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E-cigarettes may lead to accumulation of fat in the liver

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WASHINGTON — Using e-cigarettes may lead to an accumulation of fat in the liver, a study of mice exposed to the devices suggests.

The research was presented Sunday, March 18, at ENDO 2018, the Endocrine Society’s 100th annual meeting in Chicago, Ill.

“The popularity of electronic cigarettes has been rapidly increasing in part because of advertisements that they are safer than conventional cigarettes. But because extra fat in the liver is likely to be detrimental to health, we conclude that e-cigarettes are not as safe as they have been promoted to consumers,” said lead author Theodore C. Friedman of Charles R. Drew University of Medicine and Science in Los Angeles, Calif. “This has important public health and regulatory implications.”

E-cigarettes contain nicotine, which Dr Friedman and other researchers have reported is associated with non-alcohol fatty liver diseases. However, the long-term effects of e-cigarettes on liver disease, diabetes, heart disease or stroke are unknown.

In the 12-week study, Friedman and colleagues studied mice missing the gene for apolipoprotein E, which makes them more prone to developing heart disease and fat in the liver. All of the mice were fed a diet relatively high in fat and cholesterol.

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One group of mice was put in a chamber that exposed them to e-cigarette aerosol, so that their blood nicotine levels were similar to that of smokers and e-cigarette users. A second group of mice were exposed to saline aerosol.

The researchers collected liver samples, and looked at genes in the liver affected by e-cigarettes using a technique called RNA sequence analysis. They found changes in 433 genes that were associated with fatty liver development and progression in the mice exposed to e-cigarettes.

The researchers also found that genes related to circadian rhythms (the body clock) were changed in mice exposed to e-cigarettes. Circadian rhythm dysfunction is known to accelerate the development of liver disease including fatty liver diseases.

“Our experimental results will provide support to policymakers and federal and state regulatory bodies to take preventive measures to stop the increasing use of e-cigarettes among both children and adults,” Friedman said.

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Suicide can’t be predicted by asking about suicidal thoughts : Study

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Most people who died of suicide deny they experience suicidal thoughts when asked by doctors in the weeks and months leading up to their death, a major Australian study has found.

The findings, co-authored by clinical psychiatrist and Professor Matthew Large from UNSW’s School of Psychiatry, Sydney that published in the journal BJPsych Open The meta-analysis challenge the widely-held assumption that psychiatrists can predict who will suicide by asking if they are preoccupied with thoughts of killing themselves.

The study showed that 80% of patients who were not undergoing psychiatric treatment and who died of suicide reported not to have suicidal thoughts when asked by their psychiatrist or GP.

“If you meet someone who has suicidal ideation there is a 98 per cent chance that they are not going to suicide,” said Professor Large, an international expert on suicide risk assessment who also works in the emergency department of a major Sydney hospital.

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“But what we didn’t know was how frequently people who go on to suicide have denied having suicidal thoughts when asked directly,” he added.

“This study proves we can no longer ration psychiatric care based on the presence of suicidal thoughts alone. We need to provide high-quality, patient-centred care for everyone experiencing mental illness, whether or not they reveal they are experiencing suicidal thoughts,” Professor Large said.

About one in 10 people will have suicidal ideation in their lifetime. But the study showed suicidal ideation alone was not rational grounds for deciding who gets treatment and who does not, Professor Large said.

“We know that suicide feeling is pretty common and that suicide is actually a rare event, even among people with severe mental illness,” Professor Large added.

Suicidal ideation tells us an awful lot about how a person is feeling, their psychological distress, sometimes their diagnosis and their need for treatment but it’s not a meaningful test of future behaviour.

Suicidal feelings can fluctuate rapidly and people may suicide very impulsively after only a short period of suicidal thoughts.

But, people had good reasons not to disclose thoughts of suicide, fearing stigma, triggering over-reactions or upsetting family and friends, and being involuntarily admitted for psychiatric treatment, Professor Large said.

Professor Large emphasized that clinicians should not assume that patients experiencing mental distress without reporting suicidal ideas were not at elevated risk of suicide.

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