Climate change is impacting the Caribbean, with millions facing increasing food insecurity and decreasing freshwater availability as droughts become more likely across the region, according to new Cornell University research in Geophysical Research Letters.

Cases of thyroid cancer are on the rise in the United States, and experts want you to know how people at high risk for the disease can detect it early.

According to the American Cancer Society, 54 000 new cases will be diagnosed in the United States in 2018. And three out of four of these cases will be women. But anyone can get the disease. Symptoms can occur earlier in women, who are typically diagnosed in their 40s or 50s, while men commonly are diagnosed in their 60s or 70s.

“While the majority of thyroid cancers arise without a family history, if you have a family history of thyroid cancer, you should have any new lump or mass in your neck evaluated by your physician,” said Dr Brett Miles. He is co-chief of the division of head and neck oncology at the Icahn School of Medicine at Mount Sinai in New York City.

Also, people with a history of Hashimoto’s thyroiditis, radiation exposure to the neck, or familial colon polyps are at increased risk, he added.

“A good rule of thumb is that swollen lymph nodes or lumps in your neck that do not go away after about three to four weeks should be evaluated,” Miles said in a Mount Sinai news release.

Thyroid cancer facts:

• Thyroid cancer is a tumour or growth in the thyroid gland in the front of the neck.
• Several types of thyroid cancer exist. The most common is papillary carcinoma, which is curable, especially if caught early.
• Important risk factors include: A family history of thyroid cancer; a history of radiation exposure to the head, neck or chest; or a diet low in iodine.
• Regular follow-up care is an essential part of treatment.

Symptoms of thyroid cancer include:

• A lump or enlarged lymph nodes in the neck.
• Neck pain or tightness.
• Hoarseness, persistent cough.
• Difficulty swallowing or breathing.

Prevention includes:

• A thyroid exam every three years if you are 20 to 39 years of age.
• A thyroid exam every year if you are 40 or older.
• Avoid unnecessary exposure to radiation.
• Have checks often if you’ve been exposed to radiation of the head, neck or chest, and have a family history of thyroid cancer.
• Do a thyroid neck self-exam, looking for asymmetries or protrusions below the Adam’s apple.

Most thyroid cancer patients do not have any symptoms when they are diagnosed, said Dr Raymond Chai, an assistant professor of otolaryngology at the Icahn School of Medicine at Mount Sinai.

“These cancers are often only identified during routine physical examination by a physician,” Chai said. “It’s important to note the vast majority of early stage thyroid cancers can be successfully treated, and that’s why early detection is critical,” he added.

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Alzheimer’s patients taking diabetes drugs may have fewer signs of dementia in their brains than similar patients not taking the drugs, new research finds.

Specifically, the post-mortem study found that people who’d taken diabetes meds had fewer abnormalities in tiny blood vessels in their brains, and less abnormal gene activity.

Fewer Alzheimer’s lesions

“The results of this study are important because they give us new insights for the treatment of Alzheimer’s disease,” said study senior author Vahram Haroutunian, a professor of psychiatry and neuroscience at the Icahn School of Medicine at Mount Sinai in New York City.

Earlier studies on brain tissue showed that the brains of people who had Alzheimer’s and diabetes had fewer Alzheimer’s lesions than brains of people with Alzheimer’s with no diabetes.

One Alzheimer’s expert said the study highlights the relationship between cardiovascular and brain health.

The findings “remind us of how important it is to keep vascular risk factors under control as we age,” said Dr Luca Giliberto. He’s assistant professor at the Litwin-Zucker Center for Alzheimer’s Disease and Memory Disorders at The Feinstein Institute for Medical Research in Manhasset, New York.

In the new study, conducted on autopsied brains, Haroutunian and his colleagues developed a way to separate the tiny blood vessels (capillaries) in the brain from adjacent brain tissue.

They first used this method on the brains of 34 people who had been diagnosed with Alzheimer’s and type 2 diabetes treated with standard diabetes drugs.

The researchers then compared those findings to an examination of 30 brains from people with Alzheimer’s who did not have diabetes, and 19 brains of people who had experienced neither disease.

The study focused on changes in certain genetic “markers” tied closely to proper brain signalling.

Protective effect

According to the researchers, levels of about half of these markers were lower in the vessels and brain tissue of patients who had both Alzheimer’s and diabetes. And the majority of the unhealthy genetic changes that are usually seen in Alzheimer’s were missing in patients who had taken diabetes drugs.

This all suggests that diabetes medications have a protective effect on the brains of Alzheimer’s patients, the researchers said, which in turn might boost the search for effective therapies.

“Most modern Alzheimer’s treatments target amyloid plaques and haven’t succeeded in effectively treating the disease,” Haroutunian said in a Mount Sinai news release.

But the new study focused on “insulin and diabetes medications such as metformin, [which are] FDA-approved and safely administered to millions of people,” he said.

The new study suggests these drugs may “have a beneficial effect on people with Alzheimer’s,” Haroutunian said. “This opens opportunities to conduct research trials on people using similar drugs or on drugs that have similar effects on the brains’ biological pathways and cell types identified in this study.”

For his part, Giliberto said the results “are not surprising”, since experts have long noted links between diabetes’ effects on blood sugar and blood vessel health, and brain health.

Better quality of life

But he added that the study doesn’t prove that these issues cause Alzheimer’s, or whether diabetes medications could curb or stop the brain-wasting disease once it had begun.

However, “treating chronic hyperglycaemia will result in a reduction of further brain insult,” Giliberto reasoned. For people with Alzheimer’s disease, that “might result in better cognitive performance and quality of life,” he said.

Dr Satjit Bhusri is a cardiologist at Lenox Hill Hospital in New York City. Reviewing the study, he said it “establishes a relationship between the blood vessels of the brain and Alzheimer’s disease”.

The findings could “open the door to a new pathway that may be of therapeutic use in patients with Alzheimer’s disease,” Bhusri said.

The report was published online in the journal PLOS One.

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Price Woodward was the picture of health at age 52. He lived an active lifestyle and ran marathons. He was definitely not the type of person you’d expect to have a stroke.

But one night, his wife, Tammy, heard a strange noise coming from the other side of the bed. She turned on the light and Price started talking to her, but she couldn’t understand what he was saying.

Tammy could tell something wasn’t right, so she called 911. But because Price had the stroke in his sleep and his wife had no way of knowing exactly when the stroke began, he wasn’t eligible for clot-busting medication that can sometimes stop a stroke before much damage is done.

“His stroke was really bad. It affected the left side of his body, and he couldn’t even sit up. If I hadn’t been home, I think he would’ve died. It’s been a long road to recovery,” Tammy said.

Specific, tailored rehab

But Price, who lives in Greensboro, Georgia, had a lot of motivation to go through stroke rehabilitation to get better. His middle daughter got engaged after he’d had the stroke, and he was determined to be there for her wedding day.

“I told my therapist I was going to walk her down the aisle,” he said.

Stroke therapy is very specific, tailored rehab. Tammy explained that even though Price started rehabilitation in a wheelchair, his therapist helped him achieve the goal of walking. She calculated how many steps it would be, how his gait might affect his balance, and even considered how the train of the dress would play into his walking down the aisle.

Lots of hard work paid off. Not only did Price escort his middle daughter down the aisle, he was also able to attend his youngest daughter’s graduation and welcome his oldest daughter’s first child.

But as far as he’s come in recovery, Price knows that if he could have gotten help faster, things might have been very different.

A friend of his also had a stroke, but it happened in front of the friend’s family. His friend was able to get to the hospital right away and received the clot-buster drug called TPA. His friend was essentially back to normal in four months, Price said.

In comparison, Price is still recovering from his stroke four years later.

“If you see someone having a stroke, make a note of what time it is,” he advised, because doctors will want to know what time the symptoms began.

Acting quickly can save lives

Dr Olajide Williams, director of acute stroke services at New York-Presbyterian Hospital, agreed that acting quickly can save lives. An easy way to remember what to look out for is the acronym FAST:

• F is for face. If one half of the face droops when you ask someone to smile or show their teeth, that person may be having a stroke.
• A is for arm. Ask the person to raise both arms. If someone is having a stroke, one arm won’t go up at all or may not go up as much and then goes down quickly.
• S is for speech. Talking gibberish or slurring words might be a sign of a stroke.
• T is for time to call 911. “Time is brain. Every minute that a stroke is allowed to continue, you lose two million brain cells. The more brain cells that die, the less the chance is for reversing the stroke with treatment,” Williams said.

There’s usually a three-hour window from the time stroke symptoms begin until you can receive treatment with TPA, or in certain cases, 4.5 hours. With endovascular (blood vessel) treatments, you have six hours from the first symptoms, Williams said.

Don’t try to drive yourself to the hospital, he said. “The call to 911 is critical. It bypasses any waiting. The ambulance notifies the hospital and that activates the hospital system and stroke team,” he added.

Williams also cautioned not to think you’re immune from stroke if you’re younger. He said strokes are occurring in younger people, especially in communities with more obesity and diabetes.

Like Price, Williams wants people to know there is life after stroke. “Even if an individual doesn’t receive acute treatment, rehabilitation can improve function and accelerate recovery,” Williams said.

More than seven million Americans aged 20 and older have had a stroke, according to the American Stroke Association.

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Stephen Pettitt died as a “direct consequence” of robotic heart surgery, a coroner concludes.

Experts say the costs reflect a huge rise in the number of people with type 2 diabetes.

The couple were not allowed to see their son unsupervised after social workers launched an investigation.

A quarter of local NHS groups in England are not recommending the devices, data suggests.

High blood pressure, smoking and diabetes increase heart attack risk more in women, a study has found.

Injuries can’t heal without a constant influx of blood’s key ingredient — oxygen.