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From eye exams to blood tests and surgery: how doctors use light to diagnose disease

<a href="https://theconversation.com/profiles/matthew-griffith-1539353">Matthew Griffith</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> You’re not feeling well. You’ve had a pounding headache all week, dizzy spells and have vomited up your past few meals. You visit your GP to get some answers and sit while they shine a light in your eyes, order a blood test and request some medical imaging. Everything your GP just did relies on light. These are just some of the optical technologies that have had an enormous impact in how we diagnose disease. <h2>1. On-the-spot tests</h2> Point-of-care diagnostics allow doctors to test patients on the spot and get answers in minutes, rather than sending samples to a lab for analysis. The “flashlight” your GP uses to view the inside of your eye (known as an <a href="https://medlineplus.gov/ency/article/003881.htm">ophthalmoscope</a>) is a great example. This allows doctors to detect abnormal blood flow in the eye, deformations of the cornea (the outermost clear layer of the eye), or swollen optical discs (a round section at the back of the eye where the nerve link to the brain begins). Swollen discs are a sign of elevated pressure inside your head (or in the worst case, a brain tumour) that could be <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/headache/increased-intracranial-pressure-icp-headache">causing your headaches</a>. The invention of <a href="https://openmedscience.com/lighting-the-way-in-healthcare-the-transformative-role-of-lasers-in-medicine/">lasers and LEDs</a> has enabled many other miniaturised technologies to be provided at the bedside or clinic rather than in the lab. <a href="https://theconversation.com/whats-a-pulse-oximeter-should-i-buy-one-to-monitor-covid-at-home-174457">Pulse oximetry</a> is a famous example, where a clip attached to your finger reports how well your blood is oxygenated. It does this by <a href="https://www.howequipmentworks.com/pulse_oximeter/">measuring</a> the different responses of oxygenated and de-oxygenated blood to different colours of light. Pulse oximetry is used at hospitals (and <a href="https://theconversation.com/whats-a-pulse-oximeter-should-i-buy-one-to-monitor-covid-at-home-174457">sometimes at home</a>) to monitor your respiratory and heart health. In hospitals, it is also a valuable tool for detecting <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60107-X/fulltext">heart defects in babies</a>. <h2>2. Looking at molecules</h2> Now, back to that blood test. Analysing a small amount of your blood can diagnose <a href="https://theconversation.com/blood-tests-and-diagnosing-illness-what-can-blood-tell-us-about-whats-happening-in-our-body-80327">many different diseases</a>. A machine called an automated “full blood count analyser” tests for general markers of your health. This machine directs focused beams of light through blood samples held in small glass tubes. It counts the number of blood cells, determines their specific type, and reports the level of haemoglobin (the protein in red blood cells that distributes oxygen around your body). In minutes, this machine can provide a <a href="https://www.nuffieldhealth.com/article/inside-the-pathology-lab-what-happens-to-my-blood">snapshot</a> of your overall health. For more specific disease markers, blood serum is separated from the heavier cells by spinning in a rotating instrument called a centrifuge. The serum is then exposed to special chemical stains and enzyme assays that change colour depending on whether specific molecules, which may be the sign of a disease, are present. These colour changes can’t be detected with the naked eye. However, a light beam from an instrument called a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476943/#R88">spectrometer</a> can detect tiny amounts of these substances in the blood and determine if the biomarkers for diseases are present, and at what levels. <h2>3. Medical imaging</h2> Let’s re-visit those medical images your GP ordered. The development of fibre-optic technology, made famous for transforming high-speed digital communications (such as the NBN), allows light to get inside the body. The result? High-resolution optical imaging. A common example is an <a href="https://www.medicalnewstoday.com/articles/153737#risks-and-side-effects">endoscope</a>, where fibres with a tiny camera on the end are inserted into the body’s natural openings (such as your mouth or anus) to examine your gut or respiratory tracts. Surgeons can insert the same technology through tiny cuts to view the inside of the body on a video screen during <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553337/">laparoscopic surgery</a> (also known as keyhole surgery) to diagnose and treat disease. <h2>How about the future?</h2> Progress in nanotechnology and a better understanding of the interactions of light with our tissues are leading to new light-based tools to help diagnose disease. These include: <ul> <li> <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/advs.201903441">nanomaterials</a> (materials on an extremely small scale, many thousands of times smaller than the width of a human hair). These are being used in next-generation sensors and new diagnostic tests </li> <li> <a href="https://www.nature.com/articles/s41587-019-0045-y">wearable optical biosensors</a> the size of your fingernail can be included in devices such as watches, contact lenses or finger wraps. These devices allow non-invasive measurements of sweat, tears and saliva, in real time </li> <li> AI tools to analyse how blood serum scatters infrared light. This has allowed researchers to build a <a href="https://www.advancedsciencenews.com/powerful-diagnostic-approach-uses-light-to-detect-virtually-all-forms-of-cancer/">comprehensive database</a> of scatter patterns to detect <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/aisy.202300006">any cancer</a> </li> <li> a type of non-invasive imaging called <a href="https://www.ncbi.nlm.nih.gov/books/NBK554044/">optical coherence tomography</a> for more detailed imaging of the eye, heart and skin </li> <li> fibre optic technology to deliver a tiny microscope into the body on the <a href="https://www.uwa.edu.au/projects/microscope-in-a-needle">tip of a needle</a>. </li> </ul> So the next time you’re at the GP and they perform (or order) some tests, chances are that at least one of those tests depend on light to help diagnose disease.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231379/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/matthew-griffith-1539353">Matthew Griffith</a>, Associate Professor and ARC Future Fellow and Director, UniSA Microscopy and Microanalysis Facilities, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/from-eye-exams-to-blood-tests-and-surgery-how-doctors-use-light-to-diagnose-disease-231379">original article</a>.

Body

For type 2 diabetes, focusing on when you eat – not what – can help control blood sugar

<a href="https://theconversation.com/profiles/evelyn-parr-441878">Evelyn Parr</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> and <a href="https://theconversation.com/profiles/brooke-devlin-2237174">Brooke Devlin</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Type 2 diabetes affects <a href="https://www.aihw.gov.au/reports/diabetes/diabetes/contents/how-common-is-diabetes/type-2-diabetes">1.2 million Australians</a> and accounts for <a href="https://www.diabetesaustralia.com.au/about-diabetes/type-2-diabetes/">85-90%</a> of all diabetes cases. This chronic condition is characterised by high blood glucose (sugar) levels, which carry serious <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30058-2/abstract">health</a> risks. <a href="https://www.nature.com/articles/nrendo.2017.151">Complications</a> include heart disease, kidney failure and vision problems. Diet is an important way people living with type 2 diabetes manage blood glucose, alongside exercise and medication. But while we know individualised, professional dietary advice improves blood glucose, it can be <a href="https://linkinghub.elsevier.com/retrieve/pii/S0168822717317588">complex</a> and is not always <a href="https://www.publish.csiro.au/py/PY13021">accessible</a>. <a href="https://www.sciencedirect.com/science/article/pii/S0168822724008039">Our new study</a> looked at the impact of time-restricted eating – focusing on when you eat, rather than what or how much – on blood glucose levels. We found it had similar results to individualised advice from an accredited practising dietitian. But there were added benefits, because it was simple, achievable, easy to stick to – and motivated people to make other positive changes. <h2>What is time-restricted eating?</h2> Time-restricted eating, also known as <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-nutr-082018-124320">the 16:8 diet</a>, became popular for weight loss around 2015. Studies have since shown it is also an <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2811116">effective way</a> for people with type 2 diabetes to manage blood glucose. Time-restricted eating involves limiting when you eat each day, rather than focusing on what you eat. You restrict eating to a window during daylight hours, for example between 11am and 7pm, and then fast for the remaining hours. This can sometimes naturally lead to also eating less. Giving your body a break from constantly digesting food in this way helps align eating with natural <a href="https://doi.org/10.1111/jne.12886">circadian rhythms</a>. This <a href="https://doi.org/10.1111/jnc.15246">can help</a> regulate metabolism and improve overall health. For people with type 2 diabetes, there may be specific benefits. They often have their <a href="https://doi.org/10.2337/dc12-2127">highest blood glucose</a> reading in the morning. Delaying breakfast to mid-morning means there is time for physical activity to occur to help reduce glucose levels and prepare the body for the first meal. <h2>How we got here</h2> We ran an <a href="https://www.mdpi.com/2072-6643/12/11/3228">initial study</a> in 2018 to see whether following time-restricted eating was achievable for people with type 2 diabetes. We found participants could easily stick to this eating pattern over four weeks, for an average of five days a week. Importantly, they also had improvements in blood glucose, spending less time with high levels. <a href="https://www.mdpi.com/2072-6643/12/2/505">Our previous research</a> suggests the reduced time between meals may play a role in how the hormone insulin is able to reduce glucose concentrations. <a href="https://doi.org/10.1001/jamanetworkopen.2023.39337">Other studies</a> have confirmed these findings, which have <a href="https://doi.org/10.1186/s12986-021-00613-9">also shown</a> notable improvements in HbA1c. This is a <a href="https://www.ncbi.nlm.nih.gov/books/NBK304271/">marker</a> in the blood that represents concentrations of blood glucose over an average of three months. It is the <a href="https://journals.sagepub.com/doi/10.4137/BMI.S38440">primary clinical tool</a> used for diabetes. However, these studies provided intensive support to participants through weekly or fortnightly meetings with researchers. While we know this level of support <a href="https://www.nature.com/articles/0802295">increases</a> how likely people are to stick to the plan and improves outcomes, it is not readily available to everyday Australians living with type 2 diabetes. <h2>What we did</h2> In our <a href="https://www.sciencedirect.com/science/article/pii/S0168822724008039">new study</a>, we compared time-restricted eating directly with advice from an <a href="https://dietitiansaustralia.org.au/working-dietetics/standards-and-scope/role-accredited-practising-dietitian">accredited practising dietitian</a>, to test whether results were similar across six months. We recruited 52 people with type 2 diabetes who were currently managing their diabetes with up to two oral medications. There were 22 women and 30 men, aged between 35 and 65. Participants were randomly divided into two groups: diet and time-restricted eating. In both groups, participants received four consultations across the first four months. During the next two months they managed diet alone, without consultation, and we continued to measure the impact on blood glucose. In the diet group, consultations focused on changing their diet to control blood glucose, including improving diet quality (for example, eating more vegetables and limiting alcohol). In the time-restricted eating group, advice focused on how to limit eating to a nine-hour window between 10am and 7pm. Over six months, we measured each participant’s blood glucose levels every two months using the HbA1c test. Each fortnight, we also asked participants about their experience of making dietary changes (to what or when they ate). <h2>What we found</h2> We found time-restricted eating was as effective as the diet intervention. Both groups had reduced blood glucose levels, with the greatest improvements occurring after the first two months. Although it wasn’t an objective of the study, some participants in each group also lost weight (5-10kg). When surveyed, participants in the time-restricted eating group said they had adjusted well and were able to follow the restricted eating window. Many told us they had family support and enjoyed earlier mealtimes together. Some also found they slept better. After two months, people in the time-restricted group were looking for more dietary advice to further improve their health. Those in the diet group were less likely to stick to their plan. Despite similar health outcomes, time-restricted eating seems to be a simpler initial approach than making complex dietary changes. <h2>Is time-restricted eating achievable?</h2> The main barriers to following time-restricted eating are social occasions, caring for others and work schedules. These factors may prevent people eating within the window. However, there are many benefits. The message is simple, focusing on when to eat as the main diet change. This may make time-restricted eating more translatable to people from a wider variety of socio-cultural backgrounds, as the types of foods they eat don’t need to change, just the timing. Many people don’t have access to more individualised support from a dietitian, and receive nutrition advice from their GP. This makes time-restricted eating an alternative – and equally effective – strategy for people with type 2 diabetes. People should still try to stick to <a href="https://www.eatforhealth.gov.au/guidelines/guidelines">dietary guidelines</a> and prioritise vegetables, fruit, wholegrains, lean meat and healthy fats. But our study showed time-restricted eating may also serve as stepping stone for people with type 2 diabetes to take control of their health, as people became more interested in making diet and other positive changes. Time-restricted eating might not be appropriate for everyone, especially people on medications which don’t recommend fasting. Before trying this dietary change, it’s best speak to the healthcare professional who helps you manage diabetes.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/241472/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/evelyn-parr-441878">Evelyn Parr</a>, Research Fellow in Exercise Metabolism and Nutrition, Mary MacKillop Institute for Health Research, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> and <a href="https://theconversation.com/profiles/brooke-devlin-2237174">Brooke Devlin</a>, Lecturer in Nutrition and Dietetics, School of Human Movement and Nutrition Sciences, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/for-type-2-diabetes-focusing-on-when-you-eat-not-what-can-help-control-blood-sugar-241472">original article</a>.

Body

Centenarian blood tests give hints of the secrets to longevity

<a href="https://theconversation.com/profiles/karin-modig-1473484">Karin Modig</a>, <a href="https://theconversation.com/institutions/karolinska-institutet-1250">Karolinska Institutet</a> Centenarians, once considered rare, have become commonplace. Indeed, they are the <a href="https://www.weforum.org/agenda/2021/02/living-to-one-hundred-life-expectancy/">fastest-growing demographic group</a> of the world’s population, with numbers roughly doubling every ten years since the 1970s. How long humans can live, and what determines a long and healthy life, have been of interest for as long as we know. Plato and Aristotle discussed and <a href="https://pubmed.ncbi.nlm.nih.gov/12092789/">wrote about the ageing process</a> over 2,300 years ago. The pursuit of understanding the secrets behind exceptional longevity isn’t easy, however. It involves <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7105197/">unravelling the complex interplay</a> of genetic predisposition and lifestyle factors and how they interact throughout a person’s life. Now our recent study, <a href="https://link.springer.com/article/10.1007/s11357-023-00936-w">published in GeroScience</a>, has unveiled some common biomarkers, including levels of cholesterol and glucose, in people who live past 90. Nonagenarians and centenarians have long been of intense interest to scientists as they may help us understand how to live longer, and perhaps also how to age in better health. So far, studies of centenarians have often been small scale and focused on a selected group, for example, excluding centenarians who live in care homes. <h2>Huge dataset</h2> Ours is the largest study comparing biomarker profiles measured throughout life among exceptionally long-lived people and their shorter-lived peers to date. We compared the biomarker profiles of people who went on to live past the age of 100, and their shorter-lived peers, and investigated the link between the profiles and the chance of becoming a centenarian. Our research included data from 44,000 Swedes who underwent health assessments at ages 64-99 - they were a sample of <a href="https://pubmed.ncbi.nlm.nih.gov/28158674/">the so-called Amoris cohort</a>. These participants were then followed through Swedish register data for up to 35 years. Of these people, 1,224, or 2.7%, lived to be 100 years old. The vast majority (85%) of the centenarians were female. Twelve blood-based biomarkers related to inflammation, metabolism, liver and kidney function, as well as potential malnutrition and anaemia, were included. All of these <a href="https://www.nature.com/articles/s41591-019-0719-5">have been associated</a> with ageing or mortality in previous studies. The biomarker related to inflammation was uric acid – a waste product in the body caused by the digestion of certain foods. We also looked at markers linked to metabolic status and function including total cholesterol and glucose, and ones related to liver function, such as alanine aminotransferase (Alat), aspartate aminotransferase (Asat), albumin, gamma-glutamyl transferase (GGT), alkaline phosphatase (Alp) and lactate dehydrogenase (LD). We also looked at creatinine, which is linked to kidney function, and iron and total iron-binding capacity (TIBC), which is linked to anaemia. Finally, we also investigated albumin, a biomarker associated with nutrition. <h2>Findings</h2> We found that, on the whole, those who made it to their hundredth birthday tended to have lower levels of glucose, creatinine and uric acid from their sixties onwards. Although the median values didn’t differ significantly between centenarians and non-centenarians for most biomarkers, centenarians seldom displayed extremely high or low values. For example, very few of the centenarians had a glucose level above 6.5 earlier in life, or a creatinine level above 125. For many of the biomarkers, both centenarians and non-centenarians had values outside of the range considered normal in clinical guidelines. This is probably because these guidelines are set based on a younger and healthier population. When exploring which biomarkers were linked to the likelihood of reaching 100, we found that all but two (alat and albumin) of the 12 biomarkers showed a connection to the likelihood of turning 100. This was even after accounting for age, sex and disease burden. The people in the lowest out of five groups for levels of total cholesterol and iron had a lower chance of reaching 100 years as compared to those with higher levels. Meanwhile, people with higher levels of glucose, creatinine, uric acid and markers for liver function also decreased the chance of becoming a centenarian. In absolute terms, the differences were rather small for some of the biomarkers, while for others the differences were somewhat more substantial. For uric acid, for instance, the absolute difference was 2.5 percentage points. This means that people in the group with the lowest uric acid had a 4% chance of turning 100 while in the group with the highest uric acid levels only 1.5% made it to age 100. Even if the differences we discovered were overall rather small, they suggest a potential link between metabolic health, nutrition and exceptional longevity. The study, however, does not allow any conclusions about which lifestyle factors or genes are responsible for the biomarker values. However, it is reasonable to think that factors such as nutrition and alcohol intake play a role. Keeping track of your kidney and liver values, as well as glucose and uric acid as you get older, is probably not a bad idea. That said, chance probably plays a role at some point in reaching an exceptional age. But the fact that differences in biomarkers could be observed a long time before death suggests that genes and lifestyle may also play a role.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/215166/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/karin-modig-1473484">Karin Modig</a>, Associate Professor, Epidemiology, <a href="https://theconversation.com/institutions/karolinska-institutet-1250">Karolinska Institutet</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/centenarian-blood-tests-give-hints-of-the-secrets-to-longevity-215166">original article</a>.

Retirement Life

8 reasons everyone should know their blood type

Why you should know your blood type What’s in a blood type? Potentially a lot, according to research, including a review of studies published in the Wiley Interdisciplinary Reviews: Systems Biology and Medicine, that connects different blood groups to everything from risk of heart disease and dementia to urinary tract infections and the norovirus. While none of the studies are conclusive about cause and effect (they can’t say X blood type causes Y disease) and any increased risks are still pretty small, the research does highlight the importance of knowing your type – A, B, AB, or O – and how it could affect your wellbeing. Blood clots: Type AB, A, and B increases risk Danish researchers studied how blood type interacts with a genetic predisposition for deep-vein thrombosis (DVT), or blood clots in the lower legs that can travel to the lungs and become life-threatening. After analysing data on about 66,000 people over more than 30 years, they found that those with type AB, A, or B had a 40 per cent higher risk of DVT than people with type O, the most common type. When the scientists did further analysis to see which factors have the biggest impact on DVT risk on a population level, they found that an AB blood type contributed to about 20 per cent of blood clots; genetic mutations accounted for 11 per cent, being overweight accounted for 16 per cent, and smoking accounted for six per cent. Heart disease: Type AB, B, and A all increase risk People whose blood type is A, B, or AB have an increased risk of heart disease and shorter life spans than people who have type O blood, according to a large study published in BMC Medicine. After following more than 50,000 middle-age and elderly people for seven years, on average, researchers found that as many as nine per cent of cardiovascular deaths were attributed to having non-O blood types. However, as any doctor will tell you, lifestyle factors like weight, smoking and diet, which, unlike blood type, are modifiable, have a much greater impact on heart disease. Stomach cancer: Types A and AB increases risk Researchers have known for a while that people with blood type A are at risk for stomach cancer. But research published in BMC Cancer shows that people with blood type AB are also at risk. Using genetic data from a large number of cases and controls, researchers found a link between both blood types and gastric cancer in Chinese populations. A review of 39 previous studies confirmed their findings. Fertility: Type O reduces it Women with this blood type were twice as likely to have blood levels of the hormone FSH high enough to indicate low ovarian reserve, a measure of fertility, according to a study published in Human Reproduction. Researchers couldn’t say for sure why, though. Given that type O blood is the most prevalent, it doesn’t pay to worry too much about it. Age is a far more important risk factor for fertility problems. Pregnancy risks This has nothing to do with your “letter” blood type or the type determined by the ABO grouping system. This has to do with what’s known as the Rhesus (Rh) factor, which determines whether your blood type is positive or negative. This could cause complications in pregnant women if the baby’s Rh blood type is different from the mother’s. For instance, if the mother has a negative blood type and the baby has a positive one, the mother’s body can actually build up antibodies against the baby’s blood type. Luckily, this doesn’t affect the baby, but it could have a negative effect on future pregnancies. Fortunately, doctors can give pregnant women a shot early in their pregnancy that can prevent Rh-incompatibility problems. Dementia and memory loss: Type AB increases risk People with type AB blood have an 82 per cent greater risk for cognitive decline later in life, according to a study published in Neurology. That’s likely because they have larger amounts of what’s known as the Factor VIII protein, which helps with blood clotting. Study participants with higher levels of this protein were 24 per cent more likely to develop memory problems – regardless of their blood type – than people with lower levels. Blood type, however, is far from the only, or even most important, factor that affects your risk for cognitive decline. Stroke: Type O has the lowest risk People with a blood type other than O (the most common) have a higher risk of cardiovascular issues such as stroke, according to a study published in the Journal of Thrombosis and Haemostasis. Biologists are still investigating why this might be; one possible explanation is that non-O blood types contain more of the Von Willebrand factor, a protein that has been connected to blood clotting and stroke in the past. Mosquitos like Type O blood If you find yourself scratching bug bites all summer long, your blood type might be to blame. In a one small study, researchers found that type Os are up to twice as attractive to mosquitoes as type As, with type Bs falling somewhere in the middle. Image credits: Shutterstock This article originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/8-reasons-everyone-should-know-their-blood-type" target="_blank" rel="noopener">Reader's Digest</a>.

Body

Worried about getting a blood test? 5 tips to make them easier (and still accurate)

<a href="https://theconversation.com/profiles/sapha-shibeeb-1481231">Sapha Shibeeb</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a> Blood tests are a common medical procedure, offering valuable insights into a person’s health. Whether you’re getting a routine check-up, diagnosing a medical condition or monitoring treatment progress, understanding the process can make the experience more comfortable and effective. For the majority of patients, blood collections are a minor inconvenience. Others may feel <a href="https://www.sciencedirect.com/science/article/abs/pii/S0887618506000041">uneasy and anxious</a>. Preparation strategies can help get you through the procedure. <h2>How blood is collected</h2> During venipuncture (blood draw), the phlebotomist (blood collector) inserts a needle through the skin into a vein and a small amount of blood is collected and transferred into a test tube. Tubes are sent to a laboratory, where the blood is analysed. A laboratory technician may count or examine cells and measure the levels of minerals/salts, enzymes, proteins or other substances in the sample. For some tests, blood plasma is separated out by spinning (centrifuging) the sample. Others pass a light beam through the sample to determine the amount of a chemical present. For collection, the phlebotomist usually selects a vein in the crook of your elbow, where veins are readily accessible. Blood can also be drawn from veins in the wrists, fingers or heels. A tourniquet may be applied to restrict blood flow and make the chosen vein puff out. <h2>Different tests require different preparation</h2> Before a blood test, the GP or health-care provider will give you specific instructions. These may include fasting for up to 12 hours or temporarily discontinuing certain medications. It is crucial to follow these guidelines meticulously as they can significantly impact the accuracy of your test results. For example, fasting is required before glucose (blood sugar) and lipids (blood fats) testing because blood sugar and cholesterol levels typically increase after a meal. If the blood test requires fasting, you will be asked not to eat or drink (no tea, coffee, juice or alcohol) for about eight to 12 hours. Water is allowed but smoking should be avoided because it can increase <a href="https://diabetesjournals.org/care/article/19/2/112/19825/Acute-Effect-of-Cigarette-Smoking-on-Glucose">blood sugar, cholesterol and triglyceride levels</a>. Generally, you will be asked to fast overnight and have the blood collection done in the morning. Fasting for longer than 15 hours could impact your results, too, by causing dehydration or the release of certain chemicals in the blood. If you have diabetes, you must consult your doctor prior to fasting because it can increase the risk of hypoglycemia (low blood sugar) in people with type 1 diabetes. Most type 2 diabetics can safely fast before a blood test but there are some exceptions, such as people who are taking certain medications including insulin. <h2>5 tips for a better blood test</h2> To improve your blood collection experience, consider these tips: 1. Hydrate Drink plenty of water right up to 30 minutes before your appointment. Adequate hydration improves blood flow, making your veins more accessible. Avoid <a href="https://academic.oup.com/labmed/article/34/10/736/2657269">strenuous exercise</a> before your blood test, which can increase some blood parameters (such as liver function) while decreasing others (such as sodium). 2. Loose clothing Wear clothing that allows easy access to your arms to ensure a less stressful procedure. 3. Manage anxiety If the sight of blood or the procedure makes you anxious, look away while the needle is inserted and try to keep breathing normally. Distraction can help – virtual reality has been <a href="https://pubmed.ncbi.nlm.nih.gov/31889358/">trialled</a> to reduce needle anxiety in children. You could try bringing something to read or music to listen to. 4. Know your risk of fainting If you’re prone to fainting, make sure to inform the phlebotomist when you arrive. You can have your blood drawn while lying down to minimise the risk of passing out and injury. Hydration helps maintain blood pressure and can also <a href="https://www.ahajournals.org/doi/10.1161/01.CIR.0000101966.24899.CB">reduce the risk</a> of fainting. 5. Discuss difficult veins Some people have smaller or scarred veins, often due to repeated punctures, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989034/">chemotherapy</a> or blood thinner use. In such cases, venipuncture may require multiple attempts. It is important to talk to the phlebotomist if you feel discomfort or significant pain. A finger prick can be performed as an alternative for some tests, such as blood glucose levels. But other comprehensive tests require larger blood volume. <h2>Blood draws after lymph node removal</h2> Historically, there were concerns about drawing blood from an arm that had undergone lymph node removal. This was due to the risk of <a href="https://www.cancer.gov/about-cancer/treatment/side-effects/lymphedema/lymphedema-pdq#:%7E:text=Lymphedema%20is%20the%20build%2Dup,the%20way%20that%20it%20should.">lymphedema</a>, a condition marked by fluid build-up in the affected arm. Lymph nodes may have been removed (<a href="https://www.ncbi.nlm.nih.gov/books/NBK564397/#:%7E:text=Lymph%20node%20dissection%2C%20also%20known,surgical%20management%20of%20malignant%20tumors.">lymphadenectomy</a>) for cancer diagnosis or treatment. However, a <a href="https://ascopubs.org/doi/10.1200/JCO.2015.61.5948">2016 study</a> showed people who’ve had lymph nodes removed are not at a higher risk of developing lymphedema following blood draws, even when drawing blood from the affected arm. <h2>After your blood test</h2> The whole blood test procedure usually lasts no more than a few minutes. Afterwards, you may be asked to apply gentle pressure over a clean dressing to aid clotting and reduce swelling. If you do experience swelling, bruising or pain after a test, follow general first aid procedures to alleviate discomfort. These include applying ice to the site, resting the affected arm and, if needed, taking a pain killer. It is usually recommended you do not do heavy lifting for a few hours after a blood draw. This is to prevent surges in blood flow that could prevent clotting where the blood was taken.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/216073/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sapha-shibeeb-1481231">Sapha Shibeeb</a>, Senior lecturer in Laboratory Medicine , <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/worried-about-getting-a-blood-test-5-tips-to-make-them-easier-and-still-accurate-216073">original article</a>.

Body

No, you can’t reverse ageing by injecting ‘young blood’ and fasting. But that doesn’t stop people trying

<a href="https://theconversation.com/profiles/rachael-jefferson-buchanan-297850">Rachael Jefferson-Buchanan</a>, <a href="https://theconversation.com/institutions/charles-sturt-university-849">Charles Sturt University</a> Like many celebrities and entrepreneurs, 45-year-old US tech billionaire Bryan Johnson is <a href="https://www.smh.com.au/lifestyle/health-and-wellness/taking-the-blood-of-your-17-year-old-son-anti-ageing-has-gone-too-far-20230530-p5dcd6.html">trying to reverse the ageing process</a>. Spending an average of US$2 million a year on an anti-ageing regimen, Johnson <a href="https://medium.com/future-literacy/at-45-i-now-age-slower-than-the-average-10-year-old-6932448fc608">claims</a> he now ages slower than some children. He explains: “the pace my body accumulates ageing damage is less than the average ten year old”. Many of Johnson’s age-reversal methods are questionable, involve dodgy science, and have known side effects. While you can’t stop the ageing process, and the gradual decline our bodies experience as we advance in years, there are some things we can all do – for free – to maintain our health as we age. <h2>What does Johnson do? And is it scientific?</h2> Fasting Johnson reports fasting for 23 hours a day. He then eats <a href="https://medium.com/future-literacy/one-meal-23-hr-fast-100-nutrition-18187a2f5b">one meal a day</a>: 2,250 calories of nutrient-dense food “customised” to his body’s needs. Eating for time-restricted periods in the day can have a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9650338/">positive effect</a> on how we <a href="https://pubmed.ncbi.nlm.nih.gov/29955217/">metabolise nutrients</a>, inflammation levels, hormonal regulation, and <a href="https://www.health.harvard.edu/blog/how-good-is-your-cardiometabolic-health-and-what-is-that-anyway-202208182803">cardiometabolic health</a> (blood sugar, <a href="https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/triglycerides/art-20048186">triglycerides</a>, cholesterol, blood pressure, BMI and waist circumference). However, a Spartan-like food intake can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2121099/">impair</a> how our body responds to sugar (known as glucose tolerance). And it’s not necessarily any more effective for weight maintenance than <a href="https://pubmed.ncbi.nlm.nih.gov/29419624/">reducing calorie intake at each meal</a>. Large-scale, long-term human trials are needed to confirm the <a href="https://pubmed.ncbi.nlm.nih.gov/34728336/">limited risk-benefit</a> findings of fasting. Acid peels Johnson has weekly <a href="https://www.asds.net/skin-experts/skin-treatments/chemical-peels/chemical-peels-for-aging-skin">acid peels</a> (which use a mild acid to exfoliate the skin) to maintain a “youthful glow”. But you cannot smooth sagging facial skin or remove deep scars or wrinkles. Acid peels also <a href="https://www.mayoclinic.org/tests-procedures/chemical-peel/about/pac-20393473">come with risks</a>, including organ damage, infection, scarring and swelling. Plasma infusions Perhaps the most bizarre youth-inducing procedure Johnson has attempted is receiving blood transfusions from his 17-year-old son. US biotech companies have explored <a href="https://www.theguardian.com/society/2020/feb/02/could-young-blood-stop-us-getting-old-transfusions-experiments-mice-plasma">plasma infusions</a> to tackle age-related diseases in humans for decades. But there are no proven clinical benefits. <a href="https://www.redcrossblood.org/donate-blood/blood-donation-process/what-happens-to-donated-blood/blood-transfusions/risks-complications.html">Side effects from blood transfusions</a> include blood-borne infections, fever and allergic reactions. <h2>Historical attempts to stay youthful</h2> Humans have been experimenting with <a href="https://academic.oup.com/biomedgerontology/article/59/6/B515/662071">anti-ageing methods for centuries</a>. These have included all sorts of behavioural and lifestyle practices that are quirky, questionable, and even sadistic. Ancient practices included <a href="https://www.marieclaire.com/beauty/news/a14382/anti-aging-beauty-through-history/">crocodile dung face masks</a>, which the Greeks and Romans used to brighten their complexions. Romans also used <a href="https://beautytap.com/2019/03/donkey-milk">donkey milk</a> and <a href="https://www.ancient-origins.net/history/swans-fat-crocodile-dung-and-ashes-snails-achieving-beauty-ancient-rome-003240">swan fat</a> to minimise wrinkles, due to their acclaimed rejuvenating properties. <a href="https://www.livescience.com/44071-cleopatra-biography.html">Cleopatra</a> apparently took daily baths in sour donkey milk. To sustain this lavish habit, she had a <a href="https://www.naturanecosmetics.com/en/content/26-faits-historiques">herd of 700 donkeys</a>. Sour milk contains <a href="https://science.jrank.org/pages/3780/Lactic-Acid-Lactic-acid-in-foods.html">lactic acid</a>, a naturally occurring <a href="https://www.mecca.com.au/edits/ingredients/alpha-hydroxy-acids/">alpha-hydroxy acid (AHA)</a> that exists in many modern-day exfoliants. So this idea was grounded in basic science, at least. <figure class="align-center "><img src="https://images.theconversation.com/files/530478/original/file-20230607-27-bv0w1t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/530478/original/file-20230607-27-bv0w1t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/530478/original/file-20230607-27-bv0w1t.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/530478/original/file-20230607-27-bv0w1t.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/530478/original/file-20230607-27-bv0w1t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/530478/original/file-20230607-27-bv0w1t.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/530478/original/file-20230607-27-bv0w1t.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" alt="Milk bath with dried fruits and flowers" /><figcaption>Don’t waste milk on a bath. <a class="source" href="https://www.shutterstock.com/image-photo/bath-milk-flowers-1051210370">Shutterstock</a></figcaption></figure> During the 16th and 17th century, “Countess Dracula” aka <a href="https://en.wikipedia.org/wiki/Elizabeth_B%C3%A1thory">Elizabeth Bathory</a> allegedly resorted to serial killing to quench her thirst for youthfulness, <a href="https://www.nationalgeographic.com/travel/article/the-bloody-legend-of-hungarys-serial-killer-countess">bathing in the blood of her young victims</a>. <h2>The quest continues with cryotherapy</h2> Fountain of youth fixations have inspired many contemporary anti-ageing trends. Exposure to cold is a firm favourite. <a href="https://www.nature.com/articles/s43587-023-00383-4">Some research</a> suggests this could have <a href="https://neurosciencenews.com/cold-aging-22928/">benefits</a> relating to longevity, by slowing cellular degeneration, <a href="https://www.cryo.com.au/anti-ageing-benefits-of-whole-body-cryotherapy/">stimulating collagen and elastin production</a>, increasing the metabolism, and reducing inflammation. Dutch motivational speaker Wim Hof includes <a href="https://www.wimhofmethod.com/cold-water-immersion">cold water immersion</a> as one of the three pillars of his <a href="https://www.wimhofmethod.com/">Wim Hof Method</a> to “increase mind-body connection”. Athletes such as <a href="https://www.dailymail.co.uk/sport/football/article-2469985/Cristiano-Ronaldo-buys-Cryotherapy-chamber.html">Cristiano Ronaldo</a> use <a href="https://my.clevelandclinic.org/health/treatments/21099-cryotherapy">cryotherapy</a>, exposing their bodies to extremely cold temperatures for two to four minutes to decrease the signs of ageing and enhance their general health. However, the <a href="https://www.medicinenet.com/what_are_the_side_effects_of_cryotherapy/article.htm">risks of cryotherapy</a> include bone fractures, frostbite, nerve damage, bleeding, cramping, swelling and skin infections. <h2>So what can we do to age well?</h2> Two of the more mainstream anti-ageing methods that Johnson recommends are the daily self-care habits of sleep and exercise. He has a <a href="https://medium.com/future-literacy/sleep-and-impulse-control-87e844218ff2">strict sleep schedule</a> that involves retiring to bed at 8pm, with a one-hour wind-down in a darkened room. Adults report poorer sleep quality and difficulty being able to sleep for long enough <a href="https://www.news-medical.net/health/How-Does-the-Suprachiasmatic-Nucleus-(SCN)-Control-Circadian-Rhythm.aspx">as they age</a>. Sleeping too much or too little is <a href="https://www.frontiersin.org/articles/10.3389/fpubh.2023.1043347/full">associated with</a> a greater risk of obesity, heart disease and <a href="https://theconversation.com/research-check-can-sleeping-too-much-lead-to-an-early-death-101323">premature death</a>. Developing a regular sleep routine, reducing bedroom distractions such as mobile phones, and exercising regularly can all help to <a href="https://www.sleepfoundation.org/aging-and-sleep">alleviate sleep problems</a>. <figure class="align-center "><img src="https://images.theconversation.com/files/530491/original/file-20230607-29-cw0f29.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/530491/original/file-20230607-29-cw0f29.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=383&fit=crop&dpr=1 600w, https://images.theconversation.com/files/530491/original/file-20230607-29-cw0f29.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=383&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/530491/original/file-20230607-29-cw0f29.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=383&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/530491/original/file-20230607-29-cw0f29.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=482&fit=crop&dpr=1 754w, https://images.theconversation.com/files/530491/original/file-20230607-29-cw0f29.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=482&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/530491/original/file-20230607-29-cw0f29.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=482&fit=crop&dpr=3 2262w" alt="Child and grandfather walk on a beach" /><figcaption>Exercise is also important for healthy ageing. <a class="source" href="https://unsplash.com/photos/s-vhziQHngM">Vidar Nordi Mathisen/Unsplash</a></figcaption></figure> Exercise, often cited as a <a href="https://www.marketwatch.com/story/exercise-is-the-wonder-drug-for-healthy-aging-11633642719">wonder drug for healthy ageing</a>, is something Johnson takes very seriously. He does a “<a href="https://www.youtube.com/watch?v=HNywRJgCRaQ">Blueprint</a>” workout that includes specially designed daily techniques, as well as <a href="https://www.hsph.harvard.edu/nutritionsource/high-intensity-interval-training/">high-intensity interval training sessions</a>, hiking and playing sport. From middle age onwards, we all need to exercise regularly, to increase our muscle mass, bone density, strength, endurance, coordination and balance. One of the greatest health risks for older people is <a href="https://www.ncbi.nlm.nih.gov/books/NBK560761/">falling</a>, which balance, flexibility, endurance and strength training <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC381224/">can help</a> reduce. Physical activity can bring <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408452/">social benefits</a> in older adults if undertaken in groups, and there are well-known <a href="https://www.whiddon.com.au/yourlife/the-mental-health-benefits-of-exercise-for-older-adults/">mental health gains</a>. Small changes in sleep, diet (eating <a href="https://health.gov/news/202107/nutrition-we-age-healthy-eating-dietary-guidelines">plenty of vegetables, fruit, wholegrains, healthy fats, and enough protein</a>), and exercise can support <a href="https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-020-01900-5">healthy ageing</a>, reducing the chance of early death, and helping us all to lead an active and independent life in our senior years. Now that is something worth investing in.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/207038/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/rachael-jefferson-buchanan-297850">Rachael Jefferson-Buchanan</a>, Lecturer in Human Movement Studies (Health and PE) and Creative Arts, <a href="https://theconversation.com/institutions/charles-sturt-university-849">Charles Sturt University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/no-you-cant-reverse-ageing-by-injecting-young-blood-and-fasting-but-that-doesnt-stop-people-trying-207038">original article</a>. Images: Getty

Body

Big study shows that lowering blood pressure lowers risk of dementia

A study across 20 countries has strengthened a link between lowering blood pressure, and reducing the risk of dementia. The meta-analysis, published in the European Heart Journal, draws on clinical trial data from 28,008 participants, to show the strongest link to date between medication that lowers blood pressure, and reduced dementia risk. “We know that high blood pressure is a risk factor for dementia – especially high blood pressure in midlife, so say 40 to 65 years of age,” says lead author Dr Ruth Peters, an associate professor at the University of New South Wales and program lead for dementia in the George Institute’s Global Brain Health Initiative. “But there has been some uncertainty about whether lowering blood pressure, especially in older adults, would reduce risk of dementia. “What we’ve done is take five really high-quality clinical trials and combine them into one dataset, which gave us the ability to really look at this question and look at the relationship between blood pressure-lowering tablets – antihypertensives – and dementia.” The five studies were all double-blind, randomised clinical trials – the ‘gold standard’ in medical research – with participants hailing from 20 different countries. The average age of the participants was 69, and participants were followed up an average of four years after doing the trial. Participants who took antihypertensives had a significantly lower chance of being diagnosed with dementia than those who took placebos. Dementia affects 50 million people worldwide: a number projected to triple by 2050. According to The Lancet’s 2020 Commission on dementia, treatment for hypertension (high blood pressure) is “the only known effective preventive medication for dementia,” all other methods of reducing your risk come from lifestyle and environment. “The strength of this study is the use of individual patient data in a meta-analysis of data drawn from randomised controlled trials of blood pressure medication. This is the first time such data has been meta-analysed,” says Professor Kaarin Anstey, a senior principal research scientist at Neuroscience Research Australia and the UNSW. “This is important for informing clinical practice,” adds Anstey, who was not involved with the study. Professor Nicolas Cherbuin, head of the Australian National University’s Centre for Research on Ageing, Health and Wellbeing, says that the study is “well-designed”, and reflects research by his team showing that higher blood pressure is linked to lower brain volumes and poorer brain health. “The diagnostic procedure and criteria used are well-established, the sample size is large, those with dementia at baseline were excluded,” says Cherbuin. But he points out that the study didn’t find an effect of blood pressure medication on cognitive decline, and nor did it include participants with mild cognitive impairment, who would be “more likely to convert”. Anstey points out that “inevitably” the participants in the cohort are now quite old, and thus may be different to populations developing dementia now. “Clinical trials involve highly selected samples and often exclude diverse ethnic groups,” she adds. “I hope that this reinforces the importance of blood pressure control for brain health,” says Peters. But she emphasises that, while this is useful news for preventing dementia in mid-life, people of all ages can improve their brain health by other means. “It’s not just blood pressure lowering – it has to be taken in the context of a healthy lifestyle.” This article originally appeared on <a href="https://cosmosmagazine.com/health/dementia-blood-pressure-meta/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Ellen Phiddian. Image: Shutterstock

Body

Scientists have mimicked an embryo’s heart to unlock the secrets of how blood cells are born

Stem cells are the starting point for all other cells in our bodies. The <a href="https://www.eurostemcell.org/blood-stem-cells-pioneers-stem-cell-research" target="_blank" rel="noopener">first such cells to be found</a> were blood stem cells – as the name suggests, they give rise to different types of blood cells. But there’s much we don’t know about how these cells develop in the first place. In a study published today in <a href="https://doi.org/10.1016/j.celrep.2022.111339" target="_blank" rel="noopener">Cell Reports</a>, we have shown how a lab simulation of an embryo’s beating heart and circulation lead to the development of human blood stem cell precursors. The tiny device mimics embryonic blood flow, allowing us to directly observe human embryonic blood formation under the microscope. These results may help us understand how we can produce life-saving therapies for patients who need new blood stem cells. <h2>Growing life-saving therapies in the lab</h2> To treat aggressive blood cancers such as leukaemia, patients often need extremely high doses of chemotherapy; a <a href="https://www.cancer.nsw.gov.au/myeloma/diagnosis-and-treatment/treatment/types-of-treatment/stem-cell-transplant#:%7E:text=A%20stem%20cell%20transplant%20involves%20killing%20blood%20cells,they%20are%20collected%20beforehand%20and%20kept%20in%20storage." target="_blank" rel="noopener">blood stem cell transplant</a> then regenerates blood after the treatment. These are life-saving therapies but are restricted to patients who have a suitable tissue-matched donor of blood stem cells. A way around this problem would be to grow more blood stem cells in the lab. Unfortunately, past experiments have shown that harvested adult blood stem cells lose their transplantation potential if grown in the lab. The discovery of <a href="https://en.wikipedia.org/wiki/Induced_pluripotent_stem_cell" target="_blank" rel="noopener">induced pluripotent stem cells</a> – stem cells made out of adult cells – in 2006 led to a promising new approach. Induced pluripotent stem cells are made from the patient’s own cells, so there is no problem with tissue rejection, or the ethical issues surrounding the use of IVF embryos. These cell lines are similar to embryonic stem cells, so they have the potential to form any tissue or cell type – hence, they are “pluripotent”. In theory, pluripotent stem cell lines could provide an unlimited supply of cells for blood regeneration because <a href="https://en.wikipedia.org/wiki/Immortalised_cell_line" target="_blank" rel="noopener">they are immortalised</a> – they can grow in the lab indefinitely. But the development of processes to allow us to grow particular types of tissues, organs and cell types – such as blood – has been slow and will take decades to advance. One must mimic the complex process of embryogenesis in the dish! <h2>Engineering an embryonic heart</h2> Current understanding of how embryonic blood stem cells develop is based on animal models. Experiments with anaesthetised zebrafish embryos have shown that blood stem cells arise in the wall of <a href="https://pubmed.ncbi.nlm.nih.gov/20154733/" target="_blank" rel="noopener">the main blood vessel, the aorta</a>, shortly after the first heartbeat. For ethical reasons, it’s obvious this type of study is not possible in human embryos. This is why we wanted to engineer an embryonic heart model in the lab. To achieve this, we used <a href="https://www.elveflow.com/microfluidic-reviews/general-microfluidics/a-general-overview-of-microfluidics/" target="_blank" rel="noopener">microfluidics</a> – an approach that involves manipulating extremely small volumes of liquids. The first step in generating blood stem cells from pluripotent stem cells is to coax the latter to form the site where blood stem cells start growing. This is known as the AGM region (aorta-gonad-mesonephros) of the embryo. Our miniature heart pump and circulation (3 by 3 centimetres) mimics the mechanical environment in which blood stem cells form in the human embryo. The device pumps culture media – liquids used to grow cells – around a microfluidic circuit to copy what the embryo heart does. <h2>A step closer to treatment</h2> Once we got the cells to form the AGM region by stimulating cells on day two of starting our cell culture, we applied what’s known as pulsatile circulatory flow from day 10 to day 26. Blood precursors entered the artificial circulation from blood vessels lining the microfluidic channels. Then, we harvested the circulating cells and grew them in culture, showing that they developed into various blood components – white blood cells, red blood cells, platelets, and others. In-depth analysis of gene expression in single cells showed that circulatory flow generated aortic and blood stem precursor cells found in the AGM of human embryos. This means our study has shown how pulsatile circulatory flow enhances the formation of blood stem cell precursors from pluripotent stem cells. It’s knowledge we can use in the future. The next step in our research is to scale up the production of blood stem cell precursors, and to test their transplant potential in immune-deficient mice that can accept human transplants. We can do this by using large numbers of pluripotent stem cells grown in bioreactors that also mechanically stimulate blood stem cell formation. If we can easily produce blood stem cells from pluripotent stem cell lines, it would provide a plentiful supply of these cells to help treatments of cancer or genetic blood diseases. This article originally appeared on <a href="https://theconversation.com/scientists-have-mimicked-an-embryos-heart-to-unlock-the-secrets-of-how-blood-cells-are-born-190530" target="_blank" rel="noopener">The Conversation</a>. Image: UNSW

Body

"She sat on a throne of blood": Uni professor launches another attack on Queen Elizabeth

A controversial university professor has doubled down on her celebration of Queen Elizabeth's death, claiming she "sat on a throne of blood". Uju Anya, a linguistics professor at Pennsylvania's Carnegie Mellon University, <a href="https://www.oversixty.co.nz/news/news/uni-professor-slammed-for-wishing-the-queen-excruciating-pain" target="_blank" rel="noopener">came under fire</a> earlier this week for a series of controversial tweets in which she hoped the Queen was in "excruciating pain" as she died. Now, the Nigerian-American lecturer has reiterated her claims on a podcast, saying, "This was a ruler. The very crown she had on her head signified the fact that she's a monarch was made from plunder. Diamonds. Blood diamonds." "The throne that she was sitting on is a throne of blood... Her very position as a monarch, the palace she lived in... were all paid for by our blood." She stood by her controversial tweets, which she admitted were an "emotional outburst", but said, "I said what I f****** said." "I was triggered by this news. It went deep into pain and trauma for me. Due to my family experience with the rule of this monarch." Anya also shared her thoughts on the Queen's role in the Nigerian Civil War in 1967 by showing support for the turbulent government. She said, "People expected me to be calm or to be... when the person who literally paid money for bombs and guns and military supplies to come and massacre your people is dying, you're not supped to dance." Anya's claims forced her employer to say in a statement, "We do not condone the offensive and objectionable messages posted by Uju Anya today on her social media account." "Free expression is core to the mission of higher education. However, the views she shared absolutely do not represent the values of the institution, nor the standards of discourse we seek to foster," they concluded. Despite thousands of people being up in arms over her comments and demanding an apology, others have jumped to the professor's defence. Over 4,000 people have signed a petition defending Anya, saying her posts on Twitter spoke to personal anguish the scholar still feels about atrocities by the British Empire decades ago that touched her family. Refusing to apologise, Anya once again tweeted, "If anyone expects me to express anything but disdain for the monarch who supervised a government that sponsored the genocide that massacred and displaced half my family and the consequences of which those alive today are still trying to overcome, you can keep wishing upon a star." Image credits: Getty Images / Youtube

Caring

Anne Heche's blood test results revealed after horror smash

An investigation of Anne Heche’s blood results have detected “the presence of drugs” following <a href="https://www.oversixty.com.au/news/news/new-details-of-actor-anne-heche-s-fiery-crash" target="_blank" rel="noopener">her horror smash</a>. The US actress was pulled out of her burning car after she smashed into a mansion in Los Angeles while driving a terrifying 140km/h on August 5. The 53-year-old suffered severe injuries and soon after the crash fell into a coma and has not regained consciousness since. Almost a week after the incident, a Los Angeles Police Department Public Information Officer confirmed there was a “presence of drugs” in Anne’s blood system. “Based on the blood draw, it revealed the presence of drugs, however additional testing is required to rule out any substances that were administered at the hospital as part of her medical treatment,” they told <a href="https://www.foxnews.com/entertainment/anne-heche-blood-test-revealed-presence-of-drugs" target="_blank" rel="noopener">Fox News Digital</a>. "Any secondary drugs [takes] up to 30 days for [a] secondary test to come back.” TMZ previously reported that Anne had cocaine in her system upon arrival at the hospital, but that is yet to be confirmed. The crash is currently being investigated by the LAPD who have confirmed that if Anne is found to have been drunk she would face significant charges. "If found intoxicated, [Heche] could be charged with misdemeanour DUI hit and run. No arrests have been made so far,” a representative said. Anne’s representative has confirmed that she is in an “extreme critical condition”. “She has a significant pulmonary injury requiring mechanical ventilation and burns that require surgical intervention,” her representative said. “She is in a coma and has not regained consciousness since shortly after the accident.” Image: Getty

Caring

Bride wears engagement ring with blood in it

A bride-to-be has caused quite a stir after sharing a photo of her engagement ring that apparently has her fiancé’s blood in it. The woman shared the photo to the popular Facebook group “That's it, I'm wedding shaming” and at first glance it looks like a normal ring with a red stone. To everyone’s shock, she revealed that the “red stone” was in fact her fiancé’s blood. “Has anyone else opted out of a wedding band? I love my engagement ring so much, it has my fiancé’s blood in it and it is so special to me,” she began. “I’d rather that be put on my finger at the wedding instead of a band. I would have to get a custom one to fit my ring and I don’t know, I just don’t want to.” However, the comments were not nice about the $300 ring, with many questioning why anyone would do that. “I’m glad she loves it and is happy. It is heinous though,” one wrote. “I’m fine with one ring…as long as it’s not filled with BLOOD! What in the actual f**k?” someone else commented. "I hate it here," another simply wrote. Image: Facebook

Relationships

Man donates blood an incredible 600 times

A man has made an extraordinary accomplishment of saving more than 1,800 lives after donating blood 600 times. Bruce from Port Macquarie was egged on by his Aunty Mary after she had donated blood 70 times saying he would not be able to do as much as she did. But, Bruce being Bruce, he decided to accept his aunt's challenge and went ahead to donate blood. “My Aunty Mary told me she had done 70 donations, and that I would never catch her,” he said. “Smart lady, that one and the challenge was accepted.” Bruce, 60, now skateboards to an Australian Red Cross donation centre every fortnight to give generously. Since starting his blood donation, Bruce has become the first person in Port Macquarie – and one of only 60 people in Australia – to have donated blood a whopping 600 times. All those blood donations have contributed to saving the lives of up to 1,800 people including new mothers, babies, cancer patients and trauma sufferers. When asked for advice and encouragement on the process of donating, Bruce explained that it was a rewarding experience. “The vampires at [Lifeblood] are lovely and it doesn't hurt much at all, so I encourage others to put something back, roll up your sleeves and save a life,” he said. Bruce commended his Aunty Mary, saying that without her support he would not have reached the incredible milestone. Image: Australian Red Cross Lifeblood

Body

Genetic mutations slowly accumulated over a lifetime change blood production after 70 years of age

Ageing is likely caused by the gradual accumulation of molecular damage, or genetic mutations, in the cells of our bodies that occurs over a lifetime. But how this translates into the rapid deterioration in organ function that’s seen after the age of 70 has so far not been clear. Now, scientists have discovered that the accumulation of genetic mutations in blood stem cells are likely responsible for the abrupt change in how <a class="spai-bg-prepared" href="https://cosmosmagazine.com/science/biology/why-do-we-have-blood/" target="_blank" rel="noreferrer noopener">blood</a> is produced in the body after 70 years of age. The <a class="spai-bg-prepared" href="https://www.nature.com/articles/s41586-022-04786-y" target="_blank" rel="noreferrer noopener">new study</a>, published in Nature, points to a change in the diversity of stem cells that produce blood cells as the reason why the prevalence of reduced cell regeneration capacity, <a class="spai-bg-prepared" href="https://www.frontiersin.org/articles/10.3389/fonc.2020.579075/full" target="_blank" rel="noreferrer noopener">cytopenia</a> (one or more blood cell types is lower than it should be), immune disfunction, and risk of blood cancer dramatically rises after 70. “We’ve shown, for the first time, how steadily accumulating mutations throughout life lead to a catastrophic and inevitable change in blood cell populations after the age of 70,” says joint-senior author Dr Peter Campbell, head of the Cancer, Ageing and Somatic Mutation Program at the Wellcome Sanger Institute, UK. “What is super exciting about this model is that it may well apply in other organ systems too.” Blood cells are made in a process called haematopoiesis All of the cells in our blood – including red cells, white cells and platelets – develop in a process called haematopoiesis from haematopoietic stem cells in our bone marrow. These stem cells are what’s known as multipotent progenitor cells, which simply means that they can develop into more than one cell type. Researchers were interested in better understanding how this process changes as we age, so they sequenced the entire genomes of 3,579 haematopoietic stem cells from a total of 10 people – ranging in age from newborn to 81 years. <div class="newsletter-box spai-bg-prepared"> <div id="wpcf7-f6-p193434-o1" class="wpcf7 spai-bg-prepared" dir="ltr" lang="en-US" role="form"> </div> </div> Using this information, they were able to construct something similar to a family tree (<a class="spai-bg-prepared" href="https://www.nature.com/scitable/topicpage/reading-a-phylogenetic-tree-the-meaning-of-41956/#:~:text=A%20phylogenetic%20tree%2C%20also%20known,genes%20from%20a%20common%20ancestor." target="_blank" rel="noreferrer noopener">a phylogenetic tree</a>) for each stem cell, showing how the relationships between blood cells changes over the human lifespan. They found that in adults under 65, blood cells were produced from between 20,000 and 200,000 different stem cells – each contributing roughly equal amounts to production. But after 70 years of age they observed a dramatic decrease in the diversity of stem cells responsible for haematopoiesis in the bone marrow. In fact, only 12-18 independent expanded sets of stem cell clones accounted for 30-60% of cell production. These highly active stem cells had outcompeted others and progressively expanded in numbers (clones) across that person’s life, and this expansion (called <a class="spai-bg-prepared" href="https://www.nature.com/articles/s41586-022-04785-z" target="_blank" rel="noreferrer noopener">clonal haematopoiesis</a>) was caused by a rare subset of mutations known as driver mutations that had occurred decades earlier. “Our findings show that the diversity of blood stem cells is lost in older age due to positive selection of faster-growing clones with driver mutations. These clones ‘outcompete’ the slower growing ones,” explains lead researcher Dr Emily Mitchell, a haematology registrar at Addenbrooke’s Hospital,UK, and PhD student at the Wellcome Sanger Institute, US. “In many cases this increased fitness at the stem cell level likely comes at a cost – their ability to produce functional mature blood cells is impaired, so explaining the observed age-related loss of function in the blood system.” Which clones became the dominant stem cells varied between individuals, which explains why variation is seen in disease risk and other characteristics in older adults. “Factors such as chronic inflammation, smoking, infection and chemotherapy cause earlier growth of clones with cancer-driving mutations. We predict that these factors also bring forward the decline in blood stem cell diversity associated with ageing,” says joint-senior author Dr Elisa Laurenti, assistant professor at the Wellcome-MRC Cambridge Stem Cell Institute, UK. “It is possible that there are factors that might slow this process down, too,” she adds. “We now have the exciting task of figuring out how these newly discovered mutations affect blood function in the elderly, so we can learn how to minimise disease risk and promote healthy ageing.” <img id="cosmos-post-tracker" class="spai-bg-prepared" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=193434&title=Genetic+mutations+slowly+accumulated+over+a+lifetime+change+blood+production+after+70+years+of+age" width="1" height="1" /> <div id="contributors"> <a href="https://cosmosmagazine.com/science/mutations-change-blood-production/" target="_blank" rel="noopener">This article</a> was originally published on <a href="https://cosmosmagazine.com" target="_blank" rel="noopener">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/imma-perfetto" target="_blank" rel="noopener">Imma Perfetto</a>. Imma Perfetto is a science writer at Cosmos. She has a Bachelor of Science with Honours in Science Communication from the University of Adelaide. Image: Getty Images </div>

Body

How often should I check my blood pressure?

A new study investigating the role of hypertension in a person’s risk of severe COVID-19 symptoms suggests that the condition may worsen symptoms due to its association with one particular factor. Hypertension, commonly known as high blood pressure, affects 1 in 3 Australian adults and 1 in 5 New Zealanders, according to the<a href="https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/taking-the-pressure-off-high-blood-pressure" target="_blank" rel="noopener"> Australian Institute of Health and Welfare</a> and <a href="https://www.southerncross.co.nz/group/medical-library/high-blood-pressure-hypertension#:~:text=Known%20medically%20as%20hypertension%2C%20high,attack%20have%20high%20blood%20pressure." target="_blank" rel="noopener">Southern Cross NZ</a>, with men being more likely to have the condition. The study, published in <a href="https://doi.org/10.1007/s40292-022-00506-9" target="_blank" rel="noopener">PubMed</a>, concluded that hypertension doesn’t play an independent role in the severity of Covid symptoms from current evidence, but that systolic blood pressure, one the measurements used to determine blood pressure, could be a contributing factor. In light of these findings, the theme for this year’s World Hypertension Day, held on May 17, is Measure Your Blood Pressure Accurately, Control It, Live Longer in a bid to raise awareness of the condition, which can have no immediate symptoms. Andria Aird, a hypertension expert and Blooms the Chemist pharmacist, tells OverSixty that this absence of symptoms - except for headaches in severe cases - is why raising awareness is crucial, and why Blooms the Chemist is promoting free blood pressure checks this month. <img src="https://oversixtydev.blob.core.windows.net/media/2022/05/andria-aird.jpg" alt="" width="1280" height="720" /> Andria Aird says getting our blood pressure checked is key to detecting high blood pressure. Image: Supplied “Current surveys estimate that 32 percent of men and 27 percent of women in Australia have hypertension,” she says. “Left untreated, hypertension can increase your risk of life-threatening conditions like diabetes, heart attack and stroke.” This condition is particularly common among older adults, which Aird says is to do with the changes that occur in our blood vessels. “The walls of our arteries become stiffer and we are more at risk of high blood pressure,” she explains. “More mature people are also more at risk of other health conditions which often go hand in hand with hypertension.” Could I have hypertension and not know it? With no obvious symptoms, we can have hypertension without realising - and getting a blood pressure check is one of the ways to determine if we do. “Sometimes people come into our pharmacy to have their blood pressure tested and shown a systolic reading of up to 200 mmHg without even knowing it.” According to <a href="https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410#:~:text=High%20blood%20pressure%20(hypertension)%20is,problems%2C%20such%20as%20heart%20disease." target="_blank" rel="noopener">Mayo Clinic</a>, high blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow (or width) in your arteries. Blood pressure readings, given in millimetres of mercury (mmHg), consist of two numbers: systolic pressure (the pressure in your arteries when your heart beats) and diastolic pressure (the pressure in your arteries in-between beats). A healthy reading is considered to be a systolic pressure of 140 mmHg or less, and a diastolic pressure of less than 90 mmHg, according to the <a href="https://www.nia.nih.gov/health/high-blood-pressure-and-older-adults#:~:text=Normal%20blood%20pressure%20for%20most,pressure%20of%20less%20than%2080" target="_blank" rel="noopener">National Institute of Ageing</a>. As for how often we should be getting checked, Aird suggests over -50s rolling up their sleeves every 3-6 months. “At Blooms the Chemist we recommend all Australian adults have their blood pressure checked,” she says. “The Heart Foundation recommends at least every two years from 18 years, although my conservative recommendation for people over 50 would be at least 3 – 6 monthly. “Hypertension is not only a disease of the elderly, however those over 60 are at a higher risk.” But you don’t always have to go to the GP or chemist to get checked. “Reliable home blood pressure monitors are relatively affordable and easy to use. At Blooms The Chemist we can offer advice to recommend a monitor to suit your needs,” Aird says. As well as getting checked, Aird says there are some things we can do in our day-to-day lives to reduce our chances of developing hypertension. “Fortunately, there are lifestyle options we can take to reduce our risk of high blood pressure, even if there is a family history of the condition,” she says. “It is vital to quit if you are a smoker. A healthy diet, weight control and regular exercise all substantially reduce your risk. Other tips include reducing salt in your diet, managing stress and reducing alcohol intake.” Image: Getty Images

Body

Detecting skin cancer with a blood test

A team of US researchers have found a way to diagnose skin cancer using blood tests. The researchers have shown in a lab-based study that melanoma cells can be detected in blood and plasma. If the test makes it through clinical trials, the researchers hope that it could one day be used to sidestep the invasive biopsies that are currently required to diagnose melanoma. The test uses melanoma-specific antibodies, and a device designed specifically to react them with blood. The device is called MelanoBean, and it works with microfluidics: manipulating tiny amounts of fluid to do interesting things that they don’t do in larger volumes. The test is described in a <a href="https://dx.doi.org/10.1002/anbr.202100083" target="_blank" rel="noreferrer noopener">paper</a> in Advanced NanoBiomed Research. <div class="newsletter-box"> <div id="wpcf7-f6-p188890-o1" class="wpcf7" dir="ltr" lang="en-US" role="form"> </div> </div> “This is the first comprehensive study of circulating tumour cells – or CTCs – to evaluate the efficacy of surgery using microfluidic systems in melanoma, including changes in the number of CTCs, CTC cluster configuration, and gene expression profiling,” says first author Dr Yoon-Tae Kang, a researcher at the University of Michigan, US. The researchers found that with their test, melanoma cells (CTCs) could be found in the blood of cancer patients at all stages of the disease – I through to IV. It could also identify whether any CTCs were hanging around in the blood of patients who’d had skin cancer surgery to get their cells removed. “CTCs have the potential to pinpoint treatment resistance and recurrence, and can be a valuable biomarker to non-invasively monitor for disease progression,” says corresponding author Dr Sunitha Nagrath also from the University of Michican. <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=188890&title=Detecting+skin+cancer+with+a+blood+test" width="1" height="1" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /> <div id="contributors"> <a href="https://cosmosmagazine.com/health/medicine/detecting-skin-cancer-blood-test/" target="_blank" rel="noopener">This article</a> was originally published on <a href="https://cosmosmagazine.com" target="_blank" rel="noopener">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/ellen-phiddian" target="_blank" rel="noopener">Ellen Phiddian</a>. Ellen Phiddian is a science journalist at Cosmos. She has a BSc (Honours) in chemistry and science communication, and an MSc in science communication, both from the Australian National University. Image: Getty Images </div>

Body

The heart-breaking way Ukrainian parents are keeping their kids safe

As the people of Ukraine brace for increasing military conflict from Russia, parents are taking every measure to keep their children safe. Parents in Ukraine have resorted to sending their children to school wearing stickers that list their blood types in case the worst happens while out of their parents' sight. On Monday, after President Vladimir Putin gave a speech in which he “recognised the independence” of two separatist, pro-Russia regions of eastern Ukraine - an act Kyiv’s mayor described as a declaration of war - many parents started sending their children to school with special stickers. Vasyl and Marta, whose last names are being withheld for their protection, took part in the protection measure when sending their two daughters, age 5 and 9, to school in their village 15 kilometres from the Ukrainian capital of Kyiv. “It’s like a piece of paper, with blood type information, the names of their parents, and telephone numbers,” Vasyl tells Today via phone. “There is no one form for such a sticker. It depends on every parent. It’s up to them.” Mothers in the Ukraine started discussing the sticker system in closed Facebook groups after Putin's speech in order to do what they could to ensure the safety of their kids. “This was a debate in one of (many) closed groups on Facebook,” Olga Tokariuk, a Kyiv-based freelance correspondent, tells Today. “Some schools actually made these stickers mandatory.” Ukrainian mother Khrystyna has also had several safety conversations with her three daughters, making sure her 3 and 5 year olds know their address, their first and last names, and their mother’s full name. “What they know is that, ‘You should listen to your mum and do what she says.’ And if I said, ‘We go with me’ —because you know, kids want to do what they want — I said, ‘No, you do what I say, and that’s it. And if you should hear loud noises, you listen to me very carefully.’” While Khrystyna is continuing to send her 13-year-old to school, she is keeping her two youngest daughters home. "We pray a lot,” she said. “We just pray for peace.” Image credits: Getty Images

Caring

Scientists believe they found “the trigger” for AstraZeneca blood clots

Scientists believe they have discovered the reason for some people experiencing extremely rare blood clot complications after getting the AstraZeneca COVID-19 vaccine. A new study from a team of British and US researchers suggests that an interaction between the vaccine and a particular protein in blood could trigger thrombosis in some people. The team’s findings suggest that the way the viral vector - which is used to transport COVID-19’s genetic material into cells - binds to a protein called platelet factor four, which could trigger an immune response that can result in blood clots. Professor Alan Parker, an expert from Cardiff University’s School of Medicine and an author of the study, said thrombosis “only happens in extremely rare cases because a chain of complex events needs to take place to trigger this ultra-rare side effect”. <blockquote class="twitter-tweet"> 1/6 A team of scientists from <a href="https://twitter.com/cardiffuni?ref_src=twsrc%5Etfw">@cardiffuni</a> and the US believe they may have found “the trigger” that leads to extremely rare blood clots after the Oxford-AstraZeneca COVID-19 vaccine.<a href="https://t.co/V07Hy2cYcd">https://t.co/V07Hy2cYcd</a> <a href="https://t.co/IWOEzCTA5t">pic.twitter.com/IWOEzCTA5t</a> — Cardiff University (@cardiffuni) <a href="https://twitter.com/cardiffuni/status/1466432911310217227?ref_src=twsrc%5Etfw">December 2, 2021</a></blockquote> After the serious side effect prompted some countries to restrict its use and promote alternative vaccines, an investigation was started into the causes of the clots and any potential preventions. The search involved AstraZeneca’s own scientists, who joined after the team published early findings. The latest study has been published in the journal <a rel="noopener" href="https://www.science.org/doi/10.1126/sciadv.abl8213" target="_blank">Science Advances</a>. Despite the restrictions on its usage, the AstraZeneca vaccine is thought to have saved more than a million lives around the world, while preventing 50 million cases of COVID-19. Image: Getty Images

Body

Be a Richard, not a Karen: Kind note touches grieving mum

A grieving mother has shared a note she received from a kind stranger on a plane after her daughter had a mid-flight tantrum. Lindsay took to TikTok to explain her difficult situation, and the understanding passenger who helped her. "This weekend, we took our first flight since the loss of our two-year-old daughter." "Our oldest is very outward with her grief and we found ourselves afraid of the unkind world who might not be gentle with us." "She had a tantrum mid-flight and we braced ourselves for angry looks but got this instead." The note Lindsay received from the stranger read, "My name is Richard. I have four kids and I can tell you guys are great parents." "Patient and kind, the world needs that. Just wanted to say that. God Bless." The emotional mother captioned the video, "Be a Richard in a world of Karens." Lindsay posted a follow-up video explaining that her daughter Luna fought a difficult battle over several months with blood cancer, after passing away this July. Their older daughter, two-year-old Olive, was Luna's bone marrow donor. Image credit: TikTok

International Travel

New diabetes test could make blood-testing obsolete

A new diabetes test could soon make the finger-prick testing of blood glucose obsolete. Aussie researchers from the University of Newcastle have developed the “world-first, pain-free diabetes test” from 20 years of research by a team led by Professor Paul Dastoor. “What we’ve done is to develop a way of creating biosensors, that we can print using reel-to-reel printing equipment,” Professor Dastoor said. The “lickable” test works using a plastic strip coating in a natural enzyme that interacts with saliva and produces an electrical current. This current can then be detected and measured to determine glucose levels with high accuracy, with the results able to be delivered via a smartphone app. “We’re able to test and have sensitivities at the concentration levels that glucose is in your saliva,” Professor Dastoor said. “And, so, we don’t need to test blood, we will now be able to use saliva to test for glucose.” Elaine Staunton, who was diagnosed with type 2 diabetes in her 30s, is overjoyed that the finger-prick tests could soon be replaced. “That would be marvellous if we could get that, especially for children,” Ms Staunton told <a rel="noopener" href="https://www.abc.net.au/radio/newcastle/programs/mornings/stigma-of-living-with-diabetes/13441428" target="_blank">ABC Newcastle</a>. While the diagnosis didn’t come as a surprise to her, what did was the stigma associated with the condition. At a work function, Ms Staunton was victimised for needing to monitor her blood glucose levels, which are controlled by insulin injections. “I’ve always been taught to do my insulin when my meal’s in front of me,” Ms Staunton said. “I was hauled over the coals after the luncheon and told I wasn’t to inject myself in public and, if I had to do it, I had to do it in the toilet. “I was absolutely devastated. I cried all the way home and made the decision on the way home that I couldn’t go back there.” Now in her 50s, Ms Staunton said anything that would reduce the need to draw blood up to four times a day would be a welcome relief. “That’s a big thing, no blood,” she said. Professor Dastoor said the new tests would have positive health outcomes. “That’s huge because … having to test your blood puts people off doing their testing, and that then leads to poor health outcomes,” he said. The inspiration for the test came from Professor Dastoor’s wife, who would help young children monitor their glucose levels during the day as a primary school teacher. “It’s a heartbreaking scenario, where the lunch bell rings and everyone runs to the playground bar an unfortunate few, who stay back to surrender their finger for blood testing at every meal time,” he said. “Our vision was to create a world where no one needs to bleed in order to eat.” The technology will be rolled out on a commercial scale, with the Australian government announcing $6.3 million in funding to build a manufacturing facility for the tests in the Hunter by the end of 2023. Image: University of Newcastle, Elaine Staunton

Body

Vaccine-related blood clotting explained

With news spreading of the death of a second person due to an extremely rare blood clotting disorder after receiving the AstraZeneca vaccine, Australians are still feeling hesitant about getting the jab. According to the Therapeutic Goods Association (TGA), the blood clotting condition, known as thrombosis with thrombocytopenia syndrome (TTS), is likely linked to the AstraZeneca vaccine. Of the 3.3 million doses of the AstraZeneca vaccine that have been administered so far, 48 people have developed blood clots, with 31 recovering after a hospital stay. Despite the concerns over the vaccine, experts have said we’ve come a long way in understanding the disorder - as well as how to detect it and treat it. How are blood clots detected? The first step in detecting the blood clot relies on getting the timing right, said Vivien Chen, a haematologist specialising in coagulation disorders at the University of Sydney. “The first entry point is being a patient within the right time frame after receiving the AstraZeneca vaccine,” Dr Chen said. “The first dose appears to be of particular concern.” TTS symptoms - including severe headaches that don’t go away, abdominal pain, blurred vision, and leg pain or swelling - appear within four to 30 days after receiving the AstraZeneca vaccine, with most occurring within six to 14 days. If you experience any of these symptoms after getting vaccinated, it’s recommended you go to your GP in order to get a blood test known as a platelet count. What are platelets? Platelets are fragments of cells that come from the bone marrow and play a vital role in blood clotting, including preventing excessive bleeding following a cut or scrape. Normal platelet levels hover between 150,000 and 450,000 per microlitre of blood. A platelet count lower than 150,000 results in a condition called thrombocytopenia, which usually results in excessive bleeding. But when it follows a vaccination, abnormal blood clotting can occur. For a small number of people, the immune system triggers antibodies that recognise COVID-19 proteins and platelets. These antibodies can then activate the platelets, cause them to cluster and go into blood-clotting mode. “The consequences of this is the platelets are getting used up in the blood clot and their count drops,” Dr Chen said. Next steps If the platelet count is low, doctors will look at blood samples to find protein fragments called D-dimers, which are produced by the body to break down blood clots. If the level of D-dimers is five times higher than that of normal blood, it can be a sign of TTS. When a low platelet count and high D-dimer level have been detected, clinicians then look for antibodies that target a protein called platelet factor 4, or PF4. The PF4 antibodies are also tested to determine whether they can activate platelets and cause TTS. Detection speeds Vaccine-related clots can be detected via blood tests as soon as symptoms appear - whether that’s four or 20 days after getting the jab - but not before that. “In most cases, [antibodies] can only be found after people feel unwell and present at hospital,” said Jose Perdomo, a haematologist at the University of New South Wales. Patients presenting at the emergency department of a metropolitan hospital with TTS symptoms can receive results from the blood-screening tests within one hour. But, wait times can be longer in regional hospitals. Once initial tests have confirmed platelet and D-dimer levels, patients can commence treatment while waiting for their PF4 antibody test results. Treatment Two different types of treatment are combined to battle TTS. To start with, patients start taking blood-thinning medication to slow down the formation of blood clots. Patients also receive a large dose of immunoglobulins - proteins that are part of the body’s defence system - to calm down the immune system. “This essentially swamps the antibody system, so that vaccine-induced antibodies can’t activate the platelets,” Dr Chen said. This combined treatment can help return blood platelet levels to normal within a few days, according to Dr Chen. “In more severe cases, it can take longer but it’s a rapid response to commencement of new therapy,” she said. She also said this treatment is safe to use even if the blood clots end up being unrelated to the vaccine. What to do if symptoms appear Though the risk of getting a blood clot following the vaccine is very low, Dr Chen said it’s important to be aware of the symptoms and take action as soon as they appear. If you have a headache that won’t go away after taking painkillers, you should visit your GP. But if you notice more severe symptoms - including numbness, difficulty speaking, or passing blood in bowel movements - head straight to the emergency department instead.

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Vaccine-related blood clotting explained