Study details five cutting-edge advances in biomedical engineering and their applications in medicine – EurekAlert

February 29, 2024 medical

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Shankar Subramaniam is the lead author of the taskforce, distinguished professor in the Shu Chien-Gene Lay Department of Bioengineering at the University of California San Diego.

Credit: University of California San Diego

Bridging precision engineering and precision medicine to create personalized physiology avatars. Pursuing on-demand tissue and organ engineering for human health. Revolutionizing neuroscience by using AI to engineer advanced brain interface systems. Engineering the immune system for health and wellness. Designing and engineering genomes for organism repurposing and genomic perturbations.

These are the five research areas where the field of biomedical engineering has the potential to achieve tremendous impact on the field of medicine, according to Grand Challenges at the Interface of Engineering and Medicine, a study published by a 50-person task force published in the latest issue of IEEE Open Journal of Engineering in Medicine and Biology. The paper is backed by the IEEE Engineering in Medicine and Biology Society.

These grand challenges offer unique opportunities that can transform the practice of engineering and medicine, said Shankar Subramaniam, lead author of the taskforce, distinguished professor in the Shu Chien-Gene Lay Department of Bioengineering at the University of California San Diego. Innovations in the form of multi-scale sensors and devices, creation of humanoid avatars and the development of exceptionally realistic predictive models driven by AI can radically change our lifestyles and response to pathologies. Institutions can revolutionize education in biomedical and engineering, training the greatest minds to engage in the most important problem of all times human health.

In addition to Subramaniam, the following faculty from the UC San Diego Shu Chien-Gene Lay Department of Bioengineering were part of the task force: Stephanie Fraley, associate professor, Prashant Mali, professor, Berhard Palsson, Y.C. Fung Endowed Professor in Bioengineering and professor of pediatrics, and Kun Zhang, professor and a former department chair.

The study provides a roadmap to pursue transformative research work that, over the next decade, is expected to transform the practice of medicine. The advances would impact a wide range of conditions and diseases, from cancer, to diabetes, to transplants, to prosthetics.

The Five Grand Challenges Facing Biomedical Engineering

In an increasingly digital age, we have technologies that gather immense amounts of data on patients, which clinicians can add to or pull from. Making use of this data to develop accurate models of physiology, called avatars which take into account multimodal measurements and comorbidities, concomitant medications, potential risks and costs can bridge individual patient data to hyper-personalized care, diagnosis, risk prediction, and treatment. Advanced technologies, such as wearable sensors and digital twins, can provide the basis of a solution to this challenge.

Tissue engineering is entering a pivotal period in which developing tissues and organs on demand, either as permanent or temporary implants, is becoming a reality. To shepherd the growth of this modality, key advancements in stem cell engineering and manufacturing along with ancillary technologies such as gene editing are required. Other forms of stem cell tools, such as organ-on-a-chip technology, can soon be built using a patients own cells and can make personalized predictions and serve as avatars.

Using AI, we have the opportunity to analyze the various states of the brain through everyday situations and real-world functioning to noninvasively pinpoint pathological brain function. Creating technology that does this is a monumental task, but one that is increasingly possible. Brain prosthetics, which supplement, replace or augment functions, can relieve the disease burden caused neurological conditions. Additionally, AI modeling of brain anatomy, physiology, and behavior, along with the synthesis of neural organoids, can unravel the complexities of the brain and bring us closer to understanding and treating these diseases.

With a heightened understanding of the fundamental science governing the immune system, we can strategically make use of the immune system to redesign human cells as therapeutic and medically invaluable technologies. The application of immunotherapy in cancer treatment provides evidence of the integration of engineering principles with innovations in vaccines, genome, epigenome and protein engineering, along with advancements in nanomedicine technology, functional genomics and synthetic transcriptional control.

Despite the rapid advances in genomics in the past few decades, there are obstacles remaining in our ability to engineer genomic DNA. Understanding the design principles of the human genome and its activity can help us create solutions to many different diseases that involve engineering new functionality into human cells, effectively leveraging the epigenome and transcriptome, and building new cell-based therapeutics. Beyond that, there are still major hurdles in gene delivery methods for in vivo gene engineering, in which we see biomedical engineering being a component to the solution to this problem.

We are living in unprecedented times where the collision of engineering and medicine is creating entirely novel strategies for human health. The outcome of our task force, with the emergence of the major research and training opportunities is likely to reverberate in both worlds--engineering and medicine--for decades to come said Michael Miller, Professor and Director of the Department of Biomedical Engineering at Johns Hopkins University, who served as a senior author on the manuscript.

IEEE Open Journal of Engineering in Medicine and Biology

Meta-analysis

Not applicable

Grand Challenges at the Interface of Engineering and Medicine

23-Feb-2024

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Study details five cutting-edge advances in biomedical engineering and their applications in medicine - EurekAlert

Physiology

Salk Institute mourns the loss of Nobel Laureate Roger Guillemin, distinguished professor emeritus – Salk Institute

February 29, 2024 medical

February 23, 2024

Considered the father of neuroendocrinology, Guillemin died February 21 at age of 100

LA JOLLASalk Distinguished Professor Emeritus Roger Guillemin, recipient of the 1977 Nobel Prize in Physiology or Medicine and neuroendocrinology pioneer, died on February 21, 2024, in Del Mar, California at the age of 100.

We are incredibly saddened to learn of Rogers passing, says Salk President Gerald Joyce. He leaves a remarkable legacy at Salk and around the world. His brilliance, commitment, and passion for discovery brought forth some of the last centurys most significant advances in our knowledge of the human brain. He was a cherished colleague and mentor to many. I personally mourn his loss and know I speak for the entire Salk community when I say our world is less bright without him in it.

Guillemin joined Salk in 1970 to head the newly established Laboratories for Neuroendocrinology. He and his group discovered somatostatin, which regulates the activities of the pituitary gland and the pancreas. Somatostatin is used clinically to treat pituitary tumors. He was among the first people to isolate endorphins, brain molecules that act as natural opiates, and his work with cellular growth factors (FGFs) led to the recognition of multiple physiological functions and developmental mechanisms.

Guillemin played a key role in discovering the brains role in regulating hormones, substances that act as chemical messengers between different parts of the body and regulate bodily functions. While scientists had long believed that the brain ultimately controlled the function of hormone-producing endocrine glands, there had been scant evidence to prove exactly how it did so.

After meticulous study of materials harvested from 1.5 million sheep brains, Guillemin and his team made a breakthrough. They discovered releasing hormones, produced in small quantities in the hypothalamus of the brain. These are delivered to the adjacent pituitary gland, which in turn is triggered to release its own hormones that are dispersed through the body. Guillemin and Andrew Schally separately extracted a sufficient amount of one releasing hormone to determine its structure in 1969. They subsequently were able to produce it with chemical methods.

Their work would lead them to the 1977 Nobel Prize in Physiology or Medicine, shared also with Rosalyn Yalow for a separate but related discovery, for discoveries concerning the peptide hormone production of the brain.

This breakthrough resulted in the identification of a molecule called TRH (thyrotropin-releasing hormone), which ultimately controls all the functions of the thyroid gland. In the following years, he and his colleagues isolated other molecules from the hypothalamus that control all functions of the pituitary glandfor instance, GnRH (gonadotropin-releasing hormone), a hypothalamic hormone that causes the pituitary to release gonadotropins, which in turn trigger the release of hormones from the testicles or ovaries. This discovery led to advancements in the medical treatment of infertility and is also used to treat prostate cancer.

Guillemin was born in Dijon, the capital of Frances Burgundy region, on January 11, 1924. He entered medical school at the Universit de Bourgogne in 1943, receiving his MD from the Facult de Mdecine in Lyon (then under the same academic administration as his university in Dijon) in 1949. Although he enjoyed learning about medicine and would practice it for several years before committing to research full-time, much of Guillemins youth and college experience was wrought with challengesnot the least of which was the German occupation of France. Dark years of no fun these were, he wrote.

Earning his Doctor in Medicine required the composition and defense of a dissertation, something that Guillemin looked forward to doing. I had always been interested in endocrinology, said Guillemin. [An MD thesis] was usually pro forma. I decided, however, to write a dissertation that I would enjoy, hopefully on some work I could perform in a laboratory. A challenge to his desire to conduct research was a dearth of lab access. There was no laboratory facility of any sort in Dijon, except for gross anatomy.

In a fortuitous turn of events, Hans Selye was lecturing in Paris. Selye was a fellow pioneer of endocrinology, and an eager Guillemin made the journey to hear him speak. A few months later, Guillemin said, I was in Selyes newly created Institute of Experimental Medicine and Surgery at the Universit de Montral. Guillemin would go on to earn his PhD in physiology, with a special focus on experimental endocrinology, from the university in 1953.

Shortly after completing his PhD, Guillemin became an assistant professor of physiology at the University of Baylor College of Medicine. Once there, he began to pursue the identity of the chemical mediators of hypothalamic origin, which were primary suspects for controlling pituitary function in the brain.

Guillemin was a mentor to many future leaders in endocrinology and medical research while at Baylor, including Catherine and Jean Rivier and Wylie Vale, who would all follow Guillemin to Salk in 1970 and themselves become professors there.

In addition to the 1977 Nobel Prize, Guillemin was the recipient of numerous accolades for his work. These included the Gairdner International Award, the Dickson Prize, the Passano Award, the Lasker Award, and the Presidents National Medal of Science, presented to him by then-President Jimmy Carter. He was also an elected member of the National Academy of Sciences (1974) and the American Academy of Arts and Sciences (1976). Guillemins native France recognized his contributions to science and health by naming him a Commander in the Legion of Honour, the countrys highest order of merit. He served as the Salk Institutess interim president from October 2007 to February 2009.

For all of his accomplishments, Guillemin was always quick to point out the contributions of the many people who worked alongside him. I have had the extraordinary privilege to work with wonderful collaborators, some so much more knowledgeable in their own field than I was (or still am), all full of enthusiasm and sharing the common ethics of science, he wrote as he reflected on achieving the Nobel Prize.

When asked in a September 2017 interview with the La Jolla Light what his philosophy in life was, Guillemin responded, Help people. I really wanted to be a physician [and] I knew all my efforts would be to help people.

Up until his last few years of life, Guillemin was an active member of the La Jolla, California community and was an avid collector of French and American paintings and sculptures, as well as Papuan and pre-Columbian pottery.

Guillemin is survived by his five daughters, one son, four grandchildren, and two great-grandchildren. He was pre-deceased by his wife, Lucienne, a talented musician, who died at the age of 100 in 2021, after the couple was married for 69 years. Guillemin died on her birthday.

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Anesthesiology

Colorado AG breaks up anesthesiology monopoly that dominated Denver and Durango health care markets – The Denver Post

February 29, 2024 medical

Colorado AG breaks up anesthesiology monopoly that dominated Denver and Durango health care markets The Denver Post

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Colorado AG breaks up anesthesiology monopoly that dominated Denver and Durango health care markets - The Denver Post

Anesthesiology

Anesthesiology marks accomplishments in its annual report | Newsroom – University of Nebraska Medical Center

February 29, 2024 medical

The UNMC Department of Anesthesiology has released its annual report an homage to the many accomplishments of the departments faculty, house staff and dedicated nurse anesthetists.

Read the report here.

The report highlights multiple new leaders, faculty and staff members, clinical division updates and the departments significant contributions to educational and research missions.

In his final message from the chair, Steven Lisco, MD, said it has been a privilege to lead the department for the past 11-plus years.

As many know, Oct. 31, 2023, was my last official day as chair. While I remain a faculty member in this amazing department, my efforts will be focused on my new UNMC College of Medicine and Nebraska Medicine leadership roles, Dr. Lisco said. Words cannot express how thankful I am to have had the honor of serving as chair of this tremendous department.

We are very proud of the accomplishments of our team members. The department is on strong footing because of its outstanding individuals and the innovative spirit, Mohanad Shukry, MD, PhD, interim chair of the department, said. We are also grateful to Dr. Lisco for getting the department to this point and look forward to the future together as a team.

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Anesthesiology marks accomplishments in its annual report | Newsroom - University of Nebraska Medical Center

Anesthesiology

UF anesthesiology resident arrested for possession of child pornography – Alachua Chronicle

February 29, 2024 medical

Staff report

GAINESVILLE, Fla. Travis Bryant, 29, an anesthesiology resident at UF Health, was arrested yesterday morning and charged with 10 counts of possession of child pornography and one count of transmitting child pornography after Google reported child sexual abuse material on his Google Drive account and an investigation found that he had accessed the account from over 200 access points, including at UF Health.

The National Center for Missing and Exploited Children received a tip on December 6, 2023, about 22 images and one video related to child sexual abuse material on a users account. The account was in the name of Travis Bryant, used Bryants date of birth, and was connected with a phone number that reportedly belongs to Bryant.

Google also provided 241 IP addresses that were used to log in to the account, with most resolving to either Cox Communications or the University of Florida.

A subpoena to Cox for one IP address produced an address for an apartment at Windmeadows Apartments. Another IP address was associated with Crunch Fitness, and a third was associated with Greenhouse Church. Eighteen of the IP addresses were associated with the wireless network at UF Health; UF reported that the network requires authentication, and they reported that Travis Bryant was the authenticated user associated with those logins.

UF also reported that two of the IP addresses were associated with UF Health-supported computers.

Two of the IP addresses were associated with the Department of Veterans Affairs in Orlando, and three were associated with an address in Tamarac, FL, where Bryant reportedly used to live.

A search warrant for Bryants Google account reportedly produced the content that had been reported in the CyberTip, along with 53 additional child sexual abuse images and/or videos. The arrest report notes that the Google Drive account also contained various documents related to Bryants personal and professional life, including bank account statements, a UF pay stub, pictures of Bryant, and a Letter of Offer for a residency at UF Health. The letter is addressed to Dear Dr. Travis Bryant, MD and is dated March 18, 2022.

The arrest report notes that a search of UFs website showed that Bryant is a Third-Year Resident, but that information has now been removed. Additionally, a preview of an article about about Match Day 2022 previously included his name, but his name has been removed.

At about 6:25 a.m. on February 27, a search warrant was executed at Bryants apartment, where Bryant reportedly said he lives by himself.

When asked if he knew why the police were at his apartment, Bryant reportedly said he had an idea. He reportedly admitted that the Google account belonged to him and that he was aware Google had deactivated the account in early December. He reportedly said he did stuff on Google services and believed Google reported him.

When asked if he would talk about what he did on Google, he reportedly shook his head but later said he looked at and saved abusive material from Instagram. When asked if it involved the exploitation of pubescent males, he reportedly said it did and added that it also involved pre-pubescent males. He reportedly described a video that was not included in the reported videos.

According to the arrest report, Bryant said he was a normal person except for this one aspect of his life; the defendant stated that something was wrong with his brain. He reportedly said hes been viewing child sexual abuse material for years, starting before he was 18 years old; he said he knows its wrong, but he struggles with it. He reportedly said he last looked at child sexual abuse material on his laptop about two days ago.

When asked if he would provide the password to the laptop, he reportedly said he would not because it felt like he was signing a death warrant.

A search of the laptop reportedly produced over 150 child sexual abuse images and videos.

In a prepared statement, UF Healths Greg Harrison said, Travis Bryant was hired as a resident with the Department of Anesthesiology of the College of Medicine in July 2022. He was placed on administrative leave from UF Health on Tuesday.Additionally, the University of Florida Police Department issued him a trespass warning, barring him from campus for three years.

UF Health did not answer our question about why they had scrubbed Bryants name from the Match Day 2022 article.

Bryant has been charged with 10 counts of possession of child pornography and one count of transmission of child pornography. Judge Thomas Jaworski set bail at $110,000.

Articles about arrests are based on reports from law enforcement agencies. The charges listed are taken from the arrest report and/or court records and are only accusations. All suspects are innocent until proven guilty in a court of law.

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UF anesthesiology resident arrested for possession of child pornography - Alachua Chronicle

Anesthesiology

Anesthesiology Ranked No1 NIH funding nationwide for 2024 | Department of Anesthesiology, Perioperative and Pain … – Stanford Medical Center Report

February 29, 2024 medical

February 2024

Since 2006, the Blue Ridge Institute for Medical Research has published a ranking of academic departments based on NIH funding to identify institutions, departments, and individuals leading the way in medical research. The rankings are a widely tracked measure of impact and Stanford Department of Anesthesiology, Perioperative and Pain Medicine is thrilled to have been ranked the number one department for research funding in 2023. The departments mission, vision, and values underline a commitment to innovating and transforming the field of anesthesiology and pain medicine and remain exceptionally proud of the team of investigators and staff we have working to advance these goals.

In addition to the departments number one ranking, three of our esteemed faculty were ranked in the top 10 PIs nationally this year: Drs. Jen Hah, Tony Anderson, and Laura Simons.

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Anesthesiology Ranked No1 NIH funding nationwide for 2024 | Department of Anesthesiology, Perioperative and Pain ... - Stanford Medical Center Report

Cardiology

Even Modest Lp(a) Elevations Bode Poorly for Cardiovascular Health – Medpage Today

February 29, 2024 medical

Lipoprotein(a), or Lp(a), at levels well below currently accepted risk thresholds correlated with increased cardiovascular risk in a large registry study, suggesting a wider patient pool that could benefit from future preventive therapies.

Although guidelines endorse the 80th percentile cutoff of 125 nmol/L to identify higher-risk candidates for initiation or intensification of preventive therapies such as statins, any plasma Lp(a) level above the median significantly correlated with long-term major adverse cardiovascular events (MACE) in real-world patients with baseline atherosclerotic cardiovascular disease (ASCVD) in the Mass General Brigham Lp(a) Registry.

MACE risk over more than a decade was 14% higher among those in the 51st to 70th percentiles 42-111 nmol/L (adjusted HR 1.14, 95% CI 1.05-1.24) compared with average or lower Lp(a). The adjusted hazard ratio rose to 1.21 for the 71st to 90th percentile (112-215 nmol/L) and leveled off thereafter.

As for those without established ASCVD, an upward trend for MACE risk with increasing Lp(a) only reached statistical significance at the highest Lp(a) levels (aHR 1.93 for the 91-100th percentile, 95% CI 1.54-2.42), reported Ron Blankstein, MD, of Brigham and Women's Hospital in Boston, and colleagues in the Journal of the American College of Cardiology.

"Across both primary and secondary prevention groups, there was a meaningful increase in ASCVD risk with increasing Lp(a) levels, with the excess risk being strongest for MI [myocardial infarction] and coronary revascularization," Blankstein's team wrote.

"These insights can guide both current clinical risk assessment as well as future trials for Lp(a)-lowering therapies as we have identified populations of patients (both primary and secondary prevention) who would not be included in current Lp(a) trials but have significant residual Lp(a) attributable risk," the group concluded.

Lp(a) is a highly atherogenic particle and known independent risk factor for ASCVD. Nevertheless, due to Lp(a) historically being considered an unmodifiable cardiovascular risk factor, universal screening is not endorsed by U.S. guidelines and is infrequently performed.

"However, with the advent of small interfering RNAs and antisense oligonucleotides, the landscape of novel therapeutics is showing significant promise," Blankstein and colleagues noted.

They cited two ongoing phase III trials studying novel Lp(a)-lowering therapies: Lp(a)HORIZON on pelacarsen injected monthly and OCEAN(a)-Outcomes on olpasiran injected every 12 weeks. Whereas both studies focus on secondary prevention patients, minimum baseline Lp(a) entry requirements differ, at 175 and 200 nmol/L in the two studies respectively.

Study authors suggested "that there will likely be a significant population of individuals with and without baseline ASCVD who remain at increased cardiovascular risk from Lp(a) who will not be included in these trials. Thus, in addition to ongoing clinical trials, additional studies are needed to further elucidate how Lp(a) can affect risk in various populations, and whether the excess risk attributable to Lp(a) can be effectively lowered."

Nathan Wong, PhD, MPH, of the University of California Irvine, similarly urged investigation of Lp(a) in broader populations and predicted that "it may not be long before guidelines in the United States endorse universal screening, which many experts already support."

"The identification of patients at increased risk for ASCVD, in both primary and secondary prevention, remains an important challenge and priority," he wrote in an accompanying editorial. "The failure to screen and identify those with Lp(a)-associated risks represents a missed opportunity to address this risk, not only with our existing repertoire of treatments but hopefully in the future with the development of promising therapies targeting Lp(a)."

The present cohort study comprised patients with Lp(a) readings taken as part of routine care from 2000 to 2019 at two large Boston medical centers.

Altogether, the registry included 16,419 people followed for a median of 12 years (median age 60 years, 41% women). Approximately 62% had baseline ASCVD, and this group tended to have higher Lp(a) levels compared with those without ASCVD (37.8 vs 31.1 nmol/L, P<0.001).

MACE events counted during follow-up were MI, stroke, coronary revascularization, and cardiovascular mortality. Ultimately, 6.5% of individuals studied experienced a nonfatal MI, 8.4% a nonfatal ischemic stroke, 8.3% underwent coronary revascularization, and 14.7% died of cardiovascular causes.

Blankstein's group acknowledged the potential for residual confounding and biases due to the retrospective design of the study. Additionally, the authors were unable to account for genetic or inflammatory biomarkers.

Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow

Disclosures

The study was funded in part by Amgen.

Blankstein has received research support and consulting fees from Amgen and Novartis.

Wong reported institutional research support from Novo Nordisk, Novartis, and Regeneron as well as consulting for Novartis and Ionis.

Primary Source

Journal of the American College of Cardiology

Source Reference: Berman AN, et al "Lipoprotein(a) and major adverse cardiovascular events in patients with or without baseline atherosclerotic cardiovascular disease" J Am Coll Cardiol 2024; DOI: 10.1016/j.jacc.2023.12.031.

Secondary Source

Journal of the American College of Cardiology

Source Reference: Wong ND "Lipoprotein(a): ready for prime time?" J Am Coll Cardiol 2024; DOI: 10.1016/j.jacc.2024.01.004.

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Cardiology

Long-term Survivors of Childhood Cancer at Higher Risk of Death Following Heart Issues; Threshold for Treating Risk … – Diagnostic and…

February 29, 2024 medical

February 28, 2024 New research out ofVCU Massey Comprehensive Cancer Centerand VCU Health Pauley Heart Center indicates that survivors of childhood cancer are at a significantly higher risk of death following a major cardiovascular event including heart failure, heart attack or stroke than the general public.

The findings published this week in theJournal of the American College of Cardiology could fuel advocacy for a paradigm shift in clinical heart health guidelines to address cardiovascular risk factors at an earlier age in childhood cancer survivors.

We found that the risk of death after a major cardiovascular event in a 50-year-old in the general population is equivalent to that of a 30-year-old who was previously treated for cancer as a child, said Wendy Bottinor, M.D., lead author on the study and cardio-oncologist at Massey andthe Pauley Heart Center. Untreated risk factors have a larger impact on risk for death following a serious heart event among survivors of childhood cancer relative to the general population, and therefore we shouldnt just assume that because someone is young they dont need risk factors like high blood pressure or high cholesterol treated.

Previous research has demonstrated that childhood cancer survivors have an increased risk for heart disease and a higher incidence of cardiovascular mortality compared to the general public.

This study waded deeper into the understanding of the impact of childhood cancer on survivors risk of death later in life following a major cardiovascular event compared to individuals who never had cancer, but also experienced one of those same heart issues.

Bottinor and her collaborators turned to a couple of robust databases for answers, including the Childhood Cancer Survivors Study, which includes a large cohort of 25,000 survivors of childhood cancer and their siblings, and the CARDIA study, which is a racially diverse cardiology database of young adults created to gain insights on how people develop heart disease.

They found that following heart failure, heart attack or stroke, mortality was higher in childhood cancer survivors than in their siblings who did not have cancer. Strikingly, compared with the general population, survivors of childhood cancer were more than a decade younger when they experienced one of those three events.

This study supports the concept that survivors of childhood cancer experience what appears like accelerated aging, where their overall medical profiles are similar to people who are 10 or more years older, said Bottinor, who is also a member of the Cancer Prevention and Control research program at Massey.

In an effort to identify some potential solutions, the researchers determined that a medical condition known as dyslipidemia an imbalance of cholesterol or fat in the blood that can lead to clogged arteries and serious heart issues correlated to lower mortality following a cardiovascular event. People who are diagnosed with dyslipidemia are commonly prescribed statins, drugs that reduce risk of heart complications by lowering cholesterol levels and mitigating chronic inflammation, a known risk factor for both heart disease and cancer. Previous evidence suggests statins may be heart-protective medications in patients undergoing cancer treatment.

This led Bottinor and her collaborators to suggest that using statins more universally in childhood cancer survivors, instead of only in the population that presents with heart problems, could provide general and increased protection against mortality following a cardiovascular complication later in life.

Additionally, this paper indicates that hypertension elevated blood pressure was also associated with an increased risk for heart-related death in childhood cancer survivors. Previous published data demonstrates that if someone who was treated for cancer is hypertensive, their risk for heart disease is magnified compared to someone who is hypertensive but has never been treated for cancer.

Bottinor said that current guidelines from multiple medical associations often include high thresholds regarding who is eligible to receive blood pressure medication, particularly for younger patients, and that these parameters should be adjusted to reduce the risk of long-term heart complications.

We probably should be lowering that bar for treating hypertension when were talking about survivors of childhood cancer because their risk for heart disease is so much higher than the general population, Bottinor said.

Looking ahead, Bottinor said further research needs to be conducted to better understand the burden of heart health risk factors in younger adults who have been treated for cancer; clinical trials need to be activated that investigate if risk factor modification impacts patient outcomes; and efforts need to be implemented to increase general awareness of the risk factors that result following cancer treatment in children and younger adults.

The emerging field of cardio-oncology is paving the way for expert, multidisciplinary heart care before, during and after cancer treatment to mitigate adverse effects on cardiovascular health. The cardio-oncology program at Massey and the Pauley Heart Center is the only program in Virginia that has been accredited bythe International Cardio-Oncology Society as a Center of Excellence.

Collaborators on Bottinors research include Eric Chow M.D., M.P.H., and David Doody, M.S., of Fred Hutchinson Cancer Center; Cindy Im, Ph.D., and David Jacobs, Jr., Ph.D., of the University of Minnesota; Saro Armenian, D.O., M.P.H., of City of Hope; Alexander Arynchyn, M.D., Ph.D., of the University of Alabama; Borah Hong, M.D., of Seattle Childrens Hospital; Rebecca Howell, Ph.D., of MD Anderson Cancer Center; Gregory Armstrong, M.D., Kirsten Ness, Ph.D., and Yutaka Yasui, Ph.D., of St. Judes Childrens Research Hospital; Kevin Oeffinger, M.D., of Duke University; and Alexander Reiner, M.D., M.Sc., of the University of Washington.

For more information:https://www.vcu.edu/

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Long-term Survivors of Childhood Cancer at Higher Risk of Death Following Heart Issues; Threshold for Treating Risk ... - Diagnostic and...

Cardiology

Health Beat: Local cardiologists raise awareness about heart disease prevention – Iredell Free News

February 29, 2024 medical

Special to Iredell Free News

Did you know that heart disease has been the leading cause of death in the country for 100 years?

A recent American Heart Association study reveals that more than half of Americans did not know that heart disease was the No. 1 killer in the United States despite its century-long reign.

February is American Heart Month an opportunity to highlight the importance of cardiovascular health and raise awareness about heart disease prevention.

To help educate the community about heart disease, three cardiologists, Dr. Bradley Martin, Dr. John J. Allan, and Dr. Charles DeBerardinis, shed some light on heart disease prevention, when to call 911, and local heart care.

You have the power to take action to protect yourself against heart disease. While some risk factors for heart disease cannot be controlled, like family history, other risks are controllable.

Small, heart-healthy lifestyle changes like eating a healthy diet or adding more movement to your day can have a big impact on protecting your heart.

1. Eat a heart-healthy diet.

One of the most important things you can control is what youre putting into your body. Diet is very important. A lot of patients ask me, What is the perfect diet or the right diet to follow? said Martin.

Martin often recommends a Mediterranean-style diet that is low in saturated fats, high in protein, low in carbohydrates, and limits added sugars. The American Heart Association also recommends a Mediterranean-style diet as it: Emphasizes vegetables, fruits, whole grains, beans and legumes; Includes low-fat or fat-free dairy products, fish, poultry, non-tropical vegetable oils, and nuts; and Limits added sugars, sugary beverages, sodium, highly processed foods, refined carbohydrates, saturated fats, and fatty or processed meats.

Sixty percent of our caloric intake per day should be from protein. I often try to have patients stick to a 1,800 to 2,000 calories-per-day diet. However, that does vary depending on your body size and physical activity, said Martin.

2. Avoid putting toxins in your body.

You should avoid putting toxins in your body. Nicotine and tobacco products are the number one offender. If you havent already, set a goal in 2024 to stop using tobacco products, as that will always be the number one thing you can do for your health to reduce your risk of having heart attack and stroke, said Martin.

Martin also recommends limiting the consumption of highly caffeinated drinks as they may increase your likelihood of cardiac arrythmia.

I try to avoid any of the energy drinks that have anything more than just caffeine, things like taurine or guarana, said Martin.

If you must have caffeine, Martin suggests only drinking two low-level caffeinated beverages a day, like a cup of coffee or a diet soda.

3. Take care of your physical health.

Exercise, as Im sure youre aware, is very important. Running, walking, swimming, biking, punching a heavy bag whatever it is that gets your heart rate up and breathing heavy, 30 minutes, five days a week is going to lower your chances of having a cardiovascular event, said Martin.

4. Manage your stress.

Mental health can positively or negatively impact your heart health. Stress can contribute to poor health behaviors like smoking or drinking, which are linked to increased risk for heart disease.

Chronic, long-term stress can lead to high blood pressure, which can increase your risk for heart attack and stroke.

We all deal with stress. Its hard on our system. Stress increases something called catecholamines in your bloodstream, which can increase your blood pressure. Learning some relaxation techniques and just taking five minutes a day to do deep breathing exercises can help regulate your stress levels, said Martin.

Exercise and getting enough sleep can also help you manage your stress levels.

5. Work with your healthcare team.

Make sure youre following up with your primary care doctor or us here at Statesville Cardiovascular to help manage your risk factors such as high blood pressure, blood sugar, and high cholesterol levels. These factors can be tested easily through blood work or with simple testing measurements here in the office to ensure that were keeping your risk factors controlled, said Martin.

Heart attacks can be sudden and intense. But they can also develop and start out as mild pain or discomfort. Not everyone has typical heart attack symptoms. So its important to learn all the ways a heart attack might make you feeland to call 911 right away if you suspect a heart attack. Fast action could save your life or someone elses.

According to Allan, some of the common symptoms of heart attack include: Chest pain or discomfort; Back, neck, or jaw pain; Left arm or shoulder pain; Shortness of breath; Nausea or vomiting; and Sweatiness

Deciding when to call 911 can sometimes be difficult for people. Its not always clear to patients when you should do that. However, anytime you have a symptom that youre not sure what it is, chest pain youve not experienced before, or any of the other warning signs of a heart attack, its best to err on the side of caution and call 911, said Allan. If you are having a heart attack, time is of the essence. We dont want to have any damage or injury to the heart. Once thats done, its irreversible, so the quicker you get in and get treatment, the better.

Iredell Health System offers the community a wide range of heart and vascular services and has been a Certified Chest Pain Center for 13 years. Iredell Memorial Hospital was recognized as high performing in the heart failure specialty by U.S. News & World Report as part of its 2023- 2024 Best Hospitals ranking.

Iredell Health Systems team of cardiologists, vascular surgeons, and expert nursing staff are committed to providing personalized care and treating the whole person, not just the condition because heart disease affects your whole life.

Our board-certified cardiologists have a wide variety of special interests and expertise in all the subspecialties of cardiology, and we offer expansive cardiac care here. We also have several nurse practitioners and physicians assistants who are well-versed in cardiology that help us in the hospital and in our offices, said DeBerardinis.

Cardiologists and vascular surgeons at Iredell Memorial Hospitals Heart & Vascular Center can perform a variety of procedures including cardiac catheterization, pacemaker and defibrillator implantations, cardiac interventions, peripheral arterial interventions, and venous procedures. They also offer nuclear stress tests and EKG and echo stress testing.

Ive always thought being at a non-tertiary center offers us the opportunity to provide more personalized care, and I can assure everyone out there that we certainly take that privilege very seriously here, said DeBerardinis.

LEARN MORE

Dr. Martin and Dr. DeBerardinis both practice at Statesville Cardiovascular Clinic, located at 925 Thomas Street. In addition to Statesville, Martin also sees patients in Taylorsville and Mooresville. If you would like to schedule an appointment with Dr. Martin or Dr. DeBerardinis, call the office at 704-873-1189.

Dr. Allan practices at Iredell Cardiology. He sees patients in Statesville and Mooresville. If you would like to schedule an appointment with Dr. Allan, call the office at 704-878-4694.

Iredell Health System includes Iredell Memorial Hospital; Iredell Mooresville; two urgent care centers;Iredell Home Health; Iredell Wound Care & Hyperbaric Center; Community and Corporate Wellness;Occupational Medicine; the Iredell Physician Network and more. Iredell Memorial Hospital is the largestand only nonprofit hospital in Iredell County. The comprehensive healthcare facility has 247 beds; morethan 1,800 employees; and has 260 physicians representing various specialties. Centers of excellenceinclude Womens and Childrens; Cardiovascular; Cancer; Surgical Services and Wellness & Prevention.The Health Systems second campus, Iredell Mooresville, is home to the areas only 24-hour urgent carefacility, as well as an ambulatory surgery center, imaging center, rehabilitation services, and physicianpractices. The mission of Iredell Health System is to inspire wellbeing. For a comprehensive list ofservices and programs, visit http://www.iredellhealth.org.

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Cardiology