SCREENING FOR OVARIAN CANCER DID NOT REDUCE DEATHS DURING STUDY - The Daily Guardian
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SCREENING FOR OVARIAN CANCER DID NOT REDUCE DEATHS DURING STUDY

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A large-scale randomised trial of annual screening for ovarian cancer, led by UCL researchers, did not succeed in reducing deaths from the disease, despite one of the screening methods tested detecting cancers earlier.

Results from the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) have been published in a report in the medical journal The Lancet. In the UK, 4,000 women die from ovarian cancer each year. It is not usually diagnosed until it is at a late stage and hard to treat. UKCTOCS was designed to test the hypothesis that a reliable screening method that picks up ovarian cancer earlier can save lives when treatments are more likely to be effective.

The latest analysis looked at data from more than 200,000 women aged 50-74 at recruitment who were followed up for an average of 16 years. The women were randomly allocated to one of three groups: no screening, annual screening using an ultrasound scan, and annual multimodal screening involving a blood test followed by an ultrasound scan as a second-line test.

The researchers found that, while the approach using multimodal testing succeeded in picking up cancers at an early stage, neither screening method led to a reduction in deaths.

Earlier detection in UKCTOCS did not translate into saving lives. Researchers said this highlighted the importance of requiring evidence that any potential screening test for ovarian cancer actually reduced deaths and detected cancers earlier.

Professor Usha Menon (MRC Clinical Trials Unit at UCL), the lead investigator of UKTOCS, said: “UKCTOCS is the first trial to show that screening can definitely detect ovarian cancer earlier. However, this very large, rigorous trial shows clearly that screening using either of the approaches we tested did not save lives. We therefore cannot recommend ovarian cancer screening for the general population using these methods.

“We are disappointed as this is not the outcome we and everyone involved in the trial had hoped and worked for over so many years. To save lives, we will require a better screening test that detects ovarian cancer earlier and in more women than the multimodal screening strategy we used.”

Women aged between 50 and 74 were enrolled in the trial between 2001 and 2005. Screening lasted until 2011 and was either an annual blood test, monitoring changes in the level of the protein CA125, or a yearly vaginal ultrasound scan. About 100,000 women were assigned to the no screening group, and more than 50,000 women to each of the screening groups.

Blood test screening picked up 39 per cent more cancers at an early stage (Stage I/II) while detecting 10 per cent fewer late-stage cancers (Stage III/IV) compared to the no screening group. There was no difference in the stage of cancers detected in the ultrasound group compared to the no screening group.

The initial analysis of deaths in the trial occurred in 2015, but there was not enough data at that time to conclude whether or not screening reduced deaths. By looking at five more years of follow-up data from the women involved, researchers are now able to conclude that the screening did not save lives.

Professor Mahesh Parmar, Director of the MRC Clinical Trials Unit at UCL and a senior author on the paper, said: “There have been significant improvements in the treatment of advanced disease in the last 10 years since screening in our trial ended. Our trial showed that screening was not effective in women who do not have any symptoms of ovarian cancer; in women who do have symptoms early diagnosis, combined with this better treatment, can still make a difference to the quality of life and, potentially, improve outcomes. On top of this, getting a diagnosis quickly, whatever the stage of cancer, is profoundly important to women and their families.”

Professor Ian Jacobs, from the University of New South Wales (UNSW Sydney), a co-investigator who has led the ovarian cancer screening research programme since 1985 and who was the lead investigator of UKCTOCS from 2001-2014, said: “My thanks to the thousands of women, healthcare professionals and researchers who made this trial possible. The multimodal screening strategy did succeed in the detection of ovarian cancer at an earlier stage, but sadly that did not save lives. This is deeply disappointing and frustrating given the hope of all involved that we would save the lives of thousands of women who are affected by ovarian cancer each year.”

Professor Jacobs noted: “Population screening for ovarian cancer can only be supported if a test is shown to reduce deaths in a future randomised controlled trial. I remain hopeful that a new effective screening test will be found eventually, but it will take many years to conduct a large trial of the test. Realistically, this means we have to reluctantly accept that population screening for ovarian cancer is more than a decade away.”

A huge wealth of samples and data from the trial has been donated by the participants for future research. This resource referred to as the UKCTOCS Longitudinal Women’s Cohort (UKLWC), is now being used by researchers worldwide, helping to improve understanding of ovarian cancer as well as other cancers and other diseases such as cardiovascular disease.

Researchers say that the study has also generated insights into how best to design, conduct and analyse a large-scale randomised clinical trial particularly in individuals who have no signs of disease. These insights will be helpful to future trials in all areas of health. It has also contributed to advances in risk assessment, prevention and diagnosis of ovarian cancer.

The UKCTOCS trial was funded by the NIHR Health Technology Assessment (HTA) Programme and the charities Cancer Research UK and The Eve Appeal.

Michelle Mitchell, Cancer Research UK’s Chief Executive, said: “Trials don’t always find the result we had hoped for, but we need long-term studies like this to know whether new tests save lives. Cancer Research UK will continue to fund vital research into aggressive forms of ovarian cancer so we can reduce the impact of this disease.

“Screening is for people without symptoms, so it’s still important that if you notice unusual or persistent changes to talk to your doctor. Symptoms of ovarian cancer can be quite vague and similar to symptoms caused by less serious conditions, which can make spotting the disease tricky. Whether it’s needing to go to the toilet more often, pain, bloating, or something else, raise it with your GP – in most cases, it won’t be cancer but it’s best to get it checked out.”

Professor Nick Lemoine, Medical Director, NIHR Clinical Research Network, said: “These important findings from a large-scale trial, involving 200,000 participants, show that annual screening did not succeed in reducing deaths from ovarian cancer.

“However, it’s important to note that negative results can be as important as positive. The study has provided important new evidence and insights into how to conduct and analyse future large-scale randomised clinical trials into ovarian cancer, in the hope that this will prevent and diagnose this disease more effectively in the future.

“We thank every single person who took part.”

Athena Lamnisos, CEO, The Eve Appeal, said: “The threshold for introducing a national cancer screening programme is a mortality benefit. Of course, this is key – saving lives. It’s disappointing that this research programme did not show a reduction in mortality from ovarian cancer and so can’t be recommended as a national screening programme. However, the impact it had on earlier diagnosis is impressive and important.

“Ovarian cancer is so often diagnosed at stage 3 or 4 and shifting diagnosis one stage earlier makes a huge difference to both treatment options and quality of life. Earlier diagnosis will often reduce the amount and intensity of treatment, which makes all the difference to women and their families living with cancer. It may have also given them more precious time with their loved ones.”

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Study details benefits of turmeric compound

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According to a new study by the University of California, a compound found in turmeric called Curcumin helps grow engineered blood vessels and tissues.

The findings of the study were published in the journal, ‘ACS Applied Materials & Interfaces. The study indicated that a finding by UC Riverside bioengineers could hasten the development of lab-grown blood vessels and other tissues to replace and regenerate damaged tissues in human patients.

Curcumin has anti-inflammatory and antioxidant properties and is known to suppress angiogenesis in malignant tumors.

The magnetic hydrogels embedded with curcumin-coated nanoparticles promote the secretion of vascular endothelial growth factors.

Curcumin’s possible use for vascular regeneration has been suspected for some time but has not been well studied. Huinan Liu, a bioengineering professor in UCR’s Marlan and Rosemary Bourns College of Engineering, led a project to investigate curcumin’s regenerative properties by coating magnetic iron oxide nanoparticles with the compound and mixing them into a biocompatible hydrogel.

Bioengineers at UC Riverside have now discovered that when delivered through magnetic hydrogels into stem cell cultures this versatile compound paradoxically also promotes the secretion of vascular endothelial growth factor, or VEGF, that helps vascular tissues grow.

When cultured with stem cells derived from bone marrow, the magnetic hydrogel gradually released the curcumin without injuring the cells.

Compared to hydrogels embedded with bare nanoparticles, the group of hydrogels loaded with curcumin-coated nanoparticles showed a higher amount of VEGF secretion.

“Our study shows that curcumin released from magnetic hydrogels promotes the cells to secrete VEGF, which is one of the most critical growth factors to enhance the formation of new blood vessels,” said co-author Changlu Xu, a doctoral candidate in Liu’s group who focused on hydrogel research.

The researchers also took advantage of the nanoparticles’ magnetism to see if they could direct the nanoparticles to desired locations in the body.

They placed some of the curcumin-coated nanoparticles in a tube behind pieces of fresh pig tissue and used a magnet to successfully direct the movement of the nanoparticles.

The achievement suggested the method could eventually be used to deliver curcumin to help heal or regenerate injured tissue.

In fact, the best curcumin supplements contain piperine, and this makes them substantially more effective.

In addition, animal and cellular studies suggest that curcumin may block the action of free radicals and may stimulate the action of other antioxidants. Further clinical studies are needed in humans to confirm these benefits

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LONG-TERM FOLLOW UP REDUCES TYPE 2 DIABETES RISK

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Though type 2 diabetes is an inherited disease, habits can affect the risk of getting it. Obesity due to fatty and high-calorie foods, often in combination with limited activity, increases the risk considerably.

A new study at NTNU (The Norwegian University of Science and Technology) and St. Olav’s Hospital Centre of Obesity has followed people in the risk group for five years. Participants were offered organized physical activity and courses on the diet. “We’re seeing that follow-up from the health services in Norwegian municipalities over a long period can help reduce the risk of developing diabetes 2 and improve people’s health,” says researcher Ingrid Sordal Folling at NTNU’s Department of Health and Nursing.

Folling works in the Centre for Obesity Research, Surgical Clinic at St. Olavs Hospital in Trondheim. The study results have been published in the British Medical Journal.Taking action helpWorldwide, 350 million people have type 2 diabetes.

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HEART FAILURE AWARENESS MONTH 2022: CONTROL HEART FAILURE WITH HELPFUL TIPS

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Taking care of one’s heart is crucial, especially if one is suffering from heart failure. Heart failure is the inability of the heart to pump blood efficiently, as seen by shortness of breath, fast heartbeat, and exhaustion. Heart Failure Awareness Month in 2022 is a fantastic time to promote awareness about the issue while also providing simple advice to help heart failure patients live better and happier lives.

Heart failure is a chronic illness that can be adequately controlled with the right treatment and care. Heart failure patients can greatly benefit from regular interactions with their cardiologists, adherence to prescribed treatment plans, and adopting a healthy lifestyle. Dr. K Sarat Chandra, Senior Cardiologist at Apollo Spectra Hospital, Hyderabad, former Editor, Indian Heart Journal, and former President, Cardiological Society of India said, “In India, heart failure is an increasing problem and the reasons for this are the high prevalence of diabetes, hypertension, chronic kidney disease, and heart attack. Very often we see younger people coming with these conditions. To prevent these problems, we need to improve our lifestyle, do regular exercise, stop smoking and limit alcohol intake. Also control blood sugar, blood pressure, and cholesterol. Regarding heart failure, several new treatments have come into practice and early treatment will benefit our patients.”

Here are a few tips for all heart failure patients:

Talk to your cardiologist

It is good to have regular conversations with your cardiologist. Report new or worsening symptoms you observe immediately. These timely check-ups will help you keep track of your progress and get the right advice at the right time.

Check your salt consumption

Inadequate blood flow to the kidneys causes the body to retain water and fluids which leads to swollen legs, abdomen, and ankles, increased urination, and weight gain. High salt consumption is known to cause extra fluid build-up in your body and worsens heart failure. Therefore, keep your salt intake in check by lowering salt levels in your meals, replacing salt with herbs and spices, or choosing ‘low-salt’ or preferably ‘no salt added’ when buying canned or frozen foods.

Track your fluid intake

Drinking a lot of fluids can worsen your heart failure. It is advisable to limit beverages like tea, juice, and soft drinks, as well as foods with high water content like soups, watermelon, or even ice cream! Quick weight gain can be a sign of fluid build-up in your body.

Stick to the prescribed treatment

Staying on top of taking your medications as prescribed is crucial for effective heart failure management. Use reminders or alarms to never miss a dose or an appointment! If you live alone, paste sticky notes on your cabinets or refrigerator as an easy reminder.

According to Prof. (Dr.) Sundeep Mishra, former Professor of Cardiology Department of AIIMS and presently Vice-Chancellor (President) of NIMS University, “With the increasing burden of Heart Failure in India, especially in the younger population, it is necessary to recognize it – as a public health priority. The key reason for the rise in heart failure cases is the growing dependency on a sedentary lifestyle, higher consumption of salt, sugar, and fat in the diet, and rising stress levels. Although, heart failure can be still managed better by regular treatment and regular conversations with a cardiologist and a holistic treatment plan can help one manage the condition better.”

Heart failure is a serious chronic condition where the heart cannot pump enough blood to support the needs of other organs in the body. The most common causes of heart failure include coronary heart disease, myocardial infarction (heart attack), congenital heart defects, or damaged heart valves. Symptoms include breathlessness, fatigue and swollen limbs. it is the most frequent cause the age of 65.

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How brain changes during treatment of depression

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Researchers have shown what happens to the brain when treated for depression known as repetitive transcranial magnetic stimulation (rTMS).

The findings of the research were published in the ‘American Journal of Psychiatry’ by a collaborative effort across the Centre for Brain Health, including DMCBH researchers Dr Sophia Frangou, Dr Rebecca Todd, and Dr Erin MacMillan, as well as members of the UBC MRI Research Centre including Laura Barlow at the University of British Columbia. rTMS is a depression treatment typically used when other approaches — such as medications — haven’t been effective for a patient. It is estimated that approximately 40 per cent of people with major depression do not respond to antidepressants.

During an rTMS session, a device containing an electromagnetic coil is placed against a patient’s scalp. The device then painlessly delivers a magnetic pulse that stimulates nerve cells in a region of the brain involved in mood control — called the dorsolateral prefrontal cortex.

Although proven to be effective, the mechanisms behind how rTMS affects the brain have not been well understood.

“When we first started this research, the question we were asking was very simple: we wanted to know what happens to the brain when rTMS treatment is being delivered,” said Dr Fidel Vila-Rodriguez, an assistant professor in UBC’s department of psychiatry and researcher at the Djavad Mowafaghian Centre for Brain Health (DMCBH).

To answer this question, Dr Vila-Rodriguez and his team delivered one round of rTMS to patients while they were inside a magnetic resonance imaging (MRI) scanner. Since the MRI can measure brain activity, the researchers were able to see in real-time what changes were happening in the brain.

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Amit Trivedi lends voice to inhaler campaign by Cipla

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Asthma ke liye Inhalers Hain Sahi’ (inhalers are right for asthma) has been sung by Amit Trivedi and Nikita Gandhi for Cipla Limited. The song is penned by lyricist Amitabh Bhattacharya and composed by Amit Trivedi. Cipla Limited has launched the #InhalersHainSahi song under its campaign #BerokZindagi. Amit Trivedi spoke to The Daily Guardian about the song and more.

Q: Share your association with Cipla’s Berok Zindagi Campaign? What does the campaign strive to achieve and how does it aim to create an impact?

I am glad to collaborate with Cipla and contribute to their ongoing efforts toward creating awareness around asthma and inhalers. I hope this jingle will strike a chord with people and help create the right amount of awareness and help-built confidence amongst asthmatics. I feel humbled to be associated with the campaign because I know how important this issue is and I’ve got this opportunity to bring awareness about using inhalers.

Q: What drove you to be a part of this campaign? Is there any personal reason associated with the same?

I believe that awareness can liberate and help break stereotypes. And, this campaign is doing the same. #InhalersHainSahi song is another step towards starting a conversation on asthma and inhalers. The campaign gave me a reason to be part of this cause and to team up with Cipla in their effort to help & support people with asthma to live a better life.

Q: How do you think music plays an important role in driving conversations around less debated topics like asthma?

Music is a powerful medium to convey the message with a great impact and can build a strong emotional connection with the audience. It can lighten up a serious situation while still keeping the essence of the message intact.

Q: How will this jingle create an emotional touch among the audience? How do you think the jingle will help in driving awareness?

As mentioned earlier, I am certain that the music has the power to evoke an emotional chord with the audience. The #InhalersHainSahi song will help create the right amount of awareness and help-built confidence amongst asthmatics.

Q: What do you think is the most unique about this jingle?

The music is hummable and retains the message of the campaign that we want to convey through the song.

Q: What are your future projects?

 Recently I did my first Gujarati film Prem Prakaran and the rest you will know very soon.

Q: You have introduced several new singers, how do you cast the voices for your songs?

I like to bring in new voices and new musicians because talent can be found anywhere. I’m always open to giving opportunities and trying out new people for my projects.

Q: How do you keep innovating with every new film?

It’s a creative process continuously between the entire team, there is briefing discussion, jamming, the vision of the director, which ultimately leads to newer ideas.

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Punjab populace more hypertensive than the nation: NFHS Survey

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When the national average is 25.3% in terms of hypertension prevalence, Punjab is shooting up at 35.7%. As per National Family Health Survey that was conducted in 2020-2021, it is clear that Punjab is the only state where the populace is more prone to hypertension than any other state in India. All thanks to trans fat and the lifestyle of Punjabis makes them easy victims of cardiovascular diseases.

The Daily Guardian spoke to the Community Medicine Professor Dr Sonu Goel on this. Dr Goel exhorted that it has been concluded in many surveys including the NFHS survey that trans fat is an invariable component of industrial fat and one of the major dietary factors associated with cardiovascular disease mortality, increasing the risk of heart disease by 21% and deaths by 28%. Many in the early age group of 35 to 50 years in Punjab have become victims of uncontrolled high blood pressure, says Dr Goel.

“It’s being seen in people with a family history of premature chronic heart disease or stroke and a raised triglyceride level. Besides this, modifiable risk factors include unhealthy diets, excessive salt consumption, a diet high in saturated fats and trans fats, and low intake of fruits and vegetables,” says Dr Goel.

“Non-communicable diseases (NCDs) are the most found cause of disease burden. In recent years, the rising burden of cardiovascular diseases and high disease severity has been one of the significant threats in low-income and middle-income countries compared with high-income countries. People who are young believe in the myth that heart attacks can occur only in old age. They should wake up and adopt a healthy lifestyle at the earliest. One should give at least one hour to physical activity and make sure not to ignore the body’s signals,” he adds.

There has been an increase in the rate of coronary artery disease (CAD) in India in the last three decades.

A study published by the Journal of Clinical and Diagnostic Research in 2016 states that Indians have three, six, and twenty times greater risk of hypertension than Americans, Chinese, and Japanese populations respectively. “It is a matter of concern and there is a requirement to identify the factors responsible for its increasing prevalence, concludes Dr Goel.

Punjab is the only state where the populace is more prone to hypertension than any other state in India.

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