Publisher Health

More than 250,000 people undergo a transurethral procedure each year in the U.S., and up to 10% of those people will experience a postoperative infection. But researchers from the University of Missouri School of Medicine have discovered an indicator to potentially reduce infections.
A transurethral procedure is the most common type of prostate surgery. Surgeons access the prostate through the male patient’s urethra. In an effort to avoid postoperative infection, patients are often prescribed a preventative antibiotic before surgery. However, infections after transurethral procedures are still common.
“Current first-line recommended antibiotics include first-generation cephalosporins and trimethoprim-sulfamethoxazole,” said senior author Katie Murray, DO, assistant professor of surgery. “But we found different antibiotics may be more effective in certain parts of the country depending on that region’s profile of antimicrobial susceptibility.”
Murray’s research team studied antimicrobial susceptibility profiles in 40 states. Twenty-two of those had statewide data, an additional 15 states provided public medical school data and the remaining three provided a combination of data from private institutions or counties.
“After reviewing the data from each state, we discovered current first-line recommendations for preventative antibiotic regimens provide relatively poor coverage overall,” Murray said. “In most cases, we found aminoglycosides and third-generation cephalosporins to be more effective than current first-line antibiotics.”
In some cases, Murray and her team found non-first-line antibiotics were 10-15% more effective than first-line treatment against the most frequently identified organisms after transurethral procedures.
“Among the antimicrobials we studied, not one is clearly superior in all settings,” Murray said. “When possible, urologists should use up-to-date knowledge of local patterns, and large organizations should consider changing recommendations to reflect the geographic variability of susceptibility patterns.”
In addition to Murray, the study’s co-first authors included School of Medicine colleagues Geoffrey Rosen, MD, resident physician, and Shubham Kanake, MD, resident physician. Other contributors included Mojgan Golzy, PhD, assistant research professor; and Elizabeth Malm-Buatsi, MD, assistant professor of surgery.
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A specific group of fungi residing in the intestines can protect against intestinal injury and influence social behavior, according to new preclinical research by scientists at Weill Cornell Medicine. The findings extend a growing body of work identifying a “gut-immunity-brain axis,” a signaling system that may have a wide range of effects on physiology in both health and disease, influenced not only by the body’s own cells but also the resident microbes.
The study, published Feb. 16 in Cell, reveals a novel set of molecular signals connecting fungi in the gut to their host’s cells throughout the body, including immune cells and neurons.
“We have made a direct link between a major immune pathway induced by fungi in the lining of the intestine and signals in the nervous system that impact animal behavior,” said senior author Dr. Iliyan Iliev, associate professor of immunology in medicine in the Division of Gastroenterology and Hepatology and a member of the Jill Roberts Institute for Research in Inflammatory Bowel Disease at Weill Cornell Medicine.
Drs. Dilek Colak, Melanie Johncilla and Megan Allen from Weill Cornell Medicine and Dr. Rhonda K. Yantiss from Weill Cornell Medicine and NewYork-Presbyterian also contributed to this study.
The lining of the intestine must balance conflicting needs, absorbing water and nutrients from food while acting as a barrier to prevent the vast population of microbes in the gut from invading the bloodstream. Examining this system in a mouse model, the scientists mapped the locations of different fungi within the intestine and found that a unique consortium of fungi tends to accumulate at specific sites near the gut epithelium, or lining, suggesting that these species have colonized the gut and interact closely with the nearby epithelial cells.
Mice carrying some of these fungi enjoyed better protection against events that can disrupt the intestinal barrier, such as intestinal injury and bacterial infection. “There was fortification of those barrier functions when we added that specific fungal community to mice,” Dr. Iliev said.

A new study from Ann & Robert H. Lurie Children’s Hospital of Chicago found that children from less resourced neighborhoods were at increased odds of presenting with complicated appendicitis, an indicator of delayed access to surgical care. This is the first pediatric study to link many neighborhood-level factors that influence health — such as quality of schools, housing, safety, and economic opportunity — to timely surgical care access. Findings are published in the journal JAMA Network Open.
“Timely access to pediatric surgical care may help reduce the need for emergency surgery, long hospital stays, or admission to the intensive care unit,” said co-author Fizan Abdullah, MD, PhD, Division Head of Pediatric Surgery at Lurie Children’s and Professor of Surgery at Northwestern University Feinberg School of Medicine. “Most importantly, our findings may help in developing policies and programs to increase community opportunity and ensure that all children, no matter where they live, gain equitable access to surgical care.”
For the retrospective, cohort study, the researchers examined the association between neighborhood factors and the odds of presenting with complicated appendicitis, as well as the likelihood of unplanned visits or readmissions to the emergency department with either simple or complicated appendicitis. Neighborhood-level social determinants of health (SDoH) were measured by the Child Opportunity Index (COI), a validated Zip code-level index score derived from 29 independent indicators that are known to affect children’s health and development.
The study examined 67,489 patients age 18 and younger who had appendicitis. The results showed that children from lower COI neighborhoods had up to 28 percent increased odds of presenting with complicated appendicitis compared to those from the highest COI neighborhoods. There was no significant association between neighborhood opportunity levels and the odds of unplanned post-discharge healthcare utilization.
“Several large insurance companies have already started addressing the effect of these social determinants of health through direct investments in neighborhoods, and this study helps inform the allocation of these investments to increase children’s access to care,” said senior author Hassan M.K. Ghomrawi, PhD, MPH, Research Scientist at Lurie Children’s and Associate Professor of Surgery, Medicine, and Pediatrics at Northwestern University Feinberg School of Medicine.
“The lack of association between neighborhood-level factors and unplanned post-discharge hospitalizations and Emergency Department visits suggests that once patients have established care, they are connected to a pediatric resource that can support families after discharge, regardless of the patient’s neighborhood,” said lead author Megan Bouchard, MD, MPH, fourth year surgical resident at Georgetown University Hospital and former post-doctoral research fellow at Lurie Children’s.
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New UC Davis MIND Institute research has identified a novel human gene linked to fetal brain development and autism spectrum disorder (ASD). The discovery also links the gene to the mother’s early prenatal vitamin use and placental oxygen levels.
In a study published Feb. 16 in Genome Biology, the researchers used genomic sequencing to find a DNA methylation signature in the placenta of newborns eventually diagnosed with autism. This signature mark was linked to early fetal neurodevelopment.
“By taking an unbiased approach to investigating placental DNA methylation differences, we discovered a novel gene in a poorly mapped region of the genome associated with autism, ” said Janine LaSalle, lead author on the study and professor of microbiology and immunology at UC Davis Health.
ASD is a complex neurological condition linked to genetic and environmental factors. The U.S. Centers for Disease Control and Prevention (CDC) estimates that one in 44 children are diagnosed with ASD. It is much more prevalent in males than females.
Why studying the placenta is important
The placenta supports fetal development in the uterus. It regulates oxygen supply and metabolism and provides hormones and neurotransmitters critical for the fetus’ developing brain.

Weight gain produces feelings of despondency and low self-worth among middle-aged men, but it is also seen as an inevitable consequence of family and career responsibilities, according to a new peer-reviewed study.
A body mass index (BMI) of more than 25 is considered to be overweight, and over 30 is defined as obese. According to the Health Survey for England, around two thirds of men aged 16 and over are overweight or obese. Of those aged 35-64, 31% are obese.
Researchers from Anglia Ruskin University (ARU) and the University of Derby interviewed men aged 35 and over participating in The Alpha Programme (TAP), a football and weight management project delivered in local community venues. It was run by lead author of the paper, Dr Mark Cortnage.
The qualitative study featured in-depth interviews with eight participants aged between 35 and 58. Researchers explored their relationships with food and diet before enrolling on the programme, why they felt they had put on weight, whether they were concerned about their health, any previous attempts to lose weight, and how they felt about being overweight or obese.
Family and employment were the two main factors attributed to their predicament, with discussions highlighting a sense of resignation, and that weight gain was an inevitable consequence of these life choices.
Comfort eating was blamed for much of the weight gain, but interviews showed little awareness of other nutritional factors such as food types and portion sizes.

The immune system has cells stationed all over the body, and they’re actually doing their business even if you’re fit as a fiddle. This is shown in a new study published in the scientific journal Cell Metabolism.
– Until recently, it was believed that the immune system was mostly dormant unless the body was under attack in connection with infections. However, it now turns out that the immune system most likely also plays an important role for perfectly healthy people and can affect the body’s production of vital energy sources, says one of the lead authors of the study, Anne Loft, who is a postdoc at the Department of Biochemistry and Molecular Biology.
Specifically, the immune system causes the liver of the healthy body to produce an energy source called ketone bodies. This takes place by letting the liver burn fat during fasting.
Energy for the brain
“When we’re fasting — that is, we haven’t eaten anything for maybe half a day or a full day — we start drawing on our fat deposits, but not all of our body cells are capable of burning fat. This applies, among other things, to the brain, which instead depends on the production of ketone bodies, which the liver forms by metabolising fats. The ketone bodies thereby energise the body, allowing us to function even if we don’t eat anything, explains another lead author of the study,” Søren Fisker Schmidt, Assistant Professor at the Department of Biochemistry and Molecular Biology.
Ketone bodies are also the focal point of many popular weight loss diets focusing on cutting carbohydrates from our food, so the body begins burning fat instead. Other research also suggests that the ketone bodies may have a positive impact on, among other things, risk factors for the development of cardiovascular disease.
“We now believe that the immune system affects the production of ketone bodies in fit and healthy individuals and given the beneficial effects of ketone bodies in various common metabolic disorders, this knowledge can hopefully also be applied to understand how the immune system is trying to keep the body in equilibrium when we’re sick,” Anne Loft explains.
The majority of the study was performed at Helmholtz Diabetes Center in Munich, where Anne Loft and Søren Fisker Schmidt spent 4 years supported by the Novo Nordisk Foundation, in close collaboration with researchers at Ulm University.
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Materials provided by University of Southern Denmark. Original written by Birgitte Svennevig. Note: Content may be edited for style and length.

Patients with diabetes are also more likely to be described as “noncompliant,” according to large studies of medical records.Medical records contain a plethora of information, from a patient’s diagnoses and treatments to marital status to drinking and exercise habits.They also note whether a patient has followed medical advice. A health provider may add a line stating that the patient is “noncompliant” or “non-adherent,” signaling that the patient has been uncooperative and may exhibit problematic behaviors.Two large new studies found that such terms, while not commonly used, are much more likely to appear in the medical records of Black patients than in those of other races.“In medicine, we tend to label people in derogatory ways when we don’t truly ‘see’ them — when we don’t know them or understand them,” said Dr. Dean Schillinger, who directs the Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center, and was not involved in the studies. “The process of labeling provides a convenient shortcut that leads some physicians to blame the patient for their illnesses.”The first study, published in Health Affairs, found that Black patients were two and a half times as likely as white patients to have at least one negative descriptive term used in their electronic health record. The study was based on an analysis of more than 40,000 notes taken for 18,459 adult patients at a large urban medical center in Chicago between January 2019 and October 2020.About 8 percent of all patients had one or more derogatory terms in their charts, the study found. The most common negative descriptive terms used in the records were “refused,” “not adherent,” “not compliant” and “agitated.”“It’s not so much whether you should never use these words, but why are we applying these words with so much more frequency to Black patients?” said Michael Sun, the lead author of the study and a third-year medical school student at the University of Chicago’s Pritzker School of Medicine. “Do we really believe Black patients are truly not compliant, so many more times than white patients?”Rather than assume the patient is lacking in motivation or disengaged, he said, the medical team should inquire whether the patient is facing financial barriers, transportation difficulties or other obstacles to adhering to treatment, such as illiteracy or trouble with English.The researchers found that outpatient clinic records were far less likely to contain the negative comments, compared with records from hospitals and emergency rooms, perhaps because outpatient providers have ongoing relationships with their patients and are more familiar with their circumstances.Regardless of race, unmarried patients and those on government health plans like Medicare and Medicaid were more likely to have negative descriptors applied to them than married or privately insured patients. Patients in poor overall health, with several chronic underlying health problems, were also twice as likely to have negative adjectives in their medical records, the study found.The second study, published in JAMA Network Open, analyzed the electronic health records of nearly 30,000 patients at a large urban academic medical center between January and December 2018. The study looked for what researchers called “stigmatizing language,” comparing the negative terms used to describe patients of different racial and ethnic backgrounds as well as those with three chronic diseases: diabetes, substance use disorders and chronic pain.Overall, 2.5 percent of the notes contained terms like “nonadherence,” “noncompliance,” “failed” or “failure,” “refuses” or “refused,” and, on occasion, “combative” or “argumentative.” But while 2.6 percent of medical notes on white patients contained such terms, they were present in 3.15 percent of notes about Black patients.Looking at some 8,700 notes about patients with diabetes, 6,100 notes about patients with substance use disorder and 5,100 notes about those with chronic pain, the researchers found that patients with diabetes — most of whom had type 2 diabetes, which is often associated with excess weight and called a “lifestyle” disease — were the most likely to be described in negative ways. Nearly 7 percent of patients with diabetes were said to be noncompliant with a treatment regimen, or to have “uncontrolled” disease, or to have “failed.”A note might say that a patient “refused diabetic diet,” for example, or was “noncompliant with insulin regimen.” The more severe the disease, the more likely the patient was to have notes with negative descriptors.In contrast, only 3.4 percent of patients with substance use disorders were described in negative terms, and fewer than 1 percent of patients with chronic pain had notes with negative descriptions.The medical record is the first thing a hospital-based health provider sees, even before meeting the patient, said Dr. Gracie Himmelstein, the paper’s first author, and it creates a strong first impression.“Before I even go meet a patient in the emergency room, the first thing I do is call up their record and read through the previous admission notes and get a sense of their history,” said Dr. Himmelstein, a resident physician at the University of California, Los Angeles, who carried out the research as part of her doctoral thesis at Princeton University. “I’m looking to see what their medical problems are, but as I do so, I’m also reading a narrative of their interactions with previous physicians.”Instead of relying on vague and stigmatizing terms like “noncompliant,” physicians should try to understand why a patient isn’t cooperating and note specific reasons in the medical record, Dr. Himmelstein said.“If the patient is, quote-unquote ‘noncompliant’ with the regimen, what is going on?” she said. “It’s hard for people to manage insulin. It can be prohibitively expensive. There can be issues around health literacy. We need to pinpoint where that problem is.”The labels have consequences, Dr. Schillinger warned. While some of the notes convey critical information, the terms used can cloud the physician’s — and future clinicians’ —  judgment and decision-making, diminishing their compassion and empathy. And that may cause patients to lose trust in their providers.“Patients whose physicians tend to judge, blame or vilify them are much less likely to have trust in their doctors, and in the medical system overall,” Dr. Schillinger said. “Having health care providers who are trustworthy — who earn their patients’ trust by not judging them unfairly — is critical to ensuring optimal health and eliminating health disparities.”

Although microgreens were initially gourmet ingredients for upscale restaurants, they’ve become popular among gardeners and home cooks. Despite their “superfood” label, the levels of healthful compounds, such as phytonutrients, in most varieties of microgreens are unknown. Researchers in ACS Food Science & Technology now report that kale and broccoli microgreens grown in either windowsills or under commercial growing conditions are rich in phytonutrients, though the levels of some compounds varied considerably between the two environments.
As indoor gardening has taken off in recent years, microgreens have added a pop of color to the windowsills of many homes. The most commonly planted varieties of these small seedlings are from the Brassica family, which includes broccoli, kale, cabbage and mustard. The mature, fully-grown versions of these vegetables are rich in vitamins, minerals and phytochemicals, and environmental conditions can impact the plants’ nutritional contents. But not much is known about the levels of these compounds in young microgreens. In a previous study, Thomas Wang, Pei Chen and colleagues observed that red cabbage microgreens had higher amounts of phytonutrients that have been reported to have antioxidant and anticancer properties, including polyphenols and glucosinolates, than the full-grown vegetables. However, similar assessments haven’t been done on other Brassica seedlings. So, the researchers wanted to measure the levels of polyphenols and glucosinolates in broccoli and kale microgreens, and then compare data from those grown on windowsills to those raised in commercial growth chambers.
The researchers placed trays of newly planted broccoli and kale seeds either on a windowsill in natural sunlight or inside a temperature- and humidity-controlled refrigerator-like growth chamber with artificial sunlight for 12 hours a day. Ten full days after seeding, the team harvested the plants and assessed the phytonutrient content with a liquid chromatography high-resolution mass spectrometry system. The broccoli and kale microgreens were rich in polyphenols and glucosinolates, no matter how they were grown. But there was considerable variability in the amounts of individual compounds when comparing the two growth environments. For instance, three flavanol compounds that contribute to the plant’s dark color and bitter taste were higher in windowsill-grown microgreens. However, chamber-grown plants had higher levels of two glucosinolates, which are antioxidant- and anticancer-related compounds. Overall, the growth environment for kale and broccoli microgreens affects the abundance of individual phytonutrients, the researchers say, which could affect their flavor and potential health benefits.
The authors acknowledge funding from U.S. appropriated funds to the U.S. Department of Agriculture, Fundamental Research Funds for the Central Universities of China and the State Scholarship Fund of China Scholarship Council.
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People who have had a heart attack may be slightly less likely than people in the general population to develop Parkinson’s disease later in life, 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.
Parkinson’s disease is a brain disorder characterized by progressive loss of physical movement, including tremors, slow or slurred speech, and/or stiffness or limited range of motion for walking and other physical activities. There is no cure for Parkinson’s disease, and it is also associated with behavioral changes, depression, memory loss and fatigue. Secondary parkinsonism, which has symptoms similar to Parkinson’s disease, may be caused by stroke, psychiatric or cardiovascular medications, or other illness.
“We have previously found that following a heart attack, the risk of neurovascular complications such as ischemic stroke [clot-caused stroke] or vascular dementia is markedly increased, so the finding of a lower risk of Parkinson’s disease was somewhat surprising,” said lead study author Jens Sundbøll, M.D., Ph.D., from the departments of clinical epidemiology and cardiology at the Aarhus University Hospital in Aarhus, Denmark. “These findings indicate that the risk of Parkinson’s disease is at least not increased following a heart attack and should not be a worry for patients or a preventive focus for clinicians at follow-up.
“It is not known whether this inverse relationship with risk of Parkinson’s disease extends to people who have had a heart attack. Therefore, we examined the long-term risk of Parkinson’s disease and secondary parkinsonism among heart attack survivors,” Sundbøll said.
The researchers examined health registries from the Danish National Health Service. They compared the risk of Parkinson’s disease and secondary parkinsonism among about 182,000 patients who had a first-time heart attack between 1995 and 2016 (average age 71 years old; 62% male) and more than 909,000 controls matched for age, sex and year of heart attack diagnosis. The results were adjusted for a variety of factors known to influence the risk of either heart attack or Parkinson’s disease.
Over a maximum continual follow-up of 21 years, after adjusting for a wide range of potential confounding factors, the analysis found that, when compared to the control group: there was a 20% lower risk of Parkinson’s disease among people who had a heart attack; and a 28% lower risk of secondary parkinsonism among those who had a heart attack.”For physicians treating patients following a heart attack, these results indicate that cardiac rehabilitation should be focused on preventing ischemic stroke, vascular dementia and other cardiovascular diseases such as a new heart attack and heart failure, since the risk of Parkinson’s appears to be decreased in these patients, in comparison to the general population,” Sundbøll said.

Laser-driven ion acceleration has been studied to develop a compact and efficient plasma-based accelerator, which is applicable to cancer therapy, nuclear fusion, and high energy physics. Osaka University researchers, in collaboration with researchers at National Institutes for Quantum Science and Technology (QST), Kobe University, and National Central University in Taiwan, have reported direct energetic ion acceleration by irradiating the world’s thinnest and strongest graphene target with the ultra-intense J-KAREN laser at Kansai Photon Science Institute, QST in Japan. Their findings are published in Springer Nature, Scientific Reports.
It is known that a thinner target is required for higher ion energy in laser ion acceleration theory. However, it has been difficult to directly accelerate ions with an extremely thin target regime since the noise components of an intense laser destroy the targets before the main peak of the laser pulse. It is necessary to use plasma mirrors, which remove the noise components, to realize efficient ion acceleration with an intense laser.
Thus, the researchers have developed large-area suspended graphene (LSG) as a target of laser ion acceleration. Graphene is known as the world’s thinnest and strongest 2D material, which is suitable for laser-driven ion sources.
“Atomically thin graphene is transparent, highly electrically and thermally conductive, and light weight, while also being the strongest material,” study author Wei-Yen Woon explains. “To date, graphene has seen a variety of applications, including those in transportation, medicine, electronics, and energy. We demonstrate another disruptive application of graphene in the field of laser-ion acceleration, in which the unique features of graphene play an indispensable role.”
Direct irradiations of the LSG targets generate MeV protons and carbons from sub-relativistic to relativistic laser intensities from low contrast to high contrast conditions without a plasma mirror, evidently showing the durability of graphene.
“The outcomes of this research are applicable to the development of compact and efficient laser-driven ion accelerators for cancer therapy, laser nuclear fusion, high energy physics, and laboratory astrophysics,” study lead author Yasuhiro Kuramitsu explains. “Direct acceleration of energetic ions without a plasma mirror evidently shows the robustness of LSG. We will use the atomic-thin LSG as a target mount to accelerate other materials which cannot stand by themselves. We also show the energetic ion acceleration at non-relativistic intensity. This will allow us to investigate laser ion acceleration with relatively small laser facilities. Furthermore, even without a plasma mirror at the extremely thin target regime, energetic ion acceleration is realized. This opens up a new regime of laser driven ion acceleration.”
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