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Health24.com | Rare ‘brain vein’ strokes are on the rise

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  •  Cerebral venous thrombosis (CVT) is a rare kind of stroke that is, however, on the rise
  • CVT affects veins, rather than arteries in the brain
  • The incidence of CVT is higher in young women and African Americans

Most strokes strike when an artery in the brain suddenly becomes blocked, but new research shows a rarer cause of strokes is becoming more common.

It’s called cerebral venous thrombosis (CVT), and it happens when a vein in the brain is clogged. While CVT is estimated to cause less than 1% of all strokes, scientists discovered it is now more prevalent and affecting a different demographic than previously thought.

Study author Dr Fadar Otite and his colleagues pored over years of hospital records from New York and Florida to find out how many cases of CVT occurred in these states between 2006 and 2016. Otite is an assistant professor of neurology at SUNY Upstate Medical University in Syracuse, New York.

Most common in young women

Based on the data they analysed, the researchers estimated that the number of CVT cases in the United States rose from around 14 cases per million in 2006 to 20 cases per million in 2014.

“We still find that the incidence of CVT is less than 1% of all strokes, even across our study period, but the incidence increased by 70% over time,” Otite said. “In 2006, the proportion of all strokes that were CVT was 0.47%. At the end of our study, which was in 2016, that proportion increased to 0.80%.”

CVT causes blood clots to form in the veins of the brain. These veins drain blood that has already been used by brain cells, sending it back to the heart to be replenished with oxygen. If a clot forms in one of these veins, it may leak into the surrounding brain tissue and could cause a stroke, the researchers explained.

While CVT is still most common in young women – about two-thirds of all CVT hospitalisations included in the study were in females – the researchers found that the number of cases among this demographic did not increase over the 10-year study period. Instead, they saw increases in CVT among men and older women.

“Part of the message is that we agree that CVT is still more common in women, but because of the diverse clinical presentation of CVT, when other symptoms that may be attributable to CVT are present in other demographics, we should take them with more seriousness,” Otite said.

Higher in African Americans

Another major finding was that CVT incidence in African American people was significantly higher than in other races. But why that is the case remains unknown. “We have no clear explanation, because this is truly the first study to ever relate the incidence of CVT between races,” he added.

Several factors may put one at a higher risk of developing CVT, including pregnancy and taking hormonal birth control pills, which may be why it is more common in younger women, the researchers noted.

And many of the risk factors for CVT – like blood clotting disorders or medications that cause clotting, severe dehydration, infections of the ear, face or neck, head trauma, obesity and cancer – are somewhat different from the triggers typically associated with stroke.

It is important for clinicians to be aware of this rise in CVT incidence because the condition can easily be confused with something else, Otite said. Patients with CVT may have unspecific complaints such as headaches, blurry vision or seizures.

Around 3% of patients in a prior study who had CVT and went to the hospital were diagnosed with something else and sent home, according to Otite. “So, it’s important to recognise this from the start, because by the next time the clinical condition may be worse,” he said.

A specific treatment

CVT can be treated with medication to thin the blood and help prevent further clotting, which may not be prescribed if the condition isn’t properly diagnosed, he added.

Dr Jose Biller, chair of the neurology department at Loyola University Medical Center in Hines, Illinois, said the takeaway from this study is that more attention should be paid to CVT.

“I think that there should be an increased awareness of cerebral venous thrombosis because, by and large, when people think about stroke, they don’t think about it,” Biller said. “There should be an increasing level of awareness because this is a condition that has a specific treatment.”

The study was published online on 26 August in the journal Neurology.

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Health24.com | Catch prostate cancer early. It could save your life

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  • Prostate cancer is the second most common type of cancer in American men
  • This kind of cancer usually grows slowly and doesn’t need aggressive treatment
  • Men over 55 should consider being screened for prostate cancer

About one in nine men will be diagnosed with prostate cancer, but experts say early detection can be a lifesaver.

“Prostate cancer that is detected early, typically while it is still within the prostate gland, has a better chance of being successfully treated,” explained Dr Alexander Kutikov, chief of the Division of Urologic Oncology at Fox Chase Cancer Center in Philadelphia.

“Some types of prostate cancer are aggressive. However, most cancers are quite slow-growing, and a significant portion can be monitored without aggressive treatment,” he said in a Fox Chase news release.

Men aged 55–69 should consider prostate cancer screening, the American Urological Association says.

No symptoms in early stages

“Much debate has centred around screening for prostate cancer. Given the risks and benefits of screening, not every man should be screened for prostate cancer,” Kutikov said. “Men should talk to their health care provider about their risk factors, options and preferences. Together, they can make a decision.”

In the early stages, prostate cancer usually causes no symptoms. More advanced prostate cancer may cause: difficulty urinating, including a slow or weak urinary stream or the need to urinate more often, especially at night; blood in urine or semen; pain or burning during urination; discomfort in the pelvic area; bone pain, or trouble getting an erection.

“Many of these symptoms can be caused by something other than prostate cancer. However, you should let your healthcare provider know if you show any signs so the cause may be determined and treated, if needed,” Kutikov said.

September is National Prostate Cancer Awareness month. Prostate cancer is the second most common type of cancer in American men, according to the American Cancer Society. It says there will be about 191 000 new prostate cancer cases and more than 33 000 prostate cancer deaths in the United States in 2020.

Risk factors for prostate cancer include: older age (about 60% of prostate cancers are diagnosed in men over 65); race/ethnicity (Black men and Caribbean men of African ancestry have higher prostate cancer rates than men of other races), and a family history of prostate cancer.

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Health24.com | PODCAST | Health24’s sexpert discusses premature ejaculation and erectile dysfunction

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Erectile dysfunction can also occur due to: cardiovascular disease, diabetes, hypertension, high cholesterol, obesity, low testosterone levels, kidney disease, increased age, stress, anxiety, depression, relationship issues, prescription medications, sleep disorders, drug use, excessive alcohol, tobacco products, pelvic area damage. ED can be caused by only one or by several of these factors. It is important to work with a medical doctor to manage any health conditions.

Image supplied: Getty

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Health24.com | Under 50 and had a heart attack? Quit smoking, and you’ll live longer

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  • Cardiologists are always looking for ways to reduce the risk of cardiovascular events
  • They found that quitting smoking has a dramatic effect on young adults’ risk of heart disease
  • This is especially true in the case of young adults who have suffered a heart attack

If you’re a smoker under 50 and you suffer a heart attack, new research suggests kicking the smoking habit may be the best thing you can do to still be around years later.

“These results are definitive: among young people who have had a heart attack, quitting smoking is associated with a substantial benefit,” said corresponding author Dr Ron Blankstein, from the division of cardiovascular medicine at Brigham and Women’s Hospital in Boston.

“In cardiology, we are always looking for ways to reduce the risk of cardiovascular events, be it in the form of new medications or other interventions,” he said in a hospital news release.

Magnitude of risk in persistent smokers

“Our findings show the dramatic magnitude of the effect that quitting smoking can have for young adults,” he added. “But, unfortunately, we also found that most young patients kept on smoking after their heart attack, reinforcing that there is a major opportunity for improvement.”

In the study, the researchers analysed data on 2 072 patients who survived a heart attack before age 50 and were treated at Brigham and Women’s Hospital and Massachusetts General Hospital between January 2000 and April 2016.

Of those patients, 1 088 were smokers at the time of their heart attack. Data on smoking status one year after their heart attack was available for many of the patients and showed that 343 patients (38%) had quit smoking and 567 (62%) still smoked. Both groups were comparable in terms of age and race.

Over the next 10 years, 75 of the persistent smokers (13%) died, compared to 14 (4%) of those who had quit within a year of their first heart attack. Of the persistent smokers, 30 died of a heart attack or other cardiovascular event compared to six of those who quit smoking.

The study was published online recently in JAMA Network Open journal.

The “findings reinforce the critical importance of smoking cessation, especially among those who experience a heart attack at a young age,” Blankstein said. “Looking at the trajectories of young patients who quit smoking versus those who don’t paints a clear picture of the magnitude of risk compared to the benefit of smoking cessation.”

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Health24.com | Could Viagra, Cialis help boost colon cancer survival?

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  • ED medication may reduce the risk of death in men who suffer from colorectal cancer 
  • The reason why the drugs have an anti-tumour effect isn’t yet clear
  • However, according to an expert, they are known to block a protein that may play a role in cancer development

Erectile dysfunction (ED) drugs such as Viagra, Cialis and Levitra may do more than restore sexual function – they may also prolong the lives of men with colon cancer.

That’s the conclusion of a new Swedish study, which reported that the risk of premature death dropped by as much as 18% among colon cancer patients who used ED drugs.

The medications were also linked to a 15% reduction in risk for the key cause of death from colon cancer – that is, cancer that has spread.

“This is the first population-based study to explore the effect of these drugs on the death risk in men with colorectal cancer,” said lead author Wuqing Huang, a doctoral candidate at Lund University in Sweden.

Cancer-fighting potential

She and her colleagues focused on so-called “PDE5 inhibitors” – drugs that address impotence by regulating penile blood flow.

“There are two reasons why we considered the anti-cancer possibility of these drugs,” Huang said.

Prior studies suggested that ED drugs can inhibit tumour growth in mice and the activity of a gene called PDE5A. Huang said past work suggested colon cancer patients with lower PDE5A activity levels may live “significantly longer” than others.

To get a better handle on the cancer-fighting potential of the drugs, the researchers used a nationwide database to identify men in Sweden who were diagnosed with colon cancer between 2005 and 2014.

After excluding patients with late-stage cancer, researchers focused on more than 11 300 cancer patients who were not taking an ED drug and about 1 100 patients who were. (No one was instructed to use the drugs if they weren’t already doing so.)

Over more than four years of follow-up, about 10% of those who used an ED drug died, compared to 17.5% of patients who did not. The risk was even lower for those in the ED group who also had cancer surgery.

An observational study

Huang said the explanation for the drugs’ anti-tumour effect isn’t yet clear. It could have to do with the beneficial impact EDs have on immune function, reduced cell death and chemotherapy sensitivity, she said.

But until researchers can get a better understanding, “it is not suggested for colon cancer patients to get ED medications to control their cancer at this moment,” Huang said.

“The current evidence is not enough to provide recommendations, as our study is an observational study,” she stressed. “Clinical trials are necessary to confirm it.”

Still, Dr Andrew Chan, a professor at Harvard Medical School and Massachusetts General Hospital in Boston who reviewed the study, said the findings were intriguing.

“The work extends a prior study from this group showing that these medications may reduce the risk of developing colorectal cancer,” he noted. “It is also biologically plausible that these medications may have an anti-cancer effect, since they are known to block a specific protein that may play a role in cancer development.”

The findings were recently published in the journal Nature Communications.

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Health24.com | Stress and anger may worsen heart failure

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  • Stress and anger appear to make heart disease worse
  • Pandemic-related stressors may further exacerbate the situation  
  • More work is needed to find out if stress management can improve outcomes for heart failure patients

If you suffer from heart failure, try to stay calm. Stress and anger may make your condition worse, a new study suggests.

Mental stress is common in heart failure patients due to the complexities of managing the disease, progressively worsening function, and frequent medical issues and hospitalisations, according to lead author Kristie Harris, a postdoctoral associate in cardiovascular medicine at Yale University in New Haven, Connecticut.

“We have evidence that patients who experience chronically elevated levels of stress experience a more burdensome disease course with diminished quality of life and increased risk for adverse events,” Harris said in a university news release.

Mental stress test

“Clarifying the relevant behavioural and physiological pathways is especially important in the era of Covid-19 when the typical stressors of heart failure may be further compounded by pandemic-related stressors,” Harris added.

The new study included 24 heart failure patients who completed daily questionnaires for one week about their stress, anger and negative emotions.

That was followed by a mental stress test in which the patients solved maths problems and described a recent stressful experience. Echocardiograms were done to assess diastolic heart function at rest and during stress.

Diastolic function is the heart’s ability to relax and refill between beats. In heart failure, a damaged or weakened heart doesn’t pump as much blood as the body needs – a condition that can be life-threatening.

Patients who reported experiencing anger in the week before the mental stress test had worse resting diastolic pressure, the researchers found.

Stress management

According to senior study author Matthew Burg, “Factors such as mental stress and anger often go unrecognised and are under-addressed. This study contributes to the extensive literature showing that stress and anger affect clinical outcomes for patients with heart disease, adding chronic heart failure to the list that includes ischaemic heart disease (narrowed arteries) and arrhythmic disease.”

Burg, a clinical psychologist at Yale, said more work is needed to identify factors that increase vulnerability to stress in heart failure, and to find out if stress management can improve outcomes for these patients.

The study findings were published online recently in the Journal of Cardiac Failure.

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Health24.com | Most knee cracking is normal, expert says

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  • Knee cracking is generally nothing to worry about as long as it is not associated with pain
  • By itself, knee cracking does not indicate the presence of a disease like arthritis
  • A physical therapist can, however, prescribe certain exercises to help improve the situation

If your knees crack when you walk or run, don’t be too worried, an expert says.

“Knee cracking could mean lots of things,” said Harshvardhan Singh, assistant professor in the department of physical therapy at the University of Alabama at Birmingham. “If it is painful, then you should see a healthcare provider.”

The cause can be a large kneecap that doesn’t fit well into the groove, producing cracking during activities such as running and jogging.

And if the thigh muscle is too tight, it can pull the kneecap, causing an audible crack. Degeneration of knee cartilage can, too.

Association with pain

“The degenerative changes can also lead to pain and/or locking of the knee joint,” Singh said in a university news release. “Typically, degenerative changes are common in older people.”

Scans have shown that the displacement of joint surfaces forming the knee can cause a chain reaction in which natural gas bubbles collapse. The result: knee cracking.

“You should not be worried if your knees crack often as long as it is not associated with pain,” Singh said.

If you have had a recent trauma to the knee and it starts to crack, you should see a doctor even in there’s no pain, he said.

“Do not allow these sounds to make you feel abnormal or mentally stressed, or limit your functional activities,” Singh said. “A knee crack by itself does not indicate presence of any disease.”

Certain exercises may help 

It’s normal for knees to crack when you are active and it does not mean you have arthritis, he explained.

“Interestingly, in knee arthritis, the knee joint becomes hypomobile and loses its movement to a certain degree, which may lead to no knee crack,” he said. “A knee crack may mean your joint is mobile and lubricated.”

A professional may be able to help quell the cracking, Singh said.

“A physical therapist may be able to help you determine if there are specific movement patterns or any biomechanical alignment which may be leading to knee crack and prescribe you certain exercises to help improve it,” he said.

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Health24.com | Need another reason not to vape? Your oral health is at risk

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  • There is now a solid amount of evidence showing a link between e-cigarettes and poor oral health
  • A recent study shows that close to 50% of people using e-cigarettes had gum disease and oral infections
  • Vapers are risking from inflammation and tooth cavities to periodontitis and oral cancer

The warnings about vaping – inhaling the vapour of electronic cigarettes – tend to focus on the potential dangers to the heart and lungs.

But an increasing amount of research shows the chemicals in e-cigarettes start to inflict damage right where they enter the body: your mouth.

Because e-cigarettes are a recent phenomenon, said Dr Crystal Stinson, assistant professor at Texas A&M College of Dentistry in Dallas, “Studies on their impact are really new. But now we have a solid amount of evidence that shows the link between e-cigarettes and poor oral health.”

Nicotine, whether smoked or vaped, restricts blood flow to the gums, which can contribute to periodontal disease. The fluid in e-cigarettes, which can include propylene glycol, benzene, formaldehyde and other chemicals, only increases the risks.

Irreversible issues

A study published earlier this year in the journal iScience showed that 43% of people using e-cigarettes had gum disease and oral infections. That figure was higher among smokers – 73% – but only 28% among people who neither smoked nor vaped.

“The oral cavity is really resilient tissue that heals faster than other parts of the body,” Stinson said. “But we also know that when you repeatedly traumatise it, that’s when you end up having issues that are irreversible.”

Those issues, she added, range from inflammation and tooth cavities to loss of bone that anchors teeth to the jaw, called periodontitis, and oral cancer.

Another study published in May in Science Advances concluded the oral microbiome – the vast collection of friendly bacteria, viruses and other microbes that live in the mouth – of e-cigarette users without gum disease looked a lot like the microbiome of people with periodontitis.

“It’s absolutely scary stuff,” said Dr Purnima Kumar, professor at the Ohio State University College of Dentistry and the study’s senior author. “E-cigarettes stress the bacterial communities that live in your mouth, and they encase themselves in slime. So they’re no longer good bacteria and the inflammatory response is through the roof. People are walking around thinking they’re healthy, but they are just primed for disease.”

‘We’ve just scratched the surface’

Oral health is a critical element of whole-body health. Two preliminary studies presented in February at the American Stroke Association’s International Stroke Conference linked gum disease with a higher rate of strokes caused by hardening of large arteries in the brain and also with severe artery blockages. A 2018 study in the American Heart Association journal Hypertension found that gum disease appears to worsen high blood pressure and interferes with medications to treat hypertension.

Last December, the American Dental Association issued a statement urging a ban on e-cigarettes not approved by the Food and Drug Administration to help people quit smoking, as well as more research on the effects of vaping on oral health.

“We’ve just scratched the surface,” Kumar said. “We know it’s detrimental. We need to start looking at which chemical components of vape really cause this, why does it cause this, how long does it take to start, and how long does the body need to recover once you quit.”

Not enough time has passed since vaping became popular to assess the long-term dangers, Stinson said. “Unfortunately, everybody’s an experiment right now.”

But Stinson doesn’t need to wait for more studies to be convinced of the dangers of vaping. One look inside a vaper’s mouth usually tells the story.

More cavities

“Periodontal disease is normally an adult disease, and we’re seeing it in younger people,” she said. “Younger people normally have more saliva than they need, so when they present with dry mouth, periodontal disease or increased complaints of mouth ulcers, our next question is, ‘Do you vape?’ These symptoms are all tied to components in e-cigarettes.”

She also notices more cavities in her younger patients who vape, which she believes may be due to the acidity of the components in vape liquid and an increase in cavity-causing bacteria.

Stinson attributes the high rate of nicotine dependence to the sweet flavourings that helped attract adolescents to e-cigarettes. In February, the FDA banned many flavoured e-cigarettes in hopes of reducing the rise in vaping among young people, but health experts fear many are already hooked on nicotine.

“Phasing out the flavours is going to help, but we still have a population that is struggling to let go of the habit,” she said.

Both Stinson and Kumar are involved in education and cessation programmes aimed at convincing young people not to start vaping and helping those who do to stop.

‘It’s not a vapour’

The first lesson: Don’t be fooled into thinking that what looks like steam is a safe alternative to cigarette smoke.

“You hear ‘vapour’ and you think steam facials or a tea kettle,” Kumar said. “It’s not a vapour. It’s an aerosol, like hairspray or what you use to kill ants and cockroaches. When I teach young kids, I take little cans of hairspray and say, ‘I want you to spray this in your mouth.’

“They say, ‘Ew, no.’ So, I say, ‘Then why would you vape?'”

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Health24.com | The benefits of skipping your way through your exercise routine

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  • You can burn 25% more calories with a skipping rope than with jogging
  • Skipping is also beneficial for the heart and strengthens muscles
  • If you’re recovering from any injuries, consult a professional before incorporating it into your workout

Skipping isn’t just for lazy childhood days or boxers; it can be a very beneficial addition to any exercise routine.

From burning calories to increasing heart rate to building muscle, it’s a low-cost tool that many athletes use to improve their game.

Here are a few of the benefits of jumping rope.

READ | Being a copy-cat might make it easier to achieve fitness goals 

Travels easily

Lightweight and compact, it’s pretty easy to throw into your suitcase. 

Just don’t whip it out at the airport.

Good for your heart

Any exercise is beneficial to your heart, and skipping compacts a whole lot of exercise into a small amount of time.

According to a 2013 study from Harvard, 10 minutes of skipping is as beneficial for cardiovascular health as 30 minutes of jogging.

This is perfect for people with a tight schedule.

READ MORE | Video games may sabotage fitness among college students 

Burns calories

According to Calories Burned HQ, jumping rope can help you burn 15 to 20 calories a minute, which is 25% more than running.

This makes skipping an effective tool to include in your weight loss journey. It’s also a type of interval training exercise proven to effectively target subcutaneous and abdominal body fat, according to a recent study. 

Strengthens muscles

Skipping tones upper and lower body muscles – especially calves and shoulders – and helps strengthen your core.

It is also good for sculpting your abs, if that’s the look you’re aiming for.

Improves coordination

Besides the physical benefits of this high-intensity workout, jumping rope also helps your brain to improve coordination.

In a study, children who play soccer started incorporating jumping rope into their practices and found that their motor coordination and balance were considerably improved.

If it’s been too long since you skipped, remember to take it slowly and jump low at the start to prevent getting tangled in the rope and falling flat on your face.

READ | A lifetime of fitness helps women’s muscles in old age 

What you should know

Before you start skipping your way to a healthier life, here are some things to consider: 

  • When you buy a rope, it’s important that it’s not too light. A light rope won’t give you the momentum you need.
  • Also don’t opt to go barefoot on this one. Wear trainers that fit well and offer enough support for jumping. Ensure you practise in a space where you won’t be hitting anything or anyone.
  • Avoid grass and concrete surfaces. It’s easy to twist your ankle when the surface offers insufficient resistance. Wooden floors offer the best bounce, or you can opt for an exercise impact mat.
  • Remember to stretch and spend time cooling down to prevent injury.
  • If you have any knee, hip or ankle injuries or issues, skipping might not be best for you. Consult a doctor or physiotherapist before incorporating it into your exercise routine.

READ | Coronavirus lockdown | Stay fit at home: best workout tips that are not too technical

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Gabi Zietsman

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