Medical Minutes

February 27, 2022 at 12:00 a.m.
John Schieszer, author of Medical Minutes
John Schieszer, author of Medical Minutes John Schieszer John Schieszer

Walking Away from Diabetes

Walking regularly and at greater intensity may help prevent Type 2 diabetes among 70- and 80-year-olds, according to one of the first studies measuring steps and pace among this age group. The more steps a person takes, and the more intense, the lower their risk for developing diabetes, report researchers in a study published in the journal Diabetes Care.

“A key figure from our study is that for every 1,000 steps per day, our results showed a 6% lower diabetes risk in this population. What that means is, if the average older adult were to take 2,000 more steps every day—in addition to what they were already doing—they might expect a 12% reduction in diabetes risk,” said study author Alexis C. Garduno, with University of California San Diego. “We wanted to understand the extent to which stepping, or walking, is related to diabetes,” said senior author John Bellettiere, assistant professor of epidemiology at UC San Diego.

According to the American Diabetes Association, 1.5 million people are diagnosed with diabetes every year. “If we estimate that one third of that population are older adults, that’s 500,000 older individuals who are newly diagnosed with diabetes every year. If all of them increase their steps by 2,000 steps per day and our 12% estimate is proven to be causal, we would expect 60,000 people each year to not get diabetes due to that increase in steps,” said Bellettiere.

Breast Cancer Vaccine Advances

A breast cancer vaccine is a step closer to reality. Researchers at the Cleveland Clinic are studying a vaccine for preventing triple-negative breast cancer, the most aggressive and lethal form of the disease.
“We are hopeful that this research will lead to more advanced trials to determine the effectiveness of the vaccine against this highly aggressive type of breast cancer,” said study principal investigator Dr. G. Thomas Budd of the Cleveland Clinic “Long term, we are hoping that this can be a true preventive vaccine that would be administered to healthy women to prevent them from developing triple-negative breast cancer, the form of breast cancer for which we have the least effective treatments.”

 Triple-negative breast cancer accounts for a disproportionately higher percentage of breast cancer deaths and has a higher rate of recurrence. This form of breast cancer is twice as likely to occur in African American women, and approximately 70% to 80% of the breast tumors that occur in women with mutations in the BRCA1 genes are triple-negative breast cancer.

“This vaccine strategy has the potential to be applied to other tumor types,” explained Tuohy. Our translational research program focuses on developing vaccines that prevent diseases we confront with age, like breast, ovarian and endometrial cancers. If successful, these vaccines have the potential to transform the way we control adult-onset cancers and enhance life expectancy in a manner similar to the impact that the childhood vaccination program has had.”

New Handheld Technology for Treating Kidney Stones

Physicians may be able to maneuver small kidney stones to the ureter so they can be expelled naturally. Patients dealing with small kidney stones that persist after surgery may soon have options to “push” the stones from their body, rather than face another more invasive procedure.

A clinical trial at the Kidney Stone Center at the UW Medical Center in Seattle is testing the ability of ultrasound waves to dislodge and move small fragments left behind after surgery so they can naturally be expelled. So far, the results have been promising, according to Dr. Mathew Sorensen, a UW Medicine urologist.

The ultrasound procedure being tested does not require anesthesia, just one or two clinic visits of about 30 minutes each. Then the fragments have a better chance of clearing, sometimes within a few hours, Dr. Sorensen said. NASA is particularly interested in this technology. For astronauts on long missions in a weightless environment, kidney stones are a real concern because no surgical option exists to treat the condition in flight.

Kidney tissue samples from UW Medicine were recently flown to the International Space Station to observe kidneys’ function in space. Dr. Sorensen’s group also is exploring using ultrasound to break larger stones into small pieces, and then use this handheld device to push and expel the fragments to help resolve a painful event. This may allow treatment of stones without anesthesia and pose an attractive option for at-risk patients, such as those with spinal cord injuries.

Sildenafil May Help Combat Alzheimer’s Disease

A new study by researchers at the Cleveland Clinic suggests that sildenafil (Viagra) may be a promising drug candidate to help prevent and treat Alzheimer’s disease. The research team used computational methodology to screen and validate FDA-approved drugs as potential therapies for Alzheimer’s disease. Through a large-scale analysis of a database of more than 7 million patients, they determined that sildenafil is associated with 69% reduced incidence of Alzheimer’s disease, indicating the need for followup clinical trial testing of the drug’s efficacy in patients with the disease.

Drug repurposing (use of an existing drug for new therapeutic purposes) offers a practical alternative to the costly and time-consuming traditional drug discovery process.

“This paper is an example of a growing area of research in precision medicine where big data is key to connecting the dots between existing drugs and a complex disease like Alzheimer’s,” said Dr. Jean Yuan at the National Institute on Aging (NIA). “This is one of many efforts we are supporting to find existing drugs or available safe compounds for other conditions that would be good candidates for Alzheimer’s disease clinical trials.”

The research team has found that understanding subtypes of neurodegenerative diseases such as Alzheimer’s may help to reveal common underlying mechanisms and lead to the discovery of actionable targets for drug repurposing.

The buildup of beta amyloid and tau proteins in the brain leads to amyloid plaques and tau neurofibrillary tangles, which are hallmarks of Alzheimer’s-related brain changes. Recent studies show that the interplay between amyloid and tau is a greater contributor to Alzheimer’s than either by itself, according to the researchers.

Using a large gene-mapping network, researchers integrated genetic and other biologic data to determine which of over 1,600 FDA-approved drugs could be an effective treatment for Alzheimer’s disease. They pinpointed drugs that target both amyloid and tau as having higher scores compared to drugs that target just one or the other. The current study showed that sildenafil has been shown to significantly improve cognition and memory in preclinical models, according to the investigators.

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at
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