Easter Danish Cream Cheesecake

The cake will be sold for a limited time in April for 1,000 yen (plus tax) each.

New Way to Blast Kidney Stones Can Be Done in Doctor’s Office

Amy Norton wrote . . . . . . . . .

A noninvasive ultrasound technique is capable of quickly pulverizing kidney stones, an early study shows — in what researchers call a first step toward a simpler, anesthesia-free treatment for the painful problem.

The study reports on the first 19 patients who’ve had kidney stones treated with the ultrasound “bursts.” So far, it’s been able to completely, or nearly completely, break up stones within 10 minutes.

Much more research lies ahead, but experts not involved in the study called the early results “exciting.” If it pans out, they said, the ultrasound technique could make noninvasive treatment for kidney stones more readily available to patients.

Kidney stones are common, affecting about 10% of people at some point, according to the National Kidney Foundation.

Often, a stone can be passed in the urine without too much agony. In other cases — such as when a larger stone is causing a blockage or unbearable pain — treatment is necessary.

Right now, many kidney stones can be treated with a procedure called shock wave lithotripsy. It delivers high-energy sound waves through the skin to break the stone into tiny fragments that can then be passed.

But there are downsides, said Dr. Mathew Sorenson, of the University of Washington School of Medicine in Seattle, one of the researchers on the new work.

Shock wave therapy can be painful, so it’s typically done in the operating room, with patients under anesthesia, in the United States.

Sorenson and his colleagues have been developing an alternative approach called burst wave lithotripsy. They say it has the potential to blast kidney stones in a shorter amount of time, and possibly without anesthesia.

The ultimate goal, the researchers said, is to perform the procedure on fully awake patients, during an office visit with a urologist — or even in the emergency room when patients arrive in severe pain.

Unlike shock wave therapy, the burst wave approach uses “short harmonic bursts” of ultrasound energy, according to the research team. Previous research has suggested it can break up stones more quickly, and with less pain, than shock waves.

In the new study, the researchers tested the burst wave technique in 19 patients who were undergoing kidney stone treatment with a procedure called ureteroscopy. It involves threading a thin scope through the urethra, up to the location of the kidney stone; instruments are used to either snare the stone or break it into fragments that can be removed.

Because ureteroscopy requires anesthesia, the study patients were under when the ultrasound bursts were applied, for up to 10 minutes.

Overall, the researchers found, that was enough to fragment 21 of 23 stones. Half of the stones had at least 90% of their volume pulverized to pieces of no more than 2 millimeters (mm). And nine stones (39%) were completely broken down to that degree.

The findings were published recently in The Journal of Urology.

Two urologists who were not involved in the study called that effectiveness impressive, considering the short duration of treatment (which was chosen to limit patients’ time under anesthesia).

Kidney stones broken down to 2 mm or less should be relatively easy to pass, said Dr. Mantu Gupta, director of the Kidney Stone Center at Mount Sinai, in New York City.

Gupta noted that the study did not actually test the hoped-for, real-world scenario: Using the technique without anesthesia. But previous work by the team has indicated patients can tolerate it.

“This is very exciting,” Gupta said, adding that the safety data so far looks good, too.

Some patients showed mild bleeding, with small amounts of blood in the urine.

Dr. William Roberts, a professor of urology at the University of Michigan, also described the work as exciting.

“This certainly looks as safe, or safer than, shock wave lithotripsy,” he said.

Whether burst waves could be more effective is unclear, but Roberts said that if the procedure can, in fact, be done in the urologist’s office, that would be a big advantage.

None of that means the technology would help everyone with kidney stones. Roberts noted that while 19 patients were treated, a similar number entered the study but could not receive the ultrasound treatment: Some had stones that were too deep, for instance, or were obstructed by a rib or the bowel.

Still, Roberts said, even if only certain patients could have the procedure, its potential to be “more accessible” would be a boon.

But Dr. Joseph Vassalotti, chief medical officer of the National Kidney Foundation, said that while the procedure is “promising,” most of the study patients were of normal body mass index (BMI), which makes breaking up stones with shock wave therapy easier.

“Low enrollment of obese patients is important not only because obesity is common in the U.S., but also because obesity is a technical limitation to performance of [ultrasound burst and shock wave therapy],” Vassalotti said.

Since earlier work suggests the burst wave approach is tolerable, patients might not need pain medication afterward to deal with the procedure itself, Roberts said — though they might need a pain reliever like acetaminophen (Tylenol) if passing the fragments proves uncomfortable.

The study team said it has begun studies to test the approach in patients who arrive in the emergency department with kidney stone pain. The technology has also been licensed to SonoMotion Inc., which is developing a commercial version and conducting its own clinical trials.

Source: HealthDay

Roll Cakes of Flo Prestige Paris in Japan

Celebrating Kid’s Day in Japan

The cakes will be sold between May 3 and May 5.

After COVID-19, Experts Say Watch for These Potential Heart and Brain Problems

Michael Merschel wrote . . . . . . . . .

COVID-19 was full of surprises early on, causing mild problems in the short term for some people and serious complications for others.

Long term, it may be just as capricious.

Studies are spotting potential heart and brain problems up to a year after infection with SARS-CoV-2, even in people who had mild COVID-19.

The possible long-term effects include “a myriad of symptoms affecting different organs,” said Dr. José Biller, director of the COVID-19 neurology clinic at Loyola Medicine in Maywood, Illinois. “So, it could be the lungs, it could be cardiovascular, it could be the nervous system, it could be mental health or behavioral problems.”

Estimates vary widely on how many people may be affected. Research suggests about 10% to 20% of people experience mid- or long-term issues from COVID-19, according to the World Health Organization.

That may sound small, but COVID has affected hundreds of millions of people, said Dr. Siddharth Singh, director of the post-COVID-19 cardiology clinic at the Smidt Heart Institute at Cedars-Sinai Medical Center in Los Angeles. In the U.S. alone, about 80 million people have been infected with the coronavirus since the pandemic started in early 2020.

There are many more questions than answers, including about who is most at risk for post-COVID problems and how long the effects might last. But experts say people who have had COVID-19 should be aware of these potential risks:

Heart disease and stroke

A study published in Nature Medicine in February concluded the risk of heart problems one year after COVID-19 infection is “substantial.”

Those heart problems include irregular heartbeats, heart failure (the inability of the heart to pump properly), coronary disease (buildup in arteries that limits blood flow), heart attacks and more.

The study included 153,760 U.S. veterans, most of them white and male, who tested positive for COVID-19 between March 1, 2020, and Jan. 15, 2021, and survived at least 30 days. They were compared to a control group of more than 5.6 million veterans without COVID-19.

Researchers adjusted for pre-existing conditions and found that after one year, those who had COVID-19 were 63% more likely to have some kind of cardiovascular issue, resulting in about 45 additional cases per 1,000 people.

Risks were elevated even among people who did not have severe COVID-19. That matches what Singh has seen in his post-COVID clinic, which began treating patients in December 2020. “A lot of patients that we have seen with long-haul symptoms had minor illness and had been treated at home.”

Singh also treats many people with postural orthostatic tachycardia syndrome, or POTS, which can cause dizziness, fainting and heart palpitations. “These palpitations mostly tend to happen when people are standing or sitting upright,” he said.

In rare cases, “smoldering inflammation around the heart or in the heart” can occur, Singh said.

The Nature Medicine study also found a 52% increased risk of stroke at one year among COVID-19 survivors, or about four extra strokes per 1,000 people.

Brain problems

Among the 113 patients in Biller’s long COVID clinic, almost 3 in 4 reported so-called brain fog. “They are unable to multitask, and have difficulties in learning new skills,” said Biller, who also leads the department of neurology at the Loyola University Chicago Stritch School of Medicine.

A recent Nature study of 785 people ages 51 to 81 found those who had COVID-19 lost more grey matter and had more brain shrinkage than those who had not.

Mental health

A study published in February in BMJ used the same pool of U.S. veterans as the Nature Medicine study and found a 35% increased risk of anxiety disorders after COVID-19, or 11 additional cases per 1,000 people after one year compared to those without COVID-19. The risk for depression was slightly higher.

When researchers compared people who’d had COVID-19 versus the flu, the risk of mental health disorders was again significantly higher with COVID-19.

“Mental health is closely tied to cardiovascular health,” Singh said. If somebody is anxious or depressed, “they’re not going to exercise that much. They’re not going to watch their diet, take control of their hypertension and other risk factors, their sleep is affected which can impact cardiovascular health, and so on.”

He said many COVID-19 survivors also have unresolved pain, grief and post-traumatic stress disorder, which can contribute to a decline in mental health.

Fatigue

At Biller’s post-COVID clinic, patients often describe experiencing “crushing” fatigue. Fatigue was the most common post-COVID symptom reported in a review of several studies published in August in Scientific Reports.

What you can do

Even though the long-term risks from having COVID-19 may be real, Singh said, they should not cause most people to be terribly worried. Instead, he said, it’s a good time to be proactive:

  • Take care of yourself. “A lot of my family and friends have gotten COVID earlier this year and last year,” Singh said. “What I’m telling them is just to be a bit more vigilant when it comes to their cardiovascular health and making sure their cardiovascular risk factors are well-controlled. Obviously, if one is having chest pain, shortness of breath or palpitations, that should not be ignored.”
  • Symptoms lingering? See a doctor. “It can take anywhere from two to six weeks to completely bounce back from the infection,” Singh said. But if people have persistent physical and mental symptoms beyond four to six weeks, “it’s wise to get checked out.”
  • Pay attention to sleep. Sleep disorders – which are linked to heart problems – can develop after COVID-19, research shows. “The importance of good sleep cannot be overemphasized,” Singh said. If you’re having trouble, you might need to see a specialist.
  • Stay informed. As research continues to untangle the mysteries of COVID-19, people will need trustworthy information. The Centers for Disease Control and Prevention offers regular updates about the coronavirus, and the National Library of Medicine provides a tutorial for evaluating health information.
  • Get vaccinated. COVID-19 vaccines reduce the risk of infection and severe illness. And while it’s not yet clear whether vaccination influences long-term symptoms in people who get breakthrough infections, Biller said, “prevention is the key.”

Source: American Heart Association

Crêpes Suzette with Strawberries

Ingredients

1 cup all-purpose (plain) flour
pinch of salt
4 large eggs
2 cups milk
1/3 cup butter

Filling

2 cups strawberries, thinly sliced
1/2 cup freshly squeezed orange juice, warmed
2 tablespoons superfine (caster) sugar
1 tablespoon orange liqueur
1 tablespoon brandy

Method

  1. Mix the flour and salt in a medium bowl. Whisk in the eggs and milk. Set aside to rest for 1 hour.
  2. Melt 1 teaspoon of butter in a crepe pan over medium heat. Pour in 2-3 tablespoons of batter and swirl the pan to form a thin even layer. Cook until golden brown, about 2 minutes.
  3. Use a metal spatula to turn the crepe and cook until golden brown, about 2 minutes.
  4. Remove from the pan and stack on a plate. Repeat until all the batter is used. Keep the crepes in a warm oven.
  5. Arrange the strawberries on the crepes. Fold the crepes into quarters and arrange in a heatproof dish. Drizzle with the orange juice and sprinkle with sugar.
  6. Place the orange liqueur and brandy in a small saucepan and warm over low heat. Pour over the crepes and light with a long match.
  7. Serve while still burning.

Makes 4 servings.

Source: Modern Medoterranean Cooking


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