Low-dose aspirin may help new mothers cut preterm birth risk

Daily low-dose aspirin, from as early as the sixth week of pregnancy through the 36th week, may lower the risk of preterm birth among first-time mothers, suggest the results of a clinical trial which involved women from several low and middle-income countries, including India.

The study, published in the journal The Lancet, involved more than 11,000 women.

The results showed that women taking daily low-dose aspirin were 11 per cent less likely to deliver before the 37th week of pregnancy, compared to those given a placebo.

"Our results suggest that low-dose aspirin therapy in early pregnancy could provide an inexpensive way to lower the preterm birth rate in first-time mothers," said study author Marion Koso-Thomas of the US National Institutes of Health's Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

Preterm birth is the most common cause of infant death and the leading cause of long-term neurological disability in children.

According to the study authors, advances in newborn care have improved survival for preterm infants, but this care is limited or unavailable in many parts of the world.

Earlier studies have suggested that low-dose aspirin may reduce the risk of preterm birth and pre-eclampsia, a potentially life-threatening blood pressure disorder of pregnancy.

However, these studies were not large enough to statistically determine the therapy's effectiveness in reducing preterm birth.

The researchers enrolled 11,976 women with a first-time pregnancy from seven sites in India, Pakistan, Zambia, Democratic Republic of the Congo, Guatemala and Kenya.

Roughly half were assigned at random to receive 81 milligrams of aspirin daily; the other group received a daily placebo. Women were included in the study only if they maintained a pregnancy for more than 20 weeks.

Preterm birth (before 37 weeks) occurred in 11.6 per cent of the women who took aspirin and in 13.1 per cent of the women who took the placebo.

Similarly, birth before 34 weeks (early preterm delivery) occurred in 3.3 per cent of the aspirin group and 4 per cent of the placebo group (a 25 per cent reduction).

Women in the aspirin group also had a lower rate of perinatal mortality (stillbirth or newborn death in the first seven days of life), compared to the placebo group (45.7 per 1,000 births vs 53.6 per 1,000 births).

The risk of high blood pressure disorders of pregnancy at term did not differ significantly between the groups.

The low cost and safety of low-dose aspirin therapy suggests that it could be easily adapted for wide-scale use, suggested the study authors.

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Some people with Parkinson’s disease may be born with disordered brain cells

According to a recent study, some people who develop symptoms of Parkinson’s disease before they reach the age of fifty may have brain development disorder even before their birth. The disease can go undetected for 30-40 years before showing the symptoms, it added.

Parkinson’s occurs when brain neurons that make dopamine, a substance that helps coordinate muscle movement, become impaired or die.

According to a new Cedars-Sinai research, there is a particular drug that might potentially help correct these disease processes.

Symptoms, which get worse over time, include slowness of movement, rigid muscles, tremors and loss of balance. In most cases, the exact cause of neuron failure is unclear, and there is no known cure

Michele Tagliati, who was a co-author of the study said: “Young-onset Parkinson’s is especially heartbreaking because it strikes people at the prime of life. This exciting new research provides hope that one day we may be able to detect and take early action to prevent this disease in at-risk individuals.”

To perform the study, the research team generated special stem cells, known as induced pluripotent stem cells (iPSCs), from cells of patients with young-onset Parkinson’s disease. This process involves taking adult blood cells “back in time” to a primitive embryonic state.

“Our technique gave us a window back in time to see how well the dopamine neurons might have functioned from the very start of a patient’s life,” said the study’s senior author, Clive Svendsen.

The researchers detected two key abnormalities in the dopamine neurons in the dish. One was the accumulation of a protein called alpha-synuclein, which occurs in most forms of Parkinson’s disease

The other abnormality was the malfunctioning lysosomes, cell structures that act as ‘trash cans’ for the cell to break down and dispose of proteins. This malfunction could cause alpha-synuclein to build-up.

Shlomo Melmed, a dean of the Medical Faculty at Cedars-Sinai said: “This research is an outstanding example of how physicians and investigators from different disciplines join forces to produce translational science with the potential to help patients. This important work is made possible by the dual leadership of Cedars-Sinai as both a distinguished academic institution and an outstanding hospital.
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Alcoholism is linked to brain pathways

A reccent scientific study states that alcoholism may be due to dysfunction in a specific brain pathway that normally helps keep drinking in check.

Difficulty saying no to alcohol, even when it could clearly lead to harm, is a defining feature of alcohol use disorders. This study takes us a step further in understanding the brain mechanisms underlying compulsive drinking, said a researcher.

Some complex human behaviours including emotion, anxiety and motivation are regulated by the outer layers of the brain-cortex that are primarily responsible brain processes like decision-making. Unlike other addictive substances like cocaine, alcohol has very broad effects on the brain.

Another researcher said, we want to understand how the brain normally regulates drinking, so we can answer questions about what happens when this regulation isn't happening as it should.

The researchers used mice as the subject of experimentation for conducting the research.

Current treatments just aren't effective enough, nearly half of all people treated for AUD ( Alcohol use disorder) relapse within a year of seeking treatment, he said.

For decision effective treatments for alcoholism, scientists first need to understand the difference in the wiring of a normal person's brain and an alcoholic's brain.

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Most Common Myths Around Sleep

Common myths around sleep like snoring is harmless or having a drink helps to fall asleep not only shape poor habits but may also pose a significant public health threat, say researchers.
The claim by some people that they can get by on five hours of sleep was among the top myths researchers were able to dispel based on scientific evidence. 

This myth also poses the most serious risk to health from long-term sleep deficits, said the study.

"Sleep is a vital part of life that affects our productivity, mood, and general health and well-being," said the lead investigator of the study.

"Dispelling myths about sleep promotes healthier sleep habits which, in turn, promote overall better health," she added.

To reach this conclusion, researchers reviewed more than 8,000 websites to identify the 20 most common assumptions about sleep.

With a team of sleep medicine experts, they ranked them based on whether each could be dispelled as a myth or supported by scientific evidence, and on the harm that the myth could cause.

Another common myth relates to snoring. While snoring can be harmless, it can also be a sign of sleep apnea, a potentially serious sleep disorder.

The authors encourage patients not to dismiss loud snoring, but rather to see a doctor since this sleep behaviour may lead to heart stoppages or other illnesses.

The study authors also found sufficient evidence that, despite beliefs to the contrary, drinking alcoholic beverages before bed is indeed unhealthy for sleep.

"Sleep is important to health, and there needs to be greater effort to inform the public regarding this important public health issue," noted the researcher.

Researchers suggest creating a consistent sleep schedule and spending more time, at least seven hours, asleep. 

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Heavy Periods- could be suffering from undiagnosed bleeding disorder

About 30 per cent of all women report heavy menstrual periods at some point during their reproductive years. Up to 15 per cent of these have an underlying bleeding disorder  and yet most have never been diagnosed, leaving thousands of women to suffer from a treatable problem. 

As a hematologist and clinician scientist  who cares for patients with inherited bleeding disorders, it is a major source of frustration for me that women with bleeding disorders can wait up to 15 years to get appropriate testing and treatment.

I worry even more about what happens to those who never get diagnosed. These women are at risk of acute hemorrhages leading to blood transfusions and the need for hysterectomy.

Because April 17 is the 29th annual World Hemophilia Day— a day focused on outreach and education about hemophilia — I would like to share some evidence-based information about heavy periods, what it means to be a female “carrier” of hemophilia and how you can easily test yourself for a bleeding disorder.

Bleeding disorders that affect women include von Willebrand disease and hemophilia — both are inherited and are caused by low levels of “clotting factors” (proteins needed for normal blood clotting).

In families with a bleeding disorder, it is common for women to not realize their periods are heavy because other affected women in the family have similar problems. To them, heavy periods seem normal.

There are also social stigmas against an open discussion about periods that can be difficult to overcome. And there is a lack of accurate information about normal versus abnormal periods.

Key features of heavy and abnormal periods include having to change pads or tampons more than every hour, having iron deficiency anemia, frequently soaking through your sheets at night and bleeding that lasts longer than seven days.

Iron deficiency anemia is of particular concern because it leads to fatigue and shortness of breath as well as poor school and job performance.

Iron deficiency and heavy periods are too often ignored but can be signs of an underlying bleeding disorder. Both are easily treated once the diagnosis is made.

Women Can Also Have Hemophilia

Women who are carriers of hemophilia are very often considered to be “only carriers” — capable of passing on a mutant gene to their children. They may be told this by their doctor. Their bleeding then often goes untreated because of this misconception.

My own research has shown, however, that around 30-40 % of hemophilia carriers experience abnormal bleeding including heavy periods, post-partum hemorrhage and joint bleeds. Some, but not all, have low clotting factor levels.

Effective treatments for heavy periods in women with bleeding disorders  are widely available. These include the oral contraceptive pill and medications like tranexamic acid (that prevent clot breakdown) and desmopressin (that increases clotting factor levels).

Gynecologic options such as the levonorgestrel intrauterine device (IUD) and endometrial ablation  also exist.

In rare cases, women with bleeding disorders require clotting factor infusions to control heavy periods. If iron deficient, iron supplements is  key component of treatment as it improves quality of life. Dietary iron intake alone is not enough to correct iron deficiency, particularly once it has caused anemia.

Historically, much of the focus of research and education for hemophilia was on improving treatment for boys and men with the disease. The mainstay is frequent intravenous infusions of the missing clotting factor. Significant advances have been made including the development of better treatments and the possibility of cure.

Are Your Bleeding Symptoms Normal?

Many organizations are now focused on increasing public knowledge about bleeding disorders.

Many organizations are now focused on increasing public knowledge about bleeding disorders. The recognition that women can also have hemophilia is increasing through the efforts of organizations like the World Federation of Hemophilia.

The role of novel therapies for women with hemophilia isn’t clear, and additional research is required to understand exactly why these women bleed. One recent study from my lab showed that the blood clotting system of hemophilia carriers doesn’t react to hemostatic stress (such as trauma) as well as it does in healthy controls. A rapid and sustained increase of blood clotting factors is required to halt bleeding following injury and this was significantly impaired in hemophilia carriers.

If you are wondering if you have a bleeding disorder, the Self-BAT( self administered bleeding assessment tool) is freely available and can tell you if your bleeding symptoms are normal or abnormal.

This tool analyzes information about your bleeding symptoms to generate a bleeding score. A high bleeding score is associated with an increased chance of having an underlying bleeding disorder and should be discussed with your doctor.

Significant advances have been made in understanding the problems faced by women with bleeding disorders. More research and education is needed so that all women are diagnosed and treated properly.

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