Publisher Health

Monitoring daily activity patterns using a wrist-worn device may detect early warning signs of Alzheimer’s disease, according to a new study led by researchers at the Johns Hopkins Bloomberg School of Public Health.
The researchers analyzed movement data from wristwatch-like devices called actigraphs worn by 82 cognitively healthy older adults who were participants in a long-running study of aging. Some of the participants had detectable brain amyloid buildup as measured by PET scan. Buildup of the protein amyloid beta in the brain is a key feature of Alzheimer’s disease.
Using a sensitive statistical technique, the researchers found significant differences between this “amyloid-positive” group and “amyloid-negative” participants in mean activity in certain afternoon periods and differences in variability of activity across days in a broader range of time windows.
The new study was published online February 21 in the journal SLEEP.
“We need to replicate these findings in larger studies, but it is interesting that we’ve now seen a similar difference between amyloid-positive and amyloid-negative older adults in two independent studies,” says Adam Spira, PhD, professor in the Department of Mental Health at the Bloomberg School.
The new study’s results partly confirm findings from an earlier study in a smaller sample, also led by Spira, and suggest that actigraphs someday could be a tool to help detect incipient Alzheimer’s disease before significant cognitive impairment sets in. Data from the prior study came from participants in the Anti-Amyloid Treatment in Asymptomatic Alzheimer’s (A4) and the Longitudinal Evaluation of Amyloid Risk and Neurodegeneration (LEARN) studies.
For their new study, Spira and colleagues investigated the potential of actigraph-based monitoring in 82 community-dwelling individuals whose average age was about 76. Each participant had a PET scan to measure brain amyloid and wore an actigraph 24 hours per day for one week. Using a sensitive statistical technique called FOSR (function-on-scalar regression), the researchers found that the 25 amyloid-positive participants, compared to the 57 amyloid-negative participants, had higher mean activity during the early afternoon, 1:00 to 3:30 p.m., and less day-to-day variability in activity from 1:30 to 4:00 p.m. and 7:30 to 10:30 p.m.

In more conservative analyses, some of these time windows with differences were no longer statistically significant. Nonetheless, the higher afternoon activity and lower afternoon variability echoed the investigators’ prior findings.
Alzheimer’s disease, the leading cause of dementia, is estimated to affect more than 6 million older adults in the U.S. The Alzheimer’s disease process is still not fully understood but is characterized by amyloid plaques and tangles in the brain, which typically begin to accumulate a decade or two before Alzheimer’s is diagnosed.
The only approved treatments that may slow the disease course are those that target amyloid beta and reduce the plaques. Many researchers believe that such treatments can be much more effective if given earlier in the disease course — ideally, years before dementia becomes evident.
Abnormal patterns of sleep and waking activity have been studied as potential early indicators of Alzheimer’s. Alzheimer’s patients typically have abnormal sleep-wake rhythms, and prior studies have found evidence that amyloid accumulation may disrupt sleep-wake rhythms relatively early in the disease process. There is also evidence that sleep loss promotes amyloid accumulation, suggesting a “vicious circle.”
Such findings hint at the possibility that older adults might someday, among other measures, wear wristwatch-like devices that would automatically track and analyze their sleep and waking activity. Individuals with anomalous activity patterns could then consult their physicians for more in-depth Alzheimer’s screening.
The individuals in the new study were participants in a long-running study, the Baltimore Longitudinal Study of Aging, which is conducted by the Intramural Research Program of the National Institute on Aging (NIA), part of the National Institutes of Health (NIH). Several members of the NIA team were co-authors of the study.

Standard, non-FOSR statistical methods did not detect any significant differences in activity or sleep patterns, suggesting the methods may be less sensitive to amyloid deposition.
In the earlier actigraphy study, the researchers, using FOSR-based analyses in a different sample of 59 participants, found increases in mean activity in afternoon hours and differences in variability, including lower variability in the afternoon, among amyloid-positive participants.
The scientists don’t know why amyloid buildup would trigger differences in activity patterns during these particular times of day. They note that there is a well-known phenomenon among individuals with Alzheimer’s disease called “sundowning,” in which agitation increases in the afternoon and early evening.
“It’s conceivable that the higher afternoon activity we observed is a signal of ‘preclinical sundowning,'” Spira says. “At the same time, it’s important to note that these findings represent averages among a small sample of older people over a short period of time. We can’t predict whether an individual will develop amyloid plaques based on the timing of their activity. So, it would be premature for older people to be concerned because their fitness trackers say they are particularly active in the afternoon, for example.”
He and his colleagues plan to do larger studies of this kind. They also hope to do longer-term studies to see if daily activity-pattern changes are associated not only with brain amyloid but also with actual cognitive decline.
Support for the research was provided by NIH (R01AG050507, HHSN-260-2004-00012C).

Researchers from Skaggs School of Pharmacy and Pharmaceutical Sciences at the University of California San Diego have uncovered thousands of previously unknown bile acids, a type of molecule used by our gut microbiome to communicate with the rest of the body.
“Bile acids are a key component of the language of the gut microbiome, and finding this many new types radically expands our vocabulary for understanding what our gut microbes do and how they do it,” said senior author Pieter Dorrestein, Ph.D., professor at Skaggs School of Pharmacy and Pharmaceutical Sciences and professor of pharmacology and pediatrics at UC San Diego School of Medicine. “It’s like going from ‘See Spot Run’ to Shakespeare.”
The results, as described by study co-author and bile acids expert Lee Hagey, Ph.D, are akin to a molecular Rosetta stone, providing previously unknown insight into the biochemical language microbes use to influence distant organ systems.
Bile acids originate in the liver, are stored in the gallbladder and ultimately released into the intestine, where they are deployed to aid in digestion following the consumption of a meal. The microbes in our gut metabolize the bile acids produced by the liver, changing them into a vast array of different molecules called secondary bile acids, which tend to be easier for the body to absorb. Until now, the rich diversity and range of functions of secondary bile acids have been underappreciated by scientists.
“When I started working in the lab, there were about a few hundred known bile acids,” said study co-author Ipsita Mohanty, Ph.D., a postdoctoral researcher in the Dorrestein lab. “Now we’ve discovered thousands more, and we’re also working toward realizing that these bile acids do so much more than just help with digestion.”
In addition to aiding digestion, bile acids are also important signaling molecules that help regulate the immune system and serve important metabolic functions, such as controlling lipid and glucose metabolism. These molecules also help explain how microbes in the gut are able to influence distant organ systems.
“Because of their interaction with our microbiome, the influence of bile acids spreads far beyond the digestive system, and so could the diseases we treat with them — the list of diseases related to bile acids is a mile long, and there are several FDA approvals for these kinds of acids as treatments,” said co-author Helena Mannochio-Russo, Ph.D., also a postdoctoral researcher in the Dorrestein lab.

In order to discover these molecules, the researchers leveraged the unique resources of UC San Diego. Dorrestein is director of the Collaborative Microbial Metabolite Center (CMMC), a first-of-its-kind collaboration between UC San Diego and UC Riverside that seeks to gather and centralize information about the metabolites that microbes produce to help researchers learn more about their impact on human health and the environment.
“In other areas of biology like genomics, sharing data is common, but there hasn’t been an infrastructure in place for microbial metabolomics researchers to share data until now,” said Dorrestein “Ultimately these breakthroughs are the result of a convergence of collaboration and computing power, and we expect many more breakthroughs to come out of the CMMC.”
Earlier this year, the team debuted a new tool that can instantly match microbes to the metabolites they produce. The present study is the first of potentially many studies to utilize the tool for specific types of molecules. The researchers next hope to explore the specific functions of their newly-discovered bile acids as well as use their approach on other types of biomolecules, such as lipids or other kinds of acids.
“We’re rewriting the textbook of human metabolism,” said Dorrestein. “If you’d have spoken to me a few years ago, I would have said we were decades away from solving this puzzle, but now, it could happen within five years. It’s really a remarkable change in our capabilities, and we believe it’s going to revolutionize the way we approach disease.”

A new study from Karolinska Institutet in Sweden reveals that immune cells in the liver react to high cholesterol levels and eat up excess cholesterol that can otherwise cause damage to arteries. The findings, published in Nature Cardiovascular Research, suggest that the response to the onset of atherosclerosis begins in the liver.
Cholesterol is a type of fat that is essential for many functions in the body, such as making hormones and cell membranes. However, too much cholesterol in the blood can be harmful, as it can stick to the walls of the arteries and form plaques that narrow or block the blood flow. This results in atherosclerotic cardiovascular disease, the primary underlying cause of heart attacks and strokes, and the leading cause of death worldwide.
The liver responded immediately
In the current study, researchers wanted to understand how different tissues in the body react to high levels of LDL, also called ‘bad cholesterol’, in the blood. To test this, they created a system where they could quickly increase the cholesterol in the blood of mice.
“Essentially, we wanted to detonate a cholesterol bomb and see what happened next,” says Stephen Malin, lead author of the study and principal researcher at the Department of Medicine, Solna, Karolinska Institutet. “We found that the liver responded almost immediately and removed some of the excess cholesterol.”
However, it wasn’t the typical liver cells that responded, but a type of immune cell called Kupffer cells that are known for recognising foreign or harmful substances and eating them up. The discovery made in mice was also validated in human tissue samples.
“We were surprised to see that the liver seems to be the first line of defence against excess cholesterol and that the Kupffer cells were the ones doing the job,” says Stephen Malin. “This shows that the liver immune system is an active player in regulating cholesterol levels, and suggests that atherosclerosis is a systemic disease that affects multiple organs and not just the arteries.”
Several organs could be involved
The researchers hope that by understanding how the liver and other tissues communicate with each other after being exposed to high cholesterol, they can find new ways to prevent or treat cardiovascular and liver diseases.
“Our next step is to look at how other organs respond to excess cholesterol, and how they interact with the liver and the blood vessels in atherosclerosis,” says Stephen Malin. “This could help us develop more holistic and effective strategies to combat this common and deadly disease.”

Taking “study drugs” like Adderall without a diagnosis is not only dangerous in itself, but can lead to other drug use and a decline in mental health, according to new research from Binghamton University, State University of New York.
Attention Deficit Hyperactivity Disorder (ADHD) medications are frequently used illicitly by college students as a study aid, but it’s unknown what psychoactive substances are likely to be abused along with these drugs. To explore this issue, a team of Binghamton researchers led by Associate Professor of Health and Wellness Studies Lina Begdache, conducted a study of 702 undergraduate college students from across the U.S., asking about the most commonly used drugs used by students — including ADHD medications, cannabis, nicotine, alcohol, MDMA, and ecstasy — as well as questions on academic performance and physical and mental distress.
The researchers found several associations indicating that using one substance may lead to using others — as if the brain becomes primed for further substance use.
“Substance use promotes the release of the neurotransmitter dopamine, which is responsible for the initial euphoria and feelings of pleasure. These sensations act as a positive reinforcement for further substance use,” said Begdache. “The continuous activation of the limbic system through drug use leads to dependence, in a sense that this substance is no longer producing pleasurable feelings. Individuals have to either increase the dose or resort to something more potent.”
The researchers found that using one substance was associated with generally poorer mental health and lower resilience to stress. Also, low frequency of use was negatively associated with mental distress, which potentially becomes a positive reinforcement for further use.
“Since the human brain continues developing into a person’s mid/late 20s, substance use during young adulthood may have a strong negative impact on the quality of brain maturity and cognitive function,” said Begdache. “Additionally, those individuals are likely to continue using substances later in life, which means they are at risk of mental health decline as well. Our findings also indicated that substance use is linked to lower resilience to adversity. So we can speculate that the rise in mental health ailments may be mediated by a lower resilience to adversity, which impacts mood.”
Begdache said that these findings are important because many students may use study drugs not knowing their detrimental effects on the brain.

“Since these are prescribed medications to promote focus in individuals who actually have ADHD, students may think that they are safe to use and that the drug may give them an academic edge,” she said.
Begdache leads the Binghamton Student Managed Adderall Research Team (B-SMART), which investigates the harmful effects of Adderall abuse on college students and is conducting further studies. She believes that college campuses need to take a stranger stance on educating their students about the dangers of drug use on the developing brain.
“The repeated feedback we receive from students is that they wish they knew this information earlier. Lack of education and peer pressure are the main drivers,” said Begdache. “College campuses are struggling to deal with the mental health decline of their students. A preventative approach is more cost-effective and may likely improve the quality of life of their students in the future.”
The paper, “Association between ADHD Medication, Cannabis, and Nicotine Use, Mental Distress, and Other Psychoactive Substances,” was published in the International Journal of Psychological and Behavioral Sciences.

Cornell University scientists have detected higher bacterial counts in commercial, paperboard single-serving containers two weeks after processing than milk packaged in larger containers from the same facilities.
“These small paperboard milk containers are typically served in schools,” said senior author Nicole Martin, assistant research professor in dairy foods microbiology. “Since children are important milk consumers, we wanted to take a deeper dive into finding out what was going on.”
The scientists believe carton-filling machinery likely contributed to those higher counts in the post-pasteurization process. The research published in the Journal of Dairy Science.
Transportation and milk delivery routines to schools have changed in recent years, said Martin Wiedmann, professor of food science. Rural schools in New York once received fresh milk deliveries every two or three days, but now schools may receive deliveries once a week or less.
“Milk is a perishable product, and it is minimally processed, but it does have a shelf life and consumers expect that,” Martin said. “The imbalance of the shelf life between the larger containers and the smaller ones intrigued us.”
The researchers recruited four commercial milk processing facilities to collect data on single-serving carton samples of skim, white 1%, chocolate and chocolate 1% milk.
Over two initial sampling visits to four processors, the scientists found higher bacterial counts after seven and 14 days of storage, as well as slightly lower sensory scores (how the milk tasted) compared to high-quality samples.

For the first sampling visit, the Cornell scientists found no gram-negative spoilage (indicating bacterial presence) in any of the facilities’ freshly processed milk. By day 7, one facility saw gram-negative spoilage at 30%, which grew to 41% by day 14. The remaining three facilities saw single-digit gram-negative spoilage scores (3%, 8% and 6%) on day 7, rising to 19%, 23% and 14% by day 14.
The scientists followed up in the commercial facilities and learned that the carton-forming mandrels — those machinery parts that open the small, flat-lying, single-serving carton in the filling process — needed more attention and cleaning. Wiedmann acknowledged that due to its intricacy, the dairy processing equipment for single-serving paperboard cartons is tricky to clean.
“These are complex pieces of equipment,” he said. Members of his program helped to perform cleaning and sanitation at the commercial facilities to ensure consistency and to develop standard protocols.
“In the long term,” Wiedmann said, “our program can help improve the design of this equipment and perhaps make it easier to clean.”
This project was funded by the New York Dairy Promotion Order.

Published11 minutes agoShareclose panelShare pageCopy linkAbout sharingImage source, Getty ImagesImmediate action is needed to tackle the impact of ethnic and other biases in the use of medical devices, an independent review says.It found pulse oximeter devices could be less accurate for people with darker skin tones, making it harder to spot dangerous falls in oxygen levels.Meanwhile, devices using AI could under-estimate skin cancer in people with darker skin, it warns. The review said fairer devices needed to be designed urgently.In total, it made 18 recommendations for improvement. The government says it fully accepts the report’s conclusions.The review was commissioned in 2022 amid mounting concern that ethnic minorities faced greater Covid risks.It looked closely at three types of device where there is potential for “substantial” harm to patients:optical medical devices – such as pulse oximeters, which send light waves through a patient’s skin to estimate the level of oxygen in the blood. The light can behave differently depending on skin toneartificial intelligence in healthcarepolygenic risk scores – which combine the results of several genetic tests to help estimate an individual’s risk of disease and are used mostly for research purposesPulse oximeters were used frequently during the Covid pandemic, for example, alongside other observations, to help judge whether a patient needed hospital admission and treatment. ‘Inherent bias’Building on previous research, the review says the devices, which are clipped onto a finger, can over-estimate the level of oxygen in the blood for people with darker skin tones.The report says there is evidence from the US to suggests this can sometimes lead to worse health outcomes for Black patients.And researchers say the situation is compounded by the devices mostly being tested and calibrated on participants with lighter skin tones.The government points to action already being taken on the issue, including updated NHS guidance on pulse oximeters and more research into smarter devices being funded.But the researchers said it was crucial that people do not stop using pulse oximeters – which nevertheless help monitor trends of oxygen levels – while more action is taken to resolve the situation.Image source, Getty ImagesChair of the review, Professor Dame Margaret Whitehead from the University of Liverpool, called for “system-wide action” to be implemented as a matter of priority. She said: “The advance of AI in medical devices could bring great benefits, but it could also bring harm through inherent bias against certain groups in the population, notably women, people from ethnic minorities and disadvantaged socio-economic groups. “Our review reveals how existing biases and injustices in society can unwittingly be incorporated at every stage of the lifecycle of AI-enabled medical devices, and then magnified in algorithm development and machine learning.”Chest X-raysOne example is the potential under-diagnosis of skin cancers for people with darker skin.This would likely be a result of machines being ‘trained’ predominantly on images of lighter skin tones, the team explains. Another concern arises when using AI systems for reading chest x-rays – which are mainly trained on images taken of men, who tend to have larger lung capacities. This could potentially lead to under-diagnosis of heart disease in women, the report suggests, worsening an already long-standing problem. The government says it is committed to removing bias in datasets and increasing training for health professionals. Javid orders review of medical device racial biasConcern over use of oxygen monitors on darker skinWhen it comes to predicting someone’s risk of disease using so-called polygenic risk scores, the report says there are similar issues with the data because it’s based overwhelmingly on populations of European ancestry – meaning the results may not be applicable to people of other backgrounds. Another concern is that these scores are only predictive and cannot say for certain that people will develop a disease. Professor Habib Naqvi, chief executive of the NHS Race and Health Observatory, welcomed the findings, saying access to better health should not be determined by ethnicity nor by the colour of your skin and medical devices needed to be fit-for-purpose for all communities.He added that the lack of diverse representation in health research and robust equity considerations had “led to racial bias in medical devices, clinical assessments and in other healthcare interventions”.Minister of State, Andrew Stephenson said the review was important.”Making sure the healthcare system works for everyone, regardless of ethnicity, is paramount to our values as a nation. It supports our wider work to create a fairer and simpler NHS,” he said.More on this story’Ethnic bias’ delayed care before pregnancy deathPublished16 FebruaryJavid orders review of medical device racial biasPublished21 November 2021Concern over use of oxygen monitors on darker skinPublished31 July 2021Related Internet LinksEquity in medical devices- independent review – final report – GOV.UKDisparities in the risk and outcomes of COVID-19The BBC is not responsible for the content of external sites.

Published2 hours agoShareclose panelShare pageCopy linkAbout sharingImage source, Qays Najm/BBCBy Charlie JonesBBC NewsCancer patients are “being let down” and some are at risk of dying because they are not being treated on time, senior doctors have warned. Oncologist Professor Pat Price, head of the charity Radiotherapy UK, said cancer care in the UK was “in crisis”.A former nurse said the five-month wait for her cancer treatment to start had been “horrific”.A Department of Health and Social Care spokesperson said cutting waiting lists was one of the government’s priorities.Cancer waiting times for 2023 in England were the worst on record, BBC News analysis revealed last month.In December, only 65.9% of cancer patients in England started their first treatment on time, within 62 days of an urgent referral. The target is 85% and was last met in 2015.Image source, Tina BeanTina Bean, 55, from Stebbing in Essex, had to wait 158 days for her treatment for stage three bowel cancer, which has spread to her pelvic lymph nodes.The former nurse, who worked for the NHS for 35 years, had an urgent referral to Broomfield Hospital in Chelmsford in September last year after going to see her GP.But she had to wait 80 days after seeing her GP before she received her diagnosis.”I thought everything must be fine because I hadn’t heard anything for so long, so I went on my own to the appointment. My whole world turned upside down,” she said.Image source, Tina BeanMrs Bean only started daily radiotherapy and chemotherapy last month at Southend hospital.”The waiting has been horrific. I have tried to keep positive and the treatment I am now getting is the best possible treatment but I know the delay can have a negative impact on your survival rate.”All I have wanted since I have known about the cancer is to get it out of me. I just thought ‘please give me the treatment’.””I am so fortunate I have such a great support network but some people don’t have that. There are thousands of other people like me, waiting for huge lengths of time.”Image source, Tina BeanHaving treated hundreds of cancer patients during her career, Mrs Bean now feels “let down” by the service she dedicated her life to.”As a nurse I wanted to do the best for my patients. Everyone I have seen wants to do their best for me but they’re being prevented from doing that.”Mrs Bean is being treated by the Mid and South Essex NHS Foundation Trust, which treated just 46.9% of patients on time in December, making it among the worst performing in England for that target.Andrew Pike, chief operating officer at the trust, said: “We are very sorry to hear of Mrs Bean’s experience. This is being investigated and the hospital will contact Mrs Bean to resolve and address any concerns.”Prof Price, who co-founded a campaign called Catch Up With Cancer, said 225,000 cancer patients had waited too long for their treatment since 2020.”Some cancer patients are not being kept safe and that is not acceptable,” she said.She said she had heard anecdotally of people who had waited for more than a year for treatment.”The situation is very bad and it’s so distressing for patients. The most important thing is to start treatment on time which is why we have the 62 day target.”It is really serious because for every four week delay in treatment, there can be up to a 10% increase in deaths, so it is putting patients at risk.”Cancer patients are being completely let down. We are a modern country, we have got treatments that can cure people and we are just not treating people on time.”Cancer is increasing by 2% a year – if we are not coping now, how on earth are we going to cope in the future?”Prof Price said the government needed to “reprioritise cancer” and produce a designated cancer plan, with the help of experts, to “get a grip” on the crisis.Leandre Archer, from the Society of Radiographers, said the situation was “profoundly depressing”, with radiography departments often treating patients at 120% capacity, with waiting lists continually growing. “We’re hearing of departments that end up turning off some of their radiotherapy machines because there are not enough therapeutic radiographers to deliver patient care,” she said.”Long waiting times mean that cases become more complex and for some patients, even a two-week delay can mean the difference between life and death.”Cancer Research UK’s chief executive, Michelle Mitchell, said thousands of patients were facing unacceptable waits to be diagnosed and treated.”The UK government must take urgent action and provide additional investment for the NHS, coupled with reform to cancer services, so that cancer patients receive the level of care that they deserve.”A Department of Health and Social Care spokesperson said there were record numbers of urgent cancer referrals last year and record numbers of patients received a cancer diagnosis or all-clear within four weeks. “Survival rates are improving across almost all types of cancer and we will shortly legislate to create the first smokefree generation – the biggest single public health intervention in decades.”Follow East of England news on Facebook, Instagram and X. Got a story? Email eastofenglandnews@bbc.co.uk or WhatsApp 0800 169 1830More on this storyHospital waiting list tops 7.5 million in EnglandPublished10 August 2023Key cancer waiting target set to be missed in EnglandPublished7 March 2023NHS struggling to provide safe cancer care, say doctorsPublished8 June 2023

Getty ImagesCopyright: Getty ImagesGething accepts there was inadequate preparation
for the wrong pandemic.Government planning involved prepping for a flu pandemic – and
because Covid was a different virus “we went through PPE at a much faster
rate” and “some of the items weren’t fit for purpose”.Gething told the inquiry “the preparation we thought
we had didn’t stand up as well as we thought it would in those early weeks”,
adding there was a “bridge to be gapped” between expectation and reality.”So, in hindsight we weren’t as well
prepared as we could have been and we weren’t as well prepared as we thought we
were – and that’s not just in Wales but the rest of the UK,” Wales’ pandemic health minister says.Asked if Welsh government was too slow in
early 2020 to recognise the pandemic emergency, Gething says “the
full recognition of the multi-agency nature of the response which was required”
came in the middle of February. “But still not understanding the scale of
that, that still comes later,” he says.“When it comes to the middle of
February onwards, I don’t think there’s any doubt that the Welsh government is
taking this seriously and having to move resources around rapidly while still
dealing with what’s happening in front of us with every day business.”Gething says large parts of the normal
NHS in Wales being “switched off” from 13 March 2020 was a significant and
“extraordinary intervention”.

Grieving families want official records and popular discourse to move away from reflexive use of “overdose,” which they believe blames victims for their deaths.The death certificate for Ryan Bagwell, a 19-year-old from Mission, Texas, states that he died from a fentanyl overdose.His mother, Sandra Bagwell, says that is wrong.On an April night in 2022, he swallowed one pill from a bottle of Percocet, a prescription painkiller that he and a friend bought earlier that day at a Mexican pharmacy just over the border. The next morning, his mother found him dead in his bedroom.A federal law enforcement lab found that none of the pills from the bottle tested positive for Percocet. But they all tested positive for lethal quantities of fentanyl.“Ryan was poisoned,” Mrs. Bagwell, an elementary-school reading specialist, said.As millions of fentanyl-tainted pills inundate the United States masquerading as common medications, grief-scarred families have been pressing for a change in the language used to describe drug deaths. They want public health leaders, prosecutors and politicians to use “poisoning” instead of “overdose.” In their view, “overdose” suggests that their loved ones were addicted and responsible for their own deaths, whereas “poisoning” shows they were victims.“If I tell someone that my child overdosed, they assume he was a junkie strung out on drugs,” said Stefanie Turner, a co-founder of Texas Against Fentanyl, a nonprofit organization that successfully lobbied Gov. Greg Abbott to authorize statewide awareness campaigns about so-called fentanyl poisoning.“If I tell you my child was poisoned by fentanyl, you’re like, ‘What happened?’”, she continued. “It keeps the door open. But ‘overdose’ is a closed door.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Published2 hours agoShareclose panelShare pageCopy linkAbout sharingImage source, Family photoBy Owain EvansBBC NewsTwo sisters who had heart attacks just days apart have said more should be done to raise awareness of a condition that can be fatal.Rebecca Lewis, 48, had a spontaneous coronary artery dissection (SCAD), when a tear appears in the wall of a coronary artery.Although not conclusive, it is likely that her sister Angharad experienced the same thing three days later.  SCAD is a rare condition that cannot currently be predicted or prevented.The majority of cases affect women in their 40s or 50s or those who have recently had a baby.’I was told I’d die if I had a baby’Heart attack inequality ‘costing women’s lives”I gave birth two weeks after a heart attack’Rebecca, a teacher from Cardiff, was marking work in her classroom last November when she felt huge pressure on her chest.The school’s quick-thinking head teacher took Rebecca to the University Hospital of Wales in Cardiff, where she was told she had had a heart attack. An angiogram a few days later showed that it had been caused by a SCAD.What is SCAD?A SCAD happens when the inner layers of a coronary artery tear away from the outer layer, restricting blood flow.In some cases this can lead to a heart attack or cardiac arrest. Symptoms can include chest pain, tightness or pain in the arms, neck, jaw, back or stomach; feeling dizzy or lightheaded; feeling tired or out of breath; nausea, and feeling sweaty or clammy.Rebecca said she was lucky that the consultant who treated her had previously worked at Glenfield Hospital in Leicester, which is a leading centre for research into SCAD.”The consultant that actually did my angiogram… had been trained to know what SCAD looked like on an angiogram and was able to pick it out with me,” she said.The morning after visiting her in hospital, Rebecca’s sister Angharad also had a heart attack. An angiogram suggested she too had suffered a SCAD.  Angharad was treated at a different hospital, but Rebecca said she was adamant that Angharad should be checked for a SCAD.Image source, Angharad Lewis”They were happy to discharge me,” Angharad recalled.”So I was very fortunate that I had a big sister looking after me saying ‘you need to get this test, you need to mention what has happened to me and what they found’. “So, eventually, the consultants spoke to each other and I was sent down to Cardiff. If it wasn’t for Becky, I would’ve been sent home not knowing why I’d had my heart attack.”There are currently 2,000 patients helping the research at Glenfield Hospital. Prof David Adlam, who leads the research, said many cases go undiagnosed.”We try to encourage our colleagues across the health services, who will be potentially seeing patients who might have SCAD, to think of it. Because if you’re not thinking of it, then you may miss it,” he said.”When you have a conventional heart attack… generally it’s caused by a fixed narrowing in the coronary artery, and we often treat that by stretching open that narrowing and inserting a stent. “In SCAD patients we do the opposite,” he added. “We’re trying to manage the artery to let it heal by itself. And the reason for that is that it’s a different disease. It has a different underlying cause.”Rebecca and Angharad are still coming to terms with what happened to them.”It’s affected the whole family,” said Angharad.Image source, Angharad and Rebecca Lewis”I’ve been very fortunate to have support from friends. They’ve been coming here just because they are aware that I’m a bit nervous about doing things and being out and about.”Rebecca said the experience had knocked her confidence. “It caused a lot of distress when it happened,” she said.”It was the last thing I was thinking at 48 years of age that I’d be having a heart attack.”Research into SCAD is currently funded by the Beat SCAD charity, although the Scottish government is also running a pilot project. Prof Adlam hopes the Welsh government will do the same.”We would very much like to work with our friends and colleagues in Wales to ensure that these patients are properly cared for,” he said.”It’s really important to raise awareness,” Angharad added.”At the moment we are saying it’s very rare, but if we’re looking at my experience, maybe it’s going undiagnosed. Becky came home with a diagnosis, with a label. Fortunately, I’ve ended up with the same, but it could have been very different.”The Welsh government said: “We expect NHS Wales to deliver care for acute coronary syndrome in line with professional guidelines from organisations such as the National Institute for Health and Care Excellence (NICE). “For more rare cardiac conditions, NHS Wales is prepared to work with counterparts across the UK on research.”More on this story’I was told I’d die if I had a baby’Published9 November 2018Heart attack inequality ‘costing women’s lives’Published30 September 2019Women at higher risk of heart attack misdiagnosisPublished14 February 2022