It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Saturday, November 26, 2022
DECRIMINALIZE DRINKING AT HOME
Tell UK government to raise legal at-home drinking age from 5 for kids, doctors urged
And dispel French drinking myth that early exposure staves off alcohol problems in later life
Children’s doctors in the UK need to take a much stronger and more visible steer in helping to ward off future alcohol problems by, among other things, campaigning to raise the legal at-home drinking age for kids from 5, argues an independent health education lecturer in a personal viewpoint, published online in the Archives of Disease in Childhood.
And they need to do far more to educate parents about the potential harms of early exposure to alcohol, including dispelling the French family drinking myth that childhood acculturation drives responsible drinking later on, argues Dr Aric Sigman. It doesn’t.
Figures from the World Health Organization show that individual alcohol consumption in France and years of life lost are higher, while alcohol’s contribution to the overall death rate is 26% higher, than in the UK, he points out.
Figures like these have prompted the French authorities to raise the legal drinking age and move to ‘denormalise’ drinking in a bid to curb the toll taken by alcohol on the nation’s health.
Alcohol is particularly problematic for the young, highlights the author. Globally, it remains the leading risk factor for premature death and disability among 15–49 year olds, and is a causal factor in more than 200 disease and injury conditions, including “staggering increases in liver disease mortality over the last 40 years, especially in the UK,” he points out.
Delaying the age at which children and young people take their first drink, even small sips, may lower their subsequent risk of becoming problem drinkers, he says.
Preliminary research suggests that introducing children to alcohol may sensitise the neurocircuitry of addiction by inducing neuroadaptations in brain regions involved in reward and addiction. Teen drinking may also lead to changes in gene expression that could influence drinking behaviour in adulthood, he adds.
“A more visible position by the paediatric profession is required which wrests ownership from that of alcohol initiation being a cultural issue to being a formal medical issue presided over by paediatric medicine—not the national culture,” he insists.
Doctors can educate parents about role modelling. Rather like tobacco, children who see their parents drink are more likely to try it themselves, and that includes using alcohol to ‘self medicate,’ he says.
And doctors can highlight the ‘normalising’ influence of the alcohol industry on school teaching materials, including lesson plans, fact sheets, and films, through their charities, youth education projects, and education trusts, he suggests.
And they can lobby the government to raise the at-home drinking age from 5—not as an attempt “to criminalise parents, but as a signal to reset the alcohol cultural landscape through formal gesture”—accompanied by the inclusion of mandatory warnings on all alcohol products and health promotion materials, stating that delaying the drinking age may reduce children’s lifetime risk of alcohol use disorders, he suggests.
“It is time we join the dots and take a far broader and more long-term approach to prevent and reduce future alcohol-related morbidity and mortality,” he writes.
“The paediatric profession has the respect and the authority to tell society not what it is interested in hearing, but what is in its children’s best interests,” he concludes.
Paediatricians can reduce future alcohol-related morbidity and mortality
ARTICLE PUBLICATION DATE
21-Nov-2022
Put the kettle on! How black tea (and other favorites) may help your health later in life
Thanks to flavonoids, a daily cup could help you to enjoy better cardiovascular health late in life — however if you’re not a tea drinker, there are other things you can add to your diet
A daily cup of tea could help you to enjoy better health late in life — however if you’re not a tea drinker, there are other things you can add to your diet.
The key is flavonoids, which are naturally occurring substances found in many common foods and beverages such as black and green tea, apples, nuts, citrus fruit, berries and more.
They have long been known to have many health benefits — however new Edith Cowan University (ECU) research shows they may be even better for us than previously thought.
The Heart Foundation supported a study of 881 elderly women (median age of 80), which found they were far less likely to have extensive build-up of abdominal aortic calcification (AAC) if they consumed a high level of flavonoids in their diet.
AAC is the calcification of the abdominal aorta — the largest artery in the body which supplies oxygenated blood from the heart to the abdominal organs and lower limbs — and is a predictor of cardiovascular risk such as heart attack and stroke.
It has also been found to be a reliable predictor for late-life dementia.
ECU Nutrition and Health Innovation Research Institute researcher and study lead Ben Parmenter said while there were many dietary sources of flavonoids, some had particularly high amounts.
“In most populations, a small group of foods and beverages—uniquely high in flavonoids—contribute the bulk of total dietary flavonoid intake,” he said.
“The main contributors are usually black or green tea, blueberries, strawberries, oranges, red wine, apples, raisins/grapes and dark chocolate.”
The flavonoid family
There are many different types of flavonoids, such as flavan-3-ols and flavonols, which the study indicated appear to also have a relationship with AAC.
Study participants who had a higher intake of total flavonoids, flavan-3-ols and flavonols were 36-39 per cent less likely to have extensive AAC.
Black tea was the study cohort’s main source of total flavonoids and was also associated with significantly lower odds of extensive AAC.
Compared with respondents who didn’t drink tea, participants who had two-to-six cups per day had 16-42 per cent less chance of having extensive AAC.
However, some other dietary sources of flavonoids such as fruit juice, red wine and chocolate, did not show a significant beneficial association with AAC.
Not just tea
Though black tea was the main source of flavonoids in the study — likely due to the age of the participants — Mr Parmenter said people could still benefit from flavonoids without putting the kettle on.
“Out of the women who don’t drink black tea, higher total non-tea flavonoid intake also appears to protect against extensive calcification of the arteries,” he said.
“This implies flavonoids from sources other than black tea may be protective against AAC when tea is not consumed.”
Mr Parmenter said this was important as it allows non-tea drinkers to still benefit from flavonoids in their diet.
“In other populations or groups of people, such as young men or people from other countries, black tea might not be the main source of flavonoids,” he said.
“AAC is a major predictor of vascular disease events, and this study shows intake of flavonoids, that could protect against AAC, are easily achievable in most people’s diets.”
VIDEO: A NEW REPORT BY THE EUROPEAN FEDERATION OF THE ASSOCIATIONS OF DIETITIANS (EFAD), SUPPORTED BY THE INSTITUTE FOR SCIENTIFIC INFORMATION ON COFFEE (ISIC), REVEALS MAJORITY OF EUROPEAN DIETITIANS BELIEVE MODERATE COFFEE CONSUMPTION HAS CLEAR HEALTH BENEFITS.view more
CREDIT: EFAD, SUPPORTED BY ISIC
62% believe drinking coffee in moderation has clear health benefits
86% agreed that regular, moderate intake of coffee improves alertness and 67% agreed that coffee consumption is associated with an improvement in overall sports performance
However, gaps in knowledge were identified regarding the associations between coffee intake and key non-communicable diseases
Tuesday 22ndNovember: A new report by the European Federation of the Associations of Dietitians (EFAD), supported by the Institute for Scientific Information on Coffee (ISIC), has revealed that almost two thirds (62%) of European dietitians believe drinking coffee in moderation has clear health benefits, with 86% agreeing that regular moderate intake can improve alertness and 69% agreeing that regular, moderate intake is associated with an improvement in overall sports performance.
The survey was completed by 585 dietitians from across 26 European countries who have direct contact with patients/clients, and provides new insights on current awareness and attitudes to coffee consumption from a healthcare perspective.
With over 2 billion cups of coffee being enjoyed around the world every day1, emerging research into its prospective role in health has suggested a possible ‘protective effect’ in relation to a number of non-communicable diseases, particularly those with an inflammatory component2. Whilst a detailed understanding of the exact association remains unclear, coffee continues to be an important consideration for healthcare professionals when considering aspects of a health lifestyle.
Key insights from the survey of European dietitians include:
The majority of dietitians (62%) believe that moderate coffee consumption has some clear health benefits, but the potential associations between coffee consumption and health are not widely known by the general public
Coffee remains a popular beverage throughout Europe, with 43% reporting patient’s consuming up to 3 cups a day and 3-5 cups a day, respectively, intake levels that are in line with current European Food Safety Authority’s (EFSA) recommendations3
62% of dietitians surveyed acknowledged a positive association with aspects of mental and physical performance, including improved alertness (86%), improved mood (61%), improvement in overall sports performance (69%) and agreed that coffee may be beneficial prior to exercise (51%). These findings reflect a previous ISIC consumer survey conducted during the lockdown of 20204
The associations between coffee intake and key non-communicable diseases are not as well known, with only 36% positively associating moderate coffee consumption with a reduced risk of cardiovascular disease (CVD), 30% with reduced risk of type 2 diabetes and 42% with a reduced risk of neurodegenerative conditions. This is in contrast to the weight of scientific evidence that suggests potential beneficial effects across all three disease areas5-9 much of which is summarised at coffeeandhealth.org
Caution in the level of consumption was observed in some populations, including those living with GI disorders (54%). Current research in relation to GI disorders shows no association between coffee intake and a number of gastric complaints10,11. Further research also suggests the polyphenols present in coffee may induce positive changes in the composition of the ‘good bacteria’ that supports the immune system12
To read the full report, titled “European dietitians’ perspectives on coffee consumption”, click here.
-ENDS-
Notes to editors
Of 585 recipients, 329 reported being currently employed in clinical services, including oncology, diabetes, weight management, gastroenterology, geriatrics, paediatrics, critical care, inpatient services, surgery, allergy and food intolerance. The remaining 256 reported current employment in sports, education, wellbeing, food services and/or are freelance
Countries included, Austria, Belgium, Croatia, Cyprus, Czech Republic, Denmark, Estonia, France, Germany, Greece, Hungary, Ireland, Italy, Lithuania, Luxembourg, Netherlands, North Macedonia, Poland, Portugal, Romania, Slovenia, Spain, Sweden, Switzerland, Turkey and the UK
European Food Safety Authority’s (EFSA) Scientific Opinion on the Safety of Caffeine states that 400mg of caffeine (approximately 3-5 cups of coffee) per day can be considered safe for most adult individuals. A cup of coffee typically provides around 75mg caffeine per day
Established in 1978. The European Federation of the Associations of Dietitians (EFAD) is a not-for-profit organisation that aims to be ‘The Voice of European Dietetics’, by supporting the leadership role of registered dietitians in positively impacting the nutritional health of their clients, patients and the wider community and ensuring every European citizen has access to safe and appropriate dietary and nutritional interventions.
EFAD members represent more than 35,000 registered dietitians, across 28 European countries. As well as a further 40 education associate members from two further EU countries.
For more information about the important work of EFAD, please visit efad.org.
About ISIC
The Institute for Scientific Information on Coffee (ISIC) is a not-for-profit organisation founded in 1990. ISIC is devoted to the study and disclosure of science related to coffee and health, including:
Study of scientific matters related to coffee and health
Evaluation of studies and scientific information about coffee and health
Support of independent scientific research on coffee and health
Dissemination of balanced coffee and health scientific evidence and knowledge to a broad range of stakeholders
ISIC respects scientific research ethics in all its activities and all of ISIC’s communications are based on sound science and rely on scientific studies derived from peer-reviewed scientific journals and other publications.
For more information about ISIC and to view the latest research into coffee, caffeine and health, please visit our new website www.coffeeandhealth.org.
British Coffee Association (BCA). (2022). Coffee is the most popular drink worldwide with around two billion cups consumed every day. Available at: https://britishcoffeeassociation. org/coffee-consumption/.
Ribeiro M, et al. (2022). The magical smell and taste: Can coffee be good to patients with cardiometabolic disease? Critical Reviews in Food Science and Nutrition. DOI: 10.1080/ 10408398.2022.2106938.
European Food Safety Authority (EFSA) Panel on Dietetic Products, Nutrition and Allergies (NDA). (2015). Scientific Opinion on the safety of caffeine. EFSA Journal. 13(5):4102.
Institute for Scientific Information on Coffee (ISIC). (2022). Legacy of lockdown on mental wellbeing and the role of coffee to support mood. Available at: https://www. coffeeandhealth.org/information-campaign/legacy-of-lockdown-on-mental-wellbeing-and-the-role-of-coffee-to-support-mood.
Crippa A, et al. (2014). Coffee consumption and mortality from all causes, cardiovascular disease, and cancer: a dose-response meta-analysis. Am J Epidemiol. 180(8):763-75.
Carlstrom M & Larsson SC. (2018). Coffee consumption and reduced risk of developing type 2 diabetes: a systematic review with meta-analysis. Nutr Revs. 76(6):395-417
Rodriguez Artalejo F & Lopez Garcia E. (2017). Coffee consumption and cardiovascular disease: a condensed review of epidemiological evidence and mechanisms. J Agric Fd Chem. 66(21):5257-63.
O’Keefe JH, et al. (2018). Coffee for cardioprotection and longevity. Prog Cardiovasc Dis. 61(1):38-42
Nehlig A. (2016). Effects of coffee/caffeine on brain health and disease: What should I tell my patients? Pract Neurol. 16(2):89-95.
Boekema PJ. (1999). Coffee and gastrointestinal function: facts and fiction. A review. Scand J Gastroenterol. 230:35-9.
Shimamoto T, et al. (2013). No association of coffee consumption with gastric ulcer, duodenal ulcer, reflux esophagitis, and non-erosive reflux disease: a cross-sectional study of 8,013 healthy subjects in Japan. PLoS One. 8(6):e65996.
Nehlig A. (2022) Effects of coffee on the gastro-intestinal tract: a narrative review and literature update. Nutrients.14(2):399.
New insight into how long-banned chemicals (PCBs) unleash their toxicity inside the body
IMAGE: THE BASIC STRUCTURE OF A POLYCHLORINATED BIPHENYL (PCB)view more
CREDIT: HIDEYUKI INUI
Polychlorinated biphenyls (PCBs) (*1) were widely used in industrial and commercial products including plastics, paints, electronic equipment and insulating fluids. Their manufacture was extensively banned from the late 70s onwards due to their toxicity, however large amounts still remain in our environment and accumulate inside animals’ bodies.
Chiral PCBs (*2) are PCBs that have two mirror-image isomers (*3); these isomers are identical reflections of each other with the same composition. Chiral PCBs are particularly dangerous because they have more chlorine atoms, which are hard for the body to break down, so they can accumulate in the body easily and their isomers are metabolized differently, causing isomer-specific toxicity (particularly neurodevelopmental issues). However, the process behind this selective metabolism was not known. To address this, a research group has illuminated how enzymes produced by the body unevenly metabolize the mirror-image isomers. These results will make it possible to estimate PCB metabolism and detoxification pathways in animals. They will also contribute towards the development of technology to make predictions about chiral PCBs’ mirror isomers, so that we can obtain a better understanding of potential toxicity in humans and other mammals.
These findings were made by a multi-institutional research collaboration, which included Associate Professor INUI Hideyuki (Kobe University Biosignal Research Center), Lead Researcher MATSUMURA Chisato (Hyogo Prefectural Institute of Environmental Sciences), Professor YAMAMOTO Keiko and Professor ITOH Toshimasa (Showa Pharmaceutical University), Associate Professor MORI Tadashi (Osaka University Graduate School of Engineering), and Visiting Professor NAKANO Takeshi (Osaka University Research Center for Environmental Preservation).
These research results were published online in the international academic journals Environmental Science & Technology on July 8, and Chemosphere on September 6, 2022.
Main points
In the past, PCBs were utilized in a vast range of industrial and commercial products. These highly carcinogenic chemical compounds remain in our environment and accumulate inside organisms.
PCBs have a dioxin-like toxicity and research into PCB metabolism is advancing.
However, research had yet to uncover how chiral PCBs’ mirror-image isomers are metabolized.
The researchers split the two atropisomers (mirror-image isomers) found in each type of chiral PCB and used them as substrates for CYP enzymes (*4).
Even though a pair of atropisomers are physically and chemically identical, there was a big difference in the extent to which they were metabolized.
Differences in CYP’s amino acids’ binding inhibition of each atropisomer cause the atropisomers to be metabolized differently.
These findings will be useful for measuring the atropisomers of chiral PCBs, which accumulate easily inside animals’ bodies.
Research Background Even though the manufacture and use of PCBs was banned around 50 years ago, they still remain in the environment. It has been discovered that PCBs accumulate inside the bodies of humans and other animals through food consumption. In particular, PCBs with many chlorine bonds are water resistant and do not break down easily. This enables high concentrations of these PCBs to accumulate inside animals’ bodies, which adversely affects their health. PCBs’ toxicity is induced by the aryl hydrocarbon receptor (AhR) (*5), causing similar adverse effects to dioxin (*6) poisoning such as cancer, teratogenesis and immune system damage. Research is being conducted on the particular types of PCB widely known to cause these effects, which are dioxin-like PCBs with one ortho chlorine substitution in the biphenyl ring of their chemical structure, or PCBs with no substitutions (Figure 1). However, if a PCB has more than 3 chlorine substitutions at the ortho position of the biphenyl ring, it becomes a mirror-image isomer called chiral PCB (Figure 2). These chiral PCBs do not demonstrate dioxin-like toxicity but are far more dangerous, binding with the ryanodine receptors (RyR) in organisms to become neurotoxic. The two mirror-image isomers (called atropisomers) in chiral PCB have identical physical and chemical properties and exist at a 1:1 ratio in commercial chiral PCB. However, biased ratios are often observed in the environment and in animals such as earthworms and whales, as well as humans. It is believed that this unbalanced ratio is mainly caused by metabolism and that one of chiral PCB’s atropisomers is more effected by the metabolic reaction thus reducing its concentration.
However, very little research has been carried out into differences in how these atropisomers are metabolized nor the structural arrangement of the metabolic enzymes.
Research Methodology To address this knowledge gap, the team conducted research focusing on the metabolic enzyme cytochrome P450 (CYP enzyme). The CYP enzyme reacts with foreign compounds that enter an animal’s body (for example, chemicals or pollutants in food, or medicines). CYP can convert them into water-soluble compounds and promote their expulsion from the body. Previous research by this group has shown that CYP enzymes hydroxylate and dechlorinate dioxin-like PCBs. This decreases PCB’s binding with AhR and increases its water solubility, promoting expulsion from the body and therefore counteracting its toxicity. In other words, CYP is an important enzyme that determines whether or not PCBs are treated as toxic compounds by the body. To measure the metabolic action of CYP on chiral PCB, the researchers set up a CYP enzyme and PCB docking model. They used this to estimate the structure of PCB metabolites and the structure of the CYP that decides to metabolize each of the PCB atropisomers differently.
For the experiment, the group selected three types of chiral PCB, each with a different number of substituted chlorine atoms; CB45 (4 chlorine substitutions), CB91 (5 chlorine substitutions) and CB183 (7 chlorine substitutions) (Figure 2). They separated the atropisomers for each type of chiral PCB using chromatography and let them react with a human CYP enzyme. It is thought that research on separating the atropisomers and letting them react has not been done before now. The results revealed big differences in how each atropisomer is metabolized (Figure 3). This revealed that even though the two atropisomers in one PCB have the same physical and chemical composition, they are biologically different. The researchers found that one of the chiral PCB atropisomers was metabolized more than the other one, disrupting the 1:1 ratio. In addition, it is thought that the amount of (aS)-CB183 atropisomer decreases because it is metabolized more than the other atropisomer, and this is supported by the reports of low accumulation of (aS)-CB183 in humans.
But why are these physically and chemically identical atropisomers metabolized differently by the CYP enzyme? To solve this mystery, the researchers used a computer model to investigate how easily each chiral PCB atropisomer binds to the chemical structure of CYP. They found that when an atropisomer fills up the substrate-binding cavity inside the CYP enzyme, CYP’s amino acids (that form the cavity) interfere with the binding between CYP and the atropisomer (see Figures 4 and 5).
Therefore, the atropisomer that isn’t interfered with by CYP’s amino acids becomes easy to metabolize (atropisomer (aR)-CB45 in CB45, and (aS)-CB183 in CB183), resulting in alterations to the original 1:1 ratio of atropisomers found in chiral PCB.
Further Research The results of this research will be useful for making predictions about the atropisomers of chiral PCBs, which accumulate easily inside animals’ bodies. In other words, it will be possible to work out which atropisomer is reduced by the metabolic reaction with CYP enzymes and which atropisomer remains inside the body. Chiral PCB’s toxicity is activated by binding with RyR, however the ability to bind with RyR differs between the atropisomers. Therefore, this research will make it possible to estimate the toxicity of chiral PCBs.
Mirror-image isomers for 3 different types of chiral PCB.
Of the two atropisomers in each chiral PCB, (aR)-CB45 in CB45 and (aS)-CB183 in CB183 are metabolized into hydroxylated metabolites more. In CB91, each atropisomer is metabolized at a similar rate.
Light blue indicates the substrate-binding cavity inside the CYP enzyme. The CYP enzyme is unable to form a stable interaction with the atropisomer (aS)-CB45 because (aS)-CB45 collides (indicated by the red lines) with leucine 363, therefore CYP produces fewer metabolites (see Figure 3).
Light blue indicates substrate-binding cavity inside the CYP enzyme. It is thought that metabolite formation activity is the same for both atropisomers (see Figure 3) because (aR)-CB91 collides with leucine 363 and (aS)-CB91 collides with phenylalanine 206 (collisions indicated by red lines).
CREDIT
Modified from Inui et al. Environmental Science & Technology, 2022
Glossary 1. Polychlorinated biphenyl (PCB): A chemical compound with between 1 to 8 chlorine atoms bound to its biphenyl ring. There are 209 types of PCB, each with different structures. Until the late 1970s, PCBs were manufactured for use as insulating oil and were also found in a variety of products, however their manufacture and use were banned worldwide after it was discovered that they are highly toxic. PCBs with many chlorine bonds do not break down easily so large quantities remain in the environment and inside organisms even almost 50 years after they were banned. 2. Chiral PCB: This is a PCB that has 3 or more chlorine substitutions at the ortho position. This structure inhibits the rotation of the bond connecting the 2 benzene rings. It also has 2 mirror isomers (a pair of atropisomers). There are 19 types of chiral PCB and according to the Cahn-Ingold-Prelog priority rules, their atropisomers are referred to as ‘aS’ and ‘aR’. 3. Mirror-image isomer (enantiomer): A pair of isomers that are non-superimposable mirror-images of each other, slightly similar to your left and right hands. Asymmetrical carbon compounds have mirror-image isomers. These isomers have the same physical and chemical properties. In chemical synthesis, a racemic mixture consists of an equal amount of each isomer in a 1:1 ratio. 4. Cytochrome P450 monooxygenase (CYP enzyme): This metabolic enzyme is found in most organisms- it is responsible for the oxygenation reaction in the biosynthesis pathway for various chemical compounds in the body. In addition to this it has a detoxifying function; it oxygenates foreign compounds in the body, which makes them water soluble and easier to excrete. 5. Receptor: These are proteins found in organism cells that bind to chemical substances and promote or control the expression of the gene required for the organism to respond to the chemical substance. Aside from the estrogen receptor (ER) that binds to the female hormone and the aryl hydrocarbon receptor (AhR) that binds to dioxins, there are many other known receptors for various hormones. 6. Dioxin: Dioxins are generated by incinerating trash at low temperatures. They are difficult to break down and persist in the environment and inside organisms for a long period of time. When dioxins enter an animal’s body via food, they bind to AhR (aryl hydrocarbon receptors) inside the cells and the gene transcription for the enzyme that detoxifies dioxins is activated.
Acknowledgements This study was supported by a Grant-in-Aid for Challenging Exploratory Research (grant number 25550064) from the Japan Society for the Promotion of Science and the Japan Science and Technology Agency’s CREST program (grant number JPMJCR2001).
IMAGE: AN OSAKA METROPOLITAN UNIVERSITY STUDY FINDS THAT CULTURAL DIFFERENCES BETWEEN JAPANESE AND AMERICAN UNIVERSITY STUDENTS CONTRIBUTE TO HESITANCY IN PROVIDING SOCIAL SUPPORT TO CLOSE FRIENDS OR FAMILY MEMBERS.view more
CREDIT: OSAKA METROPOLITAN UNIVERSITY
A research team led by Associate Professor Hirofumi Hashimoto, from the Graduate School of Literature and Human Sciences, Osaka Metropolitan University, analyzed the perspectives of providers of social support to examine differences in the attitudes of Japanese and American university students toward providing social support to close friends or family members.
Initially, a questionnaire based on previous research was administered that surveyed 183 Japanese university students, indicated that the Japanese students were hesitant to provide social support unless the person they were close to explicitly asked for help. To confirm the robustness of these results a second questionnaire was administered to an additional 118 Japanese and 52 American university students, using a scenario-based method to gauge their willingness to support close friends or family members in need.
The results of the second survey confirmed that even when Japanese university students were aware that someone close to them was in need, they tended to be hesitant in offering assistance unless that person had explicitly asked for their help. In contrast, U.S. university students were often willing to offer assistance when they recognized that someone close to them was in need, even when they had not been asked for help. Nevertheless, when requests for assistance were clear, both Japanese and American university students were equally likely to offer assistance.
“The results of our study indicate that the reason Japanese people feel hesitation towards helping others is not because they are unsympathetic but because these situations—where a request for help is not clear—create hesitation,” said Professor Hashimoto. “Based on these findings, we need to consider ways to encourage Japanese people to provide assistance when they recognize it is needed.”
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About OMU
Osaka Metropolitan University is a new public university established by a merger between Osaka City University and Osaka Prefecture University in April 2022. For more science news, see https://www.upc-osaka.ac.jp/new-univ/en-research/, and follow @OsakaMetUniv_en, or search #OMUScience.
IMAGE: ANDREAS BARTLEY AND MAGNUS TISELL, SAHLGRENSKA ACADEMY AT THE UNIVERSITY OF GOTHENBURG.view more
CREDIT: PHOTO BY JOSEFIN BERGENHOLTZ AND UNIVERSITY OF GOTHENBURG.
A simple method can halve the number of repeat operations to remedy bleeding under the cranium, a study at the University of Gothenburg shows. The method is based on replacing irrigation fluid at room temperature with fluid at body temperature.
Bleeding between the cranium and the brain (subdural hemorrhage or hematoma) mainly affects older people and arises most often after a relatively light blow to the head. The condition can cause accumulation of inflammatory fluid mixed with blood, resulting in swelling and pressure on the brain.
This fluid sometimes continues to accumulate for weeks and months, with increasingly severe symptoms ranging from persistent headache to confusion, weakness on one side of the body, balance problems, and reduced awareness.
Surgical treatment is necessary. After the fluid is drained out through a drill hole in the skull, the surface of the brain is rinsed clean with irrigation fluid to ensure that no residues from the hemorrhage remain and grow, causing recurrence. In Sweden today, this is the most common brain operation.
Historically, fluid at various temperatures has been used for brain irrigation. Just as with other forms of irrigation, there is reason to assume that temperature may play a part in how effectively the bleeding residues can be flushed away. The temperature of the fluid can also affect how rapidly new minor bleeding is stopped.
Warmer liquid — fewer interventions
The current study, published in the journal JAMA Neurology, comprised a total of 541 patients at Uppsala University Hospital, Karolinska University Hospital in Solna, and Sahlgrenska University Hospital in Gothenburg. The participants’ average age was 76 years.
The patients were randomly assigned to receive irrigation at either body or room temperature during their operations, while the rest of the treatment proceeded in the same way for both groups. Among those who were given room-temperature irrigation fluid, 14 percent (39 of 277 patients) needed a repeat operation within six months. In the group receiving body-temperature fluid, the corresponding proportion was 6 percent (16 of 264 patients).
The study’s first author is Andreas Bartley, a PhD student in clinical neuroscience at Sahlgrenska Academy, University of Gothenburg, and neurosurgeon at Sahlgrenska University Hospital.
“The fact that we can reduce the number of recurrences, and hence repeat operations, with such a simple measure is of great importance —above all for reducing unnecessary suffering in this group of older patients, but also for lessening pressure on the healthcare services,” Bartley says.
Patient group expected to grow
The researchers involved in the study describe the operating environment as highly complex and say it is rare for systematic studies of such simple physical properties as fluid temperature to be conducted.
The study’s last author is Magnus Tisell, Associate Professor (docent) of Neurosurgery at Sahlgrenska Academy, University of Gothenburg, and neurosurgeon at Sahlgrenska University Hospital.
“The total number of operations for subdural hemorrhage is expected to rise sharply with the growing proportion of older people in the population. What’s more, raising the irrigation-fluid temperature is a measure that can be easily applied in resource-poor, low-income countries as well,” Tisell concludes.
