Gallstone risk ‘higher among obese teenagers’

Teenagers who are overweight or obese are much more likely to develop gallstones, compared with peers of a healthy weight, US research suggests. Healthcare providers Kaiser Permanente looked at 510,000 children aged ten-19. The study, in the Journal of Pediatric Gastroenterology and Nutrition, found 766 had gallstones. It found those who were overweight were twice as likely as those with a healthy weight to have gallstones—the rate was higher among those who were obese. Those who were moderately obese were four times more likely to have gallstones than those with a normal body mass index, and this rose to six times for those classed as extremely obese. A UK obesity expert said it was yet another sign that obesity-linked disorders were being seen at increasingly young ages. Gallstones are small stones, usually made of cholesterol, that form in the gallbladder. Often they do not cause any symptoms, but if one becomes trapped it can trigger intense abdominal pain. They can block the passage of bile into the intestine, which in turn can cause severe damage or infection in the gallbladder, liver, or pancreas and—if left untreated—can be fatal.

 

Historically rare

The team from Kaiser Permanente looked at electronic health records of the teenagers, who were all enrolled in its Southern California Children’s Health Study. Lead author of the study, Corinna Koebnick, said: “Although gallstones are relatively common in obese adults, gallstones in children and adolescents have been historically rare. “These findings add to an alarming trend—youth who are obese or extremely obese are more likely to have diseases we normally think of as adult conditions.” National Obesity Forum chairman Prof David Haslam said the fact gallstones were being seen in obese teenagers was not surprising—but that it was worrying. “We know there is a link between the condition and obesity. But yet again we are seeing an adult illness in young people—because of obesity. “We have already seen Type 2 diabetes, high blood pressure and high cholesterol. Now it’s gallstones.

“And because these conditions are coming earlier, deaths will come earlier.”

 

Clot nets may prevent strokes

Using small nets to extract blood clots from patients’ brains may be the future of stroke care, according to two studies. Clots block blood vessels, starving parts of the brain of oxygen, which leads to symptoms such as paralysis and loss of speech. Two studies, presented in the Lancet medical journal, suggest extracting clots with nets could improve recovery. The Stroke Association said it was very excited by the treatment’s potential. There are already techniques for reopening blocked blood vessels in people’s brains. Some patients will be given “clot-busting” drugs, but this needs to be in the hours just after the stroke and is not suitable for everyone. Other techniques have been developed to extract the clot. Some procedures pass a tube up through the groin to the brain. There the wire passes through the clot, forming a coil on the far side and then pulling the clot out. However, this is far from routine practice. The latest methods involve a tiny wire cage instead of a coil. This pushes the clot up against the walls of the artery and enmeshes the clot in the wires, allowing doctors to pull the clot back out of the groin. Two similar devices were compared with the current coil methods. One trial of 113 patients showed 58 per cent had good brain function after three months, compared with 33 per cent of those treated with the coil method, as well as a lower death rate. Another study in 178 patients showed almost double the chance of living independently after treatment.

 

One of the researchers involved, Prof Jeffrey Saver from the University of California, Los Angeles, told the BBC that these techniques would become more common, as they are more likely to clear clots than drugs. “Clot-busting drugs only partially reopen 40 per cent of large blocked arteries. These devices partially reopen 70-90 per cent of large blocked arteries. “Second, these devices can be used in patients in whom it is not safe to give ‘clot busting’ drugs, such as patients taking anticoagulant medications, patients who had recent surgery, and patients who are between 4.5 to eight hours after stroke onset.” In the long term he can see drugs being used as a first option and then clot removal if the drugs fail or cannot be used. Responding to the research, the Stoke Association’s Dr Clare Walton said clot-busters did not work for all patients so new techniques could help many patients. She added: “Clot retrieval devices have the potential to be used with more stroke patients and are better at removing blood clots than clot-busting drugs. “We are very excited about this potential new treatment and look forward to further developments.” Dr Philip Gorelick, from Michigan State University, said the studies were “major steps forward in the successful treatment of acute ischaemic stroke, and pave the way for new treatment options.” The research was published to coincide with a European Society of Cardiology meeting in Munich. (BBC)