Obesity Is Linked With Cancer – Now We Finally Know Why

Cancer is caused by genetic changes

Brain Obesity Weight Loss

Cancer is caused by genetic changes that break down normal constraints on cell growth. It is known that obesity and overweight increases the risk of developing cancer, but the question until now has been why? Now, researchers at University of Bergen have demonstrated that lipids associated with obesity make cancer cells more aggressive and likely to form actual tumors.

Nils Halberg

Associate professor Nils Halberg. Credit: Melanie Burford

The researchers have discovered that the changed environment surrounding the cancerous cell, from a normal weight body to an overweight or obese body, pushes the cancer cell to adapt. This allows the malignant cells to form a tumor.

“This means that even in the absence of new gene mutations, obesity increases the risk that tumors will form,” says associate professor Nils Halberg.
Obesity is the cause of approximately 500 000 new cancer cases each year – a number that is expected to grow as obesity rates continue to increase.

“To scientifically dissect how these two complicated diseases interact has been extremely interesting and rewarding. Especially as this new understanding will enable researchers to design improved treatments for obese cancer patients,” Halberg adds

Reference: “C/EBPB-dependent adaptation to palmitic acid promotes tumor formation in hormone receptor negative breast cancer” by Xiao-Zheng Liu, Anastasiia Rulina, Man Hung Choi, Line Pedersen, Johanna Lepland, Sina T. Takle, Noelly Madeleine, Stacey D’mello Peters, Cara Ellen Wogsland, Sturla Magnus Grøndal, James B. Lorens, Hani Goodarzi, Per E. Lønning, Stian Knappskog, Anders Molven and Nils Halberg, 10 January 2022, Nature Communications.
DOI: 10.1038/s41467-021-27734-2

Source Credit: https://scitechdaily.com/obesity-is-linked-with-cancer-now-we-finally-know-why/

Endocrine Surgery

Surgery performed with its focus on one or more of the endocrine organs is referred to as endocrine surgery. The endocrine organs are glands located throughout the body, which secrete hormones that are vital for maintaining homeostasis (i.e. a constant internal environment) and metabolism into the bloodstream.

These glands together make up what is known as the endocrine system, whose control and command centers are the pituitary gland and hypothalamus. Other endocrine glands are the endocrine pancreas, pineal, adrenal, thyroid, and parathyroid glands. Specialists who conduct surgery on these glands are called endocrine surgeons.

Endocrine organs

Hypothalamus and pituitary gland

Hamartomas, although rare, are non-neoplastic tumors that arise in the hypothalamus and cause devastating consequences, such as seizures, cognitive impairment, behavioural and emotional troubles, hormonal imbalances and early puberty. Surgical removal of the tumor is required, and surgeons take advantage of the physiological gap between the hemispheres of the brain to gain access to the tumor and remove it.

Another less invasive approach is the use of stereotactic radiosurgery (gamma knife), which uses light energy to destroy the tumor and surrounding damaged tissue. It is a more focused form of standard external beam radiotherapy that targets the tumor more precisely.

The pituitary gland, located at the base of the brain, is the size of a kidney bean, yet is responsible for growth and development, and the function of all endocrine glands. Tumors of the pituitary gland are mostly benign adenomas that remain within the pituitary gland and do not metastasize. However, some tumors produce excess hormone, which is responsible for the symptoms.

Others produce symptoms because of the mass effect of the tumor itself. Most pituitary gland tumors may not require treatment, but if the tumor is compressing the optic nerve, then emergency surgery is necessary. There are two main surgical approaches: an endoscopic trans-nasal trans-sphenoidal (ETNTS) method and a trans-cranial technique.

With the ETNTS approach, surgeons remove the pituitary tumor through the sphenoidal sinuses and the nose. There is no need for an external incision. Moreover, there is no effect on other parts of the brain, and just as importantly, there are no surgical scars producing a better aesthetic effect.

Large tumors, however, may be much more difficult to remove via this method. Therefore, a trans-cranial approach or craniotomy may be done. An incision is made through the upper part of the scalp and the tumor is removed.

Endocrine pancreas and neuroendocrine glands

In contrast to the exocrine pancreas, which produces enzymes for digestion, the endocrine pancreas secretes hormones, such as glucagon, insulin and gastrin. These are produced with the help of specialized cells called “islet cells” that are found scattered throughout the pancreas, which is itself located deep within the abdominal cavity.

Tumors may arise in the endocrine pancreas that warrant surgical removal. These tumors can cause local symptoms due to the mass of tumor compressing adjacent structures, or they may be responsible for clinical syndromes due to the overproduction of hormones.

Cells of neural crest embryological origin can develop into neuroendocrine tumors. These are commonly found in the lungs and gastrointestinal tract, and cause symptoms due to hormone production. Since endocrine pancreatic tumors as well as neuroendocrine gland tumors are found deep within the abdominal cavity, surgery is done under general anesthesia. It may be necessary in some cases to remove parts of the intestine and/ or pancreas.

Pineal gland

The pineal gland is the location of the internal biological clock in humans. It is a small gland located posteriorly within the diencephalon in the center of the brain. In the absence of light, and at night, it secretes melatonin, a hormone that plays a pivotal role in regulating circadian and seasonal rhythms.

Although extremely rare, tumors may arise in the pineal gland. These will necessitate surgery to remove the tumor, which can cause serious complications, such as visual impairment, seizures, and memory disturbances. Surgical removal is usually curative.

Adrenal glands

The adrenal glands, like other endocrine glands, are also susceptible to the formation of tumors, both benign and malignant, that can cause a wide range of symptoms. Most of these tumors can be surgically removed and are usually amenable to laparoscopy. In some patients, however, an open adrenalectomy may be required. Associated risks include infection, bleeding, and extreme changes in blood pressure. These risks are outweighed by the medical benefits of the surgery.

Thyroid and parathyroid glands

Thyroid gland removal, also referred to as thyroidectomy, may be indicated for benign and malignant thyroid lesions, as well as an overactive thyroid gland. The amount of the gland removed depends on the indication for the surgery. Partial removal is warranted in some cases, allowing the remaining parts to function normally after the operation.

In contrast, total removal means that the patient will need lifelong thyroid hormone supplementation, as is the case when other endocrine glands are completely removed. It is a safe procedure, but may have associated risks, such as bleeding, infection and inadvertent injury to the laryngeal nerve, or the parathyroid glands.

Thyroidectomies may be done by one of three approaches. In the first, which is the conventional approach, an incision is made down the center of the neck to access the gland directly. In the second approach, the gland is removed endoscopically with smaller neck incisions. The third approach is called the robotic method. Here incisions are made in the chest or armpit, circumventing the need for incisions in the center of the neck.

Parathyroid surgeries may also be required for similar indications as a thyroid surgery and the diseased parathyroid gland is surgically removed via neck incisions in a similar fashion.

Source Credit: https://www.news-medical.net/health/Endocrine-Surgery.aspx

Hernia

A hernia happens when an internal organ pushes through a weak spot in your muscle or tissue. There are several types of hernia that you can experience including, inguinal hernias, femoral hernias, umbilical hernias, and hiatal hernias. If you have a hernia, it’s important to treat it quickly.

What is a hernia?

A hernia occurs when an internal organ or other body part protrudes through the wall of muscle or tissue that normally contains it. Most hernias occur within the abdominal cavity, between the chest and the hips.

The most common forms of hernia are:

  • Inguinal hernia: In men, the inguinal canal is a passageway for the spermatic cord and blood vessels leading to the testicles. In women, the inguinal canal contains the round ligament that gives support for the womb. In an inguinal hernia, fatty tissue, or a part of the intestine pokes into the groin at the top of the inner thigh. This is the most common type of hernia and affects men more often than women.
  • Femoral hernia: Fatty tissue or part of the intestine protrudes into the groin at the top of the inner thigh. Femoral hernias are much less common than inguinal hernias and affect older women.
  • Umbilical hernia: Fatty tissue or part of the intestine pushes through the abdomen near the navel (belly button).
  • Hiatal (hiatus) hernia: Part of the stomach pushes up into the chest cavity through an opening in the diaphragm (the horizontal sheet of muscle that separates the chest from the abdomen).

Other types of hernias include:

  • Incisional hernia: Tissue protrudes through the site of an abdominal scar from a remote abdominal or pelvic operation.
  • Epigastric hernia: Fatty tissue protrudes through the abdominal area between the navel and lower part of the sternum (breastbone).
  • Spigelian hernia: The intestine pushes through the abdomen at the side of the abdominal muscle, below the navel.
  • Diaphragmatic hernia: Organs in the abdomen move into the chest through an opening in the diaphragm.

How common are hernias?

Of all hernias that occur:

  • 75 to 80% are inguinal or femoral.
  • 2% are incisional or ventral.
  • 3 to 10% are umbilical, affecting 10 to 20% of newborns; most close by themselves by 5 years of age.
  • 1 to 3% are other types.

SYMPTOMS AND CAUSES

What causes a hernia?

Inguinal and femoral hernias are due to weakened muscles that may have been present since birth or are associated with aging and repeated strains on the abdominal and groin areas. Such strain may come from physical exertion, obesity, pregnancy, frequent coughing, or straining on the toilet due to constipation.

Adults may get an umbilical hernia by straining the abdominal area, being overweight, having a long-lasting heavy cough or after giving birth.

The cause of hiatal hernias is not fully understood, but a weakening of the diaphragm with age or pressure on the abdomen could play a part.

What are the symptoms of a hernia?

A hernia in the abdomen or groin can produce a noticeable lump or bulge that can be pushed back in, or that can disappear when lying down. Laughing, crying, coughing, straining during a bowel movement, or physical activity may make the lump reappear after it has been pushed in. More symptoms of a hernia include:

  • Swelling or bulge in the groin or scrotum (the pouch that contains the testicles).
  • Increased pain at the site of the bulge.
  • Pain while lifting.
  • Increase in the bulge size over time.
  • A dull aching sensation.
  • A sense of feeling full or signs of bowel obstruction.

In the case of hiatal hernias there are no bulges on the outside of the body. Instead, symptoms may include heartburn, indigestion, difficulty swallowing, frequent regurgitation (bringing food back up) and chest pain.

DIAGNOSIS AND TESTS

How is a hernia diagnosed?

It is usually possible to see or feel a bulge in the area where a hernia has occurred by physical exam. As part of a male’s typical physical exam for inguinal hernias, the doctor feels the area around the testicles and groin while the patient is asked to cough. In some cases, soft-tissue imaging like a CT scan will accurately diagnose the condition.

MANAGEMENT AND TREATMENT

What kind of doctor do you see for a hernia?

When you have a hernia, treatment will start with your primary care provider. If you need surgery to repair the hernia, you’ll be referred to a general surgeon. In fact, ventral hernia repairs are one of the most common operations U.S. general surgeons perform.

If you think you have a hernia, don’t wait to seek help. A neglected hernia can grow larger and more painful — this can lead to complications and possibly emergency surgery. Early repair is more successful, less risky and offers a better recovery and outcome.

How is a hernia treated?

Hernias usually do not get better on their own, and surgery may be the only way to repair them. However, your doctor will recommend the best therapy to address your hernia and may refer you to a surgeon. If the surgeon thinks it is necessary to repair your hernia, then the surgeon will tailor the method of repair that best meets your needs.

In the case of an umbilical hernia in a child, surgery may be recommended if the hernia is large or if it has not healed by the age of 4 to 5 years old. By this age, a child can usually avoid surgical complications.

If an adult has an umbilical hernia, surgery is usually recommended because the condition will not likely improve on its own and the risk of complications is higher.

One of three types of hernia surgery can be performed:

  • Open surgery, in which a cut is made into the body at the location of the hernia. The protruding tissue is set back in place and the weakened muscle wall is stitched back together. Sometimes a type of mesh is implanted in the area to provide extra support.
  • Laparoscopic surgery involves the same type of repairs. However, instead of a cut to the outside of the abdomen or groin, tiny incisions are made to allow for the insertion of surgical tools to complete the procedure.
  • Robotic hernia repair, like laparoscopic surgery, uses a laparoscope, and is performed with small incisions. With robotic surgery, the surgeon is seated at a console in the operating room and handles the surgical instruments from the console. While robotic surgery can be used for some smaller hernias, or weak areas, it can now also be used to reconstruct the abdominal wall.

Each type of surgery has its advantages and disadvantages. The patient’s surgeon will decide the best approach.

What can happen if a hernia is not treated?

Other than umbilical hernias in babies, hernias will not disappear on their own. Over time, a hernia can grow larger and more painful or can develop complications.

Complications of an untreated inguinal or femoral hernia may include:

  • Obstruction (incarceration): Part of the intestine becomes stuck in the inguinal canal, causing nausea, vomiting, stomach pain, and a painful lump in the groin.
  • Strangulation: Part of the intestine is trapped in a way that cuts off its blood supply. In such cases, emergency surgery (within hours of occurring) is necessary to prevent tissue death.

PREVENTION

How can a hernia be prevented?

  • Maintain ideal body weight by eating a healthy diet and exercising.
  • Eat enough fruits, vegetables, and whole grains to avoid constipation.
  • Use correct form when lifting weights or heavy objects. Avoid lifting anything that is beyond your ability.
  • See a doctor when you are ill with persistent coughs or sneezing.
  • Don’t smoke, as the habit can lead to coughing that triggers a hernia.

OUTLOOK / PROGNOSIS

What can be expected following surgical treatment for a hernia?

After surgery, you will be given instructions. These include what diet to follow, how to care for the incision site, and how to take care to avoid physical strain. Hernias may recur regardless of the repair operations. This is sometimes caused by inherent tissue weakness or protracted healing. Smoking and obesity are also major risk factors for hernia recurrence.

Source Credit: https://my.clevelandclinic.org/health/diseases/15757-hernia

Durban metabolic surgery center joins ranks of the few in SA accredited to perform a specialized procedure

The Durban Metabolic Surgery Centre, run by well-known surgeons Dr Gert du Toit and Dr Ivor Funnell, has been accredited by the South African Society for Surgery, Obesity and Metabolism (SASSO) to perform the highly advanced Biliopancreatic Diversion with Duodenal Switch (BPD-DS) surgery. Performing procedures at Netcare St Augustine’s and Netcare uMhlanga hospitals, Drs Du Toit and Funnell started performing laparoscopic gastric bypass surgery – the preferred procedure for morbid obesity and associated illnesses including type 2 diabetes – in 2006. Since then the team has completed approximately 660 procedures, which have achieved some life-changing results for patients. Read more:

Your gut senses the difference between real sugar and artificial sweetener

Sugar preference isn’t just a matter of taste – it’s deeper than that

Date: January 13, 2022 Source: Duke University Summary: Why do mice without taste buds still prefer real sugar to fake stuff? ‘We’ve identified the cells that make us eat sugar, and they are in the gut,’ said one of the researchers. Specialized cells in the upper gut send different signals to the brain for sugar and sugar substitutes.

Your taste buds may or may not be able to tell real sugar from a sugar substitute, but there are cells in your intestines that can and do distinguish between the two sweet solutions. And they can communicate the difference to your brain in milliseconds.

Not long after the sweet taste receptor was identified in the mouths of mice 20 years ago, scientists attempted to knock those taste buds out. But they were surprised to find that mice could still somehow discern and prefer natural sugar to artificial sweeteners, even without a sense of taste.

The answer to this riddle lies much further down in the digestive tract, at the upper end of the gut just after the stomach, according to research led by Diego Bohórquez, an associate professor of medicine and neurobiology in the Duke University School of Medicine.

In a paper appearing Jan. 13 in Nature Neuroscience, “we’ve identified the cells that make us eat sugar, and they are in the gut,” Bohórquez said. Infusing sugar directly into the lower intestine or colon does not have the same effect. The sensing cells are in the upper reaches of the gut, he said.

Having discovered a gut cell called the neuropod cell, Bohórquez with his research team has been pursuing this cell’s critical role as a connection between what’s inside the gut and its influence in the brain. The gut, he argues, talks directly to the brain, changing our eating behavior. And in the long run, these findings may lead to entirely new ways of treating diseases.

Originally termed enteroendocrine cells because of their ability to secrete hormones, specialized neuropod cells can communicate with neurons via rapid synaptic connections and are distributed throughout the lining of the upper gut. In addition to producing relatively slow-acting hormone signals, the Bohórquez research team has shown that these cells also produce fast-acting neurotransmitter signals that reach the vagus nerve and then the brain within milliseconds.

Bohórquez said his group’s latest findings further show that neuropods are sensory cells of the nervous system just like taste buds in the tongue or the retinal cone cells in the eye that help us see colors.

“These cells work just like the retinal cone cells that that are able to sense the wavelength of light,” Bohórquez said. “They sense traces of sugar versus sweetener and then they release different neurotransmitters that go into different cells in the vagus nerve, and ultimately, the animal knows ‘this is sugar’ or ‘this is a sweetener.'”

Using lab-grown organoids from mouse and human cells to represent the small intestine and duodenum (upper gut), the researchers showed in a small experiment that real sugar stimulated individual neuropod cells to release glutamate as a neurotransmitter. Artificial sugar triggered the release of a different neurotransmitter, ATP.

Using a technique called optogenetics, the scientists were then able to turn the neuropod cells on and off in the gut of a living mouse to show whether the animal’s preference for real sugar was being driven by signals from the gut. The key enabling technology for the optogenetic work was a new flexible waveguide fiber developed by MIT scientists. This flexible fiber delivers light throughout the gut in a living animal to trigger a genetic response that silenced the neuropod cells. With their neuropod cells switched off, the animal no longer showed a clear preference for real sugar.

“We trust our gut with the food we eat,” Bohórquez said. “Sugar has both taste and nutritive value and the gut is able to identify both.”

“Many people struggle with sugar cravings, and now we have a better understanding of how the gut senses sugars (and why artificial sweeteners don’t curb those cravings),” said co-first author Kelly Buchanan, a former Duke University School of Medicine student who is now an Internal Medicine resident at Massachusetts General Hospital. “We hope to target this circuit to treat diseases we see every day in the clinic.”

In future work, Bohórquez said he will be showing how these cells also recognize other macronutrients. “We always talk about a gut sense,’ and say things like ‘trust your gut,’ well, there’s something to this,” Bohórquez said.

“We can change a mouse’s behavior from the gut,” Bohórquez said, which gives him great hope for new therapies targeting the gut.

Source Credit: Duke University. “Your gut senses the difference between real sugar and artificial sweetener: Sugar preference isn’t just a matter of taste – it’s deeper than that.” ScienceDaily. ScienceDaily, 13 January 2022. www.sciencedaily.com/releases/2022/01/220113111410.htm

Bowel habits written in the DNA: New clues for irritable bowel syndrome

Credit: bowel-pixabay-cco-public-domain

In a large-scale study published in Cell Genomics, researchers studied the DNA of more than 160,000 people who provided information on the frequency of their bowel movements. Genetic profiles and specific genes were identified, which influence bowel habits and susceptibility to irritable bowel syndrome, the most common gastrointestinal disorder.

How often people move the bowels is important for wellbeing and reflects the correct functioning of the gastrointestinal (GI) tract in digesting and absorbing nutrients while excreting waste products of digestion and toxic substances. Irregular bowel habits and altered gut motility, including constipation and diarrhea, are often observed in common gastrointestinal conditions like irritable bowel syndrome (IBS), a disorder that affects up to 10% of the population worldwide. The precise mechanisms regulating peristalsis (the action of intestinal muscles pushing food and feces along the GI tract), as well as the reasons why this is often altered in IBS, are unknown. They may be hidden in our genome, it turns out.

An international team coordinated by Mauro D’Amato, Ikerbasque Research Professor at CIC bioGUNE in Spain, in a research article published online in the journal Cell Genomics, have demonstrated for the first time that the frequency of defecation is a heritable character in humans, and that specific genetic profiles influence bowel habits as well as predisposition to IBS. They studied 167,875 individuals from population-based cohorts in the UK (UK Biobank), the Netherlands (LifeLines-Deep), Belgium (Flemish Gut Flora Project), Sweden (PopCol), and U.S. (Genes for Good), and correlated their genetic makeup with questionnaire data, mostly in relation to a simple query about the number of times one opens the bowels every day (the “stool frequency,” as they called it in the study).

They discovered that among people with higher (or lower) stool frequency, specific DNA changes were more common than in the rest of the population. These changes, found in 14 regions of the human genome, involved several genes that were studied more in detail: “We were surprised how much sense these new findings make, highlighting multiple molecules whose role in gut motility was already known from clinical studies, including the communication between the brain and the gut,” says Ferdinando Bonfiglio, first author of the study. Some of the genes reported in the study produce neurotransmitters, hormones, and other molecules especially active in the brain and nerve cells involved in the control of intestinal peristalsis, and even targeted pharmaceutically to induce bowel movements in previous studies (like BDNF). “These results are very exciting and warrant follow-up studies: once more stool frequency genes are unequivocally identified, we may have a battery of new drug targets to be exploited for the treatment of constipation, diarrhea and common dysmotility syndromes like IBS” explains the corresponding author Mauro D’Amato.

The team also reported evidence of a common genetic background for stool frequency and IBS, and that this information may be used to identify individuals at increased risk of disease. This was more informative for IBS predominantly characterized by diarrhea (IBS-D). The researchers translated genetic findings from their study into simple numerical values (called polygenic scores), to estimate the probability of having altered stool frequency in each individual. Using data from UK Biobank, they then showed that people with higher polygenic scores were up to five times more likely to suffer from IBS-D than the rest of the population.

“The genetic information and the polygenic scores obtained in this study can be refined and eventually contribute to the classification of patients into different treatment groups, hopefully leading to improved therapeutic precision when aiming to bring gut dysmotility and altered bowel habits back to normal. This would be a major step forward in IBS, a common condition for which there is currently no effective treatment that works for all,” concludes Mauro D’Amato.

Source:https://medicalxpress.com/news/2021-12-bowel-habits-written-dna-clues.html

Abdominal Hernia Repair: What to Expect at Home

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

Incisional Hernia text on top view isolated on white background. Healthcare/Medical concept

Your Recovery

After surgery to repair your hernia, you are likely to have pain for a few days. You may also feel tired and have less energy than normal. This is common.

You should feel better after a few days and will probably feel much better in 7 days.

For several weeks you may feel discomfort or pull in the hernia repair when you move. You may have some bruising around the area of the repair. This is normal.

How can you care for yourself at home?

Activity

  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
  • If your doctor gives you an abdominal binder to wear, use it as directed. This is an elastic bandage that wraps around your belly and upper hips. It helps support your belly muscles after surgery.
  • Avoid strenuous activities, such as biking, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay.
  • Avoid lifting anything that would make you strain. This may include heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, a vacuum cleaner, or a child.
  • Ask your doctor when you can drive again.
  • Most people are able to return to work within 1 to 2 weeks after surgery. But if your job requires that you do heavy lifting or strenuous activity, you may need to take 4 to 6 weeks off from work.
  • You may shower 24 to 48 hours after surgery, if your doctor okays it. Pat the cut (incision) dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
  • Ask your doctor when it is okay for you to have sex.

Diet

  • You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
  • Drink plenty of fluids (unless your doctor tells you not to).
  • You may notice that your bowel movements are not regular right after your surgery. This is common. Avoid constipation and straining with bowel movements. You may want to take a fibre supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. You will also be given instructions about taking any new medicines.
  • If you take aspirin or some other blood thinner, ask your doctor if and when to start taking it again. Make sure that you understand exactly what your doctor wants you to do.
  • Be safe with medicines. Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your medicine after meals (unless your doctor has told you not to).
    • Ask your doctor for a different pain medicine.

Incision care

  • If you have strips of tape on the cut (incision) the doctor made, leave the tape on for a week or until it falls off. Or follow your doctor’s instructions for removing the tape.
  • If you have staples closing the cut, you will need to visit your doctor in 1 to 2 weeks to have them removed.
  • Wash the area daily with warm, soapy water, and pat it dry. Don’t use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.

Other instructions

  • Hold a pillow over your incision when you cough or take deep breaths. This will support your belly and decrease your pain.
  • Do breathing exercises at home as instructed by your doctor. This will help prevent pneumonia.
  • If you had laparoscopic surgery, you may also have pain in your shoulder. The pain usually lasts about a day or two.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

Call your doctor or nurse call line now or seek immediate medical care if:

  • You are sick to your stomach or cannot drink fluids.
  • You have signs of a blood clot in your leg (called a deep vein thrombosis), such as:
    • Pain in your calf, back of the knee, thigh, or groin.
    • Redness and swelling in your leg or groin.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.
  • You cannot pass stools or gas.
  • You have pain that does not get better after you take pain medicine.
  • You have loose stitches, or your incision comes open.
  • Bright red blood has soaked through the bandage over your incision.

Watch closely for changes in your health, and be sure to contact your doctor or nurse’s call line if you have any problems.

Source: Credit: https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=bo1696

COVID patients on SSRI antidepressants are less likely to die, study finds

Electronic health records compared outcomes for patients across the country

Date: November 15, 2021

Source: University of California – San Francisco

Summary: A large analysis of health records from 87 health care centers across the United States found that people taking a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs), particularly fluoxetine, were significantly less likely to die of COVID-19 than a matched control group.

Box of Fluoxetine capsules 20 mg (artistic rendering).

A large analysis of health records from 87 health care centers across the United States found that people taking a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs), particularly fluoxetine, were significantly less likely to die of COVID-19 than a matched control group.

The results add to a body of evidence indicating that SSRIs may have beneficial effects against the worst symptoms of COVID-19, although large randomized clinical trials are needed to prove this.

“We can’t tell if the drugs are causing these effects, but the statistical analysis is showing significant association,” said Marina Sirota, Ph.D., associate professor of pediatrics and a member of the Bakar Computational Health Sciences Institute (BCHSI) at UC San Francisco. “There’s power in the numbers.”

The UCSF-Stanford research team analyzed electronic health records from the Cerner Real World COVID-19 de-identified database, which had information from almost 500,000 patients across the U.S. This included 83,584 adult patients diagnosed with COVID-19 between January and September 2020. Of those, 3,401 patients were prescribed SSRIs.

The large size of the dataset enabled researchers to compare the outcomes of patients with COVID-19 on SSRIs to a matched set of patients with COVID-19 who were not taking them, thus teasing out the effects of age, sex, race, ethnicity, and comorbidities associated with severe COVID-19, such as diabetes and heart disease, as well as the other medications the patients were taking.

The results showed that patients taking fluoxetine were 28 percent less likely to die; those taking either fluoxetine or another SSRI called fluvoxamine were 26 percent less likely to die, and the entire group of patients taking any kind of SSRI was 8 percent less likely to die than the matched patient controls.

Though the effects are smaller than those found in recent clinical trials of new antivirals developed by Pfizer and Merck, the researchers said more treatment options are still needed to help bring the pandemic to an end.

“The results are encouraging,” said Tomiko Oskotsky, MD, a research scientist in Sirota’s lab at BCHSI. “It’s important to find as many options as possible for treating any condition. A particular drug or treatment may not work or be well tolerated by everyone. Data from electronic medical records allow us to quickly look into existing drugs that could be repurposed for treating COVID-19 or other conditions.”

Other authors include David K. Stevenson, MD, Ivana Marić, Ph.D., Ronald J. Wong, Ph.D., and Nima Aghaeepour, Ph.D., of Stanford University; and Alice Tang and Boris Oskotsky, Ph.D., of UCSF.

Source Credit:

The results add to a body of evidence indicating that SSRIs may have beneficial effects against the worst symptoms of COVID-19, although large randomized clinical trials are needed to prove this.

“We can’t tell if the drugs are causing these effects, but the statistical analysis is showing significant association,” said Marina Sirota, PhD, associate professor of pediatrics and a member of the Bakar Computational Health Sciences Institute (BCHSI) at UC San Francisco. “There’s power in the numbers.”

The UCSF-Stanford research team analyzed electronic health records from the Cerner Real World COVID-19 de-identified database, which had information from almost 500,000 patients across the U.S. This included 83,584 adult patients diagnosed with COVID-19 between January and September 2020. Of those, 3,401 patients were prescribed SSRIs.

The large size of the dataset enabled researchers to compare the outcomes of patients with COVID-19 on SSRIs to a matched set of patients with COVID-19 who were not taking them, thus teasing out the effects of age, sex, race, ethnicity, and comorbidities associated with severe COVID-19, such as diabetes and heart disease, as well as the other medications the patients were taking.

The results showed that patients taking fluoxetine were 28 percent less likely to die; those taking either fluoxetine or another SSRI called fluvoxamine were 26 percent less likely to die, and the entire group of patients taking any kind of SSRI was 8 percent less likely to die than the matched patient controls.

Though the effects are smaller than those found in recent clinical trials of new antivirals developed by Pfizer and Merck, the researchers said more treatment options are still needed to help bring the pandemic to an end.

“The results are encouraging,” said Tomiko Oskotsky, MD, a research scientist in Sirota’s lab at BCHSI. “It’s important to find as many options as possible for treating any condition. A particular drug or treatment may not work or be well tolerated by everyone. Data from electronic medical records allow us to quickly look into existing drugs that could be repurposed for treating COVID-19 or other conditions.”

Other authors include David K. Stevenson, MD, Ivana Marić, Ph.D., Ronald J. Wong, Ph.D., and Nima Aghaeepour, Ph.D., of Stanford University; and Alice Tang and Boris Oskotsky, Ph.D., of UCSF.

Source Credit: https://www.sciencedaily.com/releases/2021/11/211115123538.htm

Stomach Cancer (Gastric Adenocarcinoma)

Image Credit: The Star

Stomach cancer is characterized by the growth of cancerous cells within the lining of the stomach. Also called gastric cancer, this type of cancer is difficult to diagnose because most people typically don’t show symptoms in the earlier stages.

What is stomach cancer?

The National Cancer Institute (NCI)Trusted Source estimates there’ll be approximately 28,000 new cases of stomach cancer in 2017. The NCI also estimates that stomach cancer is 1.7 percent of new cancer cases in the United States.

While stomach cancer is relatively rare compared to other types of cancer, one of the biggest dangers of this disease is the difficulty of diagnosing it. Since stomach cancer usually doesn’t cause any early symptoms, it often goes undiagnosed until after it spreads to other parts of the body. This makes it more difficult to treat.

Though stomach cancer can be hard to diagnose and treat, it’s important to get the knowledge you need to beat the disease.

What causes stomach cancer?

Your stomach (along with the esophagus) is just one part of the upper section of your digestive tract. Your stomach is responsible for digesting food and then moving the nutrients along to the rest of your digestive organs, namely the small and large intestines.

Stomach cancer occurs when normally healthy cells within the upper digestive system become cancerous and grow out of control, forming a tumor. This process happens slowly. Stomach cancer tends to develop over many years.

Risk factors of stomach cancer

Stomach cancer is directly linked to tumors in the stomach. However, there are some factors that might increase your risk of developing these cancerous cells. These risk factors include certain diseases and conditions, such as:

  • lymphoma (a group of blood cancers)
  • H. pylori bacterial infections (a common stomach infection that can sometimes lead to ulcers)
  • tumors in other parts of the digestive system
  • stomach polyps (abnormal growths of tissue that form on the lining of the stomach)

Stomach cancer is also more common among:

  • older adults, usually people 50 years and older
  • men
  • smokers
  • people with a family history of the disease
  • people who are of Asian (especially Korean or Japanese), South American, or Belarusian descent

While your personal medical history can impact your risk of developing stomach cancer, certain lifestyle factors can also play a role. You may be more likely to get stomach cancer if you:

  • eat a lot of salty or processed foods
  • eat too much meat
  • have a history of alcohol abuse
  • don’t exercise
  • don’t store or cook food properly

You may want to consider getting a screening test if you believe you’re at risk for developing stomach cancer. Screening tests are performed when people are at risk for certain diseases but don’t show symptoms yet.

Symptoms of stomach cancer

According to the NCITrusted Source, there are typically no early signs or symptoms of stomach cancer. Unfortunately, this means that people often don’t know anything is wrong until the cancer has reached an advanced stage.

Some of the most common symptoms of advanced stomach cancer are:

How is it diagnosed?

Since people with stomach cancer rarely show symptoms in the early stages, the disease is often not diagnosed until it’s more advanced.

To make a diagnosis, your doctor will first perform a physical exam to check for any abnormalities. They may also order a blood test, including a test for the presence of H. pylori bacteria.

More diagnostic tests will need to be done if your doctor believes that you show signs of stomach cancer. Diagnostic tests specifically look for suspected tumors and other abnormalities in the stomach and esophagus. These tests may include:

Treating stomach cancer

Traditionally, stomach cancer is treated with one or more of the following:

Your exact treatment plan will depend on the origin and stage of the cancer. Age and overall health can also play a role.

Aside from treating cancer cells in the stomach, the goal of treatment is to prevent the cells from spreading. Stomach cancer, when left untreated, may spread to the:

Preventing stomach cancer

Stomach cancer alone can’t be prevented. However, you can lower your risk of developing all cancers by:

In some cases, doctors may even prescribe medications that can help lower the risk of stomach cancer. This is usually done for people who have other diseases that may contribute to the cancer.

You may also want to consider getting an early screening test. This test can be helpful in detecting stomach cancer. Your doctor may use one of the following screening tests to check for signs of stomach cancer:

  • physical exam
  • lab tests, such as blood and urine tests
  • imaging procedures, such as X-rays and CT scans
  • genetic tests

Long-term outlook

Your chances of recovery are better if the diagnosis is made in the early stages. According to the NCITrusted Source, around 30 percent of all people with stomach cancer survive at least five years after being diagnosed.

The majority of these survivors have a localized diagnosis. This means that the stomach was the original source of cancer. When the origin is unknown, it can be difficult to diagnose and stage the cancer. This makes the cancer harder to treat.

It’s also more difficult to treat stomach cancer once it reaches the later stages. If your cancer is more advanced, you may want to consider participating in a clinical trial.

Clinical trials help determine whether a new medical procedure, device, or other treatment is effective for treating certain diseases and conditions. You can see if there are any clinical trials of treatments for stomach cancer on the NCI websiteTrusted Source.

The website also has resources trusted Source to help you and your loved ones cope with a stomach cancer diagnosis and its subsequent treatment.

Source Credit: https://www.healthline.com/health/gastric-cancer#diagnosis

Fungi that live in the gut influence health and disease

Vaccines that balance gut microbial communities may one day be used to improve gastrointestinal health

Fungi that live in the gut influence health and disease

Bacteria’s role in gut health has received a lot of attention in recent years. But new research led by scientists at the University of Utah Health shows that fungi — another microorganism that lives within us — may be equally important in health and disease.

Fungi thrive in the healthy gut, but they can also cause intestinal damage that may contribute to inflammatory bowel disease (IBD), according to the study published in Nature on July 14. Experiments with mice show that normally, the immune system keeps fungi in check, targeting the microbe when it switches into a state that can cause harm. When the system is off-balance, the disease is more likely to occur.

“Fungi have been wholly understudied in part because they are vastly outnumbered by bacteria,” says June Round, Ph.D., professor of pathology at U of U Health and the study’s senior author. New tools and technologies are starting to make investigations like this one possible, she adds. “This work adds an important piece to the bigger picture.”

These insights open new avenues for developing therapeutics to improve gut health. The study shows proof of concept that one day, vaccines could be used to curb gastrointestinal disease by enhancing natural immune responses that encourage a healthy balance of fungi and other gut microbiota.

A quest for balance

Round became interested in this line of research after noting that a common medical test for diagnosing Crohn’s disease, a type of IBD, works by detecting antibodies against fungi. And yet, how antibodies affect fungi’s influence on the disease had yet to be explored.

To dig deeper, her team searched for the trigger of the immune response. Working with patient samples and carrying out tests with mice, they determined that the yeast Candida albicans — one of the main species of fungi that reside in the human gut — elicited the strongest immune response. Further investigation showed that antibodies zeroed in on elongated fungal cell types called hyphae, specifically binding to proteins called adhesins that help microbes stick to surfaces and become invasive.

With this target in hand, the researchers could more definitively probe the fungi’s role in gut health. They found that mice populated with the yeast in its normal, rounded state remained healthy. In contrast, mice populated with Candida in its invasive form caused intestinal damage that resembled IBD. The results show that normal antibody responses in the gut inhibit disease by recognizing the harmful, hyphal form of fungi.

IBD isn’t the only health condition associated with fungi. Another is vaginal yeast infections. The researchers determined that a vaccine being investigated as a remedy for yeast infection triggered an immune reaction against adhesin proteins that is similar to the reaction in Crohn’s patients. When inoculated with the vaccine, mice normally prone to an IBD-like condition were less likely to develop the disease.

The researchers are now investigating whether vaccines could help mitigate IBD in people — and whether the same approach can be applied more broadly to shape other microbial communities in the gut. “We aim to exploit interactions with commensal microbes and the host immune system to harness microbial products for therapies,” Round says.

Healthy competition

In addition to implications for disease, the findings also suggest fungi may be important in the healthy gut. Typically, the immune system’s job is to clear infections by getting rid of invasive organisms. In this case, fungi benefit from their interaction with antibodies. The immune reaction prods fungi from their invasive state into their rounded, budding state, which improves their survival in the gut.

“The immune system is constraining Candida to its least pathogenic form,” says Kyla Ost, Ph.D., a postdoctoral researcher in Round’s lab and the study’s lead author. “This is showing us that the communication between host and microbe can be friendly, as opposed to antagonistic, in order to benefit both.”

Source Credit: https://www.sciencedaily.com/releases/2021/07/210714110525.htm