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Wednesday, August 10, 2022

HS athletes in contact sports more likely to misuse prescription stimulants throughout their 20s

 High school seniors who play contact sports are roughly 50% more likely to misuse prescription stimulants in the next decade after graduation, compared to those who do not participate in these types of sports, a new University of Michigan study found.

Overall, 12th-graders who take part in sports—both contact or non-contact—are more likely than non-athletes to misuse prescription stimulants in young adulthood, said lead author Philip Veliz, associate research professor at the U-M School of Nursing.

By contrast, seniors who participate in non-contact sports are less likely to misuse prescription  over the next decade, although more likely to misuse stimulants than non-athletes.

This is the first known national study to assess how high school sports participation is associated with prescription drug misuse from ages 17-18 to ages 27-28. Data were collected from 4,772 U.S. 12th-graders between 2006-2017 from the Monitoring the Future study and followed for a decade.

Veliz and colleagues looked at high-contact (, ice hockey, lacrosse, wrestling), semi-contact (baseball, basketball, field hockey, soccer) and non-contact sports (cross country, gymnastics, swimming, tennis, track, volleyball, weightlifting).

Other key findings:

  • About 31% of high school seniors overall indicated misusing  at least once at ages 17-18.
  • With respect to contact sport participation, the percentage of 12th-graders who indicated past-year prescription stimulant misuse was 11%, which increased to about 18% by ages 21-22.

"Misuse of prescription opioids was higher for respondents who participated in contact sports during the 12th grade. However, participation in this type of sport was not associated with initiating this type of drug use in young adulthood," Veliz said.

While surprising, he said, it should be noted that prescription drug misuse of opioids declined among adolescents and young adults during the study period because opioids were becoming less available and there was greater awareness of risks of opioid misuse during this period.

Prescription drug misuse of both opioids and stimulants has declined substantially among adolescents since 2010, Veliz said.

"However, this study found that some types of former high school athletes are at greater risk of misusing these drugs and initiating them during early adulthood (between ages 19 and 21)," he said.

Veliz was surprised that adolescents in non-contact sports had greater odds of initiating stimulant misuse during young adulthood than those who did not play a non-contact sport. Non-contact sports may yield a culture of self-control or an aversion toward physical harm, but this does not mean participants don't value competitiveness, he said.

Studies suggest that participants in non- have better academic outcomes and may view sports as a resume builder in the admissions process. Moreover, young adults commonly misuse stimulants because they believe, erroneously, that this boosts , so stimulants may appeal to this subgroup, Veliz said.

"The findings reinforce screening during adolescence as nearly one-in-three high school seniors engage in prescription drug misuse," said Sean Esteban McCabe, senior author and director of DASH, the Center for the Study of Drug, Alcohol, Smoking, and Health in the U-M School of Nursing. "Increased prescription stimulant misuse following high school warrants ongoing monitoring during young adulthood, especially among ."

Veliz said his next set of studies will focus on the relationship between sports participation and stimulant misuse among adolescents who are being treated for ADHD.

The study was published in advance online and will appear in the American Journal of Epidemiology.


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Some physical sports can lead to heroin use, prescription drug abuse among teens

More information: Philip T Veliz et al, The Initiation and Developmental Course of Prescription Drug Misuse among High School Athletes During the Transition Through Young Adulthood, American Journal of Epidemiology (2022). DOI: 10.1093/aje/kwac132
https://medicalxpress.com/news/2022-08-high-school-athletes-contact-sports.html

Which leisure activities are linked to lower risk of dementia?

 Leisure activities, such as reading a book, doing yoga and spending time with family and friends may help lower the risk of dementia, according to a new meta-analysis published in the August 10, 2022, online issue of Neurology. The meta-analysis reviewed available studies on the effects of cognitive activities, physical activities, and social activities and the risk of dementia.

"Previous studies have shown that leisure activities were associated with various , such as a lower cancer risk, a reduction of atrial fibrillation, and a person's perception of their own well-being," said study author Lin Lu, Ph.D., of Peking University Sixth Hospital in Beijing, China. "However, there is conflicting evidence of the role of leisure activities in the prevention of dementia. Our research found that leisure activities like making crafts, playing sports or volunteering were linked to a reduced risk of dementia."

The meta-analysis involved a review of 38 studies from around the world involving a total of more than 2 million people who did not have dementia. The participants were followed for at least three years.

Participants provided information on their leisure activities through questionnaires or interviews. Leisure activities were defined as those in which people engaged for enjoyment or well-being and were divided into mental, physical and social activities.

During the studies, 74,700 people developed dementia.

After adjusting for factors such as age, sex and education, researchers found that leisure activities overall were linked to a reduced risk of dementia. Those who engaged in leisure activities had a 17% lower risk of developing dementia than those who did not engage in leisure activities.

Mental activity mainly consisted of intellectual activities and included reading or writing for pleasure, watching television, listening to the radio, playing games or musical instruments, using a computer and making crafts. Researchers found that people who participated in these activities had a 23% lower risk of dementia.

Physical activities included walking, running, swimming, bicycling, using exercise machines, playing sports, yoga, and dancing. Researchers found that people who participated in these activities had a 17% lower risk of dementia.

Social activities mainly referred to activities that involved communication with others and included attending a class, joining a social club, volunteering, visiting with relatives or friends, or attending religious activities. Researchers found that people who participated in these activities had a 7% lower risk of dementia.

"This meta-analysis suggests that being active has benefits, and there are plenty of activities that are easy to incorporate into daily life that may be beneficial to the ," Lu said. "Our research found that leisure activities may reduce the risk of dementia. Future studies should include larger sample sizes and longer follow-up time to reveal more links between  and ."

A limitation of the study was that people reported their own physical and mental activity, so they may not have remembered and reported the activities correctly.


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Study: Chores, exercise, and social visits linked to lower risk of dementia

Journal information: Neurology

Blood tests in newly brain-injured patients predict death, severe disability

 Blood tests taken within 24 hours of a traumatic brain injury (TBI) flag which patients are likely to die and which patients are likely to survive with severe disability, according to a study headed by UC San Francisco, the University of Pennsylvania and the University of Michigan. Their results—available within minutes—may confirm the need for prompt surgical interventions or may help guide conversations with families in cases of devastating injury.

The tests, which detect two , were cleared by the Food and Drug Administration in 2018 for use in determining which patients with mild TBI should undergo CT scans. High values of these biomarkers, GFAP and UCH-L1, correlate with death and severe injury, the authors state in their study publishing in The Lancet Neurology on Aug. 10, 2022.

Co-senior author of the study, Geoffrey Manley, MD, Ph.D., professor and vice chair of neurosurgery at UCSF, said these blood tests are "both diagnostic and prognostic," as well as easy to administer, swift and inexpensive.

In the study, researchers from TRACK-TBI, a UCSF-led brain injury research initiative, examined the day-of-injury blood tests of 1,696 patients with TBI, using the Abbott i-STAT Alinity, a portable blood analyzer, and the ARCHITECT assays. The results of these blood tests were compared at patients' six-month assessments, using the Glasgow Outcome Scale Extended, which grades outcomes and quantifies levels of disability following TBI. These outcomes range from death (level 1) to complete recovery with resumption of normal life but minor deficits in some cases (level 8).

One in five patients died or had severe disabilities

Approximately two-thirds of the patients were male, and their average age was 39. They had been evaluated at 18 Level 1 trauma centers for injuries caused primarily by traffic accidents or falls. At six months following injury, 7% of the patients had died, 14% had an "unfavorable outcome," with level 2 to 4 injuries ranging from vegetative state to severe disability requiring daily support. The remaining 67% had "incomplete recovery" ranging from moderate  requiring assistance outside of the home to minor disabling neurological or psychological deficits.

The researchers found that the day-of-injury blood tests had a high probability of predicting death at six months, 87% for GFAP and 89% for UCH-L1; and a high probability of predicting severe disability at the same timepoint, 86% for both GFAP and UCH-L1. But they were significantly less accurate in predicting incomplete recovery versus complete recovery: 62% and 61%, respectively.

"We believe this tool may encourage clinicians to be more aggressive in their decisions to begin or continue life-saving treatment," said Manley, who is the principal investigator of TRACK-TBI and a member of the UCSF Weill Institute for Neurosciences. "Modern  can result in good outcomes in what we had once believed were non-survivable injuries."

The blood tests may also guide discussions with families in the cases of catastrophic injuries, he said, and assist in "mass casualty situations where they may play a critical role in triage and resource allocation."

This study is the "first report of the accuracy of a  that can be obtained rapidly on the day of injury to predict neurological recovery at six months after injury," said first author Frederick Korley, MD, Ph.D., associate professor of emergency medicine at the University of Michigan. "Although there have been previous prognostic studies, they have used a limited number of patients, which can result in imprecise estimates."

Prognostic models add to accuracy of blood tests

The researchers wanted to see if accuracy in predicting outcome would be boosted if the two blood tests were done together and combined with prognostic models that looked at variables like age, motor score, pupil reactivity and CT characteristics. They found that in patients with severe and moderate TBI, the accuracy of predicting  and severe disability increased to 94% and 89%, respectively. But in patients with mild TBI, the probability of predicting complete recovery versus incomplete recovery increased only to 69%.

Structural brain injury detected by CT and MRI has been reported as an independent predictor of risk of moderate and mild disability in mild TBI, noted co-senior author Ramon Diaz-Arrastia, MD, Ph.D., professor of neurology at the University of Pennsylvania's Perelman School of Medicine and director of the Traumatic Brain Injury Clinical Research Center at Penn Presbyterian Medical Center.

"Therefore, although structural , as measured by GFAP and UCH-L1, as well as CT scanning, may play a predominant role in determining poor outcome in moderate and severe TBI, mechanisms of injury relating to poor outcome after mild TBI are not yet fully understood," said Diaz-Arrastia, noting that further study would be required to reproduce these findings.

TBI is a heterogenous condition that requires a "rich and diverse dataset like that of the TRACK-TBI study," said Nsini Umoh, Ph.D., Division of Neuroscience program director at the National Institute of Neurologic Disorders and Stroke. "One aim of TRACK-TBI is to develop better prognostic tools for TBI patients, which could help predict recovery trajectory and inform therapeutic options."


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For concussion patients, CTs offer window into recovery

More information: The Lancet Neurology (2022). www.thelancet.com/journals/lan … (22)00256-3/fulltext
https://medicalxpress.com/news/2022-08-blood-newly-brain-injured-patients-death.html

Vir Shuns FDA Submission Plans For GSK-Partnered COVID Treatment

 

  • In its Q2 earnings releaseVir Biotechnology Inc  and its partner GSK plc  said that they do not plan to file a marketing application for sotrovimab for COVID-19 at this time.
  • The company also said it does not intend to pursue the US-based Phase 3 COMET-STAR prophylaxis trial, citing evolving COVID-19 landscape and FDA discussions.
  • Discussions with the FDA remain ongoing regarding the appropriate path forward for sotrovimab in the U.S.
  • In Q2, approximately 265,000 sotrovimab doses were delivered, all outside the U.S., exceeding the expectations of approximately 100,000.
  • The companies continue to conduct in vitro testing of sotrovimab against new variants and subvariants as they emerge and plan to submit data in 2H of 2022.
  • Sotrovimab is being evaluated PROTECT-V Phase 3 prophylaxis trial sponsored by Cambridge University Hospitals National Health Service Foundation Trust. Initial data are expected in 2023.
  • It is being evaluated at a 1g dose among patients hospitalized with COVID-19 in the U.K. The timing of initial data will depend on the continued rate of enrollment.
  • The company has over $2.6 billion in cash, cash equivalents, investments, and profit-share payments to be received from GSK, expected to fund the company's ongoing operations and liabilities for up to five years.