Indian-origin Radiologist who drove family off cliff will get mental health treatment

New York: An Indian-origin doctor who drove his tesla off a cliff last year with his wife and two children inside, will receive mental health treatment after doctors found he was suffering from schizoaffective disorder. 

Patel, his wife, and his children all survived the crash after the California doctor had driven his Tesla off a cliff last year, believing that his children, seven and four years old, were in danger of being sex trafficked,’ RT International reported. 

Patel, 43, pleaded not guilty to three counts of attempted murder. Last week, he was found eligible for a mental health diversion, according to court records.

Also Read:Indian-Origin Radiologist who drove family off cliff was Psychotic: Reports

According to a UNI report, the accused pleaded not guilty in September to three counts of attempted murder after plunging his Tesla 250 feet off a cliff with his family inside on January 2, 2023. All four survived after emergency workers rescued them from the rubble, a New York Times report said.

On Thursday, Patel was found eligible for a mental health diversion that allows a person charged with a crime to instead undergo treatment, according to records filed in Superior Court in San Mateo County, NYT said.

Under the provision, prosecution is postponed while the defendant undergoes mental health treatment, and may be dismissed entirely.

He will remain in jail for some more weeks and then will be released to his parents’ home in Belmont, Calif., where he will be monitored by GPS and required to report to court once a week, according to the release, news agency UNI reported.

He is not allowed to leave San Mateo County and must surrender his driver’s license and passport, the report said.

Medical Dialogues team had earlier reported that an Indian-origin radiologist residing in Pasadena, California was facing psychotic episodes leading up to a harrowing incident where he drove his family’s Tesla off a cliff near Half Moon Bay, according to recent media reports. 

Also Read:Indian-origin paediatrician helps nab nurse convicted of killing 7 babies in UK

Powered by WPeMatico

USFDA issues complete response letter for Patritumab Deruxtecan in EGFR-Mutated NSCLC: Merck, Daiichi Sankyo

Rahway: The U.S. Food and Drug Administration (FDA) has issued a Complete Response Letter (CRL) for the Biologics License Application (BLA) seeking accelerated approval of Daiichi Sankyo and Merck’s (known as MSD outside of the United States and Canada) patritumab deruxtecan (HER3-DXd) for the treatment of adult patients with locally advanced or metastatic EGFR-mutated non-small cell lung cancer (NSCLC) previously treated with two or more systemic therapies.

The CRL results from findings pertaining to an inspection of a third-party manufacturing facility. The CRL did not identify any issues with the efficacy or safety data submitted.

Patritumab deruxtecan is a specifically engineered potential first-in-class HER3 directed DXd antibody drug conjugate (ADC) discovered by Daiichi Sankyo and being jointly developed by Daiichi Sankyo and Merck.

“We will work closely with the FDA and the third-party manufacturer to address the feedback as quickly as possible in order to bring the first HER3 directed medicine to patients with previously-treated EGFR-mutated non-small cell lung cancer.” said Ken Takeshita, MD, Global Head, R&D, Daiichi Sankyo. “We remain confident in the ability to develop this medicine to its full potential.”

“Patients with previously treated EGFR-mutated non-small cell lung cancer often experience recurrence and have limited treatment options.” said Marjorie Green, MD, Senior Vice President and Head of Oncology, Global Clinical Development, Merck Research Laboratories. “We are committed to working with Daichi Sankyo and the FDA to prioritize making patritumab deruxtecan available to these patients in need.”

The BLA is based on the primary results from the HERTHENA-Lung01 pivotal phase 2 trial that were presented at the IASLC 2023 World Conference on Lung Cancer (#WCLC23) and simultaneously published in the Journal of Clinical Oncology.

In HERTHENA-Lung01, patritumab deruxtecan was studied in 225 patients with EGFR-mutated locally advanced or metastatic NSCLC following disease progression with an EGFR TKI and platinum-based chemotherapy, which demonstrated an objective response rate (ORR) of 29.8% (95% CI: 23.9-36.2), including one complete response and 66 partial responses. The median duration of response (DoR) was 6.4 months (95% CI: 4.9-7.8).

The safety profile of patritumab deruxtecan observed in HERTHENA-Lung01 was consistent with previous phase 1 clinical trials in NSCLC with a treatment discontinuation rate of 7.1% due to treatment-emergent adverse events (TEAEs). Grade 3 or higher TEAEs occurred in 64.9% of patients. The most common (≥5%) grade 3 or higher TEAEs were thrombocytopenia (21%), neutropenia (19%), anemia (14%), leukopenia (10%), fatigue (6%), hypokalemia (5%) and asthenia (5%). Twelve patients (5.3%) had confirmed treatment-related interstitial lung disease (ILD) as determined by an independent adjudication committee. One grade 5 ILD event was observed.

Read also: Merck Capvaxive gets USFDA nod for prevention of Invasive Pneumococcal Disease, Pneumococcal Pneumonia in adults

Powered by WPeMatico

Semaglutide lowers cardiovascular risk regardless of blood sugar: ADA meeting

A weekly dose of semaglutide 2.4 mg significantly reduced the risk of major adverse cardiovascular events (MACEs) in people with overweight or obesity and cardiovascular disease but not diabetes, regardless of blood sugar level, according to a clinical trial including researchers from UT Southwestern Medical Center.

The findings, published in Diabetes Care, also show the reduction in MACEs – a combination of heart attacks, stroke, or death from cardiovascular causes – isn’t due to the drug’s effect in lowering blood sugar.

“We showed that even people with completely normal blood sugar have the same benefits in reducing MACEs as people with blood sugar levels in the prediabetes range. This is very important information that helps us understand which patients might benefit from the cardiovascular risk-lowering effects of this medicine,” said first author Ildiko Lingvay, M.D., M.P.H., M.S.C.S., Professor of Internal Medicine in the Division of Endocrinology and in the Peter O’Donnell Jr. School of Public Health at UT Southwestern.

Dr. Lingvay and her international colleagues collaborated in the Semaglutide Effects on Cardiovascular Outcomes in People with Overweight or Obesity Trial (SELECT). This is the longest and largest study with semaglutide (a drug better known in the U.S. under its brand name Wegovy), designed to test its effects on MACE risk in people who have overweight or obesity with cardiovascular disease but no diabetes. Semaglutide was originally approved in 2017 by the U.S. Food and Drug Administration (FDA) at a dose of 1.0 mg for adults with Type 2 diabetes and in 2022 for chronic weight management at a dose of 2.4 mg.

The main results of the trial, published last year in tumors , showed a 20% reduction in the risk of MACE in 8,803 participants who took semaglutide, compared with 8,801 participants who took an identical-looking placebo.

How semaglutide works to lower cardiovascular risk has remained an important question. The drug exerts a wide variety of beneficial effects, including reducing blood sugar (glucose), body weight, blood pressure, blood lipids such as cholesterol, and inflammation, any of which can contribute to the reduction in MACE risk.

In the recent analysis, Dr. Lingvay and her colleagues focused on examining whether semaglutide’s glucose-lowering effects might be at least partially responsible for lowering the participants’ MACE risk. To answer this question, they tested the participants’ hemoglobin A1C (HbA1C) – a measure of average glucose over two to three months – at the start of the trial and after the participants had taken semaglutide or the placebo for 20 weeks. At baseline, a third of the participants had HbA1C readings below 5.7%, a level considered normal. However, the remaining two-thirds had readings between 5.7% and 6.5%, in the prediabetes range.

Most people on semaglutide had a significant reduction in their HbA1C levels by the 20-week mark. An analysis of the number of MACEs that occurred during the study period showed those taking the drug had about 20% fewer of these events, regardless of their HbA1C at baseline and subsequent measurements over time. These findings suggest factors other than semaglutide’s glucose-lowering effects are responsible for this reduction in MACE risk, Dr. Lingvay said.

Other recent findings of SELECT to which Dr. Lingvay contributed have shown that weight loss from semaglutide also doesn’t appear connected to the reduction in MACE risk, but a decrease in inflammation from the drug does seem to be partially responsible. She notes that she and other authors will continue to investigate the mechanisms behind semaglutide’s beneficial cardiovascular effects.

In another analysis of the SELECT study recently published in Nature Medicine, Dr. Lingvay and colleagues reported the effect of once-weekly semaglutide on kidney function. The researchers’ results suggested semaglutide also had a beneficial effect on the kidneys.

These studies were funded by Novo Nordisk A/S, the maker of semaglutide. Dr. Lingvay receives personal consulting compensation from Novo Nordisk.

References: Ildiko Lingvay; John Deanfield; Steven E. Kahn; Peter E. Weeke; Hermann Toplak; Benjamin M. Scirica; Lars Rydén ; Naveen Rathor; Jorge Plutzky; Cristobal Morales; A. Michael Lincoff; Michael Lehrke ; Ole Kleist Jeppesen; Grzegorz Gajos; Helen M. Colhoun ; Bertrand Cariou ; Donna Ryan ; SELECT Trial Investigators

Crossmark: Check for Updates

Corresponding author: Ildiko Lingvay, ildiko.lingvay@utsouthwestern.edu

Diabetes Care dc240764

https://doi.org/10.2337/dc24-0764

Powered by WPeMatico

Doctors at Kauvery Hospital give new lease of Life to 22-year-old man with Rare Diaphragmatic Hernia caused by road accident

Tirunelveli: Kauvery Hospitals, a prominent chain of multi-speciality healthcare facilities in India, is renowned for its cutting-edge medical treatments, advanced technology, and comprehensive healthcare services.  

A 22-year-old man was rushed to the emergency ward of Kauvery Hospitals in Tirunelveli, India, after sustaining severe internal injuries from an accident. A CT scan revealed that the impact had pushed his abdominal organs— including the small intestine, large intestine, stomach, and liver—through a tear in his diaphragm into his chest cavity. This condition led to breathing difficulties and posed life-threatening risks. So, immediately patient was stabilized with oxygen support, IV fluids, antibiotics and antihypertensives.  

Also Read:Kauvery Hospital opens 200-bedded Maa Kauvery Hospital for women and children

According to an ANI report, a team of specialists, including Dr Karthikeyan, Surgical Gastroenterologist and Dr Sanjiv Pandian – Cardio-thoracic Surgeon, immediately into action, a minimally- invasive laparoscopic surgical method was opted; but due to difficulty, performed a complex surgical procedure to move the displaced organs back to their original position.

After the surgery, the patient was able to breathe normally and fully recovers within 7 days. He is now back to his daily activities and work.

“The peculiarity of the case is that diaphragmatic hernia is normally seen as a birth defect, but this was caused by a road accident. I’m grateful to the entire team at Kauvery Hospital, Tirunelveli for their swift diagnosis and successful surgery, which saved the life of this young patient,” said Dr Karthikeyan, news agency ANI reported.

“This case is a testament to Kauvery Hospitals’ commitment to providing exceptional, life-saving medical care. We are proud of our team of specialists especially Dr Karthikeyan who pooled their expertise handle this rare and complex case, said Dr Lakshmanan, Medical Administrator at Kauvery Hospitals.

Also Read:Doctors at Kauvery Hospital treats 48-year-old man with complete traumatic Amputation Resulting from Wrist Injury

Powered by WPeMatico

Intensive Glycaemic Control Sustains Benefits in Type 2 Diabetes Management, reveals Long-Term Study

UK: In a groundbreaking development, the findings of extended post-trial monitoring of a randomized controlled trial (RCT) on intensive glycaemic control in type 2 diabetes have been revealed. The study, known as UKPDS 91, has provided unprecedented insights into the long-term efficacy and sustainability of intensive glucose control measures for individuals with type 2 diabetes (T2D).

The study, published in The Lancet, found that early intensive glycaemic control with insulin, sulfonylurea, or metformin appears to confer a near-lifelong reduced myocardial infarction and death risk compared with conventional glycaemic control. It showed the importance of achieving near normoglycaemia immediately following diagnosis to minimize the lifetime risk of diabetes-related complications to the greatest extent possible.
The 20-year UK Prospective Diabetes Study revealed major clinical benefits for people with newly diagnosed T2D randomly allocated to intensive glycaemic control with sulfonylurea or metformin therapy or insulin therapy, compared with conventional glycaemic control. 10-year post-trial follow-up identified enduring and emerging glycaemic and metformin legacy treatment effects. Prof Amanda I Adler, Diabetes Trials Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK, and colleagues aimed to determine whether these effects would wane by extending follow-up for another 14 years.
5102 patients enrolled between 1977 and 1991, of whom 4209 were originally randomly allocated to receive either intensive glycaemic control (insulin or sulfonylurea, or if overweight, metformin) or conventional glycaemic control (primarily diet). At the end of the 20-year interventional trial, 3277 surviving participants entered a 10-year post-trial monitoring period. Eligible participants for the study were all surviving participants at the end of the 10-year post-trial monitoring period.
The researchers performed an extended follow-up of these participants by linking them to their routinely collected National Health Service (NHS) data for another 14 years. Clinical outcomes were derived from hospital admissions, records of deaths, emergency unit and accident attendances, and outpatient visits.
Seven prespecified aggregate clinical outcomes (i.e, diabetes-related death, any diabetes-related endpoint, myocardial infarction, death from any cause, peripheral vascular disease, stroke, and microvascular disease) were examined by the randomized glycaemic control strategy on an intention-to-treat basis using Kaplan–Meier time-to-event and log-rank analyses.
The following were the key findings of the study:
· 1489 of 1525 participants could be linked to routinely collected NHS administrative data between 2007 and 2021. Their mean age at baseline was 50·2 years, and 41·3% were female. The mean age of those still alive as of Sept 30, 2021, was 79·9 years. Individual follow-up from baseline ranged from 0 to 42 years, with a median of 17·5 years. Overall follow-up increased by 21%, from 66 972 to 80 724 person-years.
· For up to 24 years after the trial ends, the glycaemic and metformin legacy effects showed no sign of waning.
· Early intensive glycaemic control with sulfonylurea or insulin therapy, compared with conventional glycaemic control, showed overall relative risk reductions of 10% for death from any cause, 17% for myocardial infarction, and 26% for microvascular disease.
· Corresponding absolute risk reductions were 2·7%, 3·3%, and 3·5%, respectively.
· Early intensive glycaemic control with metformin therapy, compared with conventional glycaemic control, showed overall relative risk reductions of 20% for death from any cause and 31% for myocardial infarction.
· Corresponding absolute risk reductions were 4·9% and 6·2%, respectively.
· No significant risk reductions during or after the trial for stroke or peripheral vascular disease were observed for both intensive glycaemic control groups, and there was no significant risk reduction for microvascular disease for metformin therapy.
In conclusion, the extended post-trial monitoring of UKPDS 91 underscores the enduring benefits of intensive glycaemic control in type 2 diabetes management. These findings underscore the importance of early intervention and sustained adherence to glucose-lowering measures in mitigating the long-term risks associated with diabetes.
Reference:
Adler AI et al. Post-trial monitoring of a randomised controlled trial of intensive glycaemic control in type 2 diabetes extended from 10 years to 24 years (UKPDS 91). Lancet 2024 May 17; [e-pub]. (https://doi.org/10.1016/S0140-6736(24)00537-3)

Powered by WPeMatico

GLP-1 medications for type 2 diabetes and obesity may lower risk of acute pancreatitis: Study

Medications for type 2 diabetes and obesity known as GLP-1 receptor agonists may lower the risk of acute pancreatitis recurrence in people with obesity and those with type 2 diabetes, according to a study presented Saturday at ENDO 2024, the Endocrine Society’s annual meeting in Boston, Mass.

Doctors have been cautious about prescribing these medications in patients with a history of pancreatitis due to the potential risk of worsening the condition – a warning that is included in prescribing information, said lead researcher Mahmoud Nassar, M.D., Ph.D., Department of Medicine fellow in the Division of Endocrinology, Diabetes, and Metabolism in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo in Buffalo, N.Y. Acute pancreatitis is a sudden inflammation of the pancreas.

“Our research highlights the safety and the potential for GLP-1 receptor agonists to reduce the risk of acute pancreatitis recurrence in individuals with obesity and type 2 diabetes, challenging previous concerns and offering new hope for effective disease management,” Nassar said.

The researchers used data from a large database called TriNetX, which contains information from about 127 million patients across 15 countries, mainly from the United States. They identified 638,501 individuals with a history of acute pancreatitis.

They focused on adults with diabetes and obesity who had been diagnosed with acute pancreatitis. The researchers wanted to see if certain medications for diabetes and obesity (specifically, GLP-1 receptor agonists, SGLT2 inhibitors and DPP4 inhibitors) affected their risk of getting pancreatitis again.

Their analysis covered a wide range of medications within each category to understand how these types of treatments might affect pancreatitis risk. They also looked closely at different patient characteristics, such as age, gender, body mass index (BMI) and blood test results, to better understand patient groups.

To figure out the risk of pancreatitis, they tracked how many patients developed pancreatitis again within 5 years of starting their medication. They compared groups of patients taking different medications, matching them by patient characteristics.

When the GLP-1 group was compared with patients taking SGLT2 inhibitors, the GLP-1 group showed a lower risk of acute pancreatitis recurrence (15.2%) compared with 24% in the SGLT2i group. When GLP-1 patients were compared with those taking DPP4i drugs, the GLP-1 group’s recurrence risk was 14.4%, compared with 23.3% in the DPP4i group. When GLP-1 patients were compared with those not taking any of these medications, the GLP-1 group’s recurrence risk was 14.5%, compared with 51.6% in the comparison group.

“This study provides critical insights that could change the treatment landscape for patients with obesity and type 2 diabetes, particularly those with a history of acute pancreatitis,” Nassar said. “The possibility of using GLP-1 receptor agonists more broadly offers hope for better managing these conditions, improving patient outcomes and enhancing quality of life. It emphasizes the importance of personalized medicine, where treatment decisions are tailored to the individual’s specific health profile and needs.”

Powered by WPeMatico

Sotagliflozin Cost-Effective for Heart Failure and Diabetes Patients, finds JACC Study

A recent analysis of the SOLOIST-WHF trial published in the JACC: Heart Failure provided strong evidence on the cost-effectiveness of sotagliflozin for patients with diabetes and recent worsening of heart failure. While the SOLOIST-WHF trial had already demonstrated the efficacy of sotagliflozin in improving health outcomes for these patients, the economic impact of the drug had not been thoroughly investigated.

The study was set out to evaluate whether sotagliflozin is a cost-effective treatment option for patients with diabetes and recent worsening of heart failure. This evaluation is crucial for informing healthcare policy and ensuring that the benefits of the drug justify its costs within the U.S. healthcare system.

To determine the cost-effectiveness of sotagliflozin, the research team developed a Markov model based on data from the SOLOIST-WHF trial, which included a total of 1,222 patients. The model estimated the lifetime impact of sotagliflozin from the perspective of the U.S. healthcare sector. Cost data were drawn from the National Inpatient Sample, while the life expectancy projections were based on census data, adjusted by the mortality rates observed in the SOLOIST-WHF trial. Event rates for both fatal and nonfatal incidents were extrapolated from trial data and utility values were derived from published reports.

The analysis revealed that patients treated with sotagliflozin had a lifetime quality-adjusted life-year (QALY) of 4.43 when compared to 4.04 for the patients who were receiving a placebo. However, this improvement in quality of life came at a higher cost: lifetime costs were $220,113 for the sotagliflozin group against $188,198 for the placebo group.

Despite the increased costs, the incremental cost-effectiveness ratio (ICER) was calculated at $81,823 per QALY gained. This metric is vital for determining the value of medical interventions as it compares the additional cost of a treatment to the additional health benefits it provides.

The study assessed the probability of sotagliflozin being cost-effective at various willingness-to-pay thresholds. At a threshold of $50,000 per QALY gained, the probability was 3.6%. This probability increased significantly to 67.5% at a threshold of $100,000 per QALY gained and further to 89.4% at $150,000 per QALY gained.

The findings indicated that sotagliflozin is a cost-effective treatment for patients with diabetes and recent worsening of heart failure when evaluated against commonly accepted willingness-to-pay thresholds in the U.S. healthcare system. Overall, this cost-effectiveness supports the inclusion of sotagliflozin in treatment protocols for these patients by potentially leading to better health outcomes and optimized resource allocation in healthcare settings.

Source:

Weintraub, W. S., Kolm, P., Dolman, S., Alva, M., Bhatt, D. L., & Zhang, Z. (2024). Cost-Effectiveness of Sotagliflozin in SOLOIST-WHF. In JACC: Heart Failure. Elsevier BV. https://doi.org/10.1016/j.jchf.2024.04.018

Powered by WPeMatico

Weight Loss Associated with Decreased Cancer Risk in Individuals with Obesity: ADA meeting

Today, data from a retrospective observational study conducted using the electronic health record at the Cleveland Clinic, shows that real-world weight loss can be associated with a reduced risk of obesity-related cancers. The findings were presented as a Late-Breaking Poster at the 84th Scientific Sessions of the American Diabetes Association® (ADA) in Orlando, FL.

Overall, 78% of people with diabetes have clinical obesity. Obesity is linked to higher risks of at least 13 types of cancer due to excess estrogen and elevated insulin, including breast, kidney, ovary, liver, and pancreatic cancer. There is an increased need to further understand the association between diabetes, obesity, and cancer and corresponding treatments.

The study included a total of 172 patients including 100,143 in the control arm and 5,329 cases. The median body mass index (BMI at censoring (kg/m2.) was 34.2 for cases and 34.5 for controls, which are considered to have obesity according to the Centers for Disease Control and Prevention (CDC). The association between the percentage change in body mass index (BMI) with three, five, and 10-year intervals prior to cancer diagnosis (for cases) versus controls for each cancer endpoint was assessed using logistic regression models. The primary endpoint of this study shows 13 obesity-related cancers found. The secondary endpoint of this study was highlighted with the occurrence of 16 other types of cancer including melanoma and other skin malignancies as well as cancers related to the urinary tract, hematopoietic and lymphoid tissues, respiratory and intrathoracic organs, male genital organs, female genital organs, eye, brain and other parts of the central nervous system, and digestive organs.

In this study, data shows that real-world weight loss is associated with a reduced risk of obesity-related cancers. The results show a reduced risk of developing obesity-related cancers with weight loss at three years (OR 0.99, 95%CI [0.984, 0.996]) and five years (OR 0.989,95% CI [0.983-0.995]), and for other types of cancer for all time intervals (ORs<1, P <0.001). The risk was reduced for renal cell carcinoma (three years), multiple myeloma (10 years), and endometrial cancer (three and five years) among primary cancer endpoints (P<0.05).

“This study reinforces how crucial it is to treat obesity as a chronic disease,” said Kenda Alkwatli, MD, Clinical Fellow at Cleveland Clinic, and author of study. “We are hopeful that these results can help us better understand how we can use weight loss to address comorbidities including cancer in patients with obesity.”

This study is an example of why more research is needed to determine whether cancer risk is influenced by the amount, rate, and method of weight loss. Future studies will focus on and test to see if specific anti-obesity medications can reduce cancer risk.

Powered by WPeMatico

Stillbirths Linked to Higher Postpartum Readmission Risk: Study Reveals

Researchers have found that the risk for postpartum readmission is significantly higher among patients who experience stillbirths compared to those who have live births. A recent retrospective cohort study utilizing the 2019 Nationwide Readmissions Database sheds light on this increased risk, emphasizing the need for targeted postnatal care and support for individuals who suffer stillbirths. This study was published in the American Journal of Obstetrics and Gynecology by Leena C. and colleagues.

Stillbirth, a devastating event, not only impacts maternal health through physical complications but also poses a significant psychosocial hazard. Pregnant people with comorbid conditions and obstetrical complications are more prone to stillbirth, which in turn increases maternal morbidity and necessitates careful postpartum management. This study aimed to compare the risk of postpartum readmission between patients with stillbirths and live births, identifying key indications for readmission and associated risk factors.

This retrospective cohort study included patients with singleton stillbirths or live births delivered at or beyond 20 weeks’ gestation. The primary outcome measured was all-cause readmission within six weeks of discharge from the childbirth hospitalization. The study utilized multivariable regression models to adjust for maternal age, sociodemographic characteristics, maternal and obstetrical conditions, and delivery characteristics.

  • Postpartum readmission occurred in 2.7% of 16,636 patients with stillbirths compared to 1.6% of 2,870,677 patients with live births (unadjusted risk ratio, 1.65; 95% confidence interval [CI], 1.47–1.86).

  • The adjusted risk ratio for readmission after stillbirth versus live birth was 1.27 (95% CI, 1.11–1.46).

  • 30.2% for stillbirths vs. 39.5% for live births (unadjusted risk ratio, 0.76; 95% CI, 0.63–0.93).

  • 6.8% for stillbirths vs. 3.6% for live births (unadjusted risk ratio, 1.90; 95% CI, 1.15–3.16).

  • 5.8% for stillbirths vs. 2.0% for live births (unadjusted risk ratio, 2.87; 95% CI, 1.60–5.17).

  • Among patients with stillbirths, 56.0% of readmissions occurred within one week, 71.8% within two weeks, and 88.1% within four weeks. The timing did not significantly differ between the stillbirth and live birth cohorts.

Risk Factors for Readmission after Stillbirth:

  • Pregestational Diabetes: Adjusted risk ratio, 1.87 (95% CI, 1.20–2.93).

  • Gestational Diabetes: Adjusted risk ratio, 1.67 (95% CI, 1.03–2.71).

  • Hypertensive Disorders of Pregnancy: Adjusted risk ratio, 1.80 (95% CI, 1.31–2.47).

  • Obesity: Adjusted risk ratio, 1.46 (95% CI, 1.01–2.12).

  • Primary Cesarean Delivery: Adjusted risk ratio, 1.74 (95% CI, 1.17–2.58).

  • Higher Household Income: Associated with a lower risk for readmission (adjusted risk ratio for income ≥$82,000 vs. $1–$47,999, 0.48; 95% CI, 0.30–0.77).

The study underscores the higher risk for postpartum readmission among patients who experience stillbirths compared to those with live births, even after accounting for various maternal and obstetrical factors. This increased risk is particularly associated with mental health or substance use disorders and venous thromboembolism, highlighting the need for comprehensive postnatal care strategies that address both physical and psychological health.

The findings of this study emphasize the critical need for enhanced postpartum care for individuals who have experienced stillbirths. The higher risk of readmission, particularly due to mental health issues and venous thromboembolism, calls for targeted interventions and support systems to improve maternal health outcomes in this vulnerable group.

Reference:

Sweeney, L. C., Reddy, U. M., Campbell, K., & Xu, X. (2024). Postpartum readmission risk: a comparison between stillbirths and live births. American Journal of Obstetrics and Gynecology. https://doi.org/10.1016/j.ajog.2024.02.017

Powered by WPeMatico

Daily intake of milk protein concentrate may improve anthropometric and metabolic markers in obese women on hypocaloric diet: Study

Daily intake of milk protein concentrate may improve anthropometric and metabolic markers in obese women on a hypocaloric diet suggests a study published in the BMC Nutrition.

Dairy consumption is associated with many health benefits. However, to our knowledge, no clinical trials examined the effects of milk protein concentrate (MPC) on metabolic health in overweight and obese adults. This study investigated the effect of supplementation with MPC on glycaemic status, lipid profile, biomarkers of inflammation, and anthropometric measurements in women with obesity under a weight loss diet. This is a single-blind, open-labelled, parallel-group, randomized trial. Forty-four healthy women with obesity were randomized into a control (n = 22) or MPC (n = 22) group. Participants in the MPC group were supplemented with 30 g of MPC per day for 8 weeks. Both groups were on a calorie-restricted diet plan with 800 Kcal lower intakes than their needs. Blood samples, dietary intake, and body composition were assessed before and after the intervention. RESULTS: MPC group had a significantly lower body mass index (P = 0.009), waist circumference (P = 0.013), fat mass (P = 0.021), appetite score (P = 0.002), fasting blood sugar (P < 0.001), insulin (P = 0.027), low-density lipoprotein cholesterol (P = 0.025), and leptin (P = 0.014) levels and higher high-density lipoprotein cholesterol (P = 0.001) and adiponectin (P = 0.032) compared to the control group after supplementation. Lean body mass, total cholesterol, and triglyceride did not differ significantly (P > 0.05). Daily intake of 30 g of MPC for 8 weeks may improve several anthropometric and metabolic markers in women with obesity under a hypocaloric diet.

Reference:

Elahikhah, Mahsa, et al. “Milk Protein Concentrate Supplementation Improved Appetite, Metabolic Parameters, Adipocytokines, and Body Composition in Dieting Women With Obesity: a Randomized Controlled Trial.” BMC Nutrition, vol. 10, no. 1, 2024, p. 80.

Keywords:

Daily, intake, milk protein, concentrate, improve, anthropometric, metabolic markers, obese, women, hypocaloric diet, study, Elahikhah, Mahsa, BMC Nutrition

Powered by WPeMatico