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Many families take patients off life support too soon after traumatic brain injuries: study

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Many families take patients off life support too soon after traumatic brain injuries: study

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Many patients who died after traumatic brain injuries may have survived and recovered if their families had waited to take them off life support, a new study found.

Researchers from Massachusetts General Hospital, Harvard Medical School and other universities analyzed “potential clinical outcomes” for patients with traumatic brain injury (TBI) who were removed from life support, according to a press release.

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The study included 1,392 patients who were treated in 18 trauma centers across the U.S. over a 7½-year period.

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Using a mathematical model, the researchers compared patients for whom life support was withdrawn to similar patients who were kept on life support.

Among the group for whom life support was not withdrawn, more than 40% recovered at least some independence, according to a press release.

Many patients who died after traumatic brain injuries may have survived and recovered if their families had waited to take them off life support, a new study has found. (iStock)

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The researchers also discovered that the notion of remaining in a vegetative state was an “unlikely outcome” six months after injury.

When designing the study, the team didn’t know what to expect, according to study author Yelena Bodien, PhD, of the Department of Neurology’s Center for neurotechnology and neurorecovery at Massachusetts General Hospital. 

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“Our anecdotal experience was that some families are told their loved ones had no chance for recovery, they would never walk, talk, work or have a meaningful relationship again — yet they chose not to discontinue life support and their loved one made a remarkable recovery,” she told Fox News Digital.

“On the other hand, clinicians are under a lot of pressure to make early prognoses and do not want to commit someone to a life that would never be acceptable to them, so it could be that those patients who died after life support was withdrawn would have had very significant impairments otherwise.”

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“Our anecdotal experience was that some families are told their loved ones had no chance for recovery … yet they chose not to discontinue life support and their loved one made a remarkable recovery,” a researcher said. (iStock)

“I think there are two stories here,” said Bodien. 

“One is that some patients with traumatic brain injury who died because life support was withdrawn may have recovered, but the other is that many would have died even if life support was continued.”

A patient’s prognosis after severe traumatic brain injury is highly uncertain, she noted. “Sometimes patients with the most devastating injuries survive and make meaningful recoveries.”

“Families can advocate for delaying a decision to discontinue life support if this is aligned with what they believe their loved one would want.”

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The problem, Bodien said, is that health care providers lack the tools required to determine which patients with devastating injuries will recover, to what extent they will recover — and how long that will take.

‘Very important’ study

Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, was not involved in the research but said it was a “very important” study.

“Previous research shows a high-level recovery from mild TBI and a significant recovery percentage even with moderate to severe injury,” Siegel told Fox News Digital.

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“After head trauma, the brain may swell, and the use of mannitol and steroids and even sometimes surgery — where the top of the skull is removed — can be used to decrease pressure on the brain and increase chance of a full recovery,” he continued. 

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Rehabilitation is also crucial, Siegel added.

“All of these tools should be given a chance to work in most cases.”

Health care providers lack the tools required to determine which patients with devastating injuries will recover, to what extent they will recover and how long that will take, a researcher said. (iStock)

Based on the study findings, Bodien recommended that clinicians should be “very cautious” with “irreversible decisions” like withdrawing life support in the days following traumatic brain injury

“Families should also be aware of our results so that they can advocate for delaying a decision to discontinue life support if this is aligned with what they believe their loved one would want,” she added. 

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Limitations of the research

There were some limitations to the study, Bodien said.

“The sample size of the study was small, which made it difficult to find an adequate number of participants who did not have life support discontinued and were clinically similar, or ‘matched,’ to those who had life support discontinued,” she told Fox News Digital.

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Among the participants who did not have life support discontinued, the researchers were not able to follow all of them for a six-month period.

Another limitation is that the researchers used clinical variables that were available on the day of, or the day after, hospitalization — but sometimes decisions to discontinue life support are made several days later.

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Based on the findings, study author Yelena Bodien (not pictured) recommended that clinicians should be “very cautious” with “irreversible decisions” such as withdrawing life support in the days following traumatic brain injury.  (iStock)

“There are many considerations that may lead to a decision to discontinue life support after traumatic brain injury that we were unable to factor into our analyses,” she continued. 

“For example, personal beliefs, religion and advanced directives could all affect decision-making but were not captured in our study.”

Bodien also noted that the Harvard study was focused on traumatic brain injury and cannot be generalized to other injuries and illnesses.

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Dairy consumption linked to lower dementia risk in surprising new study

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Dairy consumption linked to lower dementia risk in surprising new study

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A large Swedish study suggests that some high-fat dairy foods are linked to a lower risk of dementia.

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Researchers in Sweden used data from the Malmö Diet and Cancer cohort, which included 27,670 adults aged 45 to 73 in Malmö, Sweden.

The team then conducted interviews, collected food diaries, and asked the patients questionnaires to calculate how much of each dairy product people ate per day. They also separated dairy into high-fat and low-fat types. High-fat cheese was defined as more than 20% fat, and high-fat cream as more than 30% fat.

Participants joined the study between 1991 and 1996 and were followed for an average of 25 years afterward.

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People who consumed at least 20 grams per day of high-fat cream had about a 16% lower risk of all-cause dementia than non-consumers. (iStock)

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The main outcome they looked at was all-cause dementia, while Alzheimer’s disease (AD) and vascular dementia (VaD) were studied separately. Over the follow-up period, 3,208 people developed dementia. Within these groups, those who consumed high-fat cheese were significantly less likely to develop dementia.

“We were a bit surprised to see a lower dementia risk among people who ate more high-fat cheese,” Emily Sonestedt, associate professor of nutritional epidemiology at Lund University in Sweden, told Fox News Digital.

At the same time, she says it isn’t entirely unexpected to see a link with vascular dementia.

Most other dairy products, including low-fat cheese, low-fat cream, milk and fermented milk, showed no consistent association with overall dementia risk. (iStock)

“Many dementia cases involve damage to small blood vessels in the brain. Our own previous work, and several international studies, including from the US, have shown neutral or slightly protective associations between cheese and cardiovascular disease.”

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The study adjusted for factors such as age, sex, education, smoking, physical activity, alcohol use, body mass index, hypertension, overall diet quality and other dairy products.

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People who ate at least 50 grams per day of high-fat cheese had a lower risk of all-cause dementia compared with those eating less than 15 grams per day. They also had a lower risk of vascular dementia.

High butter intake was associated with a higher risk of Alzheimer’s disease, while high-fat cheese was linked to lower Alzheimer’s risk only among people without the APOE ε4 genetic risk variant. (iStock)

High-fat cream showed a similar pattern: people consuming at least 20 grams per day had a 16% lower risk for all-cause dementia compared with non-consumers.

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Other dairy products did not show clear links with overall dementia risk. Low-fat cheese, low-fat cream, milk, fermented milk, and butter generally showed no association with all-cause dementia.

One exception was that high butter intake (at least 40 grams a day) was associated with a higher risk of Alzheimer’s disease. The study also found that high-fat cheese was linked to lower AD risk only among people who did not carry the APOE ε4 risk variant, a genetic variant linked to Alzheimer’s.

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This was an observational study, so it cannot show cause and effect, and unmeasured factors may still play a role.

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“The study was conducted in Sweden, where people mainly eat hard, fermented cheeses, so the results may not apply directly to countries with very different cheese types and eating patterns,” said Sonestedt.

Because the study was observational and diet was measured only once, the results should be interpreted cautiously and cannot be used to conclude that high-fat dairy prevents dementia. (iStock)

Diet was measured only once, so changes over time were not fully captured. Cream intake was measured with less precision than cheese.

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“Although we adjusted for many lifestyle and health factors, it is still difficult to say that the cheese itself is protective. It is more likely part of a broader eating pattern and lifestyle that may support long-term brain health,” researchers noted.

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Dementia diagnoses after 2014 were not validated in detail, and baseline cognitive status was not available. 

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Some dementia cases may have been missed, and the results are from a Swedish population, which may limit generalization.

The findings were published in Neurology, the medical journal of the American Academy of Neurology.

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Misunderstood illness leaves millions exhausted, with most cases undiagnosed

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Misunderstood illness leaves millions exhausted, with most cases undiagnosed

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Fatigue can stem from a variety of illnesses and life stressors, but when that exhaustion lasts for months — often following an infection — it may indicate a condition called chronic fatigue syndrome.

Approximately 3.3 million people in the United States currently have the syndrome, with about one in four people confined to their bed at some point during the illness, according to the Centers for Disease Control and Prevention.

Despite its prevalence, experts say it’s a poorly understood condition that physicians frequently miss, with past research suggesting that only about 15% of those affected are diagnosed correctly.

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What is chronic fatigue syndrome?

Formally known as myalgic encephalomyelitis (ME), chronic fatigue syndrome (CFS) is a chronic disease that causes fatigue so severe that it impairs the ability to perform daily activities.

Approximately 3.3 million people in the United States currently have the chronic fatigue syndrome, with about one in four people confined to their bed at some point during the illness. (iStock)

The National Academy of Medicine defines the syndrome as having the following three symptoms that last at least six months.

  • Severe fatigue that is 1) new and 2) decreases the ability to perform activities that you did normally prior to illness
  • “Malaise” that worsens after physical or mental effort that previously was well-tolerated
  • Unrestful sleep

People may also experience trouble with thinking and memory (often called “brain fog”) or lightheadedness when standing up. 

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There are no tests to confirm chronic fatigue, so doctors diagnose it by talking to their patients, examining them and excluding other disorders, like hypothyroidism and depression, that often share the same symptoms.

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Chronic fatigue is frequently missed by physicians, with past research suggesting that only about 15% of those affected are diagnosed correctly. (iStock)

“CFS, fibromyalgia and long COVID are all related conditions with different names,” Dr. Jacob Teitelbaum, author of “From Fatigued to Fantastic” — whose research focuses on chronic fatigue syndrome — told Fox News Digital. “What these illnesses have in common is that they are immune disorders, and immune disorders predominantly affect women.”

Many genes related to immune disorders are on the X chromosome, suggesting a genetic component, the doctor added.

Causes of chronic fatigue

Chronic fatigue syndrome may be triggered by infection or other physiologic stressors, but its causes and symptoms can vary widely from person to person, according to Dr. Julia Oh, a professor in dermatology, molecular genetics and microbiology, and integrative immunobiology at the Duke University School of Medicine in North Carolina.

Teitelbaum compared the condition to a “severe energy crisis” in the body. When energy drops low enough, the “control center” in the brain — the hypothalamus, which regulates sleep, hormones, blood pressure and pulse — may not work as well.

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Although hypothalamic dysfunction can trigger dozens of other symptoms, the hallmark signs are insomnia (despite exhaustion), brain fog and widespread pain, the doctor said.

Anything that causes severe energy depletion can trigger the syndrome, including chronic life stressors, nutritional deficiencies, thyroid and stress hormone imbalances, and sleep problems.

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These triggers are usually associated with a gradual onset of CFS, but sudden onset can be caused by certain infections, with two classic ones being COVID and mononucleosis, past research has shown.

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Head and neck trauma and sudden hormonal shifts after pregnancy can also trigger chronic fatigue, Teitelbaum warned.

Anything that causes severe energy depletion can trigger the syndrome, including chronic life stressors, nutritional deficiencies, thyroid and stress hormone imbalances, and sleep problems, according to one doctor. (iStock)

There aren’t currently any blood tests to uniformly diagnose the syndrome, but Dr. Oh said she is hopeful that will change in the future.

Her research team developed an experimental artificial intelligence-based tool, BioMapAI, that has been shown to identify the condition with high accuracy by analyzing stool, blood and other common lab tests, according to early research published in July in the journal Nature Medicine.

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“Instead of finding one smoking gun for the disease, our AI model uncovered a distinct biological fingerprint that was dysregulated in the patients, which spanned changes in gut bacteria, hyperactive immune cells and disrupted metabolism,” Oh told Fox News Digital.

Treatments and therapies

Given how differently chronic fatigue syndrome can affect people, there is no universally effective therapy, according to Oh.

The CDC recommends that patients with CFS work with their doctors to create a management plan based on the symptoms that most affect quality of life.

There are no tests to confirm chronic fatigue, so doctors diagnose it by evaluating symptoms and excluding other disorders.

Treatments generally include a combination of lifestyle changes, therapies and medications. Patients and their physicians should weigh the potential benefits and risks of any approach.

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There are some alternative therapies that have shown to be effective for some. Teitelbaum developed a protocol called SHINE, which focuses on sleep, hormones and hypotension, infections, nutrition and exercise. Some research has shown that this approach can help to improve the quality of life for people with CFS and fibromyalgia.

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Others may find alternative treatments, like physiotherapy (physical therapy) to be helpful.

Those who experience persistent fatigue that hinders their ability to participate in regular activities or impacts their quality of life should speak with a doctor.

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Ancient plague mystery cracked after DNA found in 4,000-year-old animal remains

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Ancient plague mystery cracked after DNA found in 4,000-year-old animal remains

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Long before the Black Death killed millions across Europe in the Middle Ages, an earlier, more elusive version of the plague spread across much of Eurasia.

For years, scientists were unsure how the ancient disease managed to spread so widely during the Bronze Age, which lasted from roughly 3300 to 1200 B.C., and stick around for nearly 2,000 years, especially since it wasn’t spread by fleas like later plagues. Now, researchers say a surprising clue may help explain it, a domesticated sheep that lived more than 4,000 years ago.

Researchers found DNA from the plague bacterium Yersinia pestis in the tooth of a Bronze Age sheep discovered in what is now southern Russia, according to a study recently published in the journal Cell. It is the first known evidence that the ancient plague infected animals, not just people, and offers a missing clue about how the disease spread.

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“It was alarm bells for my team,” study co-author Taylor Hermes, a University of Arkansas archaeologist who studies ancient livestock and disease spread, said in a statement. “This was the first time we had recovered the genome from Yersinia pestis in a non-human sample.”

A domesticated sheep, likely similar to this one, lived alongside humans during the Bronze Age. (iStock)

And it was a lucky discovery, according to the researchers.

“When we test livestock DNA in ancient samples, we get a complex genetic soup of contamination,” Hermes said. “This is a large barrier … but it also gives us an opportunity to look for pathogens that infected herds and their handlers.”

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The highly technical and time-consuming work requires researchers to separate tiny, damaged fragments of ancient DNA from contamination left by soil, microbes and even modern humans. The DNA they recover from ancient animals is often broken into tiny pieces sometimes just 50 “letters” long, compared to a full human DNA strand, which contains more than 3 billion of those letters.

Animal remains are especially tough to study because they are often poorly preserved compared to human remains that were carefully buried, the researchers noted.

The finding sheds light on how the plague likely spread through close contact between people, livestock and wild animals as Bronze Age societies began keeping larger herds and traveling farther with horses. The Bronze Age saw more widespread use of bronze tools, large-scale animal herding and increased travel, conditions that may have made it easier for diseases to move between animals and humans.

When the plague returned in the Middle Ages during the 1300s, known as the Black Death, it killed an estimated one-third of Europe’s population.

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The discovery was made at Arkaim, a fortified Bronze Age settlement in the Southern Ural Mountains of present-day Russia near the Kazakhstan border. (iStock)

“It had to be more than people moving,” Hermes said. “Our plague sheep gave us a breakthrough. We now see it as a dynamic between people, livestock and some still unidentified ‘natural reservoir’ for it.”

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Researchers believe sheep likely picked up the bacteria from another animal, like rodents or migratory birds, that carried it without getting sick and then passed it to humans. They say the findings highlight how many deadly diseases begin in animals and jump to humans, a risk that continues today as people move into new environments and interact more closely with wildlife and livestock.

“It’s important to have a greater respect for the forces of nature,” Hermes said.

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The study is based on a single ancient sheep genome, which limits how much scientists can conclude, they noted, and more samples are needed to fully understand the spread.

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The researchers plan to study more ancient human and animal remains from the region to determine how widespread the plague was and which species may have played a role in spreading it. 

Researchers (not pictured) found plague-causing Yersinia pestis DNA in the remains of a Bronze Age sheep. (iStock)

They also hope to identify the wild animal that originally carried the bacteria and better understand how human movement and livestock herding helped the disease travel across vast distances, insights that could help them better anticipate how animal-borne diseases continue to emerge.

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The research was led by scientists at the Max Planck Institute for Infection Biology, with senior authors Felix M. Key of the Max Planck Institute for Infection Biology and Christina Warinner of Harvard University and the Max Planck Institute for Geoanthropology.

The research was supported by the Max Planck Society, which has also funded follow-up work in the region.

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