A simple blood test could make a great difference for those with brain cancer.

New blood test detects brain tumors with 87% accuracy

Dr. Matthew J. Baker, a reader in the Department of Pure and Applied Chemistry at the University of Strathclyde in Glasgow, United Kingdom, is the lead author of the new research.

He and his colleagues have now published their findings in the journal Nature Communications.

Of the study, Dr. Baker says, “This is the first publication of data from our clinical feasibility study, and it is the first demonstration that our blood test works in the clinic.”

Although it is quite rare, brain cancer often has a poor outlook.

According to the National Cancer Institute, around 0.6% of people will develop brain cancer or another cancer of the nervous system in their lifetime.

However, the 5 year survival rate for those who do receive such a diagnosis is less than 33%.

Largely, the poor outlook is due to the fact that brain tumors have very nonspecific symptoms, which makes them more difficult to distinguish from other conditions.

Study co-author Dr. Paul Brennan — a senior clinical lecturer and consultant neurosurgeon at the University of Edinburgh in the U.K. — explains, “Diagnosing brain tumors is difficult, leading to delays and frustration for lots of people.”

“The problem is that symptoms of brain tumor are quite nonspecific, such as headache, or memory problems. It can be difficult for doctors to tell which people are most likely to have a brain tumor,” he adds.

The lack of cost effective tests that can help doctors triage people with brain tumors in primary care also means that it takes longer to accurately diagnose brain cancer. This ultimately results in a poorer outlook.

The team’s new blood test brings much needed hope in this regard. Dr. Baker and colleagues used infrared light to create a “bio-signature” of people’s blood samples and applied artificial intelligence to scan for signs of cancer.

The test correctly identified brain cancer in a cohort of 104 people 87% of the time.

A more rapid means of diagnosis

As the researchers explain in their paper, they used a technique called attenuated total reflection-Fourier transform infrared (ATR-FTIR) spectroscopy and coupled it with machine learning technology to detect brain cancer.

The authors explain that the technique is “a simple, label free, noninvasive, nondestructive” way of analyzing the biochemical profile of a blood sample without requiring extensive preparation of the sample.

The ATR-FTIR technique allowed the researchers to work out a biochemical “fingerprint” of brain cancer.

Dr. Baker and team trained a machine learning algorithm to use these biochemical fingerprints to diagnose brain cancer in a retrospective cohort of 724 people. This cohort included people with primary and secondary cancers as well as control participants without cancer.

They then used the algorithm to predict brain cancer cases in a sample of 104 participants. Of these, 12 people had cancer, including four cases of glioblastoma. This is one of the most aggressive forms of brain tumor.

The findings revealed a sensitivity of 83.3% and a specificity of 87% for the blood test. “With this new test, we have shown that we can help doctors quickly identify which [people] with these nonspecific symptoms should be prioritized for urgent brain imaging,” says Dr. Brennan.

“This,” he adds, “means a more rapid diagnosis for people with a brain tumor, and quicker access to treatment.”

Hayley Smith — an ambassador for the Brain Tumor Charity in Hampshire, U.K. — adds that it is “very encouraging to hear that this blood test can lead to a quicker diagnosis for brain cancer.”

“This kind of test will be vital to patients, helping people to get the correct diagnosis quicker, which ultimately will help people to get the urgent medical care that they need.”

What to know about spotting in early pregnancy

Spotting in early pregnancy is common for many women and usually not a cause for concern. However, in some instances, it may occur as a symptom of a pregnancy complication.

About a quarter of pregnant women experience bleeding during the first trimester. Although bleeding is a possible sign of early pregnancy loss, it does not mean that this will happen. Several other conditions and factors, including normal hormonal shifts, may cause spotting in early pregnancy.

Causes

The most common causes of spotting in early pregnancy include:

Subchorionic hematoma

A subchorionic hematoma is sometimes called subchorionic hemorrhage. This happens when blood builds up near the chorion, which is the fetal membrane next to the placenta. The bleeding may also appear between the uterus and the placenta.

Subchorionic hematoma is a common pregnancy complication with various studies estimating the prevalence between 1.3% and 62% among different groups of pregnant women.

A subchorionic hematoma is not a pregnancy loss. Many pregnant women with this type of bleeding have no further complications during their pregnancy.

A 2012 meta-analysis of nine research studies concluded that there was a link between subchorionic hemorrhage and higher risk of pregnancy loss and preterm labor.

However, a 2013 observational study of 1,115 women that included 142 with a subchorionic hematoma found no significant increase in the risk of pregnancy complications.

Ectopic pregnancy

In an ectopic pregnancy, a fertilized egg implants outside of the uterus, often in the fallopian tubes. A woman may still have pregnancy symptoms or get a positive pregnancy test. The pregnancy, however, cannot survive. If it continues to grow, it can rupture and cause life threatening bleeding or a dangerous infection.

An ectopic pregnancy can cause spotting as the pregnancy grows. If the pregnancy ruptures, it can cause life threatening internal bleeding that may get progressively heavier over several hours.

Cervical irritation

The cervix, the doughnut-shaped entry to the uterus, increases its blood supply during pregnancy. This means it is more likely to bleed from irritation, such as after sex or a pelvic exam. Light spotting after any form of vaginal penetration is a possible sign of cervical bleeding.

Cervical bleeding is not dangerous and usually stops on its own within a few hours. The blood is typically red or brown, and the bleeding minimal.

Very rarely, a serious injury to the cervix, such as from an assault or trauma, might cause more severe cervical bleeding. These injuries can cause infections and other serious complications. It is important to see a doctor following any traumatic injury to the cervix or vagina.

Pregnancy loss

For many pregnant women, bleeding triggers fears of pregnancy loss. A 2010 study of 4,539 pregnant women found that 26.7% experienced bleeding at some point during their pregnancies, but only 12% had a pregnancy loss. These figures suggest that less than half of people who bleed during pregnancy have a pregnancy loss.

About two-thirds of people who do have a pregnancy loss report bleeding. As such, bleeding is a symptom that a pregnant person should not ignore. Any pregnant woman who has concerns about their pregnancy should speak to a doctor about risk factors and how to minimize them.

Hormonal shifts

Around the 7th week of pregnancy, a luteal-placental shift happens. This is when the placenta develops enough to begin producing hormones that sustain the pregnancy. Before this change, the corpus luteum — a group of cells that forms during ovulation — produces pregnancy hormones.

This hormonal change sometimes triggers a temporary drop in the hormone progesterone. This shift may cause spotting, or even bleeding as heavy as a period. As long as the placenta begins producing enough progesterone, the pregnancy can safely continue, and a woman will not have a pregnancy loss.

Diagnosis

A doctor or other healthcare provider may do numerous tests to diagnose bleeding. These may include:

Ultrasound

A doctor may order an ultrasound to help diagnose a subchorionic hematoma.

An ultrasound can diagnose a subchorionic hematoma. It can also tell a healthcare provider the location of the pregnancy, helping in the detection of an ectopic pregnancy.

After about the 6th week of pregnancy, an ultrasound can measure the viability of the pregnancy. If the embryo is growing correctly, and there is a sufficiently strong heartbeat, this suggests that the pregnancy will continue and the risk of pregnancy loss is low.

An ultrasound can also examine other pelvic organs to check for causes of bleeding. For example, an ovarian cyst may cause bleeding.

Blood tests

Blood tests can measure levels of the pregnancy hormone hCG. Low hCG may suggest that a pregnancy is not developing correctly or is in its early stages.

Some healthcare providers also check progesterone levels. Low progesterone may cause temporary bleeding, while very low progesterone may be a sign of an abnormal pregnancy.

Is it normal?

While many women who experience bleeding have healthy pregnancies, it is important never to treat bleeding as usual. Bleeding can be a critical symptom of several pregnancy-related symptoms, and prompt treatment for conditions such as ectopic pregnancy can save lives.

Implantation bleeding

Implantation happens when a fertilized egg embeds in the lining of the uterus. This marks the beginning of pregnancy. Some women notice spotting shortly after implantation. However, the body does not begin producing hCG until after implantation.

A woman is not pregnant until after implantation, and a pregnancy test cannot usually detect pregnancy until several days after implantation. So, bleeding that appears after a woman already knows she is pregnant is not implantation bleeding.

Implantation bleeding is usually brown. Some women may mistake the bleeding for their monthly period because it usually occurs around the time a woman expects her period.

The flow of implantation bleeding is often lighter and shorter than a period, so women who experience unusual bleeding after having sex should consider the possibility of pregnancy.

When to see a doctor

Speak to a doctor about any bleeding early in pregnancy. While the bleeding may be harmless, it is impossible to diagnose its cause without blood work, an ultrasound, or other diagnostic tests.

Bleeding from a ruptured ectopic pregnancy can endanger the life of the mother. While many pregnancy losses pass on their own, some require treatment to prevent excessive bleeding and infection.

Prompt medical care can be lifesaving. Even when there is no serious problem, the right care can offer peace of mind.

If a pregnant woman experiencing spotting has Rh-negative blood, a doctor may prescribe RhoGAM. This treatment can help prevent a condition known as erythroblastosis fetalis.

If a woman experiences light bleeding at any time, they should contact a midwife, doctor, or another healthcare provider.

A woman should visit an emergency room if:

  • they develop a fever
  • bleeding gets heavier over several hours
  • bleeding is heavy, similar to a period
  • there are large clots in the blood
  • they have cramps
  • there is severe pain in the abdomen
  • they feel dizzy or light-headed

Summary

Many women panic when they bleed during pregnancy, especially if they have a previous history of miscarriage. Seeking prompt care is the fastest way to ease anxiety and get clear answers.

It is not advisable for people to try to self-diagnose bleeding or assume that bleeding means a pregnancy loss. A few quick tests can usually diagnose the cause, and prompt treatment can prevent possible complications.

Sleeping for less than 6 hours each night could put people with diabetes or hypertension at a higher risk of premature death.

A new study analyzing the data of more than 1,600 adults found that people with hypertension or type 2 diabetes had a higher risk of death from stroke or heart disease if they slept for less than 6 hours per night.

Type 2 diabetes and hypertension (high blood pressure) are two very common health conditions around the world.

While there are tried and true ways of managing them, these conditions can increase a person’s risk of developing heart disease and experiencing a stroke.

Recently, a study that featured in the Journal of the American Heart Association found that one factor — sleep — may play a significant role for people with these health conditions.

“Our study suggests that achieving normal sleep may be protective for some people with these health conditions and risks,” says lead author Julio Fernandez-Mendoza, Ph.D., from the Pennsylvania State College of Medicine in Hershey.

“However,” he cautions, “further research is needed to examine whether improving and increasing sleep through medical or behavioral therapies can reduce risk of early death.”

Is short sleep duration ‘a useful risk factor?’

In the new study, Fernandez-Mendoza and team analyzed the data of 1,654 participants — 52.5% of whom were women — between the ages of 20 and 74 years. All of the participants had enrolled in the Penn State Adult Cohort.

The researchers split the participants into two categories according to cardiometabolic risk. The participants in one group had stage 2 hypertension or type 2 diabetes, while those in the other group had received a diagnosis of or treatment for heart disease or stroke.

Moreover, the researchers had access to data regarding the participants’ sleep duration, as this cohort had agreed to a 1-night evaluation in a sleep laboratory between 1991 and 1998. They also had access to death records and associated documentation for the years from 1992 through to 2016.

The team’s analysis revealed that of the 512 people who had died by 2016, about two-fifths had died because of causes relating to heart disease or stroke, while close to one-quarter had died following a cancer diagnosis.

What caught the investigators’ attention was the fact that among individuals who had hypertension or type 2 diabetes, the risk of death due to heart disease or stroke was two times higher in those who slept for less than 6 hours per night than in those who slept for 6 hours or more.

For the individuals with one of these two health conditions who slept for longer, the increased risk of premature death was not significant.

Additionally, participants in the heart disease and stroke group who slept for less than 6 hours a night had almost three times the risk of dying from cancer-related causes.

“Short sleep duration should be included as a useful risk factor to predict the long term outcomes of people with these health conditions and as a target of primary and specialized clinical practices.

Julio Fernandez-Mendoza, Ph.D.

“I’d like to see policy changes so that sleep consultations and sleep studies become a more integral part of our healthcare systems. Better identification of people with specific sleep issues would potentially lead to improved prevention, more complete treatment approaches, better long term outcomes, and less healthcare usage,” suggests Fernandez-Mendoza.

While this research adds to the evidence that sleep plays a crucial role in the maintenance of health and well-being, the study authors do admit that their current analysis has some limitations.

The chief limitation, they note, is the fact that they only had access to data on the duration of a single night’s sleep.

As this data came from laboratory observations, they caution that there is a possibility that the participants’ normal sleep patterns may have been different than usual because they were in an unfamiliar environment.

“Nevertheless, the associations found for those other clustered non‐[cardiovascular and cerebrovascular disease] causes of death had the expected [hazard ratios] and provided confidence about the reliability and validity of our findings,” the authors argue in their study paper.

How plant based diets can help people with rheumatoid arthritis

Many recent studies have highlighted the health benefits that a plant based diet can bring. Now, a new review explains just why it can be helpful for people living with rheumatoid arthritis.

Rheumatoid arthritis — a chronic autoimmune condition that causes pain and stiffness in the joints — has a prevalence of between 0.3% and 1% among the world’s population, according to the World Health Organization (WHO).

The condition can become so debilitating as to stop people from continuing in full time work. As the WHO also note, within only 10 years from disease onset, at least 50% of individuals with rheumatoid arthritis in high income countries become “unable to hold down a full time job.”

Doctors usually prescribe a range of drugs and lifestyle adjustments to help people manage their rheumatoid arthritis and make disability less likely. Management strategies that healthcare providers might advise include increased physical activity and weight loss.

Now, a new review appearing in the journal Frontiers in Nutrition shows that following a plant based diet can be a useful intervention when it comes to coping with this condition, as it triggers some helpful biological changes.

‘Symptoms may improve or even disappear’

The review — conducted by specialists from the Physicians Committee for Responsible Medicine in Washington, DC — looked at recent studies that observed the impact of diet on biological mechanisms that are important in rheumatoid arthritis.

It concluded that plant based diets lead to specific changes that can help relieve the symptoms of this condition.

One key way in which plant based diets can be helpful is by reducing levels of inflammation. The review authors cite a study from 2015 that showed participants who ate a plant based diet for 2 months had lower inflammation than those who ate a diet that was high in fat and featured more animal products.

The team also notes that additional research has found an association between adherence to diets high in fat and processed meat and a rise in markers of inflammation. One of these markers is C-reactive protein, a protein present in the blood, and one which reacts to inflammation.

On the other hand, following plant based diets or diets that have a high content of fiber has an association with lower levels of C-reactive protein.

Another study that the review looked at was a randomized clinical trial showing that, after following a low fat vegan diet for 4 weeks, individuals with moderate-to-severe rheumatoid arthritis saw significant improvements in symptoms, including joint pain and stiffness, tenderness, and swelling.

People with rheumatoid arthritis can also benefit from losing extra weight. According to evidence from a 2018 study, overweight individuals with rheumatoid arthritis who shed in excess of 5 kilograms were three times more likely to have improvements in their symptoms compared to those who lost less weight.

The review authors explain that vegetarian and vegan diets appear to help people lose weight, more so than any other diet types.

Finally, the researchers explain that plant based diets also seem to promote a healthy gut environment, since many of these diets are high in fiber, which, as studies have shown, influences the composition of the gut microbiome.

Specifically, plant based diets seem to increase bacterial diversity in the gut, which could help people with rheumatoid arthritis, precisely because they tend to lack bacterial diversity.

The investigators who conducted the review suggest there is a need for further research into the benefits that plant based diets may afford to people with inflammatory autoimmune conditions, as well as their underlying mechanisms.

However, they note that, so far, the emerging evidence suggests that eating more fruits, vegetables, whole grains, and legumes could make a real difference for people with rheumatoid arthritis.

“A plant based diet comprised of fruits, vegetables, grains, and legumes may be tremendously helpful for those with rheumatoid arthritis. This study offers hope that with a simple menu change, joint pain, swelling, and other painful symptoms may improve or even disappear.”

Study co-author Dr. Hana Kahleova

A complex relationship between Alcohol & Dementia

Although alcohol has been popular for millennia, and dementia is increasingly prevalent, scientists are yet to understand the relationship between the two. A recent study sets out for answers.

With dementia predicted to affect 13.9 million adults in the United States by 2060, understanding why these conditions develop is more urgent than ever.

Scientists have uncovered certain factors that increase the risk of developing dementia. Some, such as advancing age, cannot be prevented. However, it is possible to avoid other potential risk factors, such as smoking tobacco.

It is essential to identify modifiable risk factors as understanding these could help prevent or delay the onset of dementia.

Recently, researchers designed a study to look for links between dementia and alcohol consumption in older adults. They published their findings in JAMA Network Open.

What do we already know?

Perhaps surprisingly, as the authors explain, “we know little about the independent associations of quantity and frequency of alcohol consumption with dementia risk.”

Although some studies have investigated alcohol and dementia more broadly, there are still substantial gaps in our understanding. For instance, in an earlier study, researchers calculated alcohol consumption as a daily average across each year.

Using a daily average in this way misses the nuances of alcohol quantity and frequency.

This is an important point. For example, drinking 7 glasses of beer on 1 day each week is likely to have a different impact than drinking 1 glass of beer each night, every day of the week; although the quantity consumed is the same.

The authors of another study concluded that binge drinking in midlife increases the risk of dementia. However, it is still not clear whether regularly drinking smaller amounts of alcohol has the same effect.

Other studies muddy the water further by looking at the links between alcohol, dementia risk, and the presence of apolipoprotein E4 (APOE E4). This gene variant has associations with an increased risk of developing Alzheimer’s.

An earlier study concluded that alcohol consumption increases the risk of dementia and that people with the APOE E4 variant have a higher chance of developing dementia.

Another unknown is how alcohol influences dementia risk for individuals with mild cognitive impairment (MCI). Scientists consider MCI to be the stage between normal age-related cognitive decline and dementia.

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Alcohol and dementia data

To investigate, the scientists delved into an existing dataset, extracting the information from 3,021 participants, with an average age of 72.

The Ginkgo Evaluation of Memory Study from 2000–2008 supplied the data.

At the beginning of the study, participants provided information about the amount of alcohol they consumed, how often they drank, and what types of drinks they consumed — beer, wine, or liquor.

According to the authors, at the start of the study, each participant went through “a comprehensive neuropsychological battery of 10 tests.” These assessed a range of cognitive functions, and participants completed the tests every 6 months.

Scientists isolated DNA from blood samples to identify carriers of the APOE E4 variant.

Alongside genetic data and details about alcohol use, the scientists also collated information about blood pressure, body weight, height, history of heart disease, and smoking status. They also asked questions to estimate how regularly each participant was involved in social interactions.

Many gaps remain

Of the 3,021 participants, 2,548 did not have MCI, and 473 did have MCI. Over approximately 6 years of follow-up, 512 participants received a diagnosis of dementia.

The authors found that, among those without MCI, no amount of alcohol consumption increased dementia risk compared with those who drank less than one drink per week.

When they analyzed the group of individuals with MCI, it was a similar story; there was no statistically significant difference.

However, dementia risk appeared to be highest for the individuals with MCI who drank 14 drinks per week compared with those who drank less than one drink each week — a relative risk increase of 72%.

The authors also note some differences associated with drinking patterns:

“Daily low-quantity drinking was associated with lower dementia risk than infrequent higher-quantity drinking among participants without MCI at baseline.”

Although the authors are keen to underline the negative impacts of excessive drinking on brain health and health in general, they also note that:

“Our findings provide some reassurance that alcohol consumed within recommended limits was not associated with an increased risk of dementia among older adults with normal baseline cognition.”

When the researchers investigated the potential impact of APOE E4, they found no significant effect, which mirrors several previous studies. The authors theorize that the lack of effect might be because the association is more pronounced in younger populations; they call for further investigation.

In conclusion, the current study provides few solid answers. It confirms, however, that the relationship between alcohol and dementia is complex and likely to require a great deal more research.

Memory impairment in ARD correlates best with lesions of the thalamus. Atrophy of the mamillary bodies is specific for Wernicke’s Encephalopathy (WE) Diagnosis is clinical, not radiological.