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Specialized brain scans may accurately predict whether a psychotic patient will go on to develop treatment-resistant schizophrenia, Dutch researchers report. The scan — called a neuromelanin-sensitive MRI, or NM-MRI for short — zeroes in on a brain pigment called neuromelanin. This pigment can provide visual evidence of healthy dopamine function. Dopamine is a hormone that is part of the brain’s reward system. Too much dopamine may lead to the aggression and poor impulse control associated with psychosis. Led by Marieke van der Plijm, a postdoctoral researcher at the University of Amsterdam in The Netherlands, the study authors suggest NM-MRI could be a game-changer. “[T]here is an urgent need for markers to identify treatment non-responders in schizophrenia at an early stage and facilitate timely initiation of clozapine, the only antipsychotic with proven efficacy in non-responders,” they wrote in the March 13 issue of The American Journal of Psychiatry. Unlike patients who respond to treatment, those with treatment-resistant schizophrenia show no increase in dopamine function. Researchers said that suggests that neuromelanin levels — a benchmark of dopamine function — may be an early marker for treatment resistance. The study included 62 patients between the ages of 18 and 35 who had their first psychotic episode. All were diagnosed on the schizophrenia spectrum. These patients were compared with a control group of 20 healthy volunteers. All patients had… read on > read on >

Combat veterans who suffered traumatic brain injuries due to explosive blasts may have markers in their spinal fluid similar to those of Alzheimer’s disease, new research finds. “Previous research has shown that moderate to severe traumatic brain injuries may increase a person’s risk of Alzheimer’s disease,” said senior study author Dr. Elaine Peskind, of the VA Puget Sound Health Care System and the University of Washington School of Medicine. “What is lesser known is whether mild traumatic brain injuries from military training and combat may also increase a person’s risk. Our study found that these concussions may indeed increase a person’s risk of Alzheimer’s disease.” Traumatic brain injury (TBI) is caused by a bump, blow or jolt to the head, an injury as in a motor vehicle crash, or in service personnel, blast and impact injuries. In a mild TBI, also known as a concussion, person may lose consciousness for up to 30 minutes. The new study — published online March 13 in the journal Neurology — included 51 military veterans who suffered concussions from at least one war zone blast or a combination of blast and impact injuries. They were compared to 85 vets and civilians who had not experienced a TBI. On average, those in the concussion group had experienced 20 blast concussions and two impact concussions. Participants took thinking and memory tests… read on > read on >

The blockbuster weight-loss medication Zepbound (tirzepatide) appears to help folks quickly shed pounds regardless of how overweight they are, or how long they’ve lived being overweight or obese. Those are the findings of two separate analyses of a major trial of the injected drug that was funded by maker Eli Lilly. “Regardless of baseline BMI, tirzepatide consistently reduced body weight versus placebo in people with obesity,” said study co-lead author Dr. Louis Aronne. He directs the Comprehensive Weight Control Center at NewYork-Presbyterian/Weill Cornell Medical Center in New York City. Aronne spoke in a news release from the European Congress on Obesity, which will be held in Venice, Italy, in May. The Congress is releasing the research ahead of the meeting. The findings stem from a large study of hundreds of overweight or obese people, with or without a diagnosis of type 2 diabetes. “Overweight” was defined as a BMI between 27 and 30, and “obesity” as a BMI of 30 or above. After undergoing a three-month “intensive lifestyle intervention” focused on diet and exercise, patients were randomized to receive either Zepbound or a placebo injection for 18 months. According to Aronne and colleagues, Zepbound far surpassed placebo in terms of weight loss, regardless of how overweight patients were at the start of the trial. For example, while nearly all patients taking the drug lost at least… read on > read on >

College students who use drugs like Adderall to help them focus on their studies may be setting themselves up for trouble. Researchers asked 700 undergraduates across the United States about drugs commonly used by students — including ADHD medications like Adderall, cannabis, nicotine, alcohol, MDMA and ecstasy. They also asked about students’ academic performance and physical and mental distress. They found that using one substance appears to prime the brain for using others. Lead author Lina Begdache, an associate professor of health and wellness studies at Binghamton University, State University of New York, said the finding is important because many students use these so-called “study drugs” without understanding how they affect the brain. Adderall is a medication prescribed to help people with attention-deficit hyperactivity disorder (ADHD) focus. “Since these are prescribed medications to promote focus in individuals who actually have ADHD, students may think that they are safe to use and that the drug may give them an academic edge,” she said in a university news release. Instead of an edge, students may find one substance leads to another, Begdache warned. Researchers linked use of one substance to generally poorer mental health and lower ability to fight off stress. And less frequent use led to mental distress — potentially promoting continued use. The findings were published recently in the International Journal of Psychological and Behavioral… read on > read on >

Nurses who specialize in anesthesia have issued new guidelines to reduce the risk that patients taking weight-loss drugs like Ozempic or Wegovy throw up during surgery. “These medications have exploded in popularity,” said Micah Walden, of the American Association of Nurse Anesthesiology (AANA) Practice Committee. “This means additional preparation for patients, anesthesia providers and the surgical team to help minimize risks of complications during a procedure.” Because general anesthesia can cause nausea, patients are usually asked to fast before surgery. But a study published last week in the journal JAMA Surgery found these weight-loss drugs — called GLP-1 receptor agonists — slow digestion, so it takes longer for food to leave the stomach. That increases a patient’s risk of vomiting or aspiration while under anesthesia. GLP-1 agonists like Ozempic, Wegovy (semaglutide), Saxenda (liraglutide) or Zepbound (tirzepatide) were originally designed to manage type 2 diabetes, but they have become a popular way to lose weight. They make patients feel full sooner, so they eat less. As a precaution, the AANA committee said providers may need to do extra screenings such as an ultrasound of the patient’s stomach before surgery. If the examination indicates that the stomach is not empty or the imaging is inconclusive, the surgical team may consider delaying an elective surgery or proceeding as “full stomach” to reduce the risk of vomiting and aspiration while… read on > read on >

People diagnosed with attention-deficit hyperactivity disorder (ADHD) show a marked decline in their two-year risk for death once they start taking medication, new research shows. That was particularly true for deaths due to accidents and drug overdose. People taking ADHD drugs also showed no higher risk of dying from natural causes — suggesting the meds are safe for users’ heart health. Medications like Ritalin, Concerta and others probably lower users’ odds for an early death “by alleviating the core symptoms of ADHD and other psychiatric co-morbidities [illnesses], leading to improved impulse control and decision-making,” concluded a team led by Zheng Chang, of the Karolinska Institute in Stockholm, Sweden. Better impulse control and healthier decisions help people with ADHD avoid tragedies like fatal accidents and drug overdoses, the researchers said. As Chang’s team noted, prior research has shown that people with ADHD face double the odds for deaths from “unnatural causes” — events such as accidents, suicide and unintended drug overdoses. Many people struggle with the decision to start ADHD medications, however, so the new study wanted to see if the drugs might lower death risks. Chang’s team gathered data from multiple Swedish health registries. In all, they amassed medical histories on almost 149,000 Swedes who’d been diagnosed with ADHD between the ages of 6 and 64. Within three months of their diagnosis, about 57% of… read on > read on >

Women who’ve gone through menopause and hope that supplemental vitamin D plus calcium might shield them from disease may be disappointed by new data. A follow-up analysis of data from the landmark Women’s Health Initiative trial found the supplement combo lowered a woman’s long-term odds of dying from cancer by 7%. However, it also raised her odds of fatal heart disease by 6%. The bottom line: there was “no net effect on all-cause mortality” among older women who took the supplement combo, the study authors said. It’s possible “that calcium supplements may increase calcification of coronary arteries, thus increasing cardiovascular disease mortality,” said a team led by Cynthia Thomson, a professor of health promotion sciences at the University of Arizona in Tucson. The findings were published March 11 in the Annals of Internal Medicine. For years, many older women have popped a combination of calcium plus vitamin D to help strengthen their bones. Many may also wonder if the supplements cut their odds for two major killers, heart disease and cancer. The Women’s Health Initiative began enrolling tens of thousands of women as far back as 1991, and has tracked their health outcomes over subsequent decades. In 2006, the first (seven-year) findings on the effects of calcium/vitamin D supplementation on women’s health were announced; the results were “largely null,” Thomson’s group noted. Could that result… read on > read on >

Gay and bisexual people, as well as those undergoing gender transition, could face unique dermatological issues, an expert says. Board-certified dermatologist Dr. John Zampella, who runs a clinic in New York City that caters to many LGBTQ+ patients, said the risk for sexually transmitted infections is higher among this group and can sometimes lead to skin complications. “Dermatologists are the experts in the diagnosis and treatment of many sexually transmitted infections like syphilis, HPV and herpes that often have skin-related symptoms,” Zampella explained at the American Academy of Dermatology annual meeting in San Diego. There are recent reports on the emergence of fungal infections, such as ringworm, that could also be sexually transmitted among gay and bisexual men. These typically appear as a spreading rash in the groin or buttocks area, and should be examined by a physician such as a dermatologist, Zampella said. Strains of these infections often prove resistant to traditional antifungal meds and may take longer to treat. The best way to stop many STIs is prevention, of course. As Zampella noted, pre-exposure prophylaxis (PrEP) antivirals are now available as injections that can provide users with two months of protection against HIV. The U.S. Centers for Disease Control and Prevention has also approved the antibiotic doxycycline, taken within 72 hours of having sex, as a preventive measure against syphilis, chlamydia and gonorrhea.… read on > read on >

Slicing some fresh limes for that margarita savored in the sun could be a bad combo for some people’s skin, dermatologists warn. Folks can break out in what are nicknamed “margarita rashes” if they are skin-sensitive to certain fruits or vegetables and then get sun exposure soon after. The medical term for these outbreaks is photocontact dermatitis. “Sun sensitivity is a common condition that can negatively impact a person’s quality of life,” said board-certified dermatologist Dr. Brandon Adler, an assistant professor of dermatology at Keck School of Medicine at the University of Southern California in Los Angeles. He spoke about the issue on Friday during the American Academy of Dermatology’s annual meeting. Handling produce such as lime, figs and celery or coming into contact with plants like hogweed and St. John’s wort can set some folks up for photocontact dermatitis. For other people, medicines — taken either by mouth or applied to the skin — can help spur skin reactions, Adler explained. A medicinal cream might only cause a rash where it was applied, but a pill taken by mouth might bring on a rash that breaks out all over the body after sun exposure. Typical photocontact rashes occur in areas most exposed to sun — face, neck, arms or legs, Adler said. “While we will often prescribe anti-inflammatory medications to treat photocontact dermatitis, the… read on > read on >

Kids struggling with mental health problems have a tougher time recovering from a concussion, a new study finds. These troubled kids tend to have more emotional symptoms after concussion and take longer to fully recover, results show. In fact, the more mental health diagnoses a child had, the worse their emotional symptoms and the longer their recovery following a concussion, researchers reported recently in the journal Sports Health. “While research has emphasized the negative mental health effects that persist after a concussion and how they can impact development and recovery, it’s also very important to consider the burden these children and adolescents face prior to their injuries, and how their preexisting mental health status can impact recovery,” said senior researcher Dr. Matthew Grady, a pediatric sports medicine specialist at the Children’s Hospital of Philadelphia. Concussions are a common childhood injury, with about 2 million sports- and recreation-related concussions occurring each year in the United States, researchers said in background notes. These mild traumatic brain injuries can cause a variety of problems with brain function, emotions, sleep and vision, researchers said. A child’s physical health prior to concussion is known to influence their symptoms and recovery time. To see whether that held true for mental health as well, researchers analyzed data on more than 3,100 kids who had suffered a concussion. The research team checked the… read on > read on >