 13, 2023 (HealthDay Information) — The widespread irregular heartbeat generally known as atrial fibrillation (a-fib) might enhance the chance of dementia, a brand new research suggests.

Researchers discovered that folks newly identified with a-fib had a 13% greater danger of growing dementia, the progressive lack of reminiscence and considering abilities. The danger was even greater (65%) amongst those that developed a-fib earlier than age 65 and in individuals who didn’t have persistent kidney illness (20%).

“The well being penalties of atrial fibrillation could also be broader than initially acknowledged in sure people,” stated lead researcher Dr. Nisha Bansal, a professor of drugs on the College of Washington, in Seattle. “A personalised strategy is required to assist inform sufferers of the results of their atrial fibrillation.”

A-fib is the commonest sort of coronary heart arrhythmia (irregular heartbeat), Bansal stated.

“Till now, atrial fibrillation has been strongly linked with the chance of stroke, and the attainable hyperlink with dementia has been unclear,” she stated.

A-fib is a fast, disorganized beating of the center’s higher chamber. Episodes can come and go, or could also be persistent. It might result in blood clots that journey to the mind, inflicting a stroke.

This research does not show that a-fib causes dementia, solely that there seems to be a hyperlink between the 2. Bansal emphasised that not everybody who has a-fib will develop dementia.

“If atrial fibrillation can also be related to dementia, it has necessary medical and public well being implications in terms of the administration of sufferers,” Bansal stated. “Extra analysis is required to grasp the organic mechanisms that designate this affiliation in addition to whether or not remedy of atrial fibrillation would possibly decrease the chance of dementia.”

For the research, Bansal and her colleagues collected information on practically 197,000 sufferers from the Kaiser Permanente well being system in California. Half had been not too long ago identified with a-fib. They had been in contrast with a like quantity with out the situation.

The researchers took steps to offset the affect of different medical circumstances identified to extend dementia danger. Bansal, a kidney specialist, stated it was a shock to discover a higher danger amongst these with out kidney illness and in youthful sufferers.

Her crew will strive subsequent to higher perceive the organic mechanisms linking a-fib and dementia, and the way completely different therapies for irregular heartbeat consider.

It isn’t identified why a-fib would possibly trigger dementia, stated Dr. Laurence Epstein, system director of electrophysiology at Northwell Well being in Manhasset, N.Y., who reviewed the findings.

“One of many issues that we have all the time struggled with is: What’s the potential motive a-fib results in an elevated danger of dementia?” he stated.

Lots of people suppose a-fib might not solely have an effect on the center however blood vessels all through the physique, which could enhance the chance of dementia. “It’s a query this research doesn’t reply,” he stated.

“One factor individuals have considered, since we all know that a-fib results in an elevated danger of stroke, is might there be subclinical strokes or micro-strokes going to the mind that will not manifest themselves as a transparent medical stroke however over time, result in dementia?” he urged. “That is one concern we have all the time had.”

It isn’t clear whether or not a-fib causes dementia or is a marker for different illness processes that enhance the chance for dementia, Epstein stated.

The easiest way to keep away from growing a-fib is to take care of a traditional weight and blood strain, keep away from sleep apnea, get loads of train and eat a nutritious diet, he suggested.

“Managing these issues aggressively might scale back the incidence of atrial fibrillation,” Epstein stated. “However apparently, these are all the identical issues that in case you handle aggressively additionally scale back your danger of dementia.”

He stated one other open query is whether or not treating a-fib — by conserving the center in a traditional (sinus) rhythm — will decrease dementia danger.

Drugs can assist keep a traditional coronary heart rhythm, however they do not work for everyone and might have critical unwanted effects, Epstein stated.

The opposite choice is ablation, a remedy by which warmth is used to deaden the areas within the coronary heart which are inflicting a-fib. This may be efficient in the long run but it surely does not work for everybody, Epstein famous.

The findings had been revealed on-line March 8 within the Journal of the American Coronary heart Affiliation.

Extra info

For extra on atrial fibrillation, head to the American Coronary heart Affiliation.

 

SOURCES: Nisha Bansal, MD, professor, drugs, College of Washington, Seattle; Laurence Epstein, MD, system director, electrophysiology, Northwell Well being, Manhasset, N.Y.; Journal of the American Coronary heart Affiliation, March 8, 2023, on-line



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Could Melatonin Ease Self-Harm in Kids?

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By Steven Reinberg 

HealthDay Reporter

MONDAY, March 27, 2023 (HealthDay Information) — For depressed or anxious kids, taking melatonin could afford evening’s sleep and, because of this, decrease the percentages they are going to hurt themselves, new analysis suggests.

The danger of self-harm elevated earlier than melatonin was prescribed and decreased by about half after youngsters began taking the complement, the examine discovered. Teen women affected by despair or nervousness have been the most definitely to learn.

“This means that melatonin is perhaps chargeable for the diminished self-harm charges, however we can’t rule out that using different psychiatric medicines or psychotherapy could have influenced the findings,” stated senior researcher Sarah Bergen, from the division of medical epidemiology and biostatistics on the Karolinska Institute in Stockholm, Sweden.

“Melatonin is a naturally occurring hormone, and we consider the findings are on account of improved sleep,” she stated.

The examine cannot show that melatonin precipitated the drop off in self-harm, solely that there seems to be a hyperlink.

Of the greater than 25,000 younger individuals within the examine, 87% had psychiatric issues along with sleep issues.

“Melatonin was in all probability just one a part of their therapy bundle,” Bergen stated. “We discovered that controlling for antidepressant use didn’t appreciably alter the outcomes, nevertheless it’s attainable that different medicines or psychotherapy are contributing to the noticed findings.”

For the examine, her group recognized almost 25,600 Swedish kids between 6 and 18 years of age who have been prescribed melatonin.

Most had a minimum of one psychiatric dysfunction. Consideration-deficit/hyperactivity dysfunction (ADHD), nervousness issues, despair or autism spectrum dysfunction have been the commonest. Ladies have been about 5 instances extra prone to hurt themselves than boys, the examine authors famous.

Self-harm can embrace slicing or burning oneself, breaking bones, and different behaviors that may trigger harm or result in suicide makes an attempt.

“Melatonin has no critical unintended effects and isn’t addictive, so utilizing it to enhance sleep in kids and adolescents could possibly be an vital intervention technique resulting in diminished self-harm behaviors on this inhabitants,” Bergen stated.

An skilled who reviewed the findings agreed that the discount in self-harm seen within the examine is a results of higher sleep.

“In case you enhance sleep, your nervousness or despair, your suicidal ideations, your self-injurious conduct all develop into much less,” stated Dr. Sanjeev Kothare, director of the division of pediatric neurology at Cohen Youngsters’s Medical Middle in Queens, N.Y.

Kothare stated melatonin will help enhance sleep if used accurately.

“One has to take one to 3 milligrams of melatonin one hour earlier than sleep onset for finest efficacy,” he stated. “It shouldn’t be repeated the identical evening because it is not going to work. You shouldn’t be taking greater than 3 to five milligrams as a result of it may be dangerous.”

With or with out melatonin, training good sleep habits makes an enormous distinction, however Kothare stated it may be exhausting for teenagers to keep it up.

The keys to getting evening’s sleep embrace winding down by 9 p.m. with no telephones, tablets, TV or computer systems. At 10 p.m., you may take some melatonin if wanted to assist get to sleep, Kothare stated.

This sample ought to develop into the norm for weekdays and weekends, with no daytime napping, he suggested.

“Take away the naps, and preserve related schedules on weekdays and weekends. Do not take caffeinated drinks after two o’clock within the afternoon and dim the lights at evening,” he suggested. “Use melatonin judiciously and take away all of the gizmos when it is sleep time.”

The findings have been printed on-line March 23 within the Journal of Youngster Psychology and Psychiatry.

Extra data

To study extra about melatonin, go to the U.S. Nationwide Middle for Complementary and Integrative Well being.

 

SOURCES: Sarah Bergen, PhD, division of medical epidemiology and biostatistics, Karolinska Institute, Stockholm, Sweden; Sanjeev Kothare, MD, director, division of pediatric neurology, Cohen Youngsters’s Medical Middle, Queens, N.Y.; Journal of Youngster Psychology and Psychiatry, March 23, 2023, on-line



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Insomnia, Sleep Apnea Rise in Women With MS

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By Cara Murez 

HealthDay Reporter

MONDAY, March 27, 2023 (HealthDay Information) — Whereas pondering declines is usually a frequent symptom of a number of sclerosis in ladies, new analysis suggests sleep, or lack of it, may very well be making issues worse.

“Sleep issues have gained substantial recognition for his or her function in cognitive [thinking] decline, which impacts as much as 70% of individuals with a number of sclerosis,” defined research creator Dr. Tiffany Braley, director of the A number of Sclerosis/Neuroimmunology Division and the MS Fatigue and Sleep Clinic at College of Michigan Well being.

“Our outcomes highlighted vital pathways between sleep and perceptions of cognitive perform in ladies with MS,” Braley mentioned in a college information launch. “We’ve beforehand recognized vital associations between goal cognitive efficiency and sleep in folks with MS, however little is thought about how sleep and MS work together collectively to influence long-term cognitive outcomes, notably amongst ladies who’re much less prone to be recognized with sleep issues.”

Utilizing knowledge for greater than 60,000 ladies within the 2013 and 2017 waves of the Nurses’ Well being Research, the reseachers discovered that girls with MS have been extra doubtless than these with out MS to report sleep issues akin to obstructive sleep apnea, insomnia and sleepiness.
 

Sleep issues recognized in 2013 contributed to pondering issues reported by ladies with MS in 2017, together with reminiscence and skill to observe directions and conversations, in keeping with the authors.

Sleep apnea accounted for 34% of the full impact between MS and the power to observe directions, the research discovered.

The findings have been printed not too long ago within the A number of Sclerosis Journal.

“With this longitudinal research design, we’re capable of higher estimate the burden of sleep issues amongst nurses, in comparison with well being care claims knowledge of comparable measurement, which embody recognized folks with sleep issues,” mentioned senior research creator Galit Levi Dunietz, an affiliate professor within the Division of Neurology’s Division of Sleep Drugs at Michigan Drugs.

“Nevertheless, as sleep issues are regularly underdiagnosed, well being care claims knowledge miss many individuals with sleep issues who weren’t evaluated for these situations,” Dunietz mentioned within the launch.

Interventions to delay pondering points could also be handiest in pre-symptomatic or early symptomatic phases, Braley famous.

“Perceived cognitive decline, even within the absences of goal modifications, may very well be an vital window of alternative to establish treatable exacerbating components, akin to sleep issues,” she mentioned.

Extra data

The Nationwide A number of Sclerosis Society has extra on pondering declines in folks with MS.

 

SOURCE: Michigan Drugs – College of Michigan, information launch, March 21, 2023



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Who Is Most Likely to Get Long COVID? Patient Data May Tell

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March 27, 2023 – Excellent news and dangerous information on the lengthy COVID entrance: Sure teams of individuals – like girls, people who smoke, and those that had extreme COVID-19 infections – are at the next threat of lengthy COVID, a evaluate of greater than 800,000 sufferers has discovered. 

That’s the dangerous information. But, researchers additionally discovered that sufferers who had a minimum of two doses of the COVID vaccine had a considerably decrease threat of getting lengthy COVID down the road. 

“Not solely is it vital to acknowledge which people could also be at excessive threat of growing PCC [post−COVID-19 condition] and to supply follow-up care; it’s crucial to plan population-level public well being measures,” wrote lead creator Vassilios Vassiliou, PhD, a professor of cardiac drugs on the College of East Anglia in Norwich, England, and his staff. 

The analysis, revealed within the journal JAMA Inside Medication, mixed 41 beforehand revealed articles that included info from 860,783 sufferers. The evaluate uncovered a slew of demographic traits that had been considerably linked to lengthy COVID, together with feminine intercourse, being over 40 years previous, smoking, having a excessive physique mass index (BMI), and hospitalization on account of a COVID-19 an infection. 

Long COVID, as outlined by the World Well being Group, is the continuation of COVID signs or the beginning of recent signs a minimum of 3 months after preliminary an infection.

Having different circumstances – like anxiousness, melancholy, bronchial asthma, diabetes, and being immunocompromised – had been additionally linked to the next probability of getting lengthy COVID, researchers reported. 

That cisgender girls are at the next threat of lengthy COVID falls in keeping with earlier analyses, suggesting that hormones would possibly play a task “in perpetuating the hyperinflammatory standing of the acute section of COVID-19 even after restoration.” 

The identical goes for earlier research on vaccination standing and lengthy COVID threat – like a lot of the earlier analysis on the topic, vaccinations had been discovered to have a protecting impact on lengthy COVID. 

However lengthy COVID – all of the methods it presents itself, how widespread it’s, and what we will do about it – nonetheless stays considerably of a thriller, even 3 years into the pandemic. 

“Whereas this and different knowledge on vaccines recommend that there are components that may scale back the danger of lengthy COVID, nothing as of but can utterly remove the danger of lengthy COVID. The one assure towards lengthy COVID is to not get COVID,” stated Stanford College main care professor Linda Geng, MD, PhD. 

 

“Moreover, we nonetheless would not have any efficient remedy established for the tens of millions who have already got lengthy COVID, and we urgently want randomized managed trials to assist present these solutions,” she stated.



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