Urine at the U of M

The folks at the University of Michigan’s Rogel Cancer Center have been busy studying, well, pee.

First, a group of researchers found a way to use a urine sample to not only detect prostate cancer, but to differentiate the two major kinds — the slow-moving type that’s usually ‘keep an eye on’, and the dangerous aggressive type that needs immediate attention.

Second, a different group “have created a urine-based test that detects pieces of DNA fragments released by head and neck tumors.” That’s important because there isn’t any kind of test available at all, other than a biopsy, for those cancers.

Antipsychotics and dementia don’t mix

Giving dementia patients anti-psychotic meds might be a very bad idea, according to a new, big British study: It used data from 174,000 patients with dementia, more than 35,000 of whom were prescribed antipsychotics for the first time.

To cut to the chase:

Antipsychotic use compared with non-use in adults with dementia was associated with increased risks of stroke, venous thromboembolism, myocardial infarction, heart failure, fracture, pneumonia, and acute kidney injury, but not ventricular arrhythmia. (Emphasis ours.)

The risks of drugs like haloperidol, quetiapine, and risperidone weren’t a secret, but this is one of the larger studies to suss out the details, and it “found a considerably wider range of harms associated with antipsychotic use in people with dementia, and the risks of harm were highest soon after initiation.”

Their recommendation is no surprise: The risks are serious, so “Any potential benefits of antipsychotic treatment therefore need to be weighed against the risk of serious harm across multiple outcomes.”

Juice of the cabbage (and IBD)

Mmm, nothing like a glass of cabbage juice to treat what ails ya. Well, if what ails ya is inflammatory bowel disease and you’re a mouse.

We all know by now how important gut bacteria are, and University of Missouri veterinary researchers found that red cabbage juice helped some good bacteria flourish in mouse guts. “Good” because they happen to produce some short-chain fatty acids that can reduce inflammation associated with IBD. Specifically…

“These changes in the gut microbiota are associated with improved gut barrier function, enhanced colon repair and anti-oxidative effects, ultimately mitigating intestinal damage and colonic inflammation.”

Drink up!

Diet vs drugs against IBS

We won’t tell if you won’t: Changing a patient’s diet might treat the symptoms of irritable bowel syndrome better than drugs do.

Swedish researchers tested two diets against standard IBS meds.

The first diet included smaller and more-frequent meals and fewer foods with lactose, as well as cutting back on legumes, onions, and grains “which ferment in the colon and can cause pain in IBS.” The second group went with low carbs and higher protein and fat. The third group took whichever drugs were recommended based on their individual symptoms.

In the end, 76% of the first diet group saw reduce symptoms, 71% of the second diet group did, while only 58% of the medication group got relief. (For what it’s worth, all the subjects “reported significantly better quality of life, [fewer] physical symptoms and [fewer] symptoms of anxiety and depression.”)

Want to live forever?

Choose a female GP, especially if you’re a woman. A new study out of Japan — based on US Medicare data — found that “Being treated by a female physician can reduce the risk of death and hospital readmission.”

Based on data of almost 800,000 male and female patients over three years, it found a “large and clinically meaningful” difference for women seeing female docs, and a small difference for male patients.

To be fair, their definition of “large and clinically meaningful” doesn’t seem large: There was an 8.15% mortality rate when seeing a female physician, vs. 8.38% when the physician was a man. Still, if you’re rolling the dice you want the best odds you can get. (And you can bet that little detail won’t appear in a lot of news stories.)

Oh, and “Both women and men had a lower adjusted readmission rate when treated by a female physician.”

With meds, what’s old is sometimes just … old

Hospitals, it seems, are still using older, generic antibiotics even when patients have resistant infections, and even when there are newer, better drugs available.

A study from the NIH (with Emory and George Washington universities) found that not only were hospitals behind the times, “nearly 80% of the time these older agents are already known to be highly toxic or sub-optimally effective.”

Why? A few reasons. In some cases, physicians preferred to use the newer drugs only on “difficult-to-treat bloodstream infections and those with a high comorbidity burden.”

Some hospitals — such as smaller facilities and those in rural areas — tended not to have those drugs available, likely because of the low prevalence of resistant infections. And then there’s the cost, as hospital reimbursement can be lower for newer, higher-priced medication. (“Sorry, we’re not giving you the best drugs because that’s less profitable for us”?)

^* “Meropenem–vaborbactam, eravacycline, imipenem–cilastatin–relebactam, and cefiderocol,” in case you’re interested 

Ozempic answers

Why doesn’t it work for everyone?

Semaglutide helps something like 86% of patients lose weight. But what about that other 14%? Failing to lose weight could be due to a number of factors, so Healthline offers “5 reasons you may not lose weight on drugs like Ozempic or Wegovy.” (Really it’s just four reasons, because one is ‘Not taking the medication’ — that doesn’t count.)

What happens when you stop?

Most people know that a downside to GLP-1 agonists for weight loss is that once you stop taking them, you’ll probably gain back the weight you lost. But why? Can’t you lose the weight, then change your lifestyle to keep it off?

An Aussie GP explains why, while that might be possible, it’s not simply a matter of willpower.