Time-restricted eating and high-intensity exercise might work together to improve metabolic health: Study

Combining time-restricted eating with high-intensity functional training may improve body composition and cardiometabolic parameters more than either alone, according to a study published in the open-access journal PLOS ONE by Ranya Ameur and Rami Maaloul from the University of Sfax, Tunisia, and colleagues.

Changes in diet and exercise are well-known ways to lose weight and improve cardiometabolic health. However, finding the right combination of lifestyle changes to produce sustainable results can be challenging. Prior studies indicate that time-restricted eating (which limits when, but not what, individuals eat) and high-intensity functional training (which combines intense aerobic and resistance exercise) may be beneficial and easier for individuals to commit to long term.

In a new study, researchers investigated the impact of time-restricted eating and high-intensity functional training on body composition and markers of cardiometabolic health such as cholesterol, blood glucose, and lipid levels. 64 women with obesity were assigned to one of three groups: time-restricted eating (diet only), high-intensity functional training (exercise only), or time-restricted eating plus high-intensity functional training (diet + exercise). Participants following the time-restricted eating regimen ate only between 8:00 am and 4:00 pm. Those in the functional training groups worked out three days per week with an instructor.

After 12 weeks, all three groups had significant weight loss and decreases in waist and hip circumference. Likewise, all groups showed favorable changes in lipid and glucose levels.

Some differences were seen between groups. For example, fat-free mass (a combination of lean mass and skeletal muscle mass) and blood pressure improved in the diet + exercise and exercise groups but did not change in the diet-only group.

Participants in the diet + exercise group generally experienced more profound changes in body composition and cardiometabolic parameters than either diet or exercise alone.

The researchers noted that this is a relatively small study, and it is difficult to tease out the contributions of specific exercise routines or of time-restricted eating and calorie reduction since both groups reduced their calorie intake. However, they note that combining time-restricted eating with high-intensity functional training might show promise in improving body composition and cardiometabolic health.

The authors add: “Combining time-restricted eating with High Intensity Functional Training is a promising strategy to improve body composition and cardiometabolic health.”

Reference:

Ranya Ameur ,Rami Maaloul ,Sémah Tagougui,Fadoua Neffati,Faten Hadj Kacem,Mohamed Fadhel Najjar,Achraf Ammar,Omar Hammouda, Unlocking the power of synergy: High-intensity functional training and early time-restricted eating for transformative changes in body composition and cardiometabolic health in inactive women with obesity, PLoS ONE, https://doi.org/10.1371/journal.pone.0301369.

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High-Resolution Computed Tomography combined with clinical information may help detect COPD early: Study

A retrospective study conducted at the Second Affiliated Hospital of Shenyang Medical College focused on utilizing quantitative computed tomography (QCT) techniques to detect early structural changes associated with Chronic Obstructive Pulmonary Disease (COPD). The study concluded that QCT measurements, when combined with clinical information, serve as an effective tool for early detection and assessment of high-risk COPD patients.

This study was published in the International Journal Of Chronic Obstructive Pulmonary Disease by Zhang W. and colleagues. This study aimed to identify high-risk COPD participants by employing QCT measurements in conjunction with pulmonary function tests (PFTs) and clinical characteristics. 140 participants diagnosed as Non-COPD (FEV1/FVC > 70%) were divided into low-risk COPD (FEV1% ≥ 95%) and high-risk groups (80% < FEV1% < 95%).

Inspiratory high-resolution CT scans were conducted along with PFTs and clinical data collection. QCT measurements were analyzed using statistical methods like Student’s t-test, Mann–Whitney U-test, LASSO method for feature identification, and Spearman rank correlation test for assessing associations with PFTs. Support Vector Machine (SVM) was employed to identify high-risk COPD participants, evaluating the model’s performance in terms of accuracy, sensitivity, specificity, F1-score, and AUC.

  • SVM Performance: The SVM model utilizing QCT measurements exhibited promising accuracy in identifying high-risk COPD patients with 85.71% accuracy, 88.34% sensitivity, 84.00% specificity, 83.33% F1-score, and an AUC of 0.93.

  • Integration with Clinical Data: Incorporating QCT measurements with clinical information further improved the model’s performance, achieving an accuracy of 90.48%.

  • Correlation with PFTs: Certain QCT measurements, particularly the emphysema index of the left lower lung (%LAA−950), showed a negative correlation with PFTs, signifying their relevance in assessing pulmonary function status.

The integration of QCT indexes into clinical practice could significantly aid in evaluating pulmonary function status, potentially allowing for early interventions and improved management strategies for COPD patients.

Reference:

Zhang, W., Zhao, Y., Tian, Y., Liang, X., & Piao, C. Early diagnosis of high-risk chronic obstructive pulmonary disease based on quantitative high-resolution computed tomography measurements. International Journal of Chronic Obstructive Pulmonary Disease,2023;18:3099–3114. https://doi.org/10.2147/copd.s436803

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Ultrasound-guided QLB effective adjuvant analgesic technique in pediatric patients undergoing pyeloplasty, claims study

Recently published article reports the findings of a randomized clinical trial that investigated the impact of ultrasound-guided quadratus lumborum block (QLB) on analgesia and neuroendocrine stress response in pediatric patients undergoing pyeloplasty. The study involved 60 children aged 1-7 years undergoing elective open pyeloplasty, who were randomly assigned to receive either QLB with 0.5 ml/kg of 0.25% ropivacaine after induction of general anesthesia (GA) or GA alone. The researchers found that the QLB group exhibited decreased serum cortisol and blood glucose levels at 30 minutes after surgical incision and 24 hours after surgery compared to the preoperative values and the GA group. Additionally, the quality of analgesia assessed using the FLACC scale was significantly better in the QLB group, and the fentanyl consumption was lower in the QLB group compared to the GA group, both intraoperatively and postoperatively.

Benefits and Outcomes of QLB in Pediatric Pyeloplasty Patients

The study also emphasized the importance of reducing neuroendocrine stress response in pediatric surgical patients and noted that QLB attenuated this response effectively in the pyeloplasty patients. The research showcased the potential of QLB as part of multimodal analgesia and its ability to provide effective pain relief in pediatric patients undergoing pyeloplasty. The data indicated stable hemodynamics and a reduced stress response in patients receiving QLB, without significant complications such as postoperative nausea and vomiting, urinary retention, motor weakness, respiratory distress, or block site hematoma formation. The study’s strength lies in its detailed assessment of the neuroendocrine and analgesic effects of QLB in pediatric patients undergoing pyeloplasty, thereby contributing to the understanding of effective pain management strategies in this population.

In conclusion, the study demonstrated that ultrasound-guided QLB holds potential as an effective adjuvant analgesic technique in pediatric patients undergoing pyeloplasty, with the ability to attenuate neuroendocrine stress response and improve postoperative analgesia. The findings contribute to the growing body of evidence supporting the use of regional analgesic techniques such as QLB in pediatric surgical patients, particularly in procedures associated with significant postoperative pain. However, the study also noted some limitations, including the need for further research to evaluate additional stress response indicators and consider alternative forms of analgesia in the control group.

Key Points

– The study emphasized the importance of reducing neuroendocrine stress response in pediatric surgical patients and noted that QLB effectively attenuated this response in the pyeloplasty patients. QLB was found to provide stable hemodynamics and reduce the stress response in patients without significant complications. The research highlighted the potential of QLB as part of multimodal analgesia, providing effective pain relief without significant side effects in pediatric patients undergoing pyeloplasty.

– The study demonstrated that ultrasound-guided QLB holds potential as an effective adjuvant analgesic technique in pediatric patients undergoing pyeloplasty, with the ability to attenuate neuroendocrine stress response and improve postoperative analgesia. The findings contribute to the evidence supporting the use of regional analgesic techniques such as QLB in pediatric surgical patients, particularly in procedures associated with significant postoperative pain. However, the study noted the need for further research to evaluate additional stress response indicators and consider alternative forms of analgesia in the control group.

Reference –

Rathod, Pyarelal Ramsing; Bhoi, Debesh; Kumar, Ajeet; Ray, Bikash Ranjan; Mohan, Virender Kumar; Kashyap, Lokesh. Effect of ultrasound-guided quadratus lumborum block on neuroendocrine stress response and postoperative analgesia in paediatric patients undergoing elective open pyeloplasty – A randomised clinical trial. Indian Journal of Anaesthesia 68(5):p 467-472, May 2024. | DOI: 10.4103/ija.ija_608_23

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Intranasal Medications Show Efficacy in Treating Allergic Rhinitis: Study

Researchers have found that most intranasal medications, including corticosteroids and antihistamines, are effective in improving nasal and ocular symptoms, as well as the quality of life for patients with perennial or seasonal allergic rhinitis (AR). However, there are notable differences in the certainty of evidence supporting their efficacy. This study was published in the The Journal of Allergy and Clinical Immunology. The study was conducted by Bernardo S. and colleagues.

Allergic rhinitis (AR) is a common condition that affects the nasal passages, causing symptoms such as sneezing, congestion, and itchy eyes. Intranasal medications, such as corticosteroids and antihistamines, are often used to manage AR symptoms. However, the effectiveness of these medications has not been systematically compared against placebo.

A systematic review was conducted to evaluate the efficacy of individual intranasal corticosteroids and antihistamines in adult patients with seasonal or perennial AR. The review included randomized controlled trials that compared the use of intranasal medications versus placebo.

The assessed outcomes included:

  1. Total Nasal Symptom Score (TNSS)

  2. Total Ocular Symptom Score (TOSS)

  3. Rhinoconjunctivitis Quality-of-Life Questionnaire (RQLQ)

Random-effects meta-analyses were performed to compare mean differences in outcomes for each medication and placebo. Evidence certainty was assessed using the GRADE approach.

The key findings of the study were:

  • A total of 151 primary studies were included in the review, with most studies focusing on patients with seasonal AR.

  • Most assessed treatments were found to be more effective than placebo in improving symptoms and quality of life for both perennial and seasonal AR.

  • In seasonal AR, azelastine-fluticasone, fluticasone furoate, and fluticasone propionate showed the highest probability of moderate or large improvements in TNSS and RQLQ.

  • Azelastine-fluticasone also displayed the highest probability of moderate or large improvements in TOSS.

  • Evidence certainty was rated as “high” in 6 out of 46 analyses, “moderate” in 23 out of 46 analyses, and “low” or “very low” in 17 out of 46 analyses.

The study’s findings suggest that intranasal medications are generally effective in treating rhinitis symptoms and improving quality of life. However, the varying levels of evidence certainty indicate that additional research may be needed to further support the use of certain medications.

Intranasal medications, including corticosteroids and antihistamines, are effective in managing allergic rhinitis symptoms and improving quality of life. Nonetheless, the certainty of evidence supporting their efficacy varies, highlighting the need for further research in this area.

Reference:

Sousa-Pinto, B., Vieira, R. J., Brozek, J., Cardoso-Fernandes, A., Lourenço-Silva, N., Ferreira-da-Silva, R., Ferreira, A., Gil-Mata, S., Bedbrook, A., Klimek, L., Fonseca, J. A., Zuberbier, T., Schünemann, H. J., & Bousquet, J. (2024). Intranasal antihistamines and corticosteroids in allergic rhinitis: A systematic review and meta-analysis. The Journal of Allergy and Clinical Immunology. https://doi.org/10.1016/j.jaci.2024.04.016

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A Year-Long Clinical Study Compares Self-Adhesive and Conventional Bulk-Fill Composites in Class II Cavities

Egypt: In the realm of dental care, advancements in materials and techniques continually shape the landscape of treatment options available to patients. A recent randomized controlled clinical study conducted over a year has shed light on the comparative efficacy of self-adhesive and conventional bulk-fill composites in treating Class II cavities. The study, published in the Journal of Esthetic and Restorative Dentistry, offers valuable insights into the performance of these two commonly used dental materials.

In the study, the researchers compared the efficacy of self-adhesive and conventional bulk-fill composites in class II restorations over 12 months. They found that both materials met Federation Dentaire Internationale criteria, with the self-adhesive composite demonstrating comparable biological and functional performance to the conventional composite. However, the conventional composite exhibited superior esthetic qualities.

Class II cavities, which occur on the sides of molars and premolars, pose unique challenges for dental restorations due to their location and the forces they endure during chewing. In the study, Mohamed S. Ellithy, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt, and colleagues compared the clinical efficacy of self-adhesive bulk-fill Surefil One with a traditional bulk-fill composite in class II restorations.

For this purpose, the researchers included sixty-four direct class II composite restorations. They were categorized into two groups: Group I, control group (n = 32): cavities were restored by Filtek One bulk-fill composite with Scotchbond Universal (SBU) adhesive in self-etch mode, Group II, test group (n = 32): cavities were restored by Surefil One self-adhesive bulk-fill composite.

The follow-up period was one year, during which restoration assessment was done at baseline (BL), six months, and 12 months using Federation Dentaire Internationale (FDI) criteria. Data analysis was performed using nonparametric tests. A comparison of restoration characteristics was performed.

The study led to the following findings:

  • Filtek One and Surefil One bulk-fill composites revealed clinically acceptable FDI scores over 12-month recalls.
  • Thirty-two patients (64 restorations) were available for all follow-up visits; 100% of the restorations survived.
  • For esthetic properties, Filtek One was far better than Surefil One at all time points.
  • In terms of functional and biological properties, both restorations demonstrated comparable performances.

“Filtek One bulk-fill restorations were superior in terms of surface staining, surface luster, color match, and translucency, but Surefil One restorations performed well and were comparable to Filtek One restorations,” the researchers wrote. “However, there is a need for additional advancements and research to obtain better esthetics. Furthermore, there is a need for longitudinal studies with extended follow-up periods to assess the clinical potential of both materials.”

Reference:

Ellithy, M. S., Abdelrahman, M. H., & Afifi, R. R. Comparative clinical evaluation between self-adhesive and conventional bulk-fill composites in class II cavities: A 1-year randomized controlled clinical study. Journal of Esthetic and Restorative Dentistry. https://doi.org/10.1111/jerd.13242

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Revolutionizing postoperative care: CT volumetric imaging enhances lung function assessment in lung cancer patients

China: In a groundbreaking development in thoracic oncology, the clinical application of computed tomographic (CT) volumetric imaging is poised to revolutionize postoperative lung function assessment in patients undergoing lung cancer surgery. This innovative approach offers unprecedented insights into lung function recovery following surgical intervention, heralding a new era of personalized postoperative care for lung cancer patients.

A recent study published in BMC Medical Imaging has shown the potential of CT volumetric imaging analysis to determine the pre-and post-operative lung function and to predict post-surgery complication occurrence in lung cancer patients with pulmonary lobectomy.

“We found that lung function detected from CT volumetric analysis is consistent with those from the lung function measurements in lung cancer patients, suggesting that CT volumetric imaging can be a future tool to predict postoperative lung function and to predict the postoperative complications of patients,” the researchers wrote.

Lung cancer surgery, while often essential for disease management, poses inherent risks to pulmonary function, potentially leading to postoperative complications such as respiratory insufficiency and impaired lung capacity. Traditionally, lung function assessment relied on spirometry and pulmonary function tests, which provided limited information on regional lung ventilation and perfusion dynamics.

The advent of computed tomographic volumetric imaging has transformed the landscape of postoperative lung function evaluation by enabling comprehensive three-dimensional characterization of lung anatomy and function. Leveraging advanced imaging techniques, including dynamic contrast-enhanced imaging and perfusion scans, clinicians can visualize and quantify regional lung ventilation and perfusion with unprecedented precision.

Against the above background, Yanni Zhang, ZhangJiaKou First Hospital, Zhangjiakou, Hebei, China, and colleagues aimed to evaluate the effectiveness of the CT volumetric analysis in postoperative lung function assessment and the predicting value for postoperative complications in patients who had segmentectomy for lung cancer.

For this purpose, the researchers performed CT scanning and pulmonary function examination for 100 patients with lung cancer. CT volumetric analyses were performed by specific software, for the mean lung density at the expiratory phase (MLDex), for the mean inspiratory lung density (MLDin), the volume of the inspiratory phase (Vin), and the volume of the expiratory phase (Vex).

Postoperative lung function was predicted using pulmonary function examination results and CT volumetric analysis results. The correlations and concordance of these values were evaluated by Pearson correlation analysis and Bland-Altman analysis, respectively. Multivariate binomial logistic regression analysis was executed to evaluate the associations of CT data with complication occurrence.

The study revealed the following findings:

· Correlations between CT scanning data and pulmonary function examination results were significant in both pre-and post-operation (0.8083 ≤ r ≤ 0.9390).

· Forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and the ratio of FVC and FEV1 estimated by CT volumetric analyses showed high concordance with those detected by pulmonary function examination.

· Preoperative (Vin-Vex) and (MLDex- MLDin) values were identified as predictors for post-surgery complications, with hazard ratios of 5.378 and 6.524, respectively.

The findings showed that lung function detected from CT volumetric analysis is consistent with those from the lung function measurements in patients with lung cancer. In addition, CT volumetric imaging can be a future tool to predict post-operative lung function and predict patients, postoperative complications.

“This study may propose important implications for improving the prediction of patients’ post-operative lung function and ultimately contributing to better patient outcomes,” the researchers concluded.

Reference:

Xu, Z., Wang, X., Shen, Z. et al. Clinical application of computed tomographic volumetric imaging in postoperative lung function assessment in patients with lung cancer. BMC Med Imaging 24, 99 (2024). https://doi.org/10.1186/s12880-024-01268-7

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Researchers identify biomarkers in blood to predict liver cancer

Early detection has the potential to transform treatment and outcomes in cancer care, especially for cancers like liver cancer, which is typically diagnosed at a late stage with limited options for cure. A new study led by investigators from Mass General Brigham and Beth Israel Deaconess Medical Center suggests that proteins detectable in the blood could improve predictions about risk of liver cancer years before typical diagnosis. Results are published in JNCI.

“Liver cancer rates are rapidly increasing, and liver cancer has a high mortality rate, but if we can diagnose it early, therapeutic interventions can be potentially curative,” said lead author Xinyuan (Cindy) Zhang, PhD, of the Channing Division of Network Medicine at Brigham and Women’s Hospital. “We need to have a way to detect this form of cancer early enough to intervene with surgery or liver transplantation to treat the disease before it becomes metastatic.”

Liver cancer, or hepatocellular carcinoma (HCC), ranks as the third leading cause of cancer worldwide and the second leading cause of cancer-related deaths globally, with its incidence rate nearly tripled since 1980s in the US. Detection of liver cancers often occurs at advanced stages, where life expectancy typically spans less than 12 months. Certain high-risk populations, such as individuals with cirrhosis and hepatitis, stand to significantly benefit from early detection tests. Currently, there is a notable deficiency in accurate, sensitive, and specific tools for the early detection of liver cancer. Many existing methods are relatively expensive, invasive, or limited in accessibility, primarily confined to major hospitals.

The research team included investigators from Mass General Brigham’s founding members, Brigham and Women’s Hospital and Massachusetts General Hospital, Harvard T.H. Chan School of Public Health, Beth Israel Deaconess Medical Center and Yale University. The team utilized proteomics (profiling of proteins) to develop a prediction model aimed at diagnosing or screening for liver cancer at an earlier stage. They used the SomaScan Assay Kit, a high-throughput proteomics platform that measures protein levels in biological samples, available through the Beth Israel Deaconess Medical Center Genomics, Proteomics, Bioinformatics and Systems Biology Center. The SomaScan platform allowed them to detect minute levels of circulating proteins that may be present at early stage of disease, measuring 1,305 proteins simultaneously in the blood.

“It’s always been challenging to identify highly specific disease biomarkers in the blood using traditional tools, but this new technology allows us to detect a broad and dynamic range of both high and low abundant proteins,” said co-senior author Towia A. Libermann, PhD, of the Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center. “New insights into the biological mechanisms underlying liver cancer development emerge from our data that may lead to identification of novel therapeutic targets. Most importantly, we were able to validate these early detection biomarkers using alternative protein analysis techniques and in an independent population cohort from the UK.”

The study team used SomaScan to analyze plasma samples from participants in both the Nurses’ Health Study and the Health Professional Follow-Up Study, two longitudinal, ongoing, prospective cohorts in the U.S. Notably, they examined blood samples obtained from individuals an average of 12 years before their liver cancer diagnosis to pinpoint protein biomarker signals. After examination, the researchers cross-referenced medical records to confirm whether these patients ultimately developed liver cancer.

From the blood samples, the researchers identified 56 plasma proteins that showed significantly elevated levels in individuals with liver cancer compared to matched control individuals without hepatocellular cancer. The team selected four of these proteins to create a predictive model, which they tested on the UK Biobank Pharma Proteomics dataset, comprised of 50,000 individuals, 45 of whom were diagnosed with liver cancer. Their model had greater accuracy in predicting liver cancer compared to traditional risk factors.

The authors caution that their study included a limited number of liver cancer cases and further validation in larger, more diverse patient populations and in high-risk populations is needed.

“Even though further investigation in additional populations is absolutely needed, our results reveal a robust circulating protein profile associated with liver cancer years before diagnosis, which is remarkable,” said co-senior author Xuehong Zhang, MBBS, ScD, who conducted work on this study while at the Channing Division of Network Medicine at the Brigham. Zhang is now at Yale.

The study team also aims to extend their methodology to uncover additional plasma protein biomarkers utilizing the more expanded SomaScan assay measuring 11,000 proteins, explore biomarkers linked with different cancer types, and gain deeper insights into the role of hepatocellular cancer risk factors across specific patient populations. With further progress, the protein biomarkers investigated in the study could potentially hold clinical significance as a non-invasive test for assessing liver cancer risk.

Reference:

Xinyuan Zhang, Longgang Zhao, Long H Ngo, Simon T Dillon, Xuesong Gu, Michelle Lai, Tracey G Simon, Andrew T Chan, Edward L Giovannucci, Towia A Libermann, Xuehong Zhang, Pre-diagnostic plasma proteomics profile for hepatocellular carcinoma, JNCI: Journal of the National Cancer Institute, 2024;, djae079, https://doi.org/10.1093/jnci/djae079

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Nonmotor seizures may be missed in children and teenagers, finds study

Children and teens may experience nonmotor seizures for months or years before being seen in an emergency department for a more obvious seizure that includes convulsions, according to a study published in online issue of Neurology®, the medical journal of the American Academy of Neurology. Even then, the history of nonmotor seizures may not be recognized.

“Early diagnosis of epilepsy is of the utmost importance because epileptic seizures can lead to injury and even death,” said study author Jacqueline French, MD, of NYU Grossman School of Medicine in New York City and a Fellow of the American Academy of Neurology. “Medications can reduce these risks, but our study found that a history of nonmotor seizures was being missed when children and teens were seen in emergency care.”

Subtle, nonmotor seizures have no noticeable movement. Symptoms affect the senses and may include nausea, visual distortions, feelings of déjà vu, or smelling odd odors. Motor seizures involve uncontrolled movements of the arms and legs and include more severe tonic-clonic seizures with full body convulsions.

The study involved 83 children and teens 12 to 18 years old. All were within four months of starting treatment for focal epilepsy, which accounts for more than half of all epilepsy cases and involves recurring seizures that begin in a localized area of the brain. Researchers reviewed participants’ medical records. There were 39 participants whose first seizure was a motor seizure, and 44 whose first seizure was a nonmotor seizure.

Before diagnosis, 58 went to emergency care for seizures. Looking back at medical records, researchers determined for 32, their first seizure was a motor seizure, and for 26, a nonmotor seizure. But when seeking this emergency care, 90% were seen for motor seizures, with 38% of that group having an unidentified history of nonmotor seizures.

There were 17 participants who were seen for their first motor seizure who had a history of nonmotor seizures, but none were recognized at the time as having had prior nonmotor seizures. As a result, they received similar treatment as those experiencing their first seizure, even though they were more advanced in the disease. French noted nonmotor seizures often worsen over time and progress to tonic-clonic seizures when left untreated.

Researchers found those with initial nonmotor seizures were less likely to seek emergency care with only 59% seeking care compared to 82% of those with initial motor seizures.

In emergency care, researchers also found just 33% of nonmotor seizures were correctly identified compared to 81% of motor seizures.

“Participants with nonmotor seizures described symptoms of hearing repeated phrases or jumbled noises, zoning out and episodes of dizziness, yet for many, this history was not collected until they had a tonic-clonic seizure and were referred to a neurologist,” said French. “This highlights a critical need for doctors to ask about these symptoms when someone seeks care for a motor seizure to ensure they get the best care.”

A limitation of the study was that nonmotor seizures may have been underreported, particularly in children who may have had difficulty identifying and communicating the symptoms of those seizures.

Reference:

Nora Jandhyala, Monica Ferrer, Jacob Pellinen, Hadley T. Greenwood, Dennis J. Dlugos, MSCE, Kristen L. Park,  Liu Lin Thio, and Jacqueline French, Unrecognized Focal Nonmotor Seizures in Adolescents Presenting to Emergency Departments, Neurology, https://doi.org/10.1212/WNL.0000000000209389.

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Repeated low-level red light exposure may improve myopia among children: Study

Repeated low-level red light exhibited a stronger impact on myopic children compared with premyopic individuals suggests a study published in the British Journal of Ophthalmology.

A study was done to compare the effects of repeated low-level red light (RLRL) treatment on axial length growth and refractive error changes in myopic and premyopic children. Subjects were assigned randomly to four subgroups: myopia-repeated low-level red light group (M-RL), myopia-control group (M-C), premyopia-repeated low-level red light group (PM-RL) and premyopia-control group (PM-C). Subjects in the RLRL group completed a 12-month treatment composed of a 3 min repeated low-level red light treatment session twice daily, with an interval of at least 4 hours, for 7 days per week. Visits were scheduled before and at 1-month, 3-month, 6-month, 9-month and 12-month follow-up after the treatment. Repeated-measures analysis of variance was used to compare the spherical equivalent refractive errors (SE) and axial length (AL) changes between the groups across the treatment period.Results: After 12 months of treatment, in the myopia group, SE and AL changes were −0.078±0.375 D and 0.033±0.123 mm for M-RL and −0.861±0.556 D and 0.415±0.171 mm for M-C; in the premyopia group, the progression of SE and AL was −0.181±0.417 D and 0.145±0.175 mm for PM-RL and −0.521±0.436 D and 0.292±0.128 mm for PM-C. PM-RL indicated a lower myopia incidence than PM-C (2.5% vs 19.4%). Additionally, the percentage of AL shortening in the M-RL was higher than that in the PM-RL before the 9-month follow-up. Repeated low-level red light effectively delayed myopia progression in children with myopia and reduced the incidence of myopia in premyopic children. Moreover, repeated low-level red light exhibited a stronger impact on myopic children compared with premyopic individuals.

Reference:

Liu G, Rong H, Liu Y, et alEffectiveness of repeated low-level red light in myopia prevention and myopia control. British Journal of Ophthalmology. Published Online First: 17 April 2024. doi: 10.1136/bjo-2023-324260

Keywords:

Liu G, Rong H, Liu Y, British Journal of Ophthalmology, Rpeated, low-level red light, stronger impact, myopic, children, premyopic

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Fracture in number of ribs independent risk factor for venous thromboembolism, finds study

Rib fracture in number of ribs independent risk factor for venous thromboembolism suggests a new study published in the Journal of Orthopaedic Surgery and Research.

Venous thromboembolism (VTE) refers to a condition characterized by abnormal coagulation of blood within the veins, leading to impaired venous flow. Venous thromboembolism represents a potentially life-threatening complication following trauma, including both types of pulmonary embolism (PE) and deep vein thrombosis (DVT). Investigating the incidence of VTE and associated risk factors in patients with traumatic rib fractures can effectively aid in the early clinical diagnosis and improve diagnostic efficiency for this condition. This study aimed to determine the incidence and influencing factors of venous thromboembolism (VTE) in patients with traumatic rib fractures. The retrospective study analyzed medical records of patients with traumatic rib fractures from 33 hospitals. Results: The overall incidence of Venous thromboembolism in hospitalized patients with traumatic rib fractures was 8.1%. Patients with isolated traumatic rib fractures had a significantly lower incidence of Venous thromboembolism (4.4%) compared to patients with rib fractures combined with other injuries (12.0%). Multivariate analysis identified the number of rib fractures as an independent risk factor for thrombosis. Surgical stabilization of isolated rib fractures involving three or more ribs was associated with a lower Venous thromboembolism incidence compared to conservative treatment. Patients with rib fractures have a higher incidence of Venous thromboembolism, positively correlated with the number of rib fractures. However, the occurrence of thrombosis is relatively low in isolated rib fractures. Targeted thromboprophylaxis strategies should be implemented for these patients, and surgical stabilization of rib fractures may be beneficial in reducing the risk of Venous thromboembolism.

Reference:

Zhang, D., Yang, Y., Yi, Y. et al. Incidence and influence factors of venous thromboembolism in traumatic rib fracture patient: a multicenter study. J Orthop Surg Res 19, 152 (2024). https://doi.org/10.1186/s13018-024-04622-1

Keywords:

Rib fracture, number of ribs, independent risk factor, venous thromboembolism,Journal of Orthopaedic Surgery and Research, Zhang, D., Yang, Y., Yi, Y, VTE, Influencing factors, Epidemiological study

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