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
February 10,2020

Washington D.C, Feb 10: Children's vulnerability towards depression, anxiety, impulsive behaviour, and poor cognitive performance could be determined by considering the hours of sleep they manage to get.

Sleep states are active processes that support the reorganisation of brain circuitry. This makes sleep especially important for children, whose brains are developing and reorganising rapidly.

In a study by researchers from the University of Warwick -- recently published in the journal Molecular Psychiatry -- cases of 11,000 children aged between 9 and 11 years from the Adolescent Brain Cognitive Development dataset were analyzed to find out the relationship between sleep duration and brain structure.

The study was carried out by researchers Professor Jianfeng Feng, Professor Edmund Rolls, Dr. Wei Cheng and colleagues from the University of Warwick's Department of Computer Science and Fudan University.

Measures of depression, anxiety, impulsive behaviour and poor cognitive performance in the children were associated with shorter sleep duration. Moreover, the depressive problems were associated with short sleep duration one year later.

The reduced brain volume of areas such as orbitofrontal cortex, prefrontal, and temporal cortex, precuneus, and supramarginal gyrus was found to be associated with the shorter sleep duration.

Professor Jianfeng Feng, from the University of Warwick's Department of Computer Science, comments: "The recommended amount of sleep for children 6 to 12 years of age is 9-12 hours. However, sleep disturbances are common among children and adolescents around the world due to the increasing demand on their time from school, increased screen time use, and sports and social activities."

A previous study showed that about 60 per cent of adolescents in the United States receive less than eight hours of sleep on school nights.

Professor Jianfeng Feng further added: "Our findings showed that the total score for behavior problems in children with less than 7 hours sleep was 53 per cent higher on average and the cognitive total score was 7.8 per cent lower on average than for children with 9-11 hours of sleep. It highlights the importance of enough sleep in both cognition and mental health in children."

Professor Edmund Rolls from the University of Warwick's Department of Computer Science also commented: "These are important associations that have been identified between sleep duration in children, brain structure, and cognitive and mental health measures, but further research is needed to discover the underlying reasons for these relationships."

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Agencies
May 23,2020

Food with high water content is highly prescribed by doctors to stay hydrated during the summers, a season that summons a wave of soaring temperatures, higher than 40-degrees.

A much-loved fruit in India, apples are hydrating heros' in such a situation. A heatwave can affect human health in a varied manner and to maintain ideal body temperature in this soaring summer, one must remain adequately hydrated, be protected from the sun and maintain hygiene.

Working professionals and people who must step out in summers, are prone to the heatwave impact. Pediatric experts and doctors agree on the benefits of drinking water and eating fruits, especially, apples. 'An apple a day, keeps the doctor away' is true as they are rich in a number of vitamins with great anti-inflammatory benefits and many other essential minerals. Washington Apple Commission spells how apples can prove to be a summer-friendly fruit.

People often don't realise the danger of exposing themselves to extreme heat. Older adults, young children, and people with chronic illnesses are most at greater risk for serious problems. The nutrition benefits of apples may help not only in avoiding such illnesses but may also protect against many such conditions.

As popular as apples are as a fruit, they are enriched in antioxidants, dietary fibers, vitamins and a range of other nutrients that are greatly beneficial in maintaining good health. The fruit is rich in soluble fibers which may help prevent several health conditions and may lower the risk of major diseases such as heat strokes, diabetes and cancer.

The soluble fiber also promotes weight loss and improves gut health. The prebiotic effects of apples help feed the good bacteria in the gut, thus, improving digestion.

Apples are made of 85 percent water and contain vitamins, fibres and antioxidants. A high fibre content is a particularly beneficial property of apples, as improper digestion is a major health concern in the tropical climatic region. Apples are also enriched in antioxidants that help protect the lungs from oxidative damage and help oxygen flow through the blood.

Apple-based recipes

Make interesting snacks, dessert, beverages and savoury meals with this miraculous fruit during summers.

Salted apple caramel galette

Caramel apples get a grown-up makeover with this Salted Caramel Apple Galette. Warm, gooey, and delicious, this pastry is loaded with apples and homemade caramel. It's a sophisticated take on a childhood favorite and since it's easier to make than pie, it's perfect for summer get-togethers.

Caramel apple pie ice-cream sandwiches

Nothing is better at a cookout on a warm day than a cold, refreshing ice cream sandwich. In Caramel Apple Pie Ice Cream Sandwiches, the comforting flavor of apple pie is recreated in a creamy frozen banana-based ice cream studded with apple and date pieces. Then that scoop of ice cream is sandwiched between two pieces of no-bake cinnamon oat cookie dough.

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Agencies
February 23,2020

Los Angeles, Feb 23: According to researchers, if administered quickly, a common medication that reduces bleeding could be a treatment for bleeding stroke.

The Spot Sign and Tranexamic Acid on Preventing ICH Growth - Australasia Trial (STOP-AUST) was a multicenter, prospective, randomized, double-blind, placebo-controlled, phase 2 clinical trial using the antifibrinolytic agent tranexamic acid in people with intracerebral hemorrhage (ICH).

ICH is a severe form of acute stroke with few treatment options.

Tranexamic acid is currently used to treat or prevent excessive blood loss from trauma, surgery, tooth removal, nosebleeds and heavy menstruation. For this study, one hundred patients with active brain bleeding were given either intravenous tranexamic acid or placebo within 4.5 hours of symptom onset.

Researchers analyzed brain CT scans taken during the 24-hour period after treatment with tranexamic acid or placebo.

Researchers found a trend towards reduced hemorrhage expansion in the group treated with tranexamic acid, especially in those treated within 3 hours of the brain bleed. However, this trend was not statistically significant. The finding was consistent with previous research using the medication.

"Further trials using tranexamic acid are ongoing and focusing on ultra-early treatment - within 2 hours. 

This is where the greatest opportunity for intervention appears to be. Tranexamic acid is inexpensive, safe and widely available. Our results and others provide great impetus for further, focused research using this treatment," Nawaf Yassi said.

Larger trials focused on patient outcomes are required for this therapy to enter routine clinical practice.

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