Multifocal Positive Margins After Prostate Cancer Surgery

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In Cox multivariable analyses, compared with negative surgical margins, positive surgical margins were significantly associated with a 1.7- and 2.2-fold increased risk of cancer-specific and all-cause mortality, respectively, in patients with intermediate-risk and high-risk disease, respectively, Ugo Giovanni Falagario, MD, of Karolinska Institute in Stockholm, Sweden, and colleagues reported in European Urology Oncology. Positive surgical margins were also significantly associated with a 1.8-fold increased risk of adverse pathologic characteristics, including Grade group 4 or higher, pT3 or higher, pN1, or PSA persistence. Multifocal Positive Margins After Prostate Cancer Surgery Up Mortality Risks – https://www.renalandurologynews.com/news/multifocal-positive-margins-after-prostate-cancer-surgery-up-mortality-risks/

Reference:

Pellegrino F, Falagario UG, Knipper S, et al; ERUS Scientific Working Group on Prostate Cancer of the European Association of Urology. Assessing the impact of positive surgical margins on mortality in patients who underwent robotic radical prostatectomy: 20 Years’ report from the EAU Robotic Urology Section Scientific Working Group. Eur Urol Oncol. 2024 Aug;7(4):888-896. doi:10.1016/j.euo.2023.11.021

Just 2-4 Cups of Fruits and Veggies Does What?

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Lowers blood pressure, improves kidney health, improves CVD risk factors.

In a randomized control trial over a five-year period, investigators divided the cohort of 153 patients with hypertension into three groups:

  1. Study participants adding 2-4 cups of base-producing fruits and vegetables in addition to their usual daily food intake
  2. Study participants prescribed NaHCO3 (acid-reducing sodium bicarbonate, which is common baking soda) tablets in two daily doses of 4-5 650 mg tablets
  3. Study participants receiving standard medical care from primary care clinicians

The results of the study show that both fruits and vegetables and NaHCO3 improved kidney health, but only fruits and vegetables, and not NaHCO3, reduced blood pressure and improved indices of cardiovascular disease risk.

The trial supports fruits and vegetables as foundational hypertension treatment to reduce chronic kidney disease progression and cardiovascular disease risk.

Elsevier. “Eating more fruits and vegetables to reduce dietary acid lowers blood pressure and improves kidney and heart health in patients with hypertension.” ScienceDaily. http://www.sciencedaily.com/releases/2024/08/240806131316.htm (accessed August 11, 2024).

Journal Reference:

  1. Nimrit Goraya, Nicolaos E. Madias, Jan Simoni, Maninder Kahlon, Nazan Aksan, Donald E. Wesson. Kidney and Cardiovascular Protection Using Dietary Acid Reduction in Primary Hypertension: A Five-Year, Interventional, Randomized, Control Trial. The American Journal of Medicine, 2024; DOI: 10.1016/j.amjmed.2024.06.006

I had two cups of fruit in my breakfast bowl this morning.

What did you eat for breakfast?

The T2D-GENE Trial

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The prevalence of type 2 diabetes was significantly lower in the lifestyle intervention group than in the control group.

University of Eastern Finland. “Type 2 diabetes can be prevented by diet and exercise even in individuals with a high genetic risk.” ScienceDaily. http://www.sciencedaily.com/releases/2024/08/240807122749.htm (accessed August 10, 2024).

Effects of Genetic Risk on Incident Type 2 Diabetes and Glycemia: The T2D-GENE Lifestyle Intervention Trial – The Journal of Clinical Endocrinology & Metabolism, dgae422, https://doi.org/10.1210/clinem/dgae422

Remember, Stay as Thin as You Can as Long as You Can.

A Broad Range of Flexible Retirement Arrangements

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A Phased Retirement Program

Emory University is one of the few employers that offers a phased retirement program. Here’s a breakdown of how its program works:

  • The phased retirement commitment must be for a defined duration, spanning a minimum of six months to a maximum of three years.
  • Throughout this period, you’ll adjust your work hours, reducing them by anywhere from 10% to 50%, while maintaining a minimum of 20 hours per week.
  • By participating, you agree to retire at the end of the specified time frame.
  • Your pay will be adjusted to reflect the reduced workload during phased retirement.

Source: Phased Retirement: What Does It Mean And How Does It Work? — https://www.thepennyhoarder.com/retirement/phased-retirement/

Sign me up (when I’m ready).

This Is a Post For Old People – Move More, Take Vitamin D, Statins are not Evil

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Quotes are taken from summaries of three different studies. Source: Statins, Vitamin D, and Exercise in Older Adults – Medscape – July 26, 2024. https://www.medscape.com/s/viewarticle/statins-vitamin-d-and-exercise-older-adults.

On a personal level I’ve been taking a low dose statin forever, 100 IU Vitamin D3 and a multivitamin daily, need to move more, Fexofenadine prn, and still not a vegan or drive an EV.

The study found that among older adults aged 75-84, initiation of statin therapy led to a 1.2% risk reduction in major CVD over a 5-year period. For older adults aged 85 and greater, initiation of statins had an even larger impact, leading to a 4.4% risk reduction in major CVD over a 5-year period. The study found that there was no significant difference in adverse effects including myopathy or liver dysfunction in both age groups.

For older adults aged 75 or greater, empiric vitamin D supplementation is recommended because of the possible reduction of risk in all-cause mortality in this population. Of note, this was a grade 2 recommendation by the panel, indicating that the benefits of the treatment probably outweigh the risks. The panel stated that vitamin D supplementation could be delivered through fortified foods, multivitamins with vitamin D, or as a separate vitamin D supplement.

The study found that participants who were more sedentary were less likely to age healthfully, with each additional 2 hours of TV watching per day associated with a 12% reduction in likelihood of healthy aging. Light physical activity was associated with a significant increase in healthy aging, with a 6% increase in the likelihood of healthy aging for each additional 2 hours of light activity. Each additional 1 hour of moderate to vigorous activity was associated with a 14% increase in the likelihood of healthy aging. These findings support discussions with patients that behavior change, even in small increments, can be beneficial in healthy aging.

Cannabis Use and Psychosis Risk (Aussie Version)

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Professor Emmerson says Queensland’s Metro North Health — Australia’s largest public health service, based in north Brisbane and the surrounding region — is seeing increased presentations of psychosis due to medicinal cannabis.”The Metro North early psychosis service reports 10 per cent of their new presentations — so these are kids aged 16 to 21 — are people who’ve ended up on medicinal cannabis and are becoming psychotic,” the Brisbane-based psychiatrist says.

Doctors warn of significant increase in people hospitalized with psychosis after being prescribed medicinal cannabis — https://www.abc.net.au/news/2024-07-21/medicinal-cannabis-psychosis-harm-risk-prescription-marijuana/104116952