Medical News Today: Good moods may boost flu shot efficacy for seniors

happy senior woman getting injection
Researchers suggest that positive moods may have something to do with how effective flu vaccines are in seniors.
Vaccines are an important preventive measure against influenza, but they are often much less effective in the elderly. A new study suggests that seniors who get their flu shots while in a good mood have a better response to the vaccine.

Flu vaccines are an easy and important preventive measure against seasonal influenza viruses. Many, if not most, of us choose to go through the mild and short-lived discomfort of getting a flu shot each year so that we may avoid coming to more grief later.

The most recent data provided by the Centers for Disease Control and Prevention (CDC) show that vaccination reduces the risk of catching the virus by 40 to 60 percent among the general United States population.

Overall, however, the vaccines tend to be more effective for children, teenagers, and adults up to 65 years of age. Seniors, studies suggest, tend to have a poorer response, and the vaccines are not always effective in keeping the illness at bay.

Still, the CDC urge adults aged 65 and over to keep getting their flu shots, since influenza viruses can have much more serious effects on seniors, possibly leading to hospitalization and a higher mortality risk.

Now, a study conducted by researchers based at Nottingham University in the United Kingdom looks at why vaccines may be more effective for some older adults, but not for others.

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Prof. Kavita Vedhara and colleagues noted that the vaccine was more effective in seniors who turned up for their flu shot in a good mood, but less so in their unenthusiastic counterparts.

“Vaccinations are an incredibly effective way of reducing the likelihood of catching infectious diseases,” explains Prof. Vedhara. “But their Achilles heel is that their ability to protect against disease is affected by how well an individual’s immune system works.

“So,” she adds, “people with less effective immune systems, such as the elderly, may find vaccines don’t work as well for them as they do in the young.”

This is why she and her team decided to investigate which additional factors may be responsible for good – or poor – outcomes following vaccination in the elderly. The researchers published their findings in the journal Brain, Behavior, and Immunity.

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Positive thinking tied to higher effectiveness

Prof. Kavita Vedhara and team worked with 138 people aged between 65 and 85 who were due to get vaccinated for influenza. The participants were followed over 6 weeks and monitored for mood, dietary practice, physical activity, and sleep patterns three times each week.

The researchers then tested the effectiveness of the flu shot at 4 weeks and 16 weeks after inoculation, by testing the levels of antibodies in the participants’ blood.

Of all the factors monitored, it was found that positive mood was the best predictor of effectiveness. Participants who were in a good mood on the day of the vaccination itself exhibited an even better response to the flu shot, and the inoculation was significantly more effective for this group of people.

Good mood, the scientists explain, was responsible for between 8 and 14 percent of the difference in antibody levels between participants.

“We have known for many years that a number of psychological and behavioral factors such as stress, physical activity, and diet influence how well the immune system works,” says Prof. Vedhara, “and these factors have also been shown to influence how well vaccines protect against disease.”

Now, it has become apparent just how much psychological factors could influence the “receptiveness” of the immune system.

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Factors tested for single viral strain

One peculiarity of this study, the team explains, is that the vaccine administered to the participants was the same as the one they had received the previous year. The paper indicates that everyone “received a standard dose of the 2014/15 northern hemisphere influenza vaccine.”

This is an extremely rare occurrence, yet it meant that the subjects already had high antibody levels for two of the three viruses contained by the vaccine: the A H3N2 and B viral strains.

As a consequence, Prof. Vedhara and colleagues focused on the response to the third viral strain, A H1N1, to which the participants had not previously developed significant antibody levels.

The researchers emphasize in their paper that this study is the first of its kind, shedding additional light on the factors at play in the context of vaccine effectiveness in old age.

Despite these limitations, this is the first study to comprehensively examine patient behaviors and psychological factors on the vaccine-induced protective antibody response in older adults using a robust methodology.”

Prof. Vedhara and her research team hope that future studies will test the influence of the factors they monitored on multiple viral strains, to confirm the effect of mood on vaccine efficacy in the elderly.

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Medical News Today: Heart failure could be treated using umbilical cord stem cells

small heart held in hands
Scientists offer new hope for heart failure patients.
Using stem cells derived from the umbilical cord, researchers have improved the heart muscle and function of heart failure patients, paving the way for noninvasive therapies.

The lead author of the study is Dr. Jorge Bartolucci, a professor at the Universidad de los Andes (UANDES) in Santiago, Chile, and Dr. Fernando Figueroa, a professor of medicine at UANDES, is the corresponding author.

Dr. Bartolucci and colleagues conducted a trial in which they compared patients who were given an intravenous injection with stem cells from umbilical cords with patients who received a placebo.

The results – which have been published in the journal Circulation Research – were deemed “encouraging” by Dr. Figueroa. He says that the findings could improve survival rates for heart failure patients, which are currently quite disappointing.

Half of all heart failure patients are expected to die within the first 5 years after the diagnosis, and the 10-year survival rate is less than 30 percent. Worldwide, 26 million people are believed to live with the condition.

In heart failure, the heart’s muscles weaken and can no longer pump blood adequately throughout the body. Worryingly, the threat of heart failure is increasing among people in the United States; the number of people affected is currently set at 6.5 million, and this is expected to rise by 46 percent by the year 2030.

The authors of the new study note that previous research has already looked into the potential of stem cells derived from bone marrow for treating heart failure, but they say that umbilical cord-derived stem cells have never been examined.

These are a more desirable avenue for treatment, the authors add, as they are more accessible, do not pose any of the ethical concerns that embryonic stem cells do, and are not likely to elicit a negative immune response.

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Treatment proves safe and effective

In their small trial, Dr. Bartolucci and team divided 30 patients – aged between 18 and 75 – into two small groups: one received treatment, and the other received a placebo.

Patients in both groups had stable heart failure, which was appropriately treated with the standard drugs.

The stem cells used by the researchers were derived from umbilical cords, which were obtained from human placentas. These had been donated by healthy mothers who carried their pregnancy to term and had a cesarean delivery.

It was found that in the stem cell group, the therapy improved the hearts’ ability to pump blood in the year after the treatment. The stem cell therapy also seemed to improve the daily functioning and quality of life of those treated.

No adverse effects or inflammatory immune responses were noted during the treatment, despite the fact that typically, patients who receive blood transfusions are prone to adverse immune reactions.

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The treatment was “feasible and safe,” the authors conclude, and it “resulted in a significant improvement in left ventricular function, functional status, and quality of life.”

“These findings suggest [that the intervention] could have an impact on clinical outcomes, supporting further testing through large clinical trials,” they add.

This type of stem cell therapy may be extremely beneficial to heart failure patients, say the authors, especially when compared with existing treatment options.

“Standard drug-based regimens can be suboptimal in controlling heart failure, and patients often have to progress to more invasive therapies such as mechanical ventricular assist devices and heart transplantation,” explains Dr. Bartolucci.

We are encouraged by our findings because they could pave the way to a noninvasive, promising new therapy for a group of patients who face grim odds.”

Dr. Fernando Figueroa

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Medical News Today: Extended-spectrum beta-lactamases (ESBL): Infection and treatment

Extended-spectrum beta-lactamases, or ESBLs, are enzymes produced by certain types of bacteria. These enzymes can break down the active ingredients in many common antibiotics, making them ineffective.

There are at least 200 different types of ESBL enzymes. Researchers still have a lot to learn about them, in part because the infections involving ESBLs were only recently discovered.

The first reported case of infection involving ESBLs occurred in Greece in the 1960s. The United States reported its first case in 1988.

What triggers ESBLs?

Many bacteria can develop resistance to antibiotics through random mutation.

So far, ESBLs have only been reported in Gram-negative bacterial infections. Gram-negative bacteria will appear pink during staining in preparation for microscopic examination.

Bacteria have built-in tools to trick the immune system and disable drugs. They can also develop drug-resistance through random mutation and pass on useful mutations to the next generation.

Several different species of bacteria are capable of producing ESBLs. Researchers are still unsure what triggers the bacteria to produce the drug-resisting enzymes, but misuse or overuse of antibiotics is suspected.

It is important to know that within each family and group of bacteria there are usually hundreds of different species, only some of which can produce ESBLs.

Bacterial groups known to produce ESBLs include:

  • Escherichia coli (E.coli)

  • Klebsiella pneumoniae 

  • Pseudomonas aeruginosa

  • K. oxytoca

  • Proteus mirabilis

  • Salmonella enterica

  • Neisseria gonorrhoeae 

  • Haemophilus influenzae 

  • Kluyvera species

  • Enterobacter aerogenes

  • Enterobacter cloacae

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person washing hands in a sink
Thorough hand-washing can help prevent an infection.

Anyone who has contact with a surface, object, animal, or another person that is infected with or has been exposed to ESBL-producing bacteria can spread the infection.

Most ESBL infections, however, develop in healthcare settings and involve exposure to infected fecal matter.

According to a 2015 study, most people infected with ESBL-producing bacteria had been hospitalized for an average of between 11 and 64 days before developing the infection.

While traditionally associated with immune-compromised individuals, hospitals, and nursing homes, the infection is becoming more frequent and widespread.

According to the American Centers for Disease Control and Prevention (CDC), EBSL-producing bacteria are considered a serious threat in the U.S.

It is important to take extra precautions, including increased hand-washing, whenever exposure occurs or is suspected.

Many bacteria can live on the skin’s surface for several days and even be transmitted through a person’s breath. Some people who do not develop an infection or show symptoms can act as carriers, spreading the infectious bacteria without knowing it.

Associated conditions and symptoms

Bacterial infections involving ESBLs are known to cause several associated health conditions. Common complications and symptoms that accompany bacterial infections include:


Most ESBL-producing bacteria are called Enterobacteriaceae, a family of bacteria that normally lives in the gastrointestinal tract without causing infection.

For this reason, many ESBL-related infections irritate the gastrointestinal lining. When the body has an infection, the immune system also encourages increased metabolism and waste removal, causing diarrhea.

Common symptoms of diarrhea include:

  • having three or more loose stools in one day

  • bloody stool

  • gas and bloating

  • fever

  • stomach cramps

  • loss of appetite

Skin infections

Bacterial infections in wounds can cause the skin to become red and swollen. Fluid may also seep out of the wound site.

Several internal bacterial infections can also cause dermatological symptoms, including red, raised bumps.


Pneumonia occurs when bacteria infect the lungs and respiratory tract. Common symptoms of pneumonia include:

  • coughing, often with phlegm or thick mucous

  • difficulty breathing

  • fatigue or unexplained exhaustion

  • shortness of breath

  • fever and chills

  • sweating and shaking

  • nausea and vomiting

  • diarrhea

  • low body temperature

Urinary tract infections

Urinary tract infections (UTIs) occur when bacteria overgrowths develop in the urinary tract. Common symptoms of UTIs include:

  • increased need to urinate

  • burning sensation during urination

  • itching, burning sensation in the genital region


Sepsis occurs when an infection causes the immune system to overreact, releasing chemicals into the bloodstream that trigger a full-body inflammatory response. Sepsis is life-threatening and can lead to organ failure and death.

Common symptoms of sepsis include:

  • fever and chills

  • nausea and vomiting

  • feeling disorientated and confused

  • difficulty breathing

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Treatment and outlook

As ESBL-producing bacteria are resistant to common antibiotics, treatment involves using less common medications, which can sometimes be less effective.

Also, many ESBL-producing bacteria have additional tools to disable other types of antibiotics. If a person has had the infection long-term, or when medications are overused, bacteria can evolve and develop immunity to them. 

The first line of treatment for people who have been confirmed as having the infection is usually a class of drugs called carbapenems. The treatment process may involve some degree of trial and error.

It may take several courses of treatment and different medications to resolve a person’s infection completely.

Commonly used medications to treat ESBL-involved infections include:

  • carbapenems (imipenem, meropenem, and doripenem)

  • cephamycins (cefoxitin and cefotetan)

  • fosfomycin

  • nitrofurantoin

  • beta-lactamase inhibitors (clavulanic acid, tazobactam, or sulbactam)

  • non-beta-lactamases

  • colistin, if all other medications have failed

According to the CDC, carbapenem-resistant Enterobacteriaceae are a very serious developing threat.

Carbapenem-resistant infections are immune to nearly every form of antibiotic available and are responsible for 9,000 infections per year and 600 deaths. Almost half of the people who developed the infection in their bloodstream died.

In some situations, especially if a person has a weakened immune system, hospitalization and isolation may be necessary. Most infections take several weeks or months to treat.


nurse putting gloves on
Preventing ESBL-involved bacterial infections may include avoiding touching the face and mouth, disinfecting surfaces, and wearing gloves in a healthcare setting.

People with long-term conditions and people who are hospitalized are the most at-risk of developing ESBL-involved infections. Extra precautions, such as increased hand washing, should always be used in healthcare settings.

General tips for preventing ESBL-involved bacterial infections include:

  • avoiding close contact with people or animals with bacterial infections

  • wearing gloves in healthcare settings or around infected individuals

  • avoiding touching the face and mouth

  • wearing long-sleeved clothing when around infected individuals

  • washing hands before and after exposure to infected individuals

  • washing all clothing and bedding that may have been exposed to infected individuals in hot water

  • disinfecting surfaces, especially in bathrooms and kitchens

  • disinfecting fixtures, such as doorknobs and faucets

  • taking antibiotics exactly as directed

  • telling a doctor if antibiotics are not improving symptoms of an infection

  • talking with a doctor and taking extra hygiene precautions if several courses of antibiotics are necessary within a short timespan

  • if an ESBL-involved infection is confirmed, avoiding exposure to others or being in public settings, especially crowded areas

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Medical News Today: Frequent ejaculation and prostate cancer: What’s the link?

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Medical News Today: Carcinoma in situ: What is it and how is it treated?

Carcinoma in situ is a cancer designation where a person has abnormal cells that have not spread beyond where they first formed. The words “in situ” translate to “in its original place.”

These in situ cells have the potential to become cancerous cells and spread to other nearby locations. Other names for carcinoma in situ are stage 0 disease, non-invasive cancer, or pre-invasive cancer.

This article will focus on some of the more common areas where doctors diagnose carcinoma in situ and the treatment approaches that can follow a diagnosis.

Where does carcinoma in situ occur?

Some of the most common types of carcinoma in situ are listed below:

Carcinoma in situ of the urinary bladder

Bladder cancer
Carcinoma in situ commonly occurs in the bladder.

The bladder is a common location where doctors detect carcinoma in situ. According to the Journal of the National Comprehensive Cancer Care Network, an estimated 3 percent of all first-time bladder cancers are carcinoma in situ.

Carcinoma in situ of the bladder is very common in those who have a history of bladder cancer that was previously in remission. Nearly 90 percent of people with bladder cancer see a recurrence.

This cancer type is most commonly detected among male smokers who are between the ages of 60 to 70 years old.

Cervical carcinoma in situ

Doctors may identify cervical carcinoma in situ as pre-cancerous cells that rest on the surface layer of the cervix.

Doctors can treat this pre-cervical cancer type, but the cancer can sometimes recur. For this reason, doctors recommend continued Pap smear tests to check for any further pre-cancerous cells.

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Ductal carcinoma in situ (DCIS)

Doctors also call this type of carcinoma in situ intraductal carcinoma. It is one of the most common types of breast cancer, according to the American Cancer Society.

Ductal means that cells are growing in the milk ducts of the breasts. According to, an estimated 20 percent of breast cancers diagnosed annually in the United States are DCIS, equivalent to about 60,000 cases.

Squamous cell carcinoma in situ or Bowen disease

This skin cancer type is one of the earliest-known forms of squamous cell skin cancers. Again, according to the American Cancer Society, an estimated 2 out of 10 skin cancers are squamous cell skin cancers.

The cells in this type of carcinoma in situ most commonly appear on areas of the skin exposed to the sun, such as face, ears, and neck. They are more likely to grow deeper into the skin, as well as spread to other areas of the body.

The disease types listed above are just a few examples of the different areas where carcinoma in situ can occur. 

How is carcinoma in situ treated most effectively?

Some of the common treatments for each type of carcinoma in situ include:

Carcinoma in situ of the urinary bladder

surgeons at work in surgery
Surgery is recommend in the majority of cases for carcinoma in situ of the urinary bladder.

Almost all people with carcinoma in situ of the urinary bladder will undergo surgery to remove the pre-cancerous cells.

Examples of surgical procedures include transurethral resection or biopsy with electrical or laser cautery.

If doctors still detect cancerous cells after these procedures, they may recommend radical cystectomy or surgical removal of the bladder.

However, because older individuals are the most likely to present with this condition, doctors may recommend watchful waiting, as the time it could take for the cancer to progress may be longer than a person’s life expectancy.

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Cervical carcinoma in situ

In this type, doctors will often recommend removal of the precancerous cells to prevent them from turning cancerous and to reduce the likelihood of them spreading.

A doctor can remove the cells using cryosurgery, laser surgery, cold knife conization, or loop electrosurgical excision procedure (LEEP/LEETZ).

If a woman is no longer in her childbearing years, a doctor may recommend a hysterectomy.

Ductal carcinoma in situ (DCIS)

With cases of DCIS, a doctor will discuss treatment options with a woman, depending upon where in the breast the cancerous cells are.

One option is breast-conserving surgery (BCS), where the surgeon removes the cancerous cells, as well as a portion of normal breast tissue surrounding the tumor.

In some instances, a doctor may remove lymph nodes as well. A doctor may also recommend follow-up radiation therapy, to reduce the risk pre-cancerous cells could come back in the breast.

If the area of DCIS is large, a doctor may recommend a mastectomy, which involves removing the entire breast.

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Squamous cell carcinoma in situ or Bowen disease

Doctors will usually recommend removing the pre-cancerous cells in this type of carcinoma in situ. In some instances, a doctor may also recommend radiation to reduce the risk for cancer cell recurrence.

Choosing the right treatments

People should always discuss their treatment options carefully with their doctor.

Questions to ask include:

  1. “What are the chances this treatment will be successful?”

  2. “What are the side effects of this treatment?”

  3. “What happens if cancerous cells are still present afterward?”

Carefully weighing all options can help a person determine what is best for their individual health.

Outlook for carcinoma in situ

While a diagnosis of carcinoma in situ does not always mean the cells will become cancerous, the chances are usually so high the cells will one day be malignant that doctors recommend treatment.

By treating the cells before they become cancerous and can spread, a person will ideally have the greatest likelihood of being cancer-free.

The medical capabilities of identifying carcinoma in situ underlie the importance of a person engaging in preventive visits, such as women getting Pap smear tests and people going to a dermatologist for annual skin checks.

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Medical News Today: Enzyme may prevent rebound after weight loss

woman weighing herself
Scientists are looking into the possibility of using one enzyme to halt the overproduction of ghrelin, which “tells” us when to feel hungry. 
New research has investigated ways of preventing the “hunger hormone” ghrelin from driving people who have lost weight into a rebound. An enzyme with a metabolic function was found to reduce ghrelin’s influence, which may point to a new way of managing weight gain.

According to data from the Centers for Disease Control and Prevention (CDC), 36.5 percent of adults and around 17 percent of children and adolescents in the United States live with obesity.

The main approach to obesity management and prevention is adopting a more healthful lifestyle, including a more balanced diet and more physical exercise.

However, studies have shown that many individuals who shed weight after dieting have a tendency to rebound and regain the extra kilos that they worked so hard to eliminate.

This, researchers explain, is due to a rise in ghrelin levels. Ghrelin is the so-called hunger hormone, which tells our bodies when to feel hungry and when they have had enough to eat. This increase is due to our bodies’ adaptive response to the often drastic dietary changes that lead to weight loss.

Now, researchers from the Mayo Clinic – which is based in Rochester, MN – are aiming to develop a new approach to prevent weight regain in the aftermath of a diet. Dr. Stephen Brimijoin and his colleagues tested the effects of an enzyme with the potential of blocking or limiting ghrelin production on mice.

The researchers reported their findings in the Proceedings of the National Academy of Sciences.

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Enzyme regulates hunger hormone

Dr. Brimijoin and his team used mice in a context simulating the situation of people who have shed excess weight through dieting, but who are then are liable to regain it due to the increase in ghrelin levels.

The scientists wondered whether or not using butyrylcholinesterase might help to regulate the overproduction of ghrelin after weight loss. 

Butyrylcholinesterase is an enzyme naturally produced in the liver that plays a role in eliminating certain poisonous substances from the system, as well as metabolizing certain quantities of drugs such as cocaine.

The encoded enzyme was inserted into a neutralized virus, which was then administered to the mice with the aim of targeting ghrelin production.

It was found that boosting butyrylcholinesterase levels both correlated with a significant drop in the levels of the hunger hormone and moderated its activity. As a result, the animals adopted more balanced eating habits and did not gain any extra weight.

This happened after only one exposure to the enzyme-boosting procedure and had long-term outcomes, allowing the mice to avoid weight gain for the rest of their lives.

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‘A highly successful strategy’?

Dr. Brimijoin and his colleagues hope that these findings might lead not only to a more effective approach to obesity management, but also to preventive treatments for other metabolic diseases.

These include diabetes, metabolic syndrome (characterized by a combination of risk factors that could lead to coronary heart disease and other cardiovascular problems), and fatty liver disease (characterized by excess fat accumulating in the liver).

The scientists are pleased with the success of their research so far, but they emphasize the need to replicate these results in human participants before confirming the effectiveness of this approach.

We think this approach – combined reduction of calories and hormone – may be a highly successful strategy for long-term weight control. Given the growing obesity crisis worldwide, we are working hard to validate our findings for medical intervention.”

Dr. Stephen Brimijoin

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Medical News Today: Stopping aspirin treatment raises cardiovascular risk by over a third

bottle of aspirin
Discontinuing aspirin treatment may pose a serious threat to health, a new study shows.
New research published in the journal Circulation suggests that interrupting long-term, low-dose aspirin treatment may increase the likelihood of a second stroke or heart attack.

Researchers led by Johan Sundström, a professor of epidemiology at Uppsala University in Sweden, set out to examine the effect of stopping low-dose aspirin treatment on the odds of having a second heart attack or stroke.

The American Heart Association (AHA) recommend that people at risk of having a heart attack take low-dose aspirin preventively. Aspirin is also recommended by the AHA to heart attack and stroke survivors, in order to avoid recurrence.

That being said, previous research – referenced by the authors in their new study – shows that 10 to 20 percent of the patients advised to continue taking aspirin preventively choose to ignore the advice.

These patients discontinue their treatment during the first 1 to 3 years after the initial cardiovascular event. But what is the effect of stopping treatment? The new research investigates.

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Quitting aspirin raises risk by 37 percent

Prof. Sundström and his colleagues examined the medical records of 601,527 people aged 40 and above who did not have a history of cancer and took aspirin in low doses to prevent either a first or a second heart attack or stroke between 2005 and 2009.

The treatment adherence among this population sample was 80 percent in the first year.

Cardiovascular events were defined as myocardial infarction, which is more commonly known as a heart attack, stroke, or cardiovascular death. Over the follow-up period, 62,690 cardiovascular events were recorded.

Those who stopped the aspirin treatment were 37 percent more likely to have an adverse cardiovascular event than those who continued the therapy. This is equivalent to 1 in every 74 patients who quit aspirin having a heart attack, a stroke, or dying as a result of a cardiovascular event.

On the clinical implications of these results, the study authors say, “Adherence to low-dose aspirin treatment in the absence of major surgery or bleeding is likely an important treatment goal.”

As this is an observational study, it cannot explain causality. However, the team has considered the possibility that stopping aspirin may cause a so-called rebound effect.

This refers to the possibility that stopping aspirin, which has blood-thinning properties, may have blood-clotting effects after discontinuation. Some experimental studies have supported this theory.

“The clinical importance of a rebound effect may be substantial because of the large number of aspirin patients and the high discontinuation rates,” write the authors.

Low-dose aspirin therapy is a simple and inexpensive treatment […] As long as there’s no bleeding or any major surgery scheduled, our research shows the significant public health benefits that can be gained when patients stay on aspirin therapy.”

Prof. Johan Sundström

“We hope,” he adds, “our research may help physicians, healthcare providers, and patients make informed decisions on whether or not to stop aspirin use.”

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Strengths and limitations of the study

The study investigated a large national population sample, which totaled more than 60,000 cardiovascular events.

Researchers had access to all of the Swedish patients who took low-dose aspirin in the long run, as they did to “high-precision” medical registers that helped them to determine long-term outcomes of discontinuing the treatment.

But the study authors also note some limitations. They did not have access to any socioeconomic data on their patients, which might have confounded the results. Blood pressure, lipids, and smoking status were not accounted for, either.

The researchers also note the risk of reverse causation – that is, the possibility that patients who discontinued the treatment may already have been predisposed to premature death.

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Medical News Today: Suprapubic catheters: Uses, care, and what to expect

A urinary catheter is a device that empties urine from the bladder. It usually includes a flexible tube that drains the urine and a place for the urine to empty into, such as a bag. A person may need a catheter if they cannot urinate on their own.

There are several different types of catheters. The one most frequently used is known as a urethral catheter. It is inserted directly into the urethra, where urine naturally comes out of the body.

A suprapubic catheter empties the bladder through an incision in the belly instead of a tube in the urethra.

A suprapubic catheter may be an option for people who cannot have or do not want a urethral catheter. This type of catheter has some advantages over a urethral catheter, but it also needs special care to avoid infections and other problems.

Find out how this catheter works, when it is a good option, and how to care for it.

When are suprapubic catheters used?

Close up of a catheter with urine bag and syringe.
Suprapubic catheters are not used as often as urethral catheters, but may be recommended if long-term use is expected.

A suprapubic catheter offers an alternative to the frequently used urethral catheter.

Suprapubic catheters may be used:

  • when the urethra is damaged or injured

  • if the pelvic floor muscles are weakened, causing a urethral catheter to fall out

  • after surgeries that involve the bladder, uterus, prostate, or nearby organs

  • if the person is sexually active and needs a catheter for a longer period of time

  • for long-term use, as it may be more comfortable and easier to change than a urethral catheter

Long-term use of suprapubic catheters is sometimes needed when the person:

  • has a bladder blockage that cannot be corrected with surgery or other treatments

  • has incontinence that is causing skin rashes and irritation or making them worse

  • is terminally ill or severely impaired, making bed changes difficult or painful

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How does a suprapubic catheter work?

Inserting a suprapubic catheter requires a minor surgical procedure.

People are given numbing medicine, or anesthetic, to manage any pain from the procedure. A surgeon makes a small cut in the abdomen, usually a few inches below the belly button.

A suprapubic catheter does not come into contact with the urethra or genital area.

The catheter has a small balloon at the end, and once the catheter is in place in the bladder, the doctor inflates the balloon. This balloon helps prevent the tube from falling out.

Risks and benefits of suprapubic catheters

Male doctor sitting on black couch with female patient, explaining kidney problem using an anatomical model.
There are various risks that a suprapubic catheter may pose. Any concerns should be discussed with a medical professional.

Both suprapubic and urethral catheters have some risks.

If bacteria get into the catheter and travel to the bladder, they can cause an infection. The infection can affect the urinary tract and bladder and can spread to the kidneys.

This type of infection is known as CAUTI or catheter-associated urinary tract infection. CAUTIs can become serious, especially in those with weakened immune systems and other health conditions.

A person’s chances of developing an infection increase the longer the catheter is in place.

An article in American Family Physician cautions against the long-term use of catheters unless absolutely necessary. Complications of long-term catheter use include:

A report in Translational Andrology and Urology states that infections and complication rates are about the same for suprapubic and urinary catheters.

But, the authors note, suprapubic catheters are often considered to be more comfortable and that people prefer them. This is because:

  • Suprapubic catheters may be easier for a person to change and clean for long-term use.

  • A cut in the belly may be more comfortable than having a catheter placed in the urethra, especially if the person is in a wheelchair.

  • A person may feel more confident with a belly incision instead of a device placed in the genital area.

Another study also found that people prefer the suprapubic catheter over a urethral one overall. However, the authors state, they found a “significant mortality rate” associated with the insertion procedure in high-risk people.

People at high-risk may have other medical conditions or previous surgeries that make them more likely to develop complications. “The procedure may be simple but some patients and their conditions are not,” the authors state.

For this reason, the study authors recommend:

  • careful screening of people before inserting a suprapubic catheter

  • good medical care after the procedure

  • giving antibiotics through a vein during the procedure to help prevent bacterial infection

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Caring for a suprapubic catheter

Suprapubic catheters can often be managed at home, either by the individual or a caregiver. Caring for a suprapubic catheter takes some time and requires careful attention to cleanliness.

Following a few steps from the beginning will help people get off to a good start with the catheter and minimize the risk of infection.

Get instructions and ask questions

Nurse wearing disposable gloves and holding a catheter tube.
Receiving professional instruction on how to care for a catheter is important. A doctor should provide clear direction, and be able to answer any questions.

Before going home with a suprapubic catheter, it is crucial for people to understand how to care for it to help avoid problems if they or a family member will be caring for it.

People should talk with their doctor and get any questions answered. Get handouts or have someone write down each step that is needed.

This early learning is key to success, according to a report published in Home Healthcare Nurse.

Questions that may be helpful to ask include:

  • How can the catheter be kept clean? Thorough hand-washing before and after touching the catheter is vital.

  • How often should the catheter be changed? This will vary based on the person’s medical condition and how long they need the catheter.

  • What are the steps necessary to changing the catheter? Steps such as using lubricant on the tube, emptying or draining the device, and attaching a new bag may need to be reviewed.

  • What kind of care is needed for the insertion site? People often go home with a wound dressing that may need to be kept in place until the wound has healed.

  • When can the person take a shower or bath? Showers are usually recommended with gentle cleansing and soap, but baths and hot tubs are often not advised.

  • How much fluid should the person drink? The user may benefit from drinking extra water to keep the bladder and kidneys flushed out, which can lower the risk of a urinary tract infection.

Get necessary supplies

If a person needs a suprapubic catheter long-term, they will need certain supplies. Discuss what these supplies might be with the doctor or nurse before going home.

The person may get a prescription for some of the extra catheter supplies and can purchase them at a medical supply store or pharmacy.

Supplies may include:

  • extra catheter tubes and bags

  • sterile cleaning solution

  • disposable gloves

  • sterile lubricating gel that helps to insert the catheter

  • prescribed medications

Know the signs of infection

The signs of a catheter infection include:

  • redness or tenderness around the cut in the belly

  • feeling an urgent need to urinate

  • pain while urinating

  • cloudy or discolored urine

  • fever greater than 104°F

The risk of infection can be significantly reduced by washing hands with soap and water for 30 seconds before and after changing, emptying, or handling the catheter.

Signs of an infection require medical care. If any appear, one should call a doctor or go to the nearest emergency room.


Overall, many people prefer suprapubic catheters over urethral catheters. Suprapubic catheters still require careful use and attention to cleanliness, however.

Using a catheter, especially in the long-term, should be discussed with a doctor to determine the benefits and risks.

Suprapubic catheters may offer a more comfortable alternative to the standard urethral catheter and may offer people a way to manage incontinence and other issues better.

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Medical News Today: Can you live without a pancreas? What you need to know

While it is possible to live without a pancreas, doctors only recommend removing a pancreas when a person has a serious medical condition such as severe recurrent pancreatitis or pancreatic cancer.

In most cases, medical treatments can take the place of the pancreas, but people living without a pancreas require diligent monitoring and medical care. Removal of the pancreas also means a person will have to make a variety of lifestyle changes that can be tough to adjust to.

Can you live without a pancreas?

Diagram of the pancreas
The pancreas is located between the spine and stomach.

The pancreas is a gland that secretes hormones that a person needs to survive, including insulin. Decades ago, serious problems with the pancreas were almost always fatal. Now, it is possible for people to live without a pancreas.

Surgery to remove the pancreas is called pancreatectomy. The surgery can be partial, removing only the diseased portion of the pancreas, or a surgeon may remove the entire pancreas.

A complete pancreatectomy that removes the entire pancreas also requires the removal of parts of the stomach, a portion of the small intestine called the duodenum, and the end of the bile duct. The gallbladder and the spleen may be removed as well.

This extensive surgery can be dangerous and life-changing. After a pancreatectomy, a person will develop diabetes. They need to change their diet and lifestyle and will have to take insulin for the rest of their lives.

People who cannot produce enough insulin develop diabetes, which is why removing the pancreas automatically triggers the condition.

Removing the pancreas can also reduce the body’s ability to absorb nutrients from food. Without artificial insulin injections and digestive enzymes, a person without a pancreas cannot survive.

One 2016 study found that about three-quarters of people without cancer survived at least 7 years following pancreas removal. Among those with cancer, 7-year survival rates ranged from 30-64 percent, depending on the type of cancer they had and the degree to which it had spread.

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What does the pancreas do?

syringe of insulin
When the body does not create insulin, it cannot use glucose from food and blood sugar levels increase.

Located deep in the abdomen between the stomach and spine, the pancreas is a flat, leaf-shaped gland. Glands are organs that secrete chemicals the body needs to function.

The pancreas is divided into three parts: a wide end called the head, a thin end called the tail, and a middle portion called the body.

The pancreas makes insulin, a hormone that regulates blood sugar. When the body does not produce insulin, blood sugar levels (blood glucose) can become dangerously high.

Without insulin to help the body absorb blood glucose, the body cannot use glucose from food. This can result in malnutrition and other serious health problems.

The pancreas also produces digestive juices that help the body to break down and absorb food. The portion of the pancreas that makes digestive juices is called the exocrine pancreas, while the part of the pancreas responsible for making insulin is called the endocrine pancreas.

These hormones flow through a tube called the pancreatic duct into a portion of the small intestine called the duodenum. The liver and gallbladder also release digestive juices and other chemicals into the duodenum, allowing these organs to act together to help the body absorb food.

Why would the pancreas be removed?

Doctors may remove the pancreas for several reasons, including:

Pancreatic cancer

Pancreatic cancer is one of the deadliest cancers. Just 7 percent of people with this type of cancer live longer than 5 years following their diagnosis. This is primarily because pancreatic cancer is hard to detect in its early stages, which allows it to spread to other organs.

There are two types of surgery for pancreatic cancer:

  • Curative surgery, which is used to remove all cancer, potentially curing the person. This type of surgery must take place before the disease has spread.

  • Palliative surgery, which is used to prolong the life of the person and reduce the severity of some symptoms.

Chronic pancreatitis

Chronic pancreatitis is an infection or inflammation of the pancreas that recurs, or keeps coming back. Some forms of chronic pancreatitis are hereditary.

Pancreatitis can be extremely painful, and even fatal. When other treatments fail, or when the pancreas is severely damaged, a doctor may recommend a full or partial removal of the pancreas.

Intraductal papillary mucinous neoplasm

Intraductal papillary mucinous neoplasms (IPMN) are precancerous tumors that grow in the ducts of the pancreas. They can develop into cancer if left untreated. A doctor may sometimes recommend removing all or a portion of the pancreas to prevent the tumors from becoming cancerous

Removing the pancreas is not the only treatment for any of these conditions. A doctor will evaluate the risks and benefits of surgery with the person, and consider their overall health when deciding the best treatment option.

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Recovery and lifestyle changes

lady saying no sugar
Following surgery to remove a pancreas, eating a low-sugar diabetes diet is essential.

A person will remain in the hospital for several days to several weeks after surgery, depending on their condition. In the days following surgery, the person will be on a liquid diet, with solid foods slowly added in over time.

It is normal to feel pain in the days following surgery, and it can take several months to fully regain strength. The person will be unable to drive for 2-3 weeks following surgery.

It is possible to live a healthy life without a pancreas, but doing so requires on-going medical care. Pancreas removal causes diabetes, and can change the body’s ability to digest food. This requires lifelong diabetes treatment, including eating a low-sugar, low-carbohydrate diabetes diet.

The doctor may recommend eating several smaller meals each day to avoid blood sugar spikes. Avoiding drugs and alcohol can help maintain long-term health.

The person will need regular insulin injections. In some cases, these injections might be replaced by an insulin pump. It may be necessary to take digestive enzymes with each meal to ensure the food is properly absorbed.


The outlook for people without a pancreas depends on why the pancreas was removed. People with pancreatic cancer may still require cancer treatments if it has spread to other areas of the body. For other people, removing the pancreas fully cures their condition.

With proper medical care, lifestyle and diet changes, and a commitment to taking insulin as needed, it is possible to lead a relatively normal and healthy life.

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Medical News Today: Marijuana and ‘spice’ could trigger seizures, study says

marijuana and the human brain
Researchers suggest that the use of potent cannabinoids have the potential to trigger seizures.
While a number of studies have suggested that marijuana may be effective for reducing seizures, new research cautions that potent and synthetic forms of the drug have the opposite effect.

Researchers from the University of Tsukuba in Japan found that natural tetrahydrocannabinol (THC) – the psychoactive chemical in marijuana – and the synthetic cannabinoid JWH-018 caused seizures in mice.

Study leader Olga Malyshevskaya and colleagues say that their findings – which are published in the journal Scientific Reports – should serve as a “public alert” to the potential harms caused by high-potency and synthetic marijuana.

While marijuana remains that “most commonly used illicit drug” in the United States, it is becoming increasingly legalized in individual states for medicinal purposes, recreational purposes, or both.

There has been increasing research for the use of marijuana – particularly a cannabinoid in the drug called cannabidiol (CBD) – in the treatment of seizures in patients with epilepsy, though a debate surrounding its efficacy continues.

The new study from Malyshevskaya and team suggests that general use of high-potency marijuana – that is, marijuana that contains high amounts of THC – may actually trigger seizures.

The research also found that seizures could be prompted by JWH-018, which is a manmade cannabinoid that is the primary component of the synthetic marijuana known as “spice.”

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Seizure frequency higher with JWH-018

The researchers came to their findings by analyzing the brain activity of male mice after they received THC or JWH-018.

THC was given to the rodents in doses of 10 milligrams per kilogram (the equivalent to around 0.8 milligrams per kilogram in humans) and JWH-018 was administered in doses of 2.5 milligrams per kilogram (the equivalent to around 0.2 milligrams per kilograms in humans).

The team implanted electroencephalography (EEG) and electromyogram electrodes into the brains of the mice, which allowed them to monitor any seizure-related electrical activity in response to the drug compounds.


The movement and behavior of the rodents was also monitored through video recording.

The study revealed that the mice experienced seizures shortly after administration with both THC and JWH-018, though seizure frequency was significantly higher with JWH-018.

Seizure-related brain activity persisted for 4 hours after the administration of each drug, the team reports, but brain activity had returned to normal by the next day.

Interestingly, the researchers found that pre-treating the mice with AM-251 – which is a compound that binds to the cannabinoid-1-receptor – prevented seizures in response to THC and JWH-018.

As such, the team suggests that cannabinoid receptor antagonists could be useful for preventing seizures in the case of marijuana overdose.

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Study warns of possible dangers

According to the researchers, their results “provide strong evidence” that both plant-derived and synthetic cannabinoids have the potential to trigger seizures.

“On the other hand,” the authors note, “a substantial body of literature on cannabinoids in animal models shows mostly anticonvulsive effects.”

“However,” they add, “few of these used EEG recordings to assess epileptic events and many of them induced seizures either electrically or pharmacologically, changing signaling pathways and brain states prior to cannabinoid application.”

The team cautions that the doses of THC and JWH-018 used in their study were high and may not represent the doses normally seen with medicinal or recreational use in humans.

“It would be interesting in the future to also test lower doses, typically used medicinally or recreationally to determine whether the effect is lost or diminished,” they add.

Still, they believe that their findings should be viewed as a warning of the potential dangers of cannabinoids, particularly synthetic marijuana.

Our study is quite important because unaware of the particularly severe effect by those cannabinoids, people see marijuana as a soft drug, without dangerous health effects.”

Olga Malyshevskaya

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