Publisher Health

Nearly nine in ten cases of sudden cardiac death (SCD) due to hypertrophic cardiomyopathy (HCM) in young people are preceded by symptoms, ECG abnormalities or a positive family history, according to a new study published this week in the open-access journal PLOS ONE by Erik Börjesson of Sahlgrenska University Hospital, Sweden, and colleagues. Those findings suggest that expanding cardiac screening beyond competitive athletes could aid in the prevention of SCD in the young population with HCM.
HCM is a genetic cardiovascular disease believed to affect one in 500 individuals in the general population. While sudden death due to HCM is rare, it is still a major cause of natural death in the young. Identifying at-risk patients can reduce the risk of SCD in young individuals with HCM, for example by exercise restriction and drug therapies. Implantable cardioverter defibrillators (ICDs) can also prevent deaths and improve quality of life. For instance, after suffering an on-field cardiac arrest last year, Danish footballer Christian Eriksen was able to return to playing eight months later with an ICD.
In the new study, the researchers analyzed all cases of SCD with HCM between 2000 and 2010 in Sweden among individuals under age 35, along with controls. They characterized the clinical symptoms, medical history, family history and ECG findings before the occurrence of SCD using data from national registries, autopsy reports, medical records, and interviews with relatives post-mortem.
Among the 38 SCD cases identified, which included 31 males and 7 females, 71% presented with possible cardiac symptoms, including chest pain and palpitations, before death, and 69% received medical care in the 180 days before death (compared to just 21% of controls receiving medical care in that time period). 39% had a known cardiac disorder prior to death and 50% had a positive family history for heart disease. In total, 28 individuals underwent ECG evaluation at some point during their lifetime. Of these, 23 (82%) had ECG findings that were considered abnormal, but the overall number of abnormal ECG-recordings is around 60% when looking at all the cases.
The authors conclude that it may be possible to predict, and prevent, SCD in young individuals with HCM. ECG screening, for instance, could be expanded beyond competitive athletes and a routine school screening program could ensure equal detection across males and females.
The authors add: “The majority of young people dying from sudden cardiac death due to HCM present with one or more abnormalities that may be recognized during cardiac screening.”
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Instead of sitting in a tattoo chair for hours enduring painful punctures, imagine getting tattooed by a skin patch containing microscopic needles. Researchers at the Georgia Institute of Technology have developed low-cost, painless, and bloodless tattoos that can be self-administered and have many applications, from medical alerts to tracking neutered animals to cosmetics.
“We’ve miniaturized the needle so that it’s painless, but still effectively deposits tattoo ink in the skin,” said Mark Prausnitz, principal investigator on the paper. “This could be a way not only to make medical tattoos more accessible, but also to create new opportunities for cosmetic tattoos because of the ease of administration.”
Prausnitz, Regents’ Professor and J. Erskine Love Jr. Chair in the School of Chemical and Biomolecular Engineering, presented the research in the journal iScience, with former Georgia Tech postdoctoral fellow Song Li as co-author.
Tattoos are used in medicine to cover up scars, guide repeated cancer radiation treatments, or restore nipples after breast surgery. Tattoos also can be used instead of bracelets as medical alerts to communicate serious medical conditions such as diabetes, epilepsy, or allergies.
Various cosmetic products using microneedles are already on the market — mostly for anti-aging — but developing microneedle technology for tattoos is new. Prausnitz, a veteran in this area, has studied microneedle patches for years to painlessly administer drugs and vaccines to the skin without the need for hypodermic needles.
“We saw this as an opportunity to leverage our work on microneedle technology to make tattoos more accessible,” Prausnitz said. “While some people are willing to accept the pain and time required for a tattoo, we thought others might prefer a tattoo that is simply pressed onto the skin and does not hurt.”
Transforming Tattooing

According to ARRS’ American Journal of Roentgenology (AJR), the contrast-enhanced in-phase Dixon sequence could reduce the need for correlation among other imaging modalities to better identify areas of prior biopsy during breast MRI interpretation.
“Compared with clinical sequences, contrast-enhanced in-phase Dixon had higher sensitivity for detecting breast biopsy clips on MRI, as well as higher reader confidence and contrast-to-noise ratio (CNR), without change in positive predictive value (PPV),” wrote corresponding and co-first author, Michael W. Taylor-Cho, MD, MPH, of Duke University Medical Center in Durham, NC.
Dr. Taylor-Cho and team’s retrospective study numbered 164 women (mean age, 50.3 years) with a total of 281 breast biopsy clips who underwent contrast-enhanced breast MRI between January 2, 2019, and April 16, 2020. Blinded to patient identifiers, sequence information, and biopsy clip details, three radiologists independently annotated their findings on three clinical sequences — T1-weighted (T1W) non-fat-suppressed (NFS), STIR, first phase from dynamic contrast-enhanced T1W fat-suppressed (FS) — as well as contrast-enhanced in-phase Dixon. Confidence was then recorded on a scale of 1-4.
Ultimately, compared with T1W NSF, STIR, and T1WFS sequences, the contrast-enhanced in-phase Dixon sequence evidenced the highest sensitivity for breast biopsy clip detection (85.1% vs. 26.6%-78.2%), highest reader confidence (3.5 vs. 1.7-3.0), and highest CNR (4.05 vs 0.54-1.21), without a significant difference in PPV (96.4% vs. 92.2%-96.1%).
Employing this contrast-enhanced in-phase Dixon sequence may “help address a current challenge in routine clinical breast MRI interpretation,” the authors of this AJR article concluded.
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A team of international scientists led by the Nanyang Technological University, Singapore (NTU Singapore) has discovered that Neisseria — a genus of bacteria that lives in the human body — is not as harmless as previously thought, and can cause infections in patients with bronchiectasis, asthma, and chronic obstructive pulmonary disease (COPD).
In a landmark study, published today in Cell Host & Microbe, the team showed conclusive evidence that Neisseria species can cause disease in the lung and are linked to worsening bronchiectasis (a type of lung disease) in patients.
Bronchiectasis is a long-term condition where the airways of the lungs become abnormally enlarged for unknown reasons in up to 50 per cent of Singaporean patients. The disease is up to four times more prevalent among Asians as compared to their Western counterparts and can also occur following recovery from tuberculosis.[1] In Singapore, research at Tan Tock Seng Hospital described 420 incident hospitalised bronchiectasis patients in 2017.[2] The incidence rate is 10.6 per 100,000 and increases strongly with age.
Despite its prevalence among older people, no obvious cause is found in most cases of bronchiectasis and the condition tends to arise spontaneously and without warning.[3]
To unravel the puzzle of why bronchiectasis worsens at a significantly greater rate among older Asian patients, the international team — spanning researchers and hospitals in Singapore, Malaysia, China, Australia, and the UK (see Annex) — led by LKCMedicine Associate Professor Sanjay Chotirmall, Provost’s Chair in Molecular Medicine, matched disease and infection data from 225 patients with bronchiectasis of Asian (Singapore and Malaysia) origin to those from bronchiectasis patients in Europe.
Neisseria: not so harmless after all
While Neisseria species are well known to cause meningitis and gonorrhoea, they are not known to infect lungs. Through detailed identification and meticulous characterisation, the research team found that Neisseria dominated the microbiome of Asian patients with worsening bronchiectasis.

National Institutes of Health researchers have discovered a specific network of proteins that is necessary to restore hearing in zebrafish through cell regeneration. The study, led by investigators at the National Human Genome Research Institute (NHGRI), may inform the development of treatments for hearing loss in humans. The findings were published in Cell Genomics.
Although hair cell loss cannot be replaced in humans, many animals, including zebrafish, can restore hearing after injury through the regeneration of hair cells. The regenerative properties of zebrafish hair cells prompted researchers to use this animal to understand some fundamental properties of regeneration.
Hearing loss affects around 37.5 million Americans, and most cases come from the loss of hearing receptors known as “hair cells” in the inner ear. Bristles that stick out of these microscopic hair cells move and bend when sound travels into our ears, resulting in electric signals sent through nerves and into our brains that allow us to process sound.
Humans and zebrafish are visually quite different, but at a genomic level, they share more than 70% of their genes. This genomic similarity offers the potential for researchers to understand the biology of cell regeneration in zebrafish before translating the findings to humans.
Erin Jimenez, Ph.D., a postdoctoral fellow in the laboratory of Shawn Burgess, Ph.D., senior investigator in the National Human Genome Research Institute’s (NHGRI) Translational and Functional Genomics Branch, led the study in collaboration with researchers Ivan Ovcharenko, Ph.D., and Wei Song, Ph.D., at the National Library of Medicine’s National Center for Biotechnology Information.
“Humans and other mammals are born with a set number of hair cells that are slowly lost through aging and trauma. However some animals, such as zebrafish, can regenerate hair cells and recover hearing after injury,” said Burgess. “How and why regeneration happens in these animals remain a mystery that many scientists would like to unravel.”
Using a combination of genomic techniques and computational-based machine learning, Jimenez and her collaborators found that hair cell regeneration in zebrafish relied on a network of proteins that can switch genes on and off, known as transcription factors. To properly identify which transcription factors were at play, the researchers first had to look at the enhancer sequences within the zebrafish genome.

A new national survey by The Ohio State University Wexner Medical Center finds many Americans are losing sleep over stress and worry about the current state of the world. After a global pandemic, polarizing political division and more than two years of turbulent events, nearly one in five survey respondents report struggling to fall asleep at night.
“Here at Ohio State Wexner Medical Center, there was a 29% increase in referrals for insomnia from 2018 to 2021,” said Dr. Aneesa Das, professor of internal medicine. “Stress can increase your heart rate, increase your blood pressure, make you have an upset stomach and cause muscle tension. All of those things increase our alertness, making it harder to fall asleep.”
The survey also found many Americans try to mitigate sleep issues by using habits that may be detrimental to a good night’s sleep. Nearly half of Americans say they scroll their phones right before bed and 37% fall asleep with the TV on.
“Our circadian drive is that central clock telling us when we’re supposed to be awake and asleep, and that is driven by light more than anything,” said Das. “When we use our smartphones and our TVs right before bed, we increase that bright light exposure at the wrong time.”
Instead, Das suggests increasing natural light exposure by getting outside during the day as much as possible. Once the sun sets, limiting light exposure is essential to obtaining better sleep. Also, consistent exercise during the week is key to helping your body get on an optimal sleep routine.
Other simple behavioral adjustments that can help improve sleep patterns include: Keeping your bedroom cool, dark and quiet Spending time in bed only when it is time to sleep Using cognitive behavioral therapies like meditation and muscle relaxation Keeping bedtimes and wake times consistent, even on the weekendsIf you’re unable to improve your sleep, experts recommend speaking with your primary care physician as a first step. They can help determine if additional methods, like sleep restriction, may be beneficial or if the insomnia could be a symptom of an underlying health condition.
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A two-pronged approach to imaging breast density in mice, developed by researchers at Georgetown Lombardi Comprehensive Cancer Center, resulted in better detection of changes in breast tissue, including spotting early signs of cancer. The researchers hope that this approach will be translated from mice and improve breast imaging for people; it may also help with prognosis of disease as density can be linked to specific patterns of mammary gland growth, including signs of cancer development.
The findings appeared Sept. 14, 2022 in the American Journal of Pathology.
“Having a means to accurately assess mammary gland density in mice, just as is done clinically for women using mammograms, is an important research advance,” says Priscilla A. Furth, MD, professor of oncology and medicine at Georgetown Lombardi and corresponding author of the study. “This method has the benefit of being applicable across all ages of mice and mammary gland shapes, unlike some methods used in earlier studies.”
An innovative analytic computer program, developed by Georgetown alum Brendan Rooney (C’20) while working as an undergraduate in Furth’s lab, allowed for sorting of mammary gland tissue to one of two imaging assessments. Rooney initially looked at younger mouse glands and found that a program that removed background ‘noise’ in those images helped boost detection of abnormalities in what are typically rounder, more lobular tissues. But as aging occurs and the chances of developing cancer increase, lobules diminish and ridges become more apparent, just as falling autumn leaves expose tree branches. The mammary ridges represent ducts that carry milk and other fluids. When the de-noising technique was applied to the images from the older mice, it was found to be less reliable in detecting ridges. Therefore Rooney and the team turned to a different imaging program, which has primarily been used to detect blood vessel changes in the eye’s retina.
“The idea for the analytic program came from routine visual observations of tissue samples and the challenges inherent in observing differences in breast tissue with just a microscope. We found that visual human observations are important but having another read on abnormalities from optimal imaging programs added validity and rigor to our assessments,” says Rooney, the lead author of the study. “Not only does our program result in a high degree of diagnostic accuracy, it is freely available and easy to use.”
Rooney notes that he could not have done this research without Furth’s mentorship, starting as early as his freshman year. “The support that I received from Dr. Furth enabled me to introduce an idea and execute the project from start to finish — it provided an unparalleled experience in hands-on learning,” he says.
Being a mentor has been an important part of Furth’s career at Georgetown Lombardi. “Georgetown University has a program for undergraduate students called RISE, or Research Intensive Senior Experience, that enables students to delve deeply into a research project over the course of a year,” says Furth. “Brendan demonstrated exceptional drive and maturity to merit a first authorship as an undergraduate student developing his own research direction.”
Now that the broad strokes of the research have been laid down and proof-of-principle has been established, Rooney has started medical school with a possible eye toward specializing in oncology. Both Furth and Rooney believe that future studies will need to refine and streamline their research approach in mice, including better density measurements that could enable sorting of samples into higher and lower probabilities of cancer.
In addition to Furth and BL Rooney, the other authors from Georgetown include Brian P. Rooney, Vinona Muralidaran and Weisheng Wang.
This study was supported by NIH grant UH3CA213388 and an American Society for Investigative Pathology: Summer Research Opportunity Program in Pathology.
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Cercarial dermatitis, also known as swimmer’s itch or clam-digger’s itch, is caused by the larvae of blood flukes that are parasites of birds or mammals. When these larvae, called cercariae, penetrate human skin, they trigger an allergic reaction within 10-15 hours that takes about a week to heal. Unable to mature into adults, the larvae then die on the skin. The gravity of an outbreak depends on how humans and birds or mammals come in contract with the aquatic environment, but people engaged in water activities, such as farmers, fishermen, and agricultural workers, are most likely to be affected.
Between August and October 2020, a cercarial dermatitis outbreak with 359 confirmed cases occurred in Chana district, Songkhla Province, South Thailand. It mostly affected rice farmers from the area, who were busy with cultivation during the rainy season. Following a short investigation, three cases of patients were confirmed to be cercarial infections by skin biopsy (Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health, Thailand).
“The study of intermediate host and definitive host in the outbreak area are important for the control program of snail-borne disease,” the researchers argue in their research paper, which was published in the open-access scientific journal Evolutionary Systematics.
Having studied six snail species from the area, they found out that two were infected, each with three different species of flatworms. The cercarial dermatitis outbreak was due to ruminant parasites, such as the blood fluke Schistosoma indicum, which often uses domestic animals as its host.
“Ruminant-infecting trematodes, namely, S. indicum and S. spindale, cause a hepato-intestinal schistosomiasis resulting in reduced milk yield,” the authors explain. “This occurrence of S. indicum and S. spindale implies the spread of cattle blood fluke cercariae in aquatic environments.”
“Additionally, these species of the S. indicum group primarily cause cercarial dermatitis in humans, which has become an important public health issue for people living in endemic regions.”
“In South India and Southeast Asia, where S. indicum and S. spindale have been reported to be widespread, they caused major pathology and mortality to livestock, leading to welfare and socio-economic issues, predominantly among poor subsistence farmers and their families.”
Some of the other worm species they found parasitized the intestines of fish, mammals, or birds, while others caused anemia and even death in ruminant animals.
“The results of this study will provide insights into the parasite species that cause cercarial dermatitis and may improve our understanding of public health problems in the outbreak and agricultural vicinity areas,” the authors of the study say. “In addition, the sequence data generated here are the first S. indicum DNA sequences from Thailand, which will be useful for further genetic study of the other blood flukes in this region.”
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Lymph node (LN) metastasis is a sign that things are going from bad to worse in cancer patients, and prompt treatment is vital.
A research team from Tohoku University’s Graduate School of Biomedical Engineering has developed a lymphatic drug delivery system (LDDS), where anticancer drugs are injected directly into the metastatic LNs. When combined with total-body irradiation (TBI), the new LDDS has a superior antitumor effect than conventional chemotherapy on early stage LN metastasis.
TBI provides a uniform dose of radiation to the entire body, penetrating areas in which traditional chemotherapy cannot reach. Recently, TBI has shown positive results in activating immune responses and altering the tumor microenvironment. Meanwhile, LDDS is mainly used for treating metastatic LNs locally.
The research team hoped to widen LDDS’s usage to prevent distant metastases — where the cancer spreads from the primary tumor to a distant lymph node. “We knew a combination of treatment that enhances systemic tumor immune effects would be an important therapeutic strategy,” said graduate student Shota Sora, who was part of the research team headed by Professor Tetsuya Kodama.
Sora and his colleagues investigated the dual therapy of LDDS and TBI for LN and distant metastases on metastasis model mice. They used irradiation gamma rays (a onetime dose of 1.0 GY) and anticancer drug CDDP adjusted with a solvent to have an osmotic pressure of 1987 kPa and a viscosity of 11.3 mPas.
An in vivo bioluminescence imaging system, a high frequency ultrasound system, and histology showed the new therapy was more effective than employing LDDS or TBI alone. After the therapy, the expression of immune-response related genes (CD4, CD8, and IL-12b) increased in the spleen, indicating an activated immune response.
“With the results showing that both TBI and LDDS improve the efficacy of LB metastasis and distant metastases therapy, this novel approach is a promising way to treat cancer patients,” added Sora.
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Breathing particulate matter (i.e., tiny particles suspended in the air) air pollution may trigger irregular heart rhythms (arrhythmias) in healthy teenagers, according to new research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.
While the negative cardiovascular effects of air pollution on adults has already been established, this study is the first to assess the impact of air pollution on teenagers in the general population.
“While relatively rare, irregular heart rhythms can lead to sudden cardiac death in otherwise healthy adolescents and young adults. Our findings linking air pollution to irregular heart rhythms suggest that particulate matter may contribute to the risk of sudden cardiac death among youth,” said Fan He, Ph.D., lead author of the study and an instructor in public health sciences at the Penn State College of Medicine in Hershey, Pennsylvania. “Since childhood and adolescent cardiovascular conditions can track into adulthood and affect risk of major cardiovascular disease later in life, identifying modifiable risk factors of cardiac arrhythmia that may cause sudden cardiac death among adolescents should be of great public interest.”
The study examined the impact of breathing fine particulate matter on heart rhythms of adolescents. Fine particulates (PM2.5) are less than 2.5 microns in size and can easily be inhaled deep into the lungs and even enter the bloodstream. Particles smaller than 2.5 microns are usually related to fuel combustion, such as particles from car exhaust or wildfires. Once inhaled, the pollutants irritate the lungs and blood vessels around the heart, and previous research has suggested that over time, pollutants increase the process of disease in the arteries.
The investigators analyzed the impact of breathing particulate matter pollution on two types of irregular heart rhythms characterized by premature contraction in the heart muscle, often described as a “skipped heart beat.” In premature atrial contractions (PAC), the heartbeat originates from the atria (top chambers of the heart). This usually causes no symptoms or harm, however, frequent, premature atrial contractions have been related to an increased risk of atrial fibrillation — a severe form of arrhythmia in which the top chambers quiver instead of beating effectively, thereby raising the risk of blood clots and stroke. Premature ventricular contractions (PVC) occur when the heartbeat originates from one of the ventricles (lower chambers of the heart). These also raise the risk of later heart attack, stroke, heart failure or sudden cardiac death.
If premature contractions cause no symptoms, they are not treated. However, if they occur often and lead to frequently feeling a skipped heartbeat, fast heartbeat or a pounding heart, treatment with medications, implantable devices or procedures may be advised.