Below you will find the short final reports of the 2020 Clinical Research Bursary recipients. Because they are not easy to read in all aspects by lay people, we have added a few sentences in the beginning to explain. Pancreatitis is an inflammatory disease of the pancreas. It can lead to severe complications including diabetes. Dr Lanzillotta’s work demonstrates that the standard treatment of the disease by corticosteroids aggravates the risk of developing diabetes. This encourages to find alternative treatments to this disease. “Towards Treatment Optimization in autoimmune Pancreatitis (the TOP Study)” Identifying predictors for long-term metabolic, infectious, and treatment-related complications in autoimmune pancreatitis patients Marco Lanzillotta I am deeply thankful to FDIME for granting me the opportunity to carry on my project on autoimmune pancreatitis in the marvelous frame of the Karolinska Institute, Stockholm, Sweden. Type 1 autoimmune pancreatitis (AIP) is a rare form of immune-mediated pancreatitis that belongs to the Immunoglobulin-G4 related disease (IgG4-RD) spectrum, sharing its most peculiar features such as serum IgG4 level elevation and a lymphoplasmacytic infiltrate in the affected organs. AIP carries a high risk of metabolic and infectious complications, related to pancreatic insufficiency and biliary strictures or immunosuppressive treatment, respectively. Moreover, AIP it […]
Why do you need iodine in your food? Which food does contain iodine? What happens if you are iodine deficient? How much do you need? These are important questions because without sufficient amounts of iodine in the food your thyroid can not function normally and this has consequences. Both thyroid hormones thyroxin (T4) and triiodothyronin (T3) do contain iodine (iodide) 4 and 3 molecules respectively. Without iodine no thyroid hormone can be synthesised and consequently hypothyroidism and/or goitre may develop. In case of endemic iodine deficiency even cretinism can occur. The recommended daily intake is 150 µg for an adult and a child aged 13 years or older. During pregnancy and lactation more iodine intake is required: respectively 200-250 µg and 250- 290 µg daily. It is not easy to measure on an individual basis whether a person is taking enough iodine. Iodine used to be incorpated in table salt, but with decreasing intake of salt other ways have been sought to deliver iodine. In many countries iodine is added to the salt used in the production of bread (in some countries already since many decades). Other high-iodine content foods are: fish/seafood, eggs, milk and other dairy foods. Vegans and […]
Demographic, clinical and lifestyle data were collected by the UK Biobank over the course of a year between 2009 and 2012. 171.616 adults without underlying heart disease or cancer at the start of the study did participate. Questions about the use of coffee were included. The data were analyzed and the patients were classified according to their usual coffee drinking habit. Participants (average age 55.6 years) were followed during up to 7 years. When compared to non-coffee drinkers, those who drank unsweetened coffee regularly in any amount were 16 to 21 % less likely to die. Adults who drank moderate amounts of coffee sweetened with sugar ( 1 teaspoon, 1,5 – 3,5 cups per day) were 29 to 31 % less likely to die. Results were inconclusive for those who added artificial sweeteners to their coffee. This was an observational study and may have missed important factors. Confounding variables such as differences in socioeconomic status, diet, and other lifestyle factors may impact findings. Coffee drinking patterns were from over a decade before in a country where many drink tea. So a comparison with other countries might not be easy. The average amount of daily sugar per cup of coffee is […]
A big prospective, multicenter, cohort study, conducted in the UK and the USA with 14.478 CAD (cardiac artery disease) patients with a median follow-up of 6.7 (UK) to 8.9 (USA) years has shown that very high HDL-c paradoxically are associated with higher mortality in individuals with CAD. This was also the case with low HDL-c levels. Normally HDL-c is considered to have a protective role with concern to CAD in opposite to the “bad” LDL-c. A higher HDL-c thus is associated with a lower CAD risk. However, as it appears now a very high HDL-c shows a complete different picture and is a big risk for mortality in CAD patients. In a recent presentation at the European congress of Internal Medicine ( ECIM) from Spain a 10-year follow-up of 1.849.087 workers with a mean age of 36.7 years, 67.8 % men, was reported. It was investigated how low and high HDL-c were associated with the development of a malignant neoplasm. In this large group of working people the risk of neoplasia (fatal or not) in indivuals with extreme HDL-c appeared to be much higher (5 times) than in the group with average HDL-c. In the group with a low HDL-c […]
Unwanted loss of appetite after major abdominal surgery is a common problem and has significance for the prognosis of the patient. The cause lies in a reduced gastric reservoir, combined with a decrease in the formation of ghrelin ( an appetite promoting hormone ) in the stomach and decreased secretion of satiety hormones in the small bowel. German investigators conducted a systemic review into this problem. They concluded that research into the problem is limited and heterogeneous. The studies analyzed include 20.506 patients. The only treatment with a high burden of proof was chewing chewing gum, measured on the basis of the time until the first feeling of hunger. Next to that diet guidance, watching cooking shows and “rikkunshito” (a traditional Japanese herbal remedy) could stimulate appetite. Administration of sophisticated drugs such as ghrelin intravenously and 5-HT-agonists respectively showed various results or were investigated only once. Appetite stimulants such as cannabinoids and corticosteroids have not been investigated in surgical patients. Unfortunately, it was not mentioned by the authors whether peppermint or a more sweet flavour of the gum had a better effect.
Long-term outcome after acute Covid-19 infection Author: Stefan Lindgren, Sweden The Covid-19 pandemic still persists, although the consequences for patients and societies have diminished dramatically after successful vaccination of the populations. The burden of disease on individuals and societies is still high in countries where the proportion of vaccinated individuals is low. However, new variants of the virus are likely to appear and the duration of the vaccine protection is uncertain. So, we will probably have to live with the threat from the Covid-19 virus and need for revaccination for a long time. Data is accumulating regarding long-term consequences after Covid-19 infection. Although the majority recovers completely, quite a few experience persistent symptoms for many months or even longer. The clinical outcome is more clearly described and understood if we consider two categories of patients; those with severe Covid-19 in need of hospitalization or even intensive care and those with clinically milder disease, managed outside the hospital. Also, the virus variants must be considered, which is particularly obvious now with the apparent milder course of disease with the omicron variant. The vast majority of patients with mild acute disease recover rapidly and completely, particularly those who are fully vaccinated. However, […]
A pooled cohort study was done in 20.065 English (9.254) and Chinese (10.811) aged people with a mean age of 64.6 years (UK) and 57.8 years (China) and a median follow-up of respectively 8 and 4 years. The proportion of females and males was approximately equal. During 100.000 person-years of follow-up global cognitive sccores in individuals with 4 hours or less and 10 hours or more of sleep per night declined faster than in the reference group (7 hours per night). The sleep duration per night was self-reported according to face-to-face interviews. An inverted U-shaped association between sleep duration and global cognitive decline was also observed. It is concluded that cognitive function should be monitored in individuals with insufficient (≤ 4 hours per night) or excessive ( ≥ 10 hours per night) sleep duration. Future studies should examine the mechanism of the association between sleep duration and cognitive decline.
A prospective cohort study from the US was performed in 2110 young adults of 38 to 50 years, wearing an accelerometer. Patients were followed during a mean of 10,8 years. Daily steps were classified as low (< 7000 steps/d), moderate (7000 – 9999 steps/d) and high ( > 10000 steps/d) and stepping intensity as peak 30-minute-stepping rate and time spent at 100 steps/min or more. Outcome prameter was all-cause mortality. During the follow-up period 72 patients (3.4 %) died. There was significantly lower risk of mortality in the moderate and high step groups. This lower risk was about equal in Black and White participants and also in women. There was, however, no association of step intensity with mortality.
What do you need to know about covid-19 and pregnancy? Authors: Nerea Maiz1,2, Berta Serrano1, Anna Suy1, Elena Carreras1,2 1 Hospital Universitari Vall d’hebron. Barcelona. Catalonia. Spain. 2 Universitat de Vic-Universitat central de Catalunya. Catalonia. Spain. The infection caused by the SARS-CoV-2 virus, which causes the COVID-19 disease, was first described in the city of Wuhan, China, in December 2019 and rapidly spread to the rest of the planet. The World Health Organization declared the coronavirus infection a pandemic in March 2020. A progressive accumulation of scientific evidence since the beginning of the pandemic has tried to determine the effect of this new disease on pregnancy and the influence of pregnancy in the course of the disease. How do normal changes in gestation influence in SARS-CoV-2 infection? Pregnant women have higher risk of disease and mortality due to certain respiratory infections. Normal changes of pregnancy make these patients especially susceptible to respiratory infections. Respiratory changes during pregnancy include increasing oedema and congestion in the upper airway tract and elevation of the diaphragm. These changes cause increased susceptibility to respiratory pathogens, added to others such as immunotolerance, metabolic changes, etc., make pregnancy a situation of special susceptibility. How is the virus […]