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Patients with chronic kidney disease who stop using a class of common blood pressure medications may lower their risk for dialysis, but they also raise their odds of cardiovascular disease, a new study finds. The blood pressure medicines in question are called renin-angiotensin system inhibitors (RAS inhibitors), which include both ACE inhibitors and angiotensin II receptor blockers (ARBs). Not sure if you take one of these drugs? ACE inhibitors typically have “pril” as the last syllable in their name (for example, benazepril, captopril or enalapril) while ARBs typically end in “sartan” (candesartan, losartan and valsartan, among others). All of these medicines are commonly used to treat high blood pressure, cardiovascular disease, heart failure and chronic kidney disease, but how safe they are for patients with chronic kidney disease is a matter of debate. “The use of RAS inhibitors in patients with advanced chronic kidney disease is controversial, and many doctors deprescribe them,” study principal investigator Juan Jesus Carrero, professor at the department of medical epidemiology and biostatistics at Karolinska Institute in Sweden, said in an institute news release. “Rather than routinely discontinuing treatment, our results show that the issue is a complex one and that doctors must carefully weigh the protective effects of RAS inhibitors on the cardiovascular system against the potential harms on the kidneys,” Carrero said. According to study first author Dr. Edouard… read on > read on >

It’s a woman’s worst nightmare: You’re having a C-section under anesthesia, but you suddenly become aware of what is happening during your surgery. Now, a new study shows that phenomenon, known as “accidental awareness,” is more common than believed. In fact, it may occur in 1 in 256 women who have obstetric surgery and some may suffer long-term psychological harm. Accidental awareness is when a patient is temporarily conscious during general anesthetic and can remember things that occurred during surgery, such as feeling pain or being unable to move. It’s most likely to occur at the very start or end of a general anesthetic, as the patient is going to sleep or waking up. In this study, researchers analyzed data from more than 3,000 women who had general anesthesia for obstetric procedures at 72 National Health Service hospitals in England. The study authors identified 12 reports of accidental awareness, including seven patients who were distressed and five who felt paralyzed. Two patients described paralysis with pain. Other sensations reported by patients while under anesthesia included tugging, stitching, feelings of dissociation and being unable to breathe. Long-term psychological harm associated with accidental awareness often included symptoms of post-traumatic stress disorder, according to the study published Jan. 12 in the journal Anaesthesia. “We identified a complex range of risk factors for awareness, including drug types and variations… read on > read on >

Improved lung cancer treatment is a major reason for the 31% decline in cancer death rates in the United States between 1991 and 2018, including a record 2.4% decrease from 2017 to 2018, the American Cancer Society says. How the COVID-19 pandemic will affect this downward trend is unknown, the society noted. “The impact of COVID-19 on cancer diagnoses and outcomes at the population level will be unknown for several years because of the time necessary for data collection, compilation, quality control and dissemination,” according to the report’s lead author, Rebecca Siegel. “We anticipate that disruptions in access to cancer care in 2020 will lead to downstream increases in advanced-stage diagnoses that may impede progress in reducing cancer mortality rates in the years to come,” she said in a cancer society news release. The American Cancer Society said about 3.2 million cancer deaths were prevented from 1991 through 2018 due to declines in smoking, earlier detection, and improvements in treatment that led to long-term decreases in deaths from the four leading cancers: lung, breast, colon and prostate. Lung cancer is the most common cause of cancer death, causing more deaths than breast, prostate and colon cancers combined. While there’s been slow progress against breast, prostate and colon cancers in recent years, declines in lung cancer death rates grew from 2.4% a year during 2009 to… read on > read on >

There’s an expanded nationwide recall of Sportmix pet food products underway, after links were found between a mold-borne toxin in the food and the deaths of 70 dogs, with 80 other dogs being sickened, the U.S. Food and Drug Administration announced Monday. The announcement expands upon a recall first issued on Dec. 30 by Midwestern Pet Foods, Inc. At the time, the company said that at least 28 dogs had already died after eating Sportmix pet food. Testing of the pet food products conducted by the Missouri Department of Agriculture found “very high levels of aflatoxins,” the FDA noted. Aflatoxins are toxins produced by the mold Aspergillus flavus. They can trigger very serious illness in pets, and these poisons can be present even if the food doesn’t appear to be moldy. On Monday, after reports of at least 70 canine deaths tied to the tainted food, Midwestern “expanded the recall to include all pet foods containing corn and manufactured in the company’s Oklahoma plant, and having an expiration date on or before July 9, 2022,” the FDA said in its statement. The agency said not all of the dog deaths have been confirmed as caused by aflatoxin, but the FDA also stressed that “this count is approximate and may not reflect the total number of pets affected.” The agency said it is conducting an ongoing… read on > read on >

You have probably seen the social media posts: Your good friend’s co-worker is raising money online to help pay for cancer treatments or another friend needs funds to pay medical bills after a car crash. Crowdsourced fundraising seems to, at least partly, fill a gap between out-of-pocket health care costs and what people can afford. A new study looked at what the role of one of the best-known sites, GoFundMe, has played in crowdsourcing funds for medical costs over the past several years. “I think the most striking finding for us was the magnitude that the number of these fundraisers have grown over the past few years,” said study author Dr. Suveen Angraal, an internal medicine resident physician at the University of Missouri-Kansas City. The study focused solely on GoFundMe fundraisers, extracting data between May 2010 (when the site began) and December 2018. The researchers found 42 fundraisers for medical conditions in 2010 and 119,373 in 2018, a number that rose incrementally through the years. “It’s a pretty dramatic increase that shows the magnitude of how big the issue is and how big the problem is when it comes to the cost of health care,” Angraal said. “We know that health care in the U.S. is expensive and, time and again, we have seen — not just me, but many of our colleagues across the… read on > read on >

Brain drain: Arguing with others puts a lot more strain on your brain than agreeing with them, a new study finds. “Our entire brain is a social processing network,” said senior author Joy Hirsch, professor of psychiatry, comparative medicine and neuroscience at Yale University. “However, it just takes a lot more brain real estate to disagree than to agree.” The researchers, from Yale and University College London, asked 38 adults whether they agreed or disagreed with a series of potentially contentious statements such as “same-sex marriage is a civil right” or “marijuana should be legalized.” Researchers then monitored the participants’ brain activity when they were paired up and had face-to-face discussions about the topics. When people agreed, their brain activity was harmonious and tended to be focused in sensory areas of the brain such as the visual system, possibly in response to social cues from the other person, according to the authors. When people disagreed, sensory areas of the brain were less active while there was increased activity brain areas that handle higher order executive functions, such as reasoning. “There is a synchronicity between the brains when we agree,” Hirsch said in a university news release. “But when we disagree, the neural coupling disconnects.” She noted that in discord, the two brains engage many emotional and thinking resources “like a symphony orchestra playing different music.”… read on > read on >

New research offers a novel explanation for the long-term brain problems many COVID-19 patients experience. Many coronavirus patients report headaches and “brain fog” for weeks or months after they recover from respiratory symptoms. It’s been believed that these lingering neurological issues are the result of nerve cell damage, but the new study suggests that the virus may instead be striking the brain’s small blood vessels. Previous studies found that COVID-19 can cause inflammation in and around the blood vessels elsewhere in the body, so the researchers decided to examine brain tissue for the same thing in 13 patients who died of COVID-19. The investigators found that small blood vessels in the brain tissue had signs of inflammation and damage to their walls, but there was little evidence of damage to nerve cells, according to the study published online recently in the New England Journal of Medicine. The authors noted that most of the brains analyzed in the study were from COVID-19 patients who weren’t hospitalized. Previous research has focused on patients who had long hospital stays, including being on ventilators. Those factors can make it difficult to determine the direct impacts of the virus on the brain, explained study co-author Dr. Daniel Perl, director of the Brain Tissue Repository at the Uniformed Services University of the Health Sciences, in Washington, D.C. “COVID-19 seems to have… read on > read on >

Most folks infected with COVID-19 will only have mild or moderate illness — but that means they’ll still be stuck at home and feeling really lousy. What’s the best way to cope? In many ways, you want to behave as you would if you were suffering from a cold or the flu, said infectious disease expert Dr. Aaron Glatt. “The general good advice we give to people is eat well, make sure you drink enough, make sure you get enough rest, don’t overexert yourself,” said Glatt, chairman of the department of medicine and hospital epidemiologist at Mount Sinai South Nassau in Oceanside, N.Y. “Sometimes patients do a little bit more than they can, and I don’t want to say it exacerbates things, but it exacerbates things,” he continued. “It makes them much more tired and much more fatigued and it can be sometimes like a domino effect.” Difficulty breathing is the most troubling symptom related to COVID-19, so you might want to order a home pulse oxygen monitor (“oximeter”) to keep track of your blood oxygen levels, suggested Dr. Teresa Murray Amato, chairwoman of emergency medicine at Long Island Jewish Forest Hills in Queens, N.Y. Fingertip monitors can be purchased online for about $20. Blood oxygen levels “below 90 warrant at least a call to your doctor and, if persistent, a visit to your local… read on > read on >

A cup of java may not be a bad idea for men’s health: Drinking lots of coffee may reduce their risk of prostate cancer, researchers report. The investigators analyzed data from 16 studies conducted around the world. Together, the studies involved more than a million men, about 58,000 of who went on to develop prostate cancer. The team was led by urologist Dr. Kefeng Wang, of China Medical University in Shenyang. Their analysis couldn’t prove cause-and-effect, but compared to men with the lowest coffee consumption, those who drank the most coffee had a 9% lower risk of prostate cancer. As well, each additional daily cup of coffee was associated with a 1% reduction in risk, according to the research published online Jan. 11 in the journal BMJ Open. Further analysis showed that compared to those with the lowest consumption, men who drank the most coffee had a 7% lower risk of localized prostate cancer, and a 12% to 16% lower risk of advanced and fatal prostate cancer, respectively. The highest amounts of coffee consumption ranged from two to nine or more cups a day, while the lowest ranged from none to fewer than 2 cups a day. “This study suggests that increased coffee consumption may be associated with a reduced risk of prostate cancer,” Wang’s group wrote. “Further research is still warranted to explore the… read on > read on >

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Stopping Common Heart Meds Could Be Risky for Kidney Patients

‘Awareness’ Under C-Section Anesthesia May Be Less Rare Than Thought

U.S. Cancer Death Rates Keep Falling: Report

Pet Food Recall Expands After 70 Dogs Die From Mold Toxin

Crowdsourcing Raises Billions for Families Hit Hard by Medical Bills

Arguing Taxes the Brain Much More Than Agreement, Scans Show

New Insights Into How COVID-19 Damages the Brain

Stuck at Home, Suffering With COVID? Experts Offer Guidance on Care

Coffee Might Help Ward Off Prostate Cancer

U.S. Cancer Death Rates Keep Falling: Report