Researchers from the University of Toronto presented a new study at CHEST Congress 2019 Thailand in Bangkok that aimed to determine the effect of authors’ self-promotion on the social media site, Twitter, in regards to the dissemination of their research.

It’s not always possible to lower cholesterol through diet alone – sometimes there’s no way to override your DNA, and medication becomes a must.

But certain foods can be part of the plan to improve your numbers, to both lower low-density lipoprotein (LDL) cholesterol, the bad one, and raise your high-density lipoprotein (HDL), the good one.

Role of fibre and polyunsaturated fats

First, choose foods with soluble fibre. Think of this type of fibre as a magnet, drawing cholesterol out of your body. Good sources are oats, oat bran and barley, along with beans, eggplant and okra. When used in recipes, these foods tend to take on the flavours of other ingredients, so be adventurous with recipe planning – and generous with herbs and spices.

Apples, grapes, strawberries and citrus fruits are good choices because of their pectin, a type of soluble fibre.

Next, go for foods with polyunsaturated fats. These include vegetable oils like canola, sunflower and safflower, as well as fatty fish like salmon, rich with omega-3 fatty acids, and most types of seeds and nuts.

Dangers of trans fat

Plant-based foods also contain substances called plant sterols and stanols, which help keep the body from absorbing cholesterol. Particularly good sources are Brussels sprouts, wheat germ and wheat bran, peanuts and almonds, and olive, sesame and canola oils.

In terms of foods to limit, talk to your doctor about your unique needs. High-cholesterol foods like shellfish and eggs aren’t as dangerous as once thought. The verdict is still out on the saturated fat found in meat, but some research has found that full-fat yogurt, milk and even cheese may be good for you.

The one type of fat to completely avoid is trans fat. The US Food and Drug Administration banned its addition to foods in 2018, but because of extensions granted to some manufacturers, certain items could be on store shelves until January 2021. So keep checking the ingredients on any packaged foods you’re considering.

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The order covers parts of Brooklyn, which have seen 285 cases since 30 September.

Patients who have high triglycerides and take cholesterol-lowering statins to lower their risk for heart attack or stroke can cut that risk by another 30% by adding a high-dose omega-3 fatty acid pill, investigators report.

The prescription drug, called Vascepa, is not to be confused with over-the-counter dietary omega-3 (often fish oil) supplements. Such supplements typically contain far lower doses of the critical omega-3 fatty acid called EPA and have not undergone a rigorous safety and effectiveness review by the US Food and Drug Administration.

Large degree of clinical benefit

Since 2012, the FDA has approved Vascepa (icosapent ethyl) for patients whose triglyceride fat levels exceed 500 milligrams per decilitre of blood.

Now, an updated analysis of research first released last September suggests Vascepa markedly reduces a patient’s lifetime risk of dying from heart disease; experiencing a nonlethal heart attack or stroke, or needing heart surgery or hospitalisation for a heart complication.

“We found a 30% reduction in total ischaemic events,” said lead author Dr Deepak Bhatt, referring to any number of serious heart problems caused by restricted blood flow. “That is a very large degree of clinical benefit.”

Among 1 000 patients who take Vascepa for five years, nearly 160 serious heart problems would be prevented, he noted. That includes 12 cardiovascular-related deaths, 42 heart attacks, 14 strokes, 76 coronary artery bypasses and 16 hospitalisations for unstable angina (chest pain or heaviness) while at rest or during moderate activity.

Bhatt is executive director of international cardiovascular programmes at Brigham and Women’s Hospital in Boston.

Problematic saturated fat

He and his colleagues are slated to present their research – which was funded by the New Jersey-based drug manufacturer Amarin Pharma, Inc. – this week at a meeting of the American College of Cardiology, in New Orleans.

Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

The study team likened the high dose of EPA contained in Vascepa to eating more than 20 servings of fish a week, minus the problematic saturated fat.

The updated findings concern the “REDUCE-IT” study, which involved nearly 8 200 patients. All had high cholesterol and were taking statins to control it.

This, investigators said, meant patients were receiving a good standard of care. But that care did not mean they were out of the cardiac woods.

Subsequent events

All also had high triglycerides, and about 70% had a heart disease diagnosis. The other 30% were diabetic and were thought to be at risk for future heart complications.

For the trial, half took 2g of Vascepa twice a day for an average of about five years. Half took a placebo.

Initial results suggested a 25% reduction in the risk for experiencing a first cardiac event, such as a heart attack or stroke.

Now, researchers have also examined subsequent events as well – for example, a fatal stroke after an initial heart attack.

And that new analysis showed a 30% lower lifetime risk for heart attack, stroke and the like.

Supplements unregulated

Eileen Handberg is research professor of medicine, and programme director of the Cardiovascular Clinical Trials Program at the University of Florida. She was not involved with the study.

Handberg said the findings are important, because even when heart patients receive the very best of care, some risk remains. And patients with a risk for heart disease tend to experience more than one event – meaning multiple heart attacks, or a heart attack and then a stroke, she added.

“But here, the data shows that this drug reduces that risk, whether it’s a first, second or third event,” Handberg said. “That is very important information for patients to have, because it means there is a way to reduce risk over the long term.”

She underscored the research team’s warning that consumers should not look to over-the-counter fish-oil supplements for the same protection.

“Supplements are not manufactured to consistent standards and are unregulated,” Handberg said. “So you have no real idea of what you’re taking.”

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Dr Hadiza Bawa-Garba was convicted of manslaughter by gross negligence after Jack Adcock’s death.

As the American population ages, elder abuse rates are increasing, particularly among men, federal health officials reported.

Between 2002 and 2016, the rate of assaults among men 60 and older jumped 75%, while it rose 35% among women between 2007 and 2016. Among older men, the homicide rate increased 7% between 2010 and 2016, according to the US Centers for Disease Control and Prevention.

Problem worse than reported

“We are still examining the circumstances that appear to be associated with the increase in violence against this age demographic,” said lead researcher Joseph Logan, from the CDC’s National Center for Injury Prevention and Control.

“We have identified that many of the assailants were known to the victims and in a position of trust,” Logan noted.

Dr Ronan Factora, chair of the Special Interest Group on Elder Abuse and Mistreatment at the American Geriatrics Society, thinks the problem is probably even worse than the report suggests.

“These data underestimate the extent of elder abuse in America,” he said. “We probably underestimate the amount of physical violence, because this study only used records from emergency departments.”

Many more cases of abuse were probably seen by private doctors or not reported at all, said Factora, who had no part in the study. “This is really a small fraction that represents a larger problem that has been growing,” he added.

Gaining more visibility

The biggest issue is that most elder abuse isn’t recognised, Factora said. That’s because there isn’t a standard way to screen for it or recognise it.

Factora believes, however, that elder abuse is gaining more visibility, which may be part of why it’s seen as increasing.

“As the years have gone by, elder abuse has become more highlighted and thus better detected,” he said. “But the increase is not just a demographic issue.”

Factora said that much of the abuse among people who are physically or mentally impaired is perpetrated by caregivers who are stressed out by the demands of caring for a loved one.

Still, “abuse can have lasting effects that aren’t reversible after a certain point,” he said.

“People who need help with transportation, finances and medication put a lot of burden on caregivers,” Factora said. According to the CDC report, it’s family members who commit most of the violence.

“A lot of this is because of the demands placed on them for care, which really puts a stress on them,” Factora said.

Help is available

Unfortunately, many seniors are in jeopardy because of their physical or mental condition, and can’t defend themselves, he said. Abuse is really related to dependency, Factora explained.

Help in finding ways to cope with the burden of caring for someone is available. Perhaps if more people took advantage of programmes for family caregivers, a lot of elder abuse could be stopped before it starts, he suggested.

“The resources are there. The problem is connecting the caregivers who are burned out with the resources that can help them,” Factora said.

The best way to deal with elder abuse is through awareness of all its forms. This study deals with physical abuse and murder, he pointed out, but abuse also includes neglect and financial exploitation.

Often a person is the victim of several kinds of abuse. Someone who is physically abused can also be neglected and financially exploited.

Only the tip of the iceberg

Factora believes that if you see or suspect someone is a victim of elder abuse, you should report it to adult protective services.

“We need to find these cases, and once we find how big this epidemic is, that may be a push to identify the abuse we don’t see,” he said. “What we are seeing is the tip of the iceberg.”

For the study, researchers used data from the US National Electronic Injury Surveillance System – All Injury Program and National Vital Statistics System to look for trends in assaults and murders among men and women aged 60 and older.

The report was published in the CDC’s Morbidity and Mortality Weekly Report.

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The Epilepsy Society is calling for an urgent review of how medicines are stocked and supplied in the UK.

A senior at Auburn University injured herself during a gymnastics competition on Friday that resulted in two broken legs and dislocated knees, according to the Times-Picayune.

The gymnast, Samantha Cerio, was attempting a blind landing at the National Collegiate Athletic Association (NCAA) Regional Semifinal held in Baton Rouge, Louisiana.

Cerio's coach, Jeff Graba, told the Times-Picayune that when Cerio was performing the trick that resulted in her injuries, she got a little too high and reached to the ground a little too early. You can see her injury in the video below, although consider yourself warned: Some are calling Cerio's injury the worst sports injury of all time.

Health spoke to a sports medicine expert to find out what the recovery from an accident that gruesome might look like. New York-based sports medicine surgeon Sabrina Strickland, MD, says that the video footage of the accident appears to show Cerio hyperextending her knees. Dr. Strickland, who is not involved in Cerio's care, says the gymnast's accident could have necessitated multiple operations to address problems with her bones and ligaments, which are "the bands that connect one bone to the next."

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"Her knees essentially hyperextended, and it looks like she most likely caused a ligament injury first," Dr. Strickland says. "If you dislocate first, the stress first goes to the ligaments. It can result in a fracture of the tibia."

Immediately after an accident such as this one, doctors would be looking out for any injury to the patient's arteries, Dr. Strickland says. "The most important thing is this can cause a vascular injury. [The] artery in her knee—that's the most important thing with this type of injury." The patient might start taking a medication that can prevent blood clots because of this concern.

The first operation a patient might have after an accident of this caliber would be one that stabilized the patient's legs, Dr. Strickland says. A trauma surgeon would do surgery on the bones to temporarily fix them in place. "Usually they'll put something that's outside the bones that holds the bones and the joint in place until they can do [more] surgery, to hold it in place temporarily while the swelling goes down," Dr. Strickland explains. After this initial procedure, they can do a CT scan or an MRI to assess the total damage.

"The next thing would be to actually fix the bone," Dr. Strickland says, often with a surgery called an open reduction internal fixation (ORIF) surgery within the next few days. Cerio might also need an operation to allow doctors to reconstruct her ligaments, depending on her injury. Dr. Strickland says the knee houses four main ligaments and that sometimes doctors can simply sew injured ligaments back together.

Immediately after surgery, doctors would have two concerns: the risk of infection post-surgery and whether or not the bones were healing well. Later on down the road, Dr. Strickland says, doctors would worry about the patient's chances of suffering from arthritis.

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Cerio probably won't be able to stand for about six weeks, according to Dr. Strickland. In the meantime, doctors might have her use a continuous passive motion machine. "It's a pretty simple machine that bends and straightens your knee," Dr. Strickland says. When a patient can stand after such an injury, they might ride an exercise bike or do pool therapy to strengthen their legs again.

Dr. Strickland says that after an injury like this, an athlete's chances of returning to gymnastics would be questionable.

And in fact, Cerio said on her Instagram account that Friday was her last day as a gymnast. She's practiced the sport for 18 years and will be graduating from Auburn in May. "[Gymnastics has] given me challenges and road blocks that I would have never imagined that has tested who I am as a person," Cerio wrote on Instagram. "It may not have ended the way I had planned, but nothing ever goes as planned." We think she deserves a gold medal for her positive attitude alone.

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For an estimated 4.2 million children living with peanut allergies, the slightest trace of peanut and peanut ingredients could have fatal consequences. The allergy is the result of allergens binding with an antibody called immunoglobulin E (IgE) on the surface of immune cells, setting off a complex chain reaction that could lead to a response ranging in severity from a rash to anaphylactic shock.