Category: 8. Health

Wildlife experts revealed that the unsettling condition is caused by Shope papilloma virus, a disease that creates wart-like tumors on rabbits, often around the head, ears, and eyelids. While the growths may look disturbing, officials stressed they do not pose a threat to humans, pets, or other wildlife.

The virus only spreads between rabbits, typically through bites from insects such as mosquitoes and ticks. According to the University of Missouri, the condition is a DNA virus ‘seen most frequently in cottontail rabbits of the Midwest with outbreaks in domestic rabbits’.

Local Sightings and reactions

Fort Collins residents have reported multiple sightings, including one rabbit that returned to a homeowner’s yard for two consecutive years with increasingly severe growths.

Some residents initially feared the animals had plague or another dangerous illness.

Descriptions of the appearance range from ‘black quills’ to a ‘scabby growth’ covering parts of the face.

“I thought he would die off during the winter, but he didn’t,” a local, Susan Mansfield, told NBC local affiliate KUSA.“He came back a second year, and it grew.”

What is Shope Papilloma Virus?

The virus causes benign wart-like tumors, but in some cases, these can become malignant (cancerous). While generally not harmful to the rabbit’s overall health, tumors can create problems if they obstruct the mouth, nose, or eyes.

The disease is relatively common in wild rabbit populations, particularly during warmer months when insect activity is high.

There is no known cure for the virus; surgical removal of tumors is sometimes performed for domestic rabbits.

Colorado Parks and Wildlife is advising residents to keep their distance. The rabbits are not dangerous.

Editor’s note: This article was adapted from a release from the University of Utah.

Nearly a quarter of people over the age of 40 experience painful osteoarthritis, making it a leading cause of disability in adults. Osteoarthritis involves degradation of joint-cushioning cartilage, and there is currently no way of reversing this damage: the only option is to manage pain with medication, and eventually, joint replacement. 

A study conducted at Stanford University is now demonstrating the potential for another option: gait retraining. 

By making a small adjustment to the angle of their foot while walking, participants in a year-long randomized control trial experienced pain relief equivalent to medication. Critically, those participants also showed less knee cartilage degradation over that period as compared to a group that received a placebo treatment.

Published in The Lancet Rheumatology, it is the first placebo-controlled study to demonstrate the potential effectiveness of a biomechanical intervention for osteoarthritis. 

The study was led by an interdisciplinary team at Stanford: Scott Uhlrich, who is now an assistant professor in the John and Marcia Price College of Engineering’s Department of Mechanical Engineering at the University of Utah; Valentina Mazzoli, who is now an assistant professor in New York University’s Department of Radiology; and Julie Kolesar, a research engineer in Stanford’s Human Performance Lab who worked for the Veteran’s Administration at the time of the study. 

“We’ve known that for people with osteoarthritis, higher loads in their knee accelerate progression, and that changing the foot angle can reduce knee load,” said Uhlrich. “So the idea of a biomechanical intervention is not new, but there have not been randomized, placebo-controlled studies to show that they’re effective.” 

A personalized approach 

The researchers were specifically looking at patients with mild-to-moderate osteoarthritis in the medial compartment of the knee – on the inside of the leg – which tends to bear more weight than the lateral, outside, compartment. This form of osteoarthritis is the most common, but the ideal foot angle for reducing load in the medial side of the knee differs from person to person depending on their natural gait and how it changes when they adopt the new walking pattern. 

“Previous trials prescribed the same intervention to all individuals, resulting in some individuals not reducing, or even increasing, their joint loading,” said Uhlrich. “We used a personalized approach to selecting each individual’s new walking pattern, which improved how much individuals could offload their knee and likely contributed to the positive effect on pain and cartilage that we saw.” 

“This study not only demonstrates a promising approach to help individuals with osteoarthritis,” said Scott Delp, a senior author of the paper, director of the Wu Tsai Human Performance Alliance at Stanford, and James H. Clark Professor in the School of Engineering, “It also showcases how powerful a more personalized approach can be.”

In their first two visits, participants received a baseline MRI and practiced walking on a pressure-sensitive treadmill while motion-capture cameras recorded the mechanics of their gait. This allowed the researchers to determine whether turning the patient’s toe inward or outward would reduce load more, and whether a 5- or 10-degree adjustment would be ideal.

This personalized analysis also screened out potential participants who could not benefit from the intervention, as none of the foot angle changes could decrease loading in their knees. These participants were included in previous studies, which may have contributed to those studies’ inconclusive pain results. 

Moreover, after their initial intake sessions, half of the 68 participants were assigned to a sham treatment group to control for the placebo effect. These participants were prescribed foot angles that were identical to their natural gait. Conversely, participants in the intervention group were prescribed the change in foot angle that maximally reduced their knee loading. 

Participants from both groups returned to the lab for six weekly training sessions, where they received biofeedback – vibrations from a device worn on the shin – that helped them maintain the prescribed foot angle while walking on the lab’s treadmill. After the six-week training period, participants were encouraged to practice their new gait for at least 20 minutes a day, to the point where it became natural. Periodic check-in visits showed that participants were adhering to their prescribed foot angle within a degree on average. 

After a year, all participants self-reported their experience of knee pain and had a second MRI to quantitatively assess the damage to their knee cartilage. 

“The reported decrease in pain over the placebo group was somewhere between what you’d expect from an over-the-counter medication, like ibuprofen, and a narcotic, like OxyContin,” Uhlrich said. 

Delp added, “The MRIs also showed improved biomarkers of cartilage health in the intervention group. This is an exciting finding that gives hope to people with osteoarthritis.” 

A lasting intervention 

Beyond the quantitative measures of effectiveness, participants in the study expressed enthusiasm for both the approach and the results. One participant said: “I don’t have to take a drug or wear a device … it’s just a part of my body now that will be with me for the rest of my days, so that I’m thrilled with.” 

Participants’ ability to adhere to the intervention over long periods of time is one of its potential advantages. 

“Especially for people in their 30s, 40s, or 50s, osteoarthritis could mean decades of pain management before they’re recommended for a joint replacement,” said Uhrlich. “This intervention could help fill that large treatment gap.” 

Before this intervention can be clinically deployed, the gait retraining process will need to be streamlined. The motion-capture technique used to make the original foot angle prescription is expensive and time-consuming; the researchers envision this intervention to eventually be prescribed in a physical therapy clinic and retraining can happen while people go for a walk around their neighborhood. 

“We and others have developed technology that could be used to both personalize and deliver this intervention in a clinical setting using mobile sensors, like smartphone video and a ‘smart shoe,’” said Uhlrich. Future studies of this approach are needed before the intervention can be made widely available to the public.

A 74-year-old female with a medical history of hypertension and type 2 diabetes mellitus was admitted to ICU following severe trauma from a road traffic accident. On admission, her home medications included empagliflozin, gliclazide, metformin, ramipril, amlodipine, and esomeprazole.

Initially, the patient presented with no hemorrhagic shock or organ failure. Her Glasgow Coma Scale (GCS) score was 14 upon arrival at the trauma center.

A computed tomography (CT) scan revealed:

• Mild traumatic brain injury with brain contusion hemorrhage and subarachnoid hemorrhage.

• Facial bone fractures.

• Thoracic trauma (Thoracic Trauma Score = 11) with a left-sided hemopneumothorax, which did not require drainage.

• American Association for the Surgery of Trauma (AAST) grade 3 traumatic splenic injury.

• Non hemorrhagic, non surgical pelvic trauma.

None of these injuries necessitated surgical intervention. An occipital scalp wound was debrided and sutured. Apart from esomeprazole, none of her long-term medications were resumed upon initial management. The patient’s initial medical course was favorable. Consequently, on Day 4, oral antidiabetic medications, including empagliflozin, were reintroduced.

From Day 5, the patient developed an unexplained fever without deterioration in her general condition.

By Day 7, while awaiting discharge from the ICU, her overall condition acutely deteriorated. She presented with a decreased level of consciousness (GCS 7/15), atrial fibrillation (heart rate 150–160 bpm), hemodynamic instability (90/54 mmHg), tachypnea (25–30 breaths per minute), hyperthermia (40 °C), and facial and left arm edema.

Arterial blood gas analysis revealed severe metabolic acidosis (pH 6.99, bicarbonate 6 mmol/L, pCO2 15 mmHg, pO2 105 mmHg, base excess − 23.4 mmol/L) with a lactate concentration of 1.8 mmol/L and a glucose concentration of 13.7 mmol/L.

Management initiated for septic shock included fluid resuscitation, vasopressor therapy, and broad-spectrum antibiotics. Subsequent cranial and thoraco-abdomino-pelvic CT scans revealed dermo-hypodermitis of the face, secondary to an occipital skin wound infection.

Further laboratory analysis showed a serum creatinine level of 55 µmol/L, discordant with her profound metabolic acidosis. This biochemical dissociation excluded acute kidney injury as the primary etiology, prompting evaluation for alternative causes such as diabetic ketoacidosis or toxic-mediated acidosis. In this context, a plasma ketone measurement was performed, revealing a level greater than 6 mmol/L. This strongly supported a diagnosis of EDKA associated with SGLT2i use.

All oral antidiabetic drugs, including empagliflozin, were discontinued. After achieving hemodynamic stability with aggressive crystalloid fluid resuscitation and correction of hypokalemia, a continuous intravenous insulin infusion was initiated, concurrently with a 10% dextrose infusion to prevent hypoglycemia.

Microbiological analysis confirmed methicillin-susceptible Staphylococcus aureus bacteremia, with positive blood cultures for nearly six days. Based on the antibiogram, antibiotic therapy was adjusted, and cloxacillin was subsequently introduced. A mitral valve endocarditis, characterized by a 12 mm mobile vegetation with renal and splenic emboli, developed as a secondary complication of the bacteremia. The patient was deemed unsuitable for surgical treatment due to her head trauma, which contraindicated extracorporeal circulation.

The shock resolved after 4 days, leading to the discontinuation of norepinephrine. After 5 days of insulin therapy, the patient’s acidosis resolved, and serum ketone bodies were negative. The continuous intravenous insulin infusion was then transitioned to a basal-bolus insulin regimen.

Ultimately, the clinical course of this infectious episode was favorable under well-managed antibiotic therapy for 6 weeks. The patient was transferred to a rehabilitation center after a 62-day ICU stay.

Artificial intelligence, touted for its potential to transform medicine, led to some doctors losing skills after just a few months in a new study.

AI helped health professionals to better detect pre-cancerous growths in the colon, but when the assistance was removed, their ability to find tumors dropped by about 20% compared with rates before the tool was ever introduced, according to findings published Wednesday.

Patients see doctors in a white coat as professional and trustworthy but often mistake a female medic wearing one for a nurse or medical assistant, a study has found.

Female physicians are “unfairly judged based on appearance and attire, which affected patients’ perceptions of professionalism and competency”, according to a global review of the evidence around patients’ impressions of what doctors wear.

“Female physicians are often judged more on appearance than their male counterparts,” it said.

“The way female physicians dress significantly influences perceptions of competence and professionalism, highlighting the gendered expectations that patients hold.

“Even when male and female physicians wore identical attire, female physicians were still more likely to be misidentified as nurses or medical assistants.”

The researchers found that “gender-related perceptions of physician attire” existed across the 13 countries studied, including the US, India, Japan, China and Germany.

The paper, published in the journal BMJ Open, is based on an analysis of 32 previously published studies on perceptions of doctors’ clothing.

“The expectations regarding attire are often gendered, particularly affecting the recognition and respect given to female physicians,” the paper’s co-authors write.

Such behaviour is so widespread that hospitals and other healthcare providers should try to reduce bias among patients and “foster equitable perceptions” of male and female medics, they add.

The white coat has been a symbol of medical expertise for decades. Its association in patients’ minds with cleanliness and professionalism meant that “white medical coats became the standard attire for physicians worldwide in the 20th century”.

Until then, doctors had generally worn black clothing to reflect the seriousness of meetings with patients.

People receiving healthcare find the white coat reassuring, the study found.

“Regardless of gender, patients exhibited favourable attitudes towards physicians wearing white coats, perceiving the physicians as trustworthy, respectful, skilled, communicative and empathetic.”

The white coat is still widely used by doctors worldwide. However, it was banned in the UK in 2008, when the government decided that medics working in the NHS should follow a “bare below the elbows” approach to reduce their risk of spreading infections. The British Medical Association was unsure that evidence justified the change.

Despite patients’ preference for doctors wearing formal clothing, the Covid-19 pandemic made them more accepting of scrubs.

“Patients tended to feel more comfortable with physicians wearing scrubs after Covid-19 ceased. While the traditional white coat is seen as a symbol of professionalism and trust, patients have increasingly accepted scrubs, especially in emergency or high-risk settings,” the researchers found.

Globally, male doctors seem to enjoy another advantage in many patients’ minds as to what they wear.

“Patients’ perceptions of male physicians’ accessories have shown that details such as watches and glasses significantly impact professionalism and trustworthiness” and add to their perceived authority, the study found.

(NewsNation) — New research suggests popular weight loss drugs like Ozempic and Wegovy may affect more than just fat, raising questions about muscle strength and organ size after significant weight loss.

University of Utah scientists studied semaglutide, the active ingredient in weight loss medications, in mice.

In the study, published in the journal Cell Metabolism, researchers revealed “unexpected effects,” highlighting that lean mass, or body weight that isn’t fat, dropped about 10%. Most of the loss came from nonmuscle tissues, particularly the liver, which shrank by nearly half. Some skeletal muscles lost around 6% of their size, while others remained unchanged.

Despite relatively small changes in muscle size, certain muscles became weaker. Researchers said this could be especially concerning for adults over 60, who already face higher risks of muscle loss and reduced mobility.

“The loss of physical function is a strong predictor of not just quality of life but longevity,” said Katsu Funai, the senior author on the study. 

The findings challenge the assumption that lean mass loss comes mainly from skeletal muscle. Instead, they point to changes in metabolically active organs, such as the liver, which can shrink during healthy weight loss without harming function.

“It’s unlikely that the observed lean mass loss represents a serious adverse effect,” said Takuya Karasawa, co-first author on the study. 

Still, scientists emphasize that further human studies are necessary to determine whether similar effects occur in humans and whether they pose health risks.

“There remains a significant need for validation in humans, especially concerning muscle strength,” Karasawa said.

They also suggest that future clinical trials should track not only lean mass but also muscle strength and physical function, especially as more weight loss drugs enter the market.

“There are many additional weight loss drugs that are in clinical trials and coming out in the next three to five years,” Funai said. “But with all those clinical trials, if they’re interested in measuring lean mass loss, they need to consider physical function.”