Patients who undergo angioplasty and stenting to open clogged arteries in and around the heart should also be screened for depression, according to a new study. Researchers found that depressed patients were less likely than their mentally healthy peers to take their prescribed medications, including beta-blockers, antiplatelets and statins. These medications reduce the likelihood of another heart attack or cardiovascular event after angioplasty and stenting (also called percutaneous coronary intervention, or PCI). “It is well-appreciated that depression carries adverse cardiovascular risk. We wanted to understand better why that is the case,” said Dr. Jared Magnani, a cardiologist and associate professor of medicine at the University of Pittsburgh. “We found that 10% to 20% of individuals with depression were less likely to take their medicine after PCI, which is significant because this group is at a higher risk for serious complications or dying from a heart attack,” he said in a university news release. Using medical claims data that included prescriptions filled at pharmacies, the researchers examined the records of more than 124,000 patients who had the procedure and were also diagnosed with depression. Patients were followed for a year. Medication adherence may depend on social factors, such as having the money to cover medication costs, the study authors noted. Pharmacy access is another challenge. Prior research has found that a high percentage of people with…  read on >  read on >

For those who care about their teeth, a new study sounds a pretty clear alarm: using tobacco in any form — including the increasingly popular practice of vaping — is a recipe for a dental nightmare. The warning comes from the U.S. National Institute of Dental and Craniofacial Research (NIDCR), after scientists analyzed several years of tracking data that looked at associations between smoking and poor dental health among thousands of American men and women. The bottom line: regular users of cigarettes, electronic cigarettes (vapes), cigars, pipes, hookahs and/or smokeless tobacco face a notably higher risk for various forms of dental trouble. Depending on the type of tobacco involved, that includes a significantly heightened likelihood for six different types of dental concerns, including gum disease; precancerous oral lesions; bone loss surrounding the teeth; loose teeth; and/or tooth loss due to tooth decay or gum disease. And vaping, which is sometimes viewed as a safer form of tobacco use, was linked to a 27% higher risk for bleeding following brushing or flossing. “We’ve always known that smoking increases your odds for gum disease,” said Dr. Purnima Kumar, a spokesperson for the American Dental Association. Though not a part of the study team, Kumar — who is also chair of the department of periodontics and oral medicine at the University of Michigan School of Dentistry, in Ann…  read on >  read on >

Having COPD can make it hard to breathe as it taxes both the lungs and the heart, but a new study offers a possible solution: Using an air purifier helped patients’ hearts work better. Researchers found that when people with COPD, also known as chronic obstructive pulmonary disease, consistently used air purifiers, their hearts were better able to adapt their heart rates in response to daily demands, something known as heart rate variability (HRV). HRV is a key measure of overall heart health. In fact, the participants who used air purifiers daily saw a 25% increase in their HRV. Study author Dr. Sarath Raju, an assistant professor of medicine who specializes in lung diseases at the Johns Hopkins University School of Medicine in Baltimore, explained that an increase in HRV is important. “People with poor HRVs are at risk for a number of cardiac problems, such as heart attacks or a worsening of COPD symptoms,” he said. “All of these things increase the odds of someone with COPD being hospitalized, which is of course something we want to avoid.” The study also looked at the role of what scientists call ultrafine particles, tiny pieces of irritants in the air that people breathe. Raju and his colleagues found there was an association between the presence of these particles in a person’s home environment and a negative…  read on >  read on >

Capitalism is thought to bring out the best in workers, but there’s a dark side to tying a person’s everyday efforts to their weekly paycheck. Folks relying on short-term, freelanced office jobs, or jobs where pay is linked to hustle — depending largely on tips, commissions and bonuses — may often suffer poor health related to their financial insecurity, new research has shown. Employees with fluctuating and unpredictable pay tend to have poorer sleep, more stress and miserable physical symptoms that affect their work and home life, said lead researcher Gordon Sayre, an assistant professor of organizational behavior at Emlyon Business School in France. Those symptoms grow worse as a person’s finances become more unstable, Sayre said, and the amount of savings they might have on hand seems to provide no solace. “There’s a lot of research looking at how performance-based pay, commission-based pay, piece-rate based pay leads to higher levels of motivation or higher levels of performance. That’s been sort of fairly well-established, and that’s one of the reasons why these pay practices have become popular,” Sayre said. “But there are some costs to these types of pay arrangements, and we need to consider them in addition to the performance benefits they bring,” he added. “They also have these health costs.” Millions of Americans are in jobs where they can’t count on a steady…  read on >  read on >

Both extremely hot and very cold days take their toll on people who have heart disease, particularly those with heart failure. A new multinational analysis of 32 million heart-related deaths over the past 40 years found more occurred on days with severe temperatures, an issue that climate change could make even worse. Although the greatest number of deaths were due to heart failure, extreme weather also led to a rise in stroke; arrhythmia (an irregular heartbeat); and ischemic heart disease (which is caused by narrowed heart arteries). “The decline in cardiovascular death rates since the 1960s is a huge public health success story as cardiologists identified and addressed individual risk factors such as tobacco, physical inactivity, type 2 diabetes, high blood pressure and others,” according to researcher Dr. Barrak Alahmad. He is a fellow at Harvard T.H. Chan School of Public Health in Boston. “The current challenge now is the environment and what climate change might hold for us,” Alahmad said in a news release from the American Heart Association (AHA). Heart disease is the leading cause of death worldwide. To study the impact of temperatures, researchers analyzed data for 32 million heart-related deaths in 27 countries between 1979 and 2019. The investigators compared heart-related deaths on the hottest and the coldest 2.5% of days in 567 cities with those on days when temperatures were…  read on >  read on >

If someone is stricken with a blood cancer or life-threatening clot, they’ll probably fare better if they are white and wealthy, three new studies show. The ongoing impact of patient race and income to medical outcomes was in the spotlight Saturday in New Orleans at the annual meeting of the American Society of Hematology (ASH). In one study, a team led by Dr. Matthew Maurer, of the Mayo Clinic in Rochester, Minn., looked at who got enrolled (or didn’t) in clinical trials for new treatments against a blood cancer known as diffuse large B-cell lymphoma (DLBCL). It’s the most common form of lymphoma in the United States. According to ASH, existing therapies help cure about 60% of patients, but another 40% may not be helped. So, enrollment in clinical trials can be crucial for some patients. The Mayo study examined data on enrollment in DLBCL trials from eight large academic medical centers across America. It found that 76% of enrollees were white. Results from lab tests were key to getting accepted into the trials, but Black or Hispanic Americans were much less likely to meet those lab-based criteria than were whites, the research showed. That means trial organizers may need to take a closer look at lab-based eligibility criteria to help level the playing field for entry into future clinical trials. “These exclusion criteria are…  read on >  read on >

Former elite football players may age faster than their more average peers, a new study suggests. NFL players, especially former linemen, had fewer disease-free years and earlier high blood pressure and diabetes diagnoses. Two age-related diseases, arthritis and dementia, were also more commonly found in former football players than in other men of the same age. This research was part of the ongoing Football Players Health Study at Harvard University. “We wanted to know: Are professional football players being robbed of their middle age? Our findings suggest that football prematurely weathers them and puts them on an alternate aging trajectory, increasing the prevalence of a variety of diseases of old age,” said senior investigator Rachel Grashow, director of epidemiological research initiatives for the Football Players Health Study. “We need to look not just at the length of life but the quality of life,” she said in a university news release. “Professional football players might live as long as men in the general population, but those years could be filled with disability and infirmity.” For this research, nearly 3,000 former NFL players completed a survey for investigators at the Harvard T. H. Chan School of Public Health and Harvard Medical School. “Our analysis raises important biological and physiological questions about underlying causes but, just as importantly, the results should serve as an alarm bell telling clinicians…  read on >  read on >

With more American men turning to testosterone therapy as a way to boost energy levels, build muscle and tackle erectile dysfunction, it’s no wonder that web-based merchants have stepped into the breach, seeking to grab market share away from doctors and pharmacies. But are online testosterone purchases safe? No, a new investigation warns. The conclusion follows an anonymous testing of seven U.S.-based online entities that sell testosterone therapy to consumers across the country. The upshot: The vast majority of online portals are perfectly willing to sell the hormone to patients who are not, in fact, testosterone-deficient. Most also fail to inquire about potentially problematic underlying conditions and neglect to caution patients about the possible risks involved, including infertility. “We found that most of these platforms offer treatment to men who are not considered appropriate candidates according to existing medical guidelines, and many platforms were not offering appropriate counseling regarding the risks of treatment,” said study author Dr. Joshua Halpern. He is an andrology and infertility specialist and assistant professor with Northwestern University’s Feinberg School of Medicine, in Chicago. This is a potentially big and growing concern, the study team pointed out, given that between 2017 and 2019 there was a 1500% jump in the number of visits to direct-to-consumer online portals that claim to treat erectile dysfunction. That said, “testosterone therapy is a well-established medical…  read on >  read on >

An experimental therapy that uses the body’s own immune system cells may beat a standard treatment for patients with advanced melanoma, a new clinical trial finds. Researchers found that the therapy doubled the amount of time melanoma patients lived without their skin cancer progressing, versus a long-used drug called ipilimumab (Yervoy). The approach, called tumor-infiltrating lymphocyte (TIL) therapy, harnesses the natural tumor-fighting ability of patients’ own immune system T cells. Experts stressed that TIL is still experimental, and for now, patients can only receive it if they enroll in a clinical trial. “It’s very promising, but it’s still investigational,” said Dr. Nikhil Khushalani, who specializes in treating melanoma at Moffitt Cancer Center, in Tampa, Fla. That said, the new findings show that for patients who are good candidates for TIL, it beats ipilimumab, according to Khushalani, who was not involved in the trial. “I’d definitely utilize TIL over ipilimumab in the appropriate patients,” he said. However, the TIL process is no easy feat. And Khushalani said he foresees it being offered only at certain medical centers with the necessary expertise and resources — akin to organ transplantation. The study was published in the Dec. 8 issue of the New England Journal of Medicine. Melanoma is the least common but deadliest form of skin cancer. Historically, the prognosis has been dismal for people with metastatic melanoma…  read on >  read on >

Some Americans appear to be moving from areas with frequent hurricanes and heat waves to places threatened by wildfire and rising heat. They’re trading in the risk of one set of natural disasters for another because the wildfires are only beginning to become a national issue, according to researchers. “These findings are concerning, because people are moving into harm’s way — into regions with wildfires and rising temperatures, which are expected to become more extreme due to climate change,” lead author Mahalia Clark said in a news release from the University of Vermont. She’s a researcher at the university’s Gund Institute for Environment and Rubenstein School of Environment and Natural Resources. The researchers studied the issue by combining U.S. Census data with that on natural disasters, weather, temperature, land cover, demographics and socioeconomic factors. Between 2010 and 2020, the top U.S. migration destinations included cities in the Pacific Northwest; Arizona, Colorado, Nevada and Utah in the Southwest; Texas; Florida, and a large area of the Southeast from Nashville to Atlanta to Washington, D.C. They moved away from the Midwest, the Great Plains and areas along the Mississippi River, including many counties hit hardest by hurricanes or frequent heat waves, the researchers said. “These findings suggest that for many Americans, the risks and dangers of living in hurricane zones may be starting to outweigh the benefits…  read on >  read on >