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Could cancer treatment protocols one day recommend delaying treatment until levels of emotional distress reduce? In the PRADO study of neoadjuvant immune checkpoint blockers to treat stage IIIB-D melanoma, 88 patients completed a baseline questionnaire that included questions to determine if a person is emotionally distressed (“Did you feel tense?”, “Did you worry?”, “Did you feel irritable?”, and “Did you feel depressed?”). Based on their answers, 28 patients were classed as having emotional distress, and they were found to be less likely to respond to treatment and had lower ...

This article, written by Rosemary Marks, provides information to help ensure the best health and wellbeing outcomes for your patients with Down syndrome and their whānau, by focusing on the care of children and young people. It highlights the most common issues you will need to consider, as well as those that can have serious consequences if missed

Reducing salt intake is as effective for lowering blood pressure as commonly used first line antihypertensive drugs in people aged 50-75 years. This small, but important, study of 213 people included roughly equal numbers of people with normal blood pressure, treated blood pressure, inadequately treated blood pressure, and untreated high blood pressure. The researchers found an average lowering of 8 mm Hg in systolic blood pressure in those who reduced their usual salt intake compared with those who increased it over one week. Everyone seemed to benefit from cutting down on salt regardless...

A randomised control trial in Nature Medicine hypothesised that cell therapies would be more effective than corticosteroid injections for reducing pain from knee osteoarthritis at one year. The researchers looked at three different sources of stem cell injection—from the bone marrow, adipose tissue, and umbilical cord—to see which would be more effective. A total of 480 people aged between 40 and 70 years with knee osteoarthritis were randomised and had their treatment concealed by means of sham cell harvesting procedures. Pain scores were lower after a year in each of the four arms of the...

How much should we worry about over-suppression of thyroid simulating hormone (TSH) when reviewing blood results in older people being treated for hypothyroidism? A cohort study looked at the records of over 60 000 patients in the US with thyrotoxicosis, defined as a TSH level below reference range. It found that patients with exogenous thyrotoxicosis—due to overtreatment of hypothyroidism—were more likely to receive a cognitive disorder diagnosis by the age of 75 years (adjusted hazard ratio 1.34 (95% confidence interval 1.10 to 1.63). The risk was greater for those with TSH ≤0.1 mI...