Medical Minutes for January 2022
January 4, 2022 at 10:18 a.m.
John Schieszer, author of Medical Minutes
...by JOHN SCHIESZER
New applications for smartphone data are continually emerging, and the area of surgical care is no exception. In a new study presented at the American College of Surgeons Clinical Congress 2019, surgeons report that they can describe the impact of certain postoperative events in their patients by capturing data from a patient’s smartphone. This data allows surgeons to understand a patient’s level of postoperative physical activity, and how it may be impacted if a patient experiences a complication, readmission, or reoperation.
“In surgery, we traditionally rely on outcome measures like readmission rates, 30-day mortality, and disease-free survival, which are all extremely valuable and will always have a place in measuring outcomes. But sometimes those outcomes fail to capture what really matters to a patient,” said lead study author Dr. Nikhil Panda, who is a general surgery resident at Massachusetts General Hospital-Harvard Medical School, and postdoctoral fellow at Ariadne Labs, Boston.
Dr. Panda and his colleagues developed an app that could capture the accelerometer sensor data from the smartphones of patients undergoing cancer surgery. Patients who enrolled in the study were asked to download the app and were told their activity would be tracked following their operation. The research team did not prescribe any specific level of activity. They told the patients to simply use their phones as they normally would.
In this study, 62 patients were followed for a median of 147 days. Of the 62 patients in the study, 17 of them experienced a postoperative event, which was defined as either a complication, readmission, or reoperation that was not expected based on the type of operation the patient underwent. The average daily activity for all patients before surgery was approximately 100 minutes per week. Patients who experienced a postoperative event had a significantly lower level of daily activity compared with their baseline as well as compared with patients who did not experience a postoperative event.
“Ultimately, we would like to see this research lead to the development of a tool that helps surgeons better counsel patients on the risks of surgery. That way we will be able to tell them the manifestation of a potential complication on their lives,” Dr. Panda said. “We think this tool will truly help our patients in terms of understanding the impacts of surgery, and aid recovery so they can make decisions that are informed by what matters most to them.”
The researchers also see potential in expanding the use of this app to other areas of medicine. For example, a patient’s smartphone accelerometer data could be used to measure their activity not only after surgery, but also after adjuvant therapy, including chemo-radiation.
Mushrooms May Help Lower Risk for Prostate Cancer
Results from the first long-term study of more than 36,000 Japanese men are suggesting an association between eating mushrooms and a lower risk of prostate cancer. The findings, which were published on September 5, 2019 in the International Journal of Cancer, showed that eating more mushrooms on a regular basis may pack an important hidden health benefit.
Mushrooms are widely in used in Asia, both for their nutritional value and medicinal properties. "Test-tube studies and studies conducted on living organisms have shown that mushrooms have the potential to prevent prostate cancer," said lead study author Shu Zhang, who is an assistant professor of epidemiology in the Department of Health Informatics and Public Health at Tohoku University School of Public Health in Japan. "However, the relationship between mushroom consumption and incident prostate cancer in humans has never been investigated before."
For this study, the researchers monitored two groups consisting of a total of 36,499 men between the ages of 40 and 79 years in Miyagi and Ohsaki, Japan. The follow-up duration for the Miyagi group extended from June 1, 1990 to December 31, 2014 (24.5 years). The follow-up duration for the Ohsaki group extended from January 1, 1995 to March 31, 2008 (13.25 years). The men were asked to complete a questionnaire related to their lifestyle choices, such as mushroom and other food consumption, physical activity, smoking habits, drinking habits, and information on their education.
Long-term follow-up of the participants indicated that consuming mushrooms on a regular basis reduces the risk of prostate cancer in men, and was especially significant in men aged 50 and older and in men whose diet consisted largely of meat and dairy products, with limited consumption of fruit and vegetables. In addition, statistical analysis of the data indicated that regular mushroom consumption was related to a lower risk of prostate cancer regardless of how much fruit and vegetables, or meat and dairy products were consumed.
Of the participants, 3.3% developed prostate cancer during the follow-up period. Participants who consumed mushrooms once or twice a week had an 8% lower risk of developing prostate cancer, compared to those who ate mushrooms less than once per week, while those who consumed mushrooms three or more times per week had a 17% lower risk than those who ate mushrooms less than once a week.
Zhang said mushrooms are a good source of vitamins, minerals and antioxidants, especially L-ergothioneine, which is believed to mitigate against oxidative stress, a cellular imbalance resulting from a poor diet and exposure to environmental toxins.
Some Foods May Lower Lung Cancer Risk
Along with mushrooms, a diet high in fiber and yogurt is associated with a reduced risk for lung cancer, according to a study by researchers at Vanderbilt University Medical Center. The benefits of a diet high in fiber and yogurt have already been established for cardiovascular disease and gastrointestinal cancer. The new findings, which are based on an analysis of data from studies involving 1.4 million adults in the United States, Europe and Asia, suggest this diet may also protect against lung cancer.
Participants were divided into five groups, according to the amount of fiber and yogurt they consumed. Those with the highest yogurt and fiber consumption had a 33% reduced lung cancer risk as compared to the group who did not consume yogurt and consumed the least amount of fiber.
“Our study provides strong evidence supporting the U.S. 2015-2020 Dietary Guideline recommending a high fiber and yogurt diet,” said senior author Dr. Xiao-Ou Shu, who is an associate director for Global Health and co-leader of the Cancer Epidemiology Research Program at Vanderbilt-Ingram Cancer Center, Nashville, Tennessee. “This inverse association was robust, consistently seen across current, past and never smokers, as well as men, women and individuals with different backgrounds,”
Dr. Shu said the health benefits may be rooted in their prebiotic (non-digestible food that promotes growth of beneficial microorganisms in the intestines) and probiotic properties. The properties may independently or synergistically modulate gut microbiota in a beneficial way.
John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at medicalminutes@gmail.com.
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