Physical activity interventions improve depression and anxiety
Worldwide, the annual costs of mental health disorders are an estimated $2.5 trillion (USD), a sum which is projected to rise to $6 trillion by 2030. This is cited by Singh et al (2023), who note that depression is the leading cause of mental health-related disease burden, with anxiety the most prevalent mental health disorder.
In this umbrella review, Singh et al (2023) considered the evidence on how physical activity affected the symptoms of depression, anxiety and psychological distress in adult populations. A total of 97 reviews (1039 trials and 128 119 participants) were evaluated, and the populations included healthy adults, people with mental health disorders and people with various chronic diseases.
The review's findings suggest that physical activity interventions are effective at improving symptoms of depression and anxiety; improvements that were observed across different clinical populations. The greatest benefits were conferred on people with depression, pregnant and postpartum women, apparently healthy individuals, and individuals diagnosed with HIV or kidney disease. ‘Physical activity should be a mainstay approach in the management of depression, anxiety and psychological distress.’
Although higher intensity exercise was associated with greater improvements for depression and anxiety, all types of physical activity were effective. Interestingly, ‘longer duration interventions had smaller effects compared with short and mid-duration, though the longest duration interventions still had positive effects.’
Primary care can reduce barriers to latent tuberculosis infection treatment
Prior to the COVID-19 pandemic, tuberculosis (TB) was the leading infectious cause of death globally. In the US, TB elimination largely depends on identifying and treating those with latent tuberculosis infection (LTBI), and community health centres play a key role. In this retrospective analysis, Tang et al (2023) describe LTBI testing and treatment practices during a series of quality improvement interventions at an urban primary care setting serving primarily non-US-born Asian patients in San Francisco for the period 2010 to 2019.
Of 124 695 patients visiting primary care, 40% were tested for TB infection, and of those tested, 20% tested positive, including 39% of adults aged 50–79 years. Compared to adults aged 18–49 years, children aged 6–17 had greater odds of LTBI testing and treatment initiation, while those aged 65 years and over were associated with lower odds of both testing and treatment initiation. During the study period the authors found a significant increase in the proportion of patients receiving prescriptions for LTBI treatment, as well as provider use of evidence-based strategies including rifamycin-based treatment.
In conclusion, the authors state that their study ‘suggests that primary care interventions can reduce barriers to LTBI treatment and drive TB elimination.’
No evidence for deodorant bans in breast radiotherapy
Despite progress in modern radiotherapy (RT) techniques, acute radiation dermatitis (RD) can occur during and after post-operative RT as a response to ionising RT. RD has a variable incidence and clinical presentation depending on treatment factors and patient characteristics like genetic profile, breast size or smoking status. Crucial factors in breast cancer patients may include friction caused by movement and certain types of clothing.
With the use of antiperspirant/deodorant during breast RT still undetermined, Salvestrini et al (2023) undertook a systematic review and meta-analysis that evaluated five randomised controlled trials on the effect of antiperspirant/deodorant on acute RD during post-operative breast RT. The authors found that using antiperspirant/deodorant did not ‘significantly affect the incidence of grade 1 or higher RD, and no significant effect was reported in terms of grade 3 RD between the antiperspirant/deodorant and control groups.’ It was also found that advice to patients is often based on an institution's and individual physician's experience. There appears to be a considerable lack of high-quality evidence supporting a specific skin care protocol during post-operative breast RT, and data on the role of topical agents in the prevention and management of RD are still underreported.
Using antiperspirant/deodorant during breast RT, the authors report, ‘does not significantly affect the incidence of acute RD, pruritus, and pain.’
Earlier age of obesity onset is related to COVID-19 outcomes in later life
A growing body of evidence has documented the long-term consequences of COVID-19, commonly referred to as long COVID, and research has found associations between higher body mass index (BMI) and a greater risk of contracting SARS-CoV-2 resulting in an increased severity of illness. This is cited by Staatz et al (2023) who also note emerging evidence that having a higher BMI may also be related to an increased risk of acquiring long COVID.
In this UK study, Staatz et al (2023) aimed to estimate the risk of severe COVID-19 outcomes, including long COVID, associated with the age at which participants first become overweight or obese, compared to those who are never overweight or obese, respectively. The authors evaluated BMI data collected through adulthood in the 1958 National Child Development Study (NCDS) and the 1970 British Cohort Study (BCS).
The results showed that an earlier age of first obesity was related to long COVID and COVID-19 severity, ‘although results were mixed and, in some analyses, underpowered due to the relatively small number of individuals experiencing the outcome.’ Both NCDS and BCS cohorts provided consistent evidence that becoming obese earlier in adulthood was associated with an increased likelihood of long COVID. The authors consider obesity as a state of low-grade inflammation, with the possible consequences this may have for the immune system.