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Pune: Pune reported its first two cases of Zika virus infection as a 46-year-old doctor and his teenage daughter have tested positive but their health condition is stable, an official said on Wednesday.
The man recently developed symptoms like fever and rashes, following which he was admitted to a private hospital. The medical facility sent his blood samples to the city-based National Institute of Virology (NIV) for analysis. On June 21, his reports confirmed that he tested positive for Zika virus infection, a health official of the Pune Municipal Corporation (PMC) said.
Also Read:Uttarakhand Health Secretary urges for blood donation amid surge in dengue cases
The doctor is a resident of the Erandwane area of the city, he said.
According to a PTI report, “After he tested positive, the blood samples of his five family members were collected and sent for analysis, and it was found that his 15-year-old daughter was also positive for the infection,” the official added.
The Zika virus disease is transmitted through the bite of an infected Aedes mosquito, which is also known to transmit infections like dengue and chikungunya. The virus was first identified in Uganda in 1947.
After these two cases were reported in the city, the PMC’s health department has started conducting surveillance, the official said.
Although no other suspected cases have been found in the area, the authorities have started taking precautionary steps like fogging and fumigation to curb the breeding of mosquitoes, he said, news agency PTI reported.
“The mosquito samples have been collected by the state health department. We have started the general public awareness in the area and given instructions to monitor the health of pregnant women in the area. Zika does not lead to serious complications in general, but in case a pregnant woman gets infected, it may cause microcephaly in the foetus,” he said.
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Jammu: Dr Shariq Rashid
Masoodi, a renowned endocrinologist has been appointed as
the Dean of the Medical Faculty at the Sher-i-Kashmir Institute of Medical
Sciences (SKIMS). This prestigious appointment underscores his significant
contributions to the medical institution and the field of endocrinology in
Jammu & Kashmir.
SKIMS released a
statement highlighting Dr Masoodi’s vast contributions to the institute. He is
the Head of the Department of Endocrinology at SKIMS and plays a pivotal
role in the Endocrinology Department, where he also manages Pediatric
Endocrinology services, focusing on diabetes and endocrine disorders in
children.
Masoodi boasts an impressive academic background and
extensive postgraduate training. He did his M.B.B.S. in December 1987 from
Government Medical College (GMC) Srinagar, under the University of Kashmir and then
completed his M.D. in Medicine in April 1993 at the SKIMS, affiliated with
SKIMS Deemed University. Dr Masoodi
received a D.M. in Endocrinology in December 2003 from the esteemed
Postgraduate Institute of Medical Education & Research (PGIMER) in
Chandigarh.
Additionally, he obtained a Fellowship in Personalized
and Genomic Diabetes Medicine in August 2014 from the University of Maryland
School of Medicine, Baltimore, MD, demonstrating his commitment to staying at
the forefront of medical advancements.
Currently, Dr Masoodi is a key figure in Endocrinology,
with a distinguished career marked by diverse roles and achievements, a
statement issued by the SKIMS said. Apart
from leading the Department of Endocrinology, he oversees Pediatric
Endocrinology services at SKIMS, specializing in diabetes and endocrine
disorders in children, reports UNI.
He also serves as Chairman of the Medical Board at
SKIMS, Convenor of the Data Safety & Monitoring Board (DSMB), and
Editor-in-Chief of the Journal of Medical Sciences (JMS). Internationally, he is a Visiting Professor at the
University of Maryland School of Medicine, Division of Endocrinology, Diabetes
& Nutrition. Dr Masoodi’s research has been widely recognized, with
numerous publications in high-impact journals, over 24,647 citations, and an
h-index of 38, making him one of the leading researchers in medical sciences in
the region.
He is also an active member of the International Endocrine
Society (ESI) USA & life member of various societies including the Endocrine
Society of India (ESI), Research Society for Study of Diabetes in India (RSSDI),
Association of Physicians of India (API), Bone and Mineral Research Society of
India (ISBMR).
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USA: A recent study presented as abstract 56-OR at a prominent medical conference has raised concerns about the impact of delays in statin therapy due to patient non-acceptance of cardiovascular outcomes in individuals with diabetes. The findings highlight significant implications for clinical practice and patient education regarding the importance of timely intervention in managing cardiovascular risk factors.
The study, published in the journal Diabetes and presented at the American Diabetes Association 84th Scientific Sessions, showed that patients with diabetes without atherosclerotic cardiovascular disease (ASCVD) who delay statin therapy due to statin non-acceptance have an increased risk of cardiovascular (CV) events.
The finding identifies a previously unexplored gap in care that increases the CV burden in this already high-risk population.
Diabetes is a known risk factor for cardiovascular disease, making effective management of cholesterol levels crucial in reducing associated risks. Statins are widely prescribed to lower cholesterol and prevent cardiovascular events in diabetic patients. However, the study focused on cases where patients delayed or refused statin therapy, leading to potential adverse consequences.
Many patients diagnosed with diabetes choose not to follow their clinicians’ recommendations for statin therapy. The long-term clinical consequences of refusing statins remain uncertain. Considering this, Nisarg Shah, New Haven, CT, Boston, MA, Baltimore, MD, and colleagues conducted a retrospective cohort study of patients with diabetes without ASCVD treated at Mass General Brigham from 2000-2018. They analyzed the relationship between delay in statin therapy due to statin non-acceptance by patients and the incidence of CV events (ischemic stroke or myocardial infarction).
Information about baseline characteristics and statin non-acceptance was obtained from the electronic medical records and a previously validated Natural Language Processing tool.
The following were the key findings of the study:
In conclusion, patients diagnosed with both type 1 and type 2 diabetes who postpone initiating statin therapy, recommended to mitigate their heightened risk of cardiovascular events, experience markedly increased rates of cardiovascular events during a 10-year follow-up period compared to those who begin treatment promptly.
Reference:
NISARG SHAH, ZHOU LAN, SETH S. MARTIN, C J. BROWN, ALEXANDER TURCHIN; 56-OR: Impact of Delays in Statin Therapy Due to Statin Nonacceptance on Cardiovascular Outcomes in Patients with Diabetes. Diabetes 14 June 2024; 73 (Supplement_1): 56–OR. https://doi.org/10.2337/db24-56-OR
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Researchers have found that serum levels of certain unsaturated fatty acids are associated with prediabetes risk. This study, leveraging data from the National Health and Nutrition Examination Survey (NHANES) for 2003-2004 and 2011-2012, provides new insights into how regulating these fatty acids could help prevent prediabetes. This study was recently published in the journal Diabetes Research and Clinical Practice by Liwen Zhang and colleagues.
Prediabetes is a condition characterized by elevated blood glucose levels that are not yet high enough to be classified as diabetes. Understanding the risk factors associated with prediabetes is crucial for developing preventive strategies. Unsaturated fatty acids (UFAs), which include polyunsaturated fatty acids (PUFAs) and monounsaturated fatty acids (MUFAs), play significant roles in metabolism and health. This study aimed to explore the association between serum levels of common and uncommon UFAs and the risk of prediabetes.
Data were analyzed from 3575 individuals enrolled in NHANES for the years 2003-2004 and 2011-2012. Weighted proportional and multivariate logistic regression analyses were performed to assess the association of serum PUFAs and MUFAs with prediabetes risk. The analyses adjusted for potential confounders such as age, sex, body mass index (BMI), smoking status, and physical activity levels.
The study identified significant associations between specific PUFAs and MUFAs and the risk of prediabetes. Key findings include:
PUFAs:
• Eicosapentaenoic acid (EPA, 20:5 n3) was associated with an increased risk of prediabetes (OR = 1.878, 95% CI: 1.177–2.996, Ptrend = 0.002).
• Gamma-linolenic acid (GLA, 18:3 n6) was also associated with an increased risk (OR = 1.702, 95% CI: 1.140–2.541, Ptrend = 0.016).
MUFAs
• Palmitoleic acid (PA, 16:1 n7) was linked to a higher risk of prediabetes (OR in quintile5 = 1.780, 95% CI: 1.056–3.001, Ptrend = 0.003).
• Eicosenoic acid (EA, 20:1 n9) was inversely associated with prediabetes risk (OR = 0.587, 95% CI: 0.347–0.994, Ptrend = 0.010).
• Additionally, nonlinear analysis revealed that serum levels of EPA (20:5 n3) and EA (20:1 n-9) were nonlinearly associated with prediabetes risk, indicating complex relationships between these fatty acids and metabolic health.
The study’s findings suggest that some serum n-3 PUFAs are positively associated with prediabetes, while several n-6 PUFAs have inverse associations. This indicates that different types of UFAs can have varying impacts on prediabetes risk, highlighting the importance of individualized nutritional strategies.
The study concludes that certain serum unsaturated fatty acids are associated with the risk of prediabetes. Specifically, n-3 PUFAs such as EPA and GLA are linked to increased risk, while certain MUFAs like EA are associated with reduced risk. These results suggest that managing serum levels of specific UFAs may play a role in prediabetes prevention, offering new directions for clinical and nutritional interventions.
Reference:
Zhang, L., Liu, J., Cao, Y., Liu, S., Zhao, W., Wang, C., Banzhao, S., Liu, Z., & Liu, L. (2024). Association between circulating levels of unsaturated fatty acids and risk for prediabetes in the NHANES 2003–2004 and 2011–2012. Diabetes Research and Clinical Practice, 111728, 111728. https://doi.org/10.1016/j.diabres.2024.111728
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A new study to be presented at the SLEEP 2024 annual meeting found that low-dose acetylsalicylic acid, also known as aspirin, can reduce inflammatory responses to sleep restriction.
Results show that compared with placebo, preemptive administration of low-dose aspirin during sleep restriction reduced pro-inflammatory responses. Specifically, aspirin reduced interleukin-6 expression and COX-1/COX-2 double positive cells in lipopolysaccharide-stimulated monocytes, as well as C-reactive protein serum levels.
“The novelty of this study is that it investigated whether we can pharmacologically reduce the inflammatory consequences of sleep restriction,” said lead author Larissa Engert, who has a doctorate in behavioral physiology and is a postdoctoral fellow in the department of neurology at Beth Israel Deaconess Medical Center and the division of sleep medicine at Harvard Medical School in Boston. “We used a non-steroidal, anti-inflammatory drug because it has been shown to affect specific inflammatory pathways, which were previously shown to be dysregulated by experimental sleep restriction or sleep disturbances.”
The researchers collected data from 46 healthy adults in a randomized placebo-controlled crossover trial with three protocols – sleep restriction/aspirin, sleep restriction/placebo, and control sleep/placebo – each consisting of a 14-day at-home phase followed by an 11-day in-hospital stay. In the sleep restriction/aspirin condition, participants took low-dose aspirin during the at-home phase and in-hospital stay. Each in-hospital stay started with two nights of an eight-hour sleep opportunity. Then, under the sleep restriction conditions, participants were exposed to five nights of a four-hour sleep opportunity, followed by three nights of recovery sleep. The control sleep condition provided an eight-hour sleep opportunity throughout the in-hospital stay. Sleep and immunologic measures were assessed at baseline and various points throughout the study.
The data also reveal that the aspirin-induced reduction of inflammatory pathway activity in sleep-restricted participants was paralleled by decreased wake after sleep onset and increased sleep efficiency during recovery sleep, Engert noted.
“These findings show that it is possible to blunt inflammatory pathways activated by sleep restriction through preemptive administration of low-dose aspirin. This may foster the development of new therapeutics that specifically target those pathways, and do not exhibit the undesirable side effects associated with aspirin, such as bleeding and stroke. Such therapeutics could complement behavioral sleep improvement therapies to better prevent or control inflammation and its consequences in those experiencing periods of sleep deficiency,” Engert said.
Reference:
Larissa Engert, Carola Ledderose, Careen Biniamin, Paola Birriel, Olivia Buraks, Bryan Chatterton, Rammy Dang, Surya Daniel, Annika Eske, Taylor Reed, Ava Tang, Suzanne Bertisch, Janet Mullington, Wolfgang Junger, Monika Haack, 0174 Using Low-Dose Acetylsalicylic Acid to Target Inflammation in Response to Experimental Sleep Restriction in Humans, Sleep, Volume 47, Issue Supplement_1, May 2024, Page A75, https://doi.org/10.1093/sleep/zsae067.0174.
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An unexpectedly versatile and regenerative stem cell in early embryos may be key to creating new effective fertility treatments, suggests a new study in mice from the University of Copenhagen.
It probably will not surprise anyone that pregnancy is a very complicated process. First, a sperm cell must find its way and fertilize an egg in the fallopian tube, after which the egg begins to divide. After about five days, the egg becomes a blastocyst, which eventually develops into a fetus.
But for more and more people, fertility is becoming increasingly harder to achieve due to various factors affecting either sperm or egg quality, in addition to issues surrounding implantation of the embryo into the womb. In Denmark more people are seeking help to have children through fertility treatments, counting for 1 out of 8 pregnancies.
But the success rate for treatment remains low, around 20-30 percent, depending on the woman’s age and fertility. Now, researchers from the University of Copenhagen discovered a breakthrough that could lead to more successful fertility treatments in the future.
“We are looking at cells in the mouse embryo called the primitive endoderm, also known as the hypoblast. We found these cells were unique and could generate an embryo on their own. This is particularly interesting as a recent study suggests that the primitive endoderm is the only cell type in the embryo associated with high implantation success in clinical studies,” says PhD student and first author of the study Madeleine Linneberg-Agerholm. She adds:
“These cells would normally only provide nutrition and support for a normal embryo, but when we isolate them, they can remake an embryo on their own, which is a very surprising find.”
They also found that stem cells from the primitive endoderm grown in the laboratory develop in a dish to form “stem cell-based embryo models,” called a blastoid at very high efficiency. These embryo models have the potential to be very important tools that can be used to discover new drugs for improving IVF outcomes.
“This could be particularly important for improving current treatments for infertility, as plasticity and robustness may be the secret to enabling embryos to survive the abnormal environmental conditions found in the laboratory and in the process of transfer to the mother,” says Professor Joshua Brickman, who is the senior author of the study.
The study has been done in mice, but the researchers behind the study are already looking into doing similar research on human stem cells.
When an embryo starts to develop, it is a single cell that then becomes a cluster of cells, where the outer cells will become the future placenta and the inner cells will make either the primitive endoderm, the future yolk sac, or the epiblast, which makes the embryo itself.
“The final step of blastocyst development is the primitive endoderm. And if you take all the things around the primitive endoderm away, the primitive endoderm somehow ‘remembers’ how to create an embryo, and it can do it on its own,” Joshua Brickman explains and continue:
“We also show that these cells in the primitive endoderm remember how to make the other cell types as they have transcription factors that sit on DNA at important regulatory sequences (enhancers), like bookmarks. At these sites, these factors don’t normally do anything but can remember what to do in the event there is a problem. Think of the genome as a book, these bookmarks are a reminder of what page contains the instructions to make other cell types.”
The researchers hope that their results can bring some light to how to enhance the chance of successful IVF treatments. But also, to give us more knowledge on why some people have trouble getting pregnant in the first place.
“In cases where women are having trouble getting pregnant, it could also be a defect in the primitive endoderm that causes the problem, as not only does it provide nutrients, but it also could have an important role in repairing damage. For now, this is speculation, but it is curious that this cell type is such a clear predictor of successful implantation,” says Joshua Brickman.
For now, the researchers will focus on gaining more knowledge of the functions of the primitive endoderm and focusing on how to improve their existing human primitive endoderm stem cells.
“We believe that this suggests that the early primitive endoderm is a structure that can regenerate the missing lineages in case of damage. As we have produced primitive endoderm stem cells, the study of these cells, and the signals that guide them could lead to enhanced IVF treatments,” says Joshua Brickman.
Reference:
Madeleine Linneberg-Agerholm, Annika Charlotte Sell, Alba Redó-Riveiro, Marta Perera, Martin Proks, Teresa E. Knudsen, Antonio Barral, Miguel Manzanares, The primitive endoderm supports lineage plasticity to enable regulative development, Cell, https://doi.org/10.1016/j.cell.2024.05.051.
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Today, findings from the ATTEMPT study, showed that a low-dose of SGLT2 inhibitor could safely be given to youth and adolescents with type 1 diabetes to improve kidney function and glycemic management. ATTEMPT is the first of its kind, landmark trial designed to evaluate the effectiveness of SGLT2 inhibitors to optimize diabetes control and prevent early subclinical kidney complications in an at-risk pediatric population with type 1 diabetes. The results were presented as a Late-Breaking Symposium at the 84th Scientific Sessions of theAmerican Diabetes Association® (ADA) in Orlando, FL.
Type 1 diabetes impacts 352,000 children and adolescents younger than an age of 20 years. Diabetes is the number one cause of kidney disease, highlighting the need for renal precautions and interventions among individuals with diabetes. About 65% of children with type 1 diabetes may experience kidney complications which can lead to chronic kidney disease (CKD) as they age.
ATTEMPT (The Adolescent Type 1 Diabetes Treatment with SGLT2i for hyperglycEMia & hyperfiltration Trial) is a double-blinded, randomized, placebo-controlled trial that evaluated the impact of the SGLT2 inhibitor, Dapagliflozin, versus a placebo in combination with insulin therapy in adolescents with type 1 diabetes. Over a 16-week monitoring period, this trial assessed detailed renal mechanistic evaluations with direct measurement of glomerular filtration rate (GFR), glycemic control (HbA1c), and safety outcomes in 98 participants with type 1 diabetes. As a result, the ATTEMPT trial provides essential information in establishing a framework for young adolescents to evaluate key physiologic, mechanistic, and metabolic outcomes when using SGLT2i alongside insulin in type 1 diabetes.
The study demonstrated that a low dose of SGLT2 inhibitor could safely be given to youths and adolescents to improve kidney function as well as improve glycemic management. Treatment with low dose Dapagliflozin attenuated direct measures of GFR and was associated with a significant decline in HbA1c of 0.48% (P=0.001). No significant differences in the proportion of participants who experienced adverse events, elevated ketone levels, hypoglycemia and genitourinary tract infections in the Dapagliflozin vs Placebo groups were seen. A single case (N=1) of mild DKA was seen in the Dapagliflozin group. While rates of DKA were low, a greater number of elevated blood ketone events ≥0.6mmol/L were seen in the Dapagliflozin group (n=106) vs Placebo group (n=62) (P<0.001), emphasizing the patient centered DKA Risk Mitigation Education strategy operationalized during the study.
This study paves the way for us to evaluate treatments that can reduce kidney disease progression for those with type 1 diabetes,” said Farid Mahmud, MD, University of Toronto, lead investigator of study. “These findings also give us meaningful insights as we look how we optimize diabetes management in youth and young adults during a challenging period associated with kidney disease progression and above-target A1c.”
The authors note the trial was designed with protocols to successfully mitigate the risk for diabetic ketoacidosis, a risk that will need to be considered before these drugs can be widely used in clinical practice. They also state that the ATTEMPT Trial paves the way for researchers to produce longer studies that could help better understand additional benefits of adjunctive therapy in type 1 diabetes.
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A new study revealed that Laryngeal Recalibration Therapy (LRT) guided by speech-language pathologists (SLPs) effectively reduces chronic laryngopharyngeal symptoms like cough, throat clearing, voice changes, paradoxic vocal fold movement and laryngospasm. These symptoms are often caused by local irritation from substances like refluxate and increased sympathetic tone. The key findings were published in the recent issue of American Journal of Gastroenterology.
The study evaluated the symptom response to LRT in patients with chronic laryngopharyngeal symptoms who were undergoing evaluation for gastroesophageal reflux disease (GERD). This study prospectively followed adults who were referred for GERD evaluation and the participants had to complete at least two SLP-directed LRT sessions to be included
This research collected data from various diagnostic tools, including endoscopy, ambulatory reflux monitoring and patient-reported outcomes. The primary focus was on the symptom response to LRT.
A total of 65 participants completed the study with a mean age of 55.4 years. Most of them were female (71%) with a mean body mass index of 25.6 kg/m² where the participants underwent an average of 3.7 LRT sessions. Also, 85% of the participants met the criteria for symptom response that indicated significant improvement in their conditions.
The study examined specific subgroups and found that among the participants with only laryngopharyngeal symptoms, 87% responded positively to LRT. Those with both laryngopharyngeal and esophageal symptoms had an 84% positive response rate. The symptom response rates were analyzed in participants who underwent reflux monitoring by revealing similar positive outcomes regardless of GERD status. Also, 86% of participants with proven GERD, 89% of the participants with inconclusive GERD and 77% of participants without GERD showed improvement of symptoms and quality of life.
The findings highlight the effectiveness of SLP-directed LRT in treating chronic laryngopharyngeal symptoms, regardless of GERD diagnosis or the presence of esophageal symptoms. This suggests that LRT can be a valuable component in the multidisciplinary management of these conditions.
The study emphasizes the role of mechanical desensitization and cognitive recalibration in suppressing hyper-responsive laryngeal patterns. Overall, LRT offers a promising treatment option for individuals who suffer from chronic laryngopharyngeal symptoms. The high response rates observed in the study support the integration of LRT into the broader management strategy for these conditions which can potentially benefit a wide range of patients.
Source:
Walsh, E., Krause, A. J., Greytak, M., Kaizer, A. M., Weissbrod, P. A., Liu, K., Taft, T., & Yadlapati, R. (2024). Laryngeal Recalibration Therapy Improves Laryngopharyngeal Symptoms in Patients With Suspected Laryngopharyngeal Reflux Disease. In American Journal of Gastroenterology. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.14309/ajg.0000000000002839
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Singapore: A recent study has uncovered concerning implications for individuals with type 2 diabetes who develop incident heart failure, revealing an elevated risk of progressing to end-stage kidney disease (ESKD). Type 2 diabetes is already known to increase the likelihood of cardiovascular complications, including heart failure, which affects the heart’s ability to pump blood effectively.
In a recent Singaporean study, heart failure (HF) markedly raised severe ESKD risk in type 2 diabetes (T2D) patients, peaking at onset. The findings, published in Cardiovascular Diabetology, highlight the need for intensive surveillance of kidney function after incident heart failure, especially within the first two years after HF diagnosis.
“Younger patients with higher UACR & HbA1c faced increased risks. Individuals with HFpEF showed a higher ESKD risk versus HFrEF (aHR 13.7 vs. 6.5). Final analyses showed a 9.6-fold ESKD risk increase post-HF, stressing urgent renal monitoring, particularly within 2yrs post-diagnosis,” the researchers reported.
Type 2 diabetes remains a prevalent health concern globally, affecting millions with its complex web of metabolic challenges. Among its numerous complications, cardiovascular disease and kidney dysfunction stand out as primary contributors to morbidity and mortality.
Diabetic kidney disease is an established risk factor for HF. However, there is no systematic assessment of the impact of incident heart failure on the subsequent renal failure risk in the diabetic population. Sylvia Liu, Clinical Research Unit, Khoo Teck Puat Hospital, Singapore, and colleagues sought to study the risk of progression to ESKD after incident heart failure in Asian patients with T2D.
For this purpose, the researchers conducted a prospective cohort study comprising 985 outpatients with type 2 diabetes from a regional hospital and a primary care facility in Singapore; they were followed for a median of 8.6 years. ESKD was defined as a composite of progression to sustained eGFR below 15 ml/min/1.73m2, maintenance dialysis, or renal death, whichever occurred first.
The key findings of the study were as follows:
· 180 incident heart failure events and 181 incident ESKD events were identified during follow-up.
· Of 181 ESKD events, 21% occurred after incident heart failure.
· Compared to those did not progress to ESKD after incident heart failure (n = 142), participants who progressed to ESKD after heart failure occurrence were younger and had higher HbA1c and higher urine albumin-to-creatinine ratio at baseline.
· The excess risk of ESKD manifested immediately after heart failure occurrence, persisted for two years, and was moderated thereafter.
· Cox regression suggested that, compared to counterparts with no heart failure event, participants with heart failure occurrence had a 9.6-fold increased risk for incident ESKD after adjustment for baseline cardio-renal risk factors, including eGFR and albuminuria.
· Heart failure with preserved ejection fraction had a higher risk for ESKD than those with reduced ejection fraction (adjusted HR 13.7 versus 6.5).
In conclusion, incident heart failure impinged a high risk for progression to ESKD in T2D patients. Intensive surveillance of kidney function is warranted after heart failure diagnosis, especially in the first two years after HF occurrence.
Reference:
Liu, S., Liu, JJ., Ang, K. et al. Incident heart failure and the subsequent risk of progression to end stage kidney disease in individuals with type 2 diabetes. Cardiovasc Diabetol 23, 204 (2024). https://doi.org/10.1186/s12933-024-02279-y
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