Blood transfusion during liver cancer surgery associated with increased risk of cancer recurrence

Agencies
June 3, 2019

Jun 3: In a study, researchers have claimed that receiving blood transfusion during liver cancer surgery (hepatocellular carcinoma) increases the risk of cancer recurrence and dying prematurely.

The risk was markedly increased even when only a small amount of blood was transfused, researchers said.

The study is being presented at the 'European Society of Anaesthesiology' in Vienna, Austria (1-3 June).

Findings showed that transfusion of one to four units of blood increased the risk of cancer recurrence by 23 per cent and death by 55 per cent compared to matched controls.

"Our findings from a large cohort highlighted a significant association between red blood cell transfusions and the risk of cancer recurrence as well as a dose-response relationship between the number of transfusions and death after curative surgery for liver cancer," said Dr Ying-Hsuan Tai from Taipei Medical University Shuang Ho Hospital in Taiwan who led the research.

"The reason why blood transfusions substantially worsen cancer prognosis remains unclear, but it is likely to be related to the suppressive effects on the immune system," Dr Tai added.

Hepatocellular carcinoma (HCC) is the fifth most common form of cancer worldwide and the third most common cause of cancer-related deaths. It occurs frequently in people with cirrhosis (scarring of the liver) due to previous damage from hepatitis B or C virus, or long-term alcohol abuse. Surgery to remove cancer and a margin of healthy tissue that surrounds it (resection) is a curative treatment for people with early-stage liver cancers who have a normal liver function.

In this study, Tai and colleagues investigated the effect of perioperative blood transfusion on cancer prognosis following HCC resection in 1,469 patients without lymph node involvement or metastasis undergoing surgery between 2005 and 2016.

Researchers assessed postoperative disease-free survival and overall survival up to September 2018. Using statistical modelling (a technique called the inverse probability of treatment weighting) they were able to match patients who had equivalent age and health conditions when comparing their outcomes.

Almost one in three patients (30 per cent; 447 patients) received one to four units of allogeneic (from another individual) blood during or within seven days of surgery, while more than one in 10 (12 per cent; 179 patients) were given more than four units.

During a median 45 month follow-up, analyses showed that cancer was 23 per cent more likely to recur in patients who received a transfusion (1-4 units) compared to those not given a transfusion.

While those who received more than four units faced an 18 per cent greater risk of recurrence compared with those who received none.

Compared to those not given a transfusion, patients given 1-4 units of blood were 55 per cent more likely to die from any cause, while those receiving four or more units had almost double the risk of death.

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Agencies
May 10,2020

Washington D.C., May 9: Do the middle age feel much stressful now, and seems to have changed over time, if compared to the life in the 90s? Well, this recent study indicates that it might be true.

The study has signalled to the fact that life may become more stressful majorly for middle-aged people than it was in the 1990s. The researchers reached this analysis even before the novel coronavirus started sweeping the globe.

A team of researchers led by Penn State found that across all ages, there was a slight increase in daily stress in the 2010s compared to the 1990s. But when researchers restricted the sample to people between the ages of 45 and 64, there was a sharp increase in daily stress.

"On average, people reported about 2 percent more stressors in the 2010s compared to people in the past," said David M. Almeida, professor of human development and family studies at Penn State.

"That's around an additional week of stress a year. But what really surprised us is that people at mid-life reported a lot more stressors, about 19 percent more stress in 2010 than in 1990. And that translates to 64 more days of stress a year."

Almeida said the findings were part of a larger project aiming to discover whether health during the middle of Americans' lives has been changing over time.

"Certainly, when you talk to people, they seem to think that daily life is more hectic and less certain these days," Almeida said.

For the study, the researchers collected data from 1,499 adults in 1995 and 782 different adults in 2012.

Almeida said the goal was to study two cohorts of people who were the same age at the time the data was collected but born in different decades. All study participants were interviewed daily for eight consecutive days.

During each daily interview, the researchers asked the participants about their stressful experiences throughout the previous 24 hours.

They asked questions related to arguments with family or friends or feeling overwhelmed at home or work, so and so. The participants were also asked how severe their stress was and whether those stressors were likely to impact other areas of their lives.

"We were able to estimate not only how frequently people experienced stress, but also what those stressors mean to them," Almeida said.

"For example, did this stress affect their finances or their plans for the future. And by having these two cohorts of people, we were able to compare daily stress processes in 1990 with daily stress processes in 2010," Almeida added.

After analyzing the data, the researchers found that participants reported significantly more daily stress and lower well-being in the 2010s compared to the 1990s.

Additionally, participants reported a 27 percent increase in the belief that stress would affect their finances and a 17 percent increase in the belief that stress would affect their future plans.

Almeida said he was surprised not that people were more stressed now than in the 90s, but at the age group that was mainly affected.

"We thought that with economic uncertainty, life might be more stressful for younger adults. But we didn't see that. We saw more stress for people at mid-life," Almeida said.

"And maybe that's because they have children who are facing an uncertain job market while also responsible for their own parents. So it's this generational squeeze that's making stress more prevalent for people at mid-life," he concluded.

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News Network
February 4,2020

Boston, Feb 4: Practising yoga may increase levels of a messenger molecule involved in regulating brain activity, and completing one yoga class per week may maintain elevated levels of this chemical, according to a study which may lead to better ways of mitigating depressive symptoms.

The study, published in the Journal of Alternative and Complementary Medicine, assessed a group of 30 clinically depressed patients who were randomly divided into two groups.

According to the researchers, including those from Boston University in the US, both groups engaged in coherent breathing, and Iyengar yoga -- a form of hatha yoga, developed by B. K. S. Iyengar, emphasising on detail, precision, and alignment in the performance of yoga postures.

The only difference between the groups, the scientists said, was the number of 90 minute yoga sessions, and home sessions in which each group participated.

Over three months, they said, the high-dose group (HDG) was assigned three sessions per week, while the low-intensity group (LIG) engaged in two sessions per week.

The participants underwent magnetic resonance imaging (MRI) scans of their brain before the first and after the last yoga session, and also completed a clinical depression scale to monitor their symptoms, the study noted.

Results of the study revealed that both groups had improvement in depressive symptoms after three months.

Their MRI analysis showed that levels of the brain messenger molecule GABA were elevated after three months of yoga, as compared to the levels before starting yoga.

According to the study, this increase was found for approximately four days after the last yoga session, but the rise was no longer observed after about eight days.

"The study suggests that the associated increase in GABA levels after a yoga session are 'time-limited' similar to that of pharmacologic treatments such that completing one session of yoga per week may maintain elevated levels of GABA," explained study co-author Chris Streeter from Boston University.

Providing evidence-based data may help in getting more individuals to try yoga as a strategy for improving their health and well-being, the scientists said.

"A unique strength of this study is that pairing the yoga intervention with brain imaging provides important neurobiological insight as to the 'how' yoga may help to alleviate depression and anxiety," said study co-author Marisa Silveri from Harvard University.

In this study, we found that an important neurochemical, GABA, which is related to mood, anxiety, and sleep, is significantly increased in association with a yoga intervention," Silveri said.

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Agencies
May 17,2020

Geneva, May 17: Spraying disinfectant on the streets, as practised in some countries, does not eliminate the new coronavirus and even poses a health risk, the World Health Organization (WHO) warned on Saturday.

In a document on cleaning and disinfecting surfaces as part of the response to the virus, the WHO says spraying can be ineffective. "Spraying or fumigation of outdoor spaces, such as streets or marketplaces, is... not recommended to kill the Covid-19 virus or other pathogens because disinfectant is inactivated by dirt and debris," explains the WHO.

"Even in the absence of organic matter, chemical spraying is unlikely to adequately cover all surfaces for the duration of the required contact time needed to inactivate pathogens." The WHO said that streets and pavements are not considered as "reservoirs of infection" of Covid-19, adding that spraying disinfectants, even outside, can be "dangerous for human health".

The document also stresses that spraying individuals with disinfectants is "not recommended under any circumstances".

"This could be physically and psychologically harmful and would not reduce an infected person's ability to spread the virus through droplets or contact," said the document.

Spraying chlorine or other toxic chemicals on people can cause eye and skin irritation, bronchospasm and gastrointestinal effects, it adds.

The organisation is also warning against the systematic spraying and fumigating of disinfectants on to surfaces in indoor spaces, citing a study that has shown it to be ineffective outside direct spraying areas.

"If disinfectants are to be applied, this should be done with a cloth or wipe that has been soaked in disinfectant," it says.

The SARS-CoV-2 virus, the cause of the pandemic that has killed more than 300,000 people worldwide since its appearance in late December in China, can attach itself to surfaces and objects.

However, no precise information is currently available for the period during which the viruses remain infectious on the various surfaces.

Studies have shown that the virus can stay on several types of surfaces for several days. However, these maximum durations are only theoretical because they are recorded under laboratory conditions and should be "interpreted with caution" in the real-world environment.

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