MRI is a reliable tool for the detection of TMJ disc perforations, reveals study

MRI is a reliable tool for detecting TMJ disc perforations according to a study published in the Journal of Cranio-Maxillofacial Surgery.

This study aimed to evaluate the reliability of magnetic resonance imaging (MRI) in detecting disc perforations in the temporomandibular joint (TMJ), and to establish diagnostic criteria for this purpose. The retrospective analysis included patients who had undergone preoperative MRI and TMJ arthroscopy at the same hospital. Direct and indirect signs of disc abnormalities on MRI were compared with arthroscopic findings of disc perforation. Out of 355 joints evaluated in 185 patients, arthroscopy confirmed disc perforations in 14.7% of cases. Several MRI findings were significantly associated with disc perforation, including anterior disc displacement without reduction (ADDwoR), signal alterations in the mid-disc area, disc deformity (SAMD), retro condylar disc fragments, osteophytes, condylar bone marrow degeneration (CBMD), and joint effusion in both joint spaces (ESJS-EIJS). Regression analysis revealed that SAMD, osteophytes, and CBDM were strongly associated with disc perforation. The ROC curve showed that MRI had an AUC = 0.791, with a sensitivity of 88.5% and a specificity of 61.5%. Two diagnostic methods, one based on three findings (osteophytes, ADDwoR, and SAMD) and one based on two direct signs (ADDwoR and SAMD), yielded high sensitivity and specificity values of 80.4% and 69.8%, and 84.3% and 62.5%, respectively. In conclusion, MRI demonstrated acceptable accuracy in detecting TMJ disc perforations, with specific diagnostic criteria offering high sensitivity and specificity. Significant MRI indicators of disc perforation included SAMD, osteophytes, and CBDM. This study provides valuable information on the use of MRI as a diagnostic tool for TMJ disc perforations.

Reference:

Alejandrina Millón Cruz, Rafael Martin-Granizo, Simona Barone, Luis Miguel Pérez Rodríguez, Salomé Merino Menéndez, Farzin Falahat Noushzady, Javier Arias Díaz,

Reliability of magnetic resonance for temporomandibular joint disc perforation: A 12 years retrospective study. Journal of Cranio-Maxillofacial Surgery. Volume 52, Issue 5,

2024, Pages 548-557, ISSN 1010-5182. https://doi.org/10.1016/j.jcms.2024.04.005.

(https://www.sciencedirect.com/science/article/pii/S1010518224001434)

Keywords:

MRI, reliable tool, detection, TMJ disc, perforations, study, Journal of Cranio-Maxillofacial Surgery, Magnetic resonance imaging; Temporomandibular joint; disc perforation; Arthroscopy, Alejandrina Millón Cruz, Rafael Martin-Granizo, Simona Barone, Luis Miguel Pérez Rodríguez, Salomé Merino Menéndez, Farzin Falahat Noushzady, Javier Arias Díaz

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Amoebic meningoencephalitis: Kerala Govt to issue special guidelines

Thiruvananthapuram: In response to recent incidents of two deaths and one hospitalization due to amoebic meningoencephalitis in Kerala over the past two months, Kerala Health Minister Veena George chaired a significant meeting of the health department.

It has been decided that special guidelines will be released for the state regarding amoebic meningoencephalitis. Instructions have been given to strengthen awareness. The amoeba enters the brain through rare openings in the thin membrane that separates the nose from the brain or through a hole in the eardrum and causes meningoencephalitis. Therefore, children with pus in their ears should not bathe in ponds, stagnant water, etc. The minister requested to seek treatment immediately if symptoms are seen.

As per a media report in ANI, caution should be exercised against amoebic meningoencephalitis. Bathing in stagnant water and diving in water should be avoided as much as possible. Water in water theme parks and swimming pools should be properly chlorinated to ensure that it is clean.

Medical Dialogues team recently reported that days after a 13-year-old girl from Kannur died from amoebic meningoencephalitis, another case of the rare brain infection caused by a free-living amoeba found in contaminated waters has surfaced in Kerala’s Kozhikode district.

Also Read:Third case of Brain-Eating Amoeba: 12-year-old Kozhikode boy tests positive

Notably, Amoebic meningoencephalitis is a very rare disease in people who have contact with standing or running water sources. There are very few scientific studies and study results about this rare disease. Statistics indicate that only 2.6 out of 10 lakh people who come in contact with such water in the world get this disease. The disease usually occurs when Naegleria fowleri, a type of amoeba, infects the brain. 

This disease is not transmitted from human to human. The amoeba that lives in stagnant water enters the human body through the thin skin of the nose and causes encephalitis, which seriously affects the brain. Free-living amoebas are generally found in stagnant water bodies. Bacteria from the amoeba family are transmitted through the fine pores in the nose by bathing in drains or pools. Enters the human body and severely affects the brain and causes encephalitis.

Symptoms appear within one to nine days of infection. The primary symptoms are severe headache, fever, nausea, vomiting and difficulty turning the neck. Later, when it reaches a critical condition, there are symptoms like epilepsy, loss of consciousness and memory loss. Diagnosis is made by taking fluid from the spinal cord and testing it. People who bathe in stagnant water should report these symptoms and seek treatment.

Amoeba enters the body through bathing in stagnant or unclean water. So avoid getting sick by bathing in stagnant water or drains and not pouring water into your nose. Do not ignore symptoms and see a doctor as soon as possible. There is no problem with children bathing in properly chlorinated swimming pools, a press release from the health minister’s office said, news agency ANI reported.

Also Read:Fatal Brain infecting Amoeba found in Florida

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Strawberries may lower CVD risk and improve glucose control, new study shows

Strawberries, America’s favorite fruit, are top for consumers in taste, and research shows that they may be a good choice in promoting heart health as well. A new study looking specifically at cardiovascular health and improved glucose control was presented in a poster session at Nutrition 2024, the American Society for Nutrition’s annual meeting, on June 30 in Chicago. Primary investigator Lasantha Krishan Hirimuthugoda, M.D., postdoctoral research associate at Illinois Institute of Technology, presented the findings. The study aimed to investigate dose-related effects of strawberry fruit intake on endothelial function and glucose control, specifically investigating the relationship of flow-mediated dilation (FMD) responses to intervention on cardiovascular disease (CVD) risk.

The study included 36 women and 32 men, aged 20 to 62 years with a body mass index (BMI) 29.8±4.8 kg/m2. Researchers assessed the effects of strawberry intake on FMD as well as the relationship of the FMD responses to intervention on CVD risk. FMD% was significantly influenced by eating strawberry daily for 4 weeks compared to control suggesting a dose-response toward higher to lower median, respectively (Kruskal-Wallis test, p<0.001). Preliminary analyses of CGM suggest no significant differences between interventions in changes from baseline (Kruskal-Wallis test p>0.05). In a logistic regression model (with goodness of fit p=0.33) using all interventions with FMD responses and a 2% increase in FMD as an indicator of reduced CVD risk, suggested strawberry intake dose-dependently reduced CVD risk by 8-times compared to the control group (p<0.001). The sensitivity analysis, in which missing primary outcome data were imputed, resulted in similar findings (odd ratio, 8.029; to 7.029; p<0.001 to p=0.002).

“A diet low in fruit is among the top three risk factors for cardiovascular disease and diabetes,” said co-author Britt Burton-Freeman, Ph.D., professor at the Illinois Institute of Technology. “Adding as little as one cup of strawberries a day to your diet may show beneficial effects on your cardiovascular health.”

As one of the most popular and accessible fruits in the U.S., strawberries are a flavor-favorite with consumers. A serving of 8 strawberries (one cup) fulfills the daily recommended value of vitamin C and delivers a host of other nutrients and beneficial bioactive compounds. Available year-round, strawberries offer consumers a versatile and convenient fruit option loved by kids and adults.  

Reference:

New study shows strawberries may lower cardiovascular disease risk and improve glucose control, Wild Hive, Meeting: NUTRITION 2024

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Use of glucose monitors by people not living with diabetes needs more regulation: Study

A new narrative review led by researchers at UCL and Birmingham Children’s Hospital has found there is a lack of evidence to demonstrate the effective use of continuous glucose monitors (CGMs) in people not living with diabetes (PNLD).

In the study, published in Diabetic Medicine, researchers conclude there is currently little published evidence on how accurate CGMs are in measuring blood glucose levels in PNLD, nor sufficient evidence of what the health benefits or utility such information would provide. The researchers also suggest CGMs may have unintended adverse health effects in this user group and are now calling for better regulation.

In recent years, CGMs have helped transform the treatment of type-1 diabetes and have been used with good effect by people with type-2 diabetes who are on insulin therapy. The devices, originally developed for those with diabetes, are attached to the body and monitor blood glucose levels in real-time, transmitting the information to an insulin pump in people with type-1 diabetes that delivers the correct amount of insulin required to keep blood glucose levels within a defined range.

For those living with diabetes, CGMs are less burdensome and offer real-time trends in glucose changes compared to older testing methods, such as regular finger prick blood tests.

However, more recently CGMs have been increasingly marketed to PNLD for uses without a medical indication, such as health, wellness and lifestyle management, with some companies providing advice around how to manage glucose levels or ‘glucose spikes’.

Explaining the current interest in CGMs, senior author and dietitian, Dr Adrian Brown (UCL Division of Medicine), said: “Several health companies are now using CGMs as part of paid-for programmes designed to give people personalised nutrition information.

“Some claim to tailor a person’s diet and activity to help keep blood glucose within ‘normal’ levels. But what constitutes a normal blood sugar level varies between individuals and in the same individuals at different times, and CGM accuracy varies between CGM models.

“With this in mind, we wanted to see what research had been undertaken into the use of CGMs in people who do not have diabetes.”

In this narrative review, the team from UCL and Birmingham Children’s Hospital searched online databases (PubMed, Medline, Embase and the Cochrane Library), in the years 1980-2023, for studies examining aspects of CGM utility and performance in PNLD. They found 25 relevant studies.

Researchers then looked to establish what, if any, evidence there was on how effective CGMs were at measuring glucose levels, glucose variability and elevated glucose levels in PNLD, as well as any research on the influence of CGM use on eating behaviours.

The review concludes that there is a lack of consistent and high-quality evidence to support CGM use in PNLD. For instance, there is little evidence to show how accurate CGMs are at measuring blood glucose levels or detecting changes in PNLD, nor sufficient research into the value and utility of the CGM data obtained in PNLD.

The review also found evidence that CGM use in PNLD could cause anxiety about what is normal in terms of diet and blood sugar levels. Researchers say this could present a risk of developing eating disorders, such as orthorexia (an unhealthy obsession with eating ‘pure’ food).

An earlier separate review by the authors, referenced in this paper, looked at the regulation of CGM in people with diabetes, and found there was no specific statutory guidance available.

Dr Brown, who is based at the UCL Centre of Obesity Research, said: “While there are some benefits to personalised health programmes offered by commercial providers, including getting people to think about what and how much they’re eating, the fact is that we don’t have the same health outcome data for CGM use in people not living with diabetes.

“This review unpicks the idea of ‘abnormal glucose’, the accuracy of CGM data, and the effect on behavioural change when CGMs are used by people without diabetes.

“At the moment there are big questions about how much guidance these health companies are giving customers to help them interpret their glucose data, and what scientific evidence this guidance is based on. This can leave the customer to interpret what the variations in their blood glucose mean, posing a risk that they misinterpret the data and avoid certain foods unnecessarily.”

Co-author John Pemberton, a Specialist Paediatric Diabetes Dietitian from Birmingham Children’s Hospital who sits on the International Federation of Clinical Chemistry (IFCC) and Laboratory Medicine Working Group on CGM, said: “CGMs with an accuracy within 20% of actual blood glucose levels, at least 95% of the time, represent current market leading performance, and are extremely helpful for people with diabetes to make daily treatment decisions.

“However, the regulations for CGMs for people living with diabetes are ambiguous both nationally and internationally, making it difficult to know if available CGMs meet this level of accuracy. This is why the IFCC CGM group are pushing for an international standard.

“For individuals not living with diabetes, the situation is even more uncertain. We have little robust information on whether CGMs achieve the required accuracy in this population.

“Normal glucose levels for individuals without diabetes range from 3.3 to 7.8 mmol/L and the most accurate CGMs have a 20% accuracy margin most of the time. This means that the most accurate CGM devices will display readings between 2.6 and 9.4 mmol/L, even when the actual glucose level is within the normal range. Such discrepancies can lead to unintended stress and potential psychological and behavioural implications.

“While CGMs for people not living with diabetes show promise, the accuracy, regulatory standards, and psychological impacts of false highs and lows are not well understood. Despite this, CGMs are being heavily promoted without mention of these issues.”

Reference:

Zhanna Oganesova, John Pemberton, Adrian Brown, Innovative solution or cause for concern? The use of continuous glucose monitors in people not living with diabetes: A narrative review, Diabetic Medicine, https://doi.org/10.1111/dme.15369

.

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Accelerated initiation dosing of propranolol for infantile hemangiomas doesn’t increase adverse events: Study

Accelerated initiation dosing of propranolol for infantile hemangiomas doesn’t increase adverse events suggests a study published in the Pediatric Dermatology.

Infantile hemangiomas are common vascular tumors in children. Propranolol has proven effective in treating infantile hemangiomas and while generally safe, has potential risk for more serious side effects of hypoglycemia, hypotension, bradycardia, bronchospasm, and cardiovascular or respiratory compromise. Current prescribing guidelines recommend initiating propranolol doses at 1 mg/kg/day, with up-titration to 2 mg/kg/day. This study aims to compare the incidence of adverse events in infants and children treated with propranolol initiated at 1 mg/kg/day versus being initiated directly at 2 mg/kg/day.

A retrospective cohort study was conducted using medical records of patients receiving propranolol therapy for infantile hemangiomas between October 2018–March 2021 at the Children’s Hospital of Philadelphia. Patients were categorized by initial propranolol dosage: 1 or 2 mg/kg/day. The primary outcome measures included parent-reported adverse events, hypotension (defined by the Pediatric Advanced Life Support criteria), and bradycardia (defined as <1st percentile for age) following propranolol initiation. Results: Out of the 244 patients identified, 123 were initiated at the 1 mg/kg/day dose, and 121 at the 2 mg/kg/day dose. There was no significant difference in the incidence of adverse events between the two groups (p = .057). Additionally, among patients initiated at 2 mg/kg/day, there were no significant differences in the incidence of age-related or weight-related adverse events for those younger than 2 months or those in the 1st or 2nd quartile for weight (p = .53). Infants and children initiated at 2 mg/kg/day did not demonstrate an increased incidence of adverse events associated with propranolol compared to those initiated at 1 mg/kg/day. These findings provide clinical evidence for the practice of accelerated propranolol initiation dosing.

Reference:

Huang CY, Perman MJ, Yan AC. Regimen for accelerated propranolol initial dosing (RAPID). Pediatr Dermatol. 2024; 1-7. doi:10.1111/pde.15623

Keywords:

Accelerated, initiation, dosing, propranolol, infantile, hemangiomas, increase, adverse, events, study, Pediatric Dermatology

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PCOS Linked to Increased Risk of Endometrial Cancer, claims study

Researchers have found that polycystic ovary syndrome (PCOS) is associated with a higher risk of endometrial cancer, with no significant increased risk for ovarian or cervical cancers. This conclusion was drawn from a large-scale analysis of data from the National Inpatient Sample (NIS) database, providing new insights into the cancer risk profiles of patients with PCOS. The study was recently published in the European Journal of Obstetrics Gynecology and Reproductive Biology by Ahmed Abu-Zaid and colleagues.

PCOS is a common endocrine disorder among women of reproductive age, characterized by irregular menstrual periods, excess androgen levels, and polycystic ovaries. Previous studies have suggested potential links between PCOS and various gynecologic cancers, but comprehensive data have been lacking. This study aimed to systematically investigate the relationship between PCOS and the risks of ovarian, endometrial, and cervical cancers using the extensive NIS database.

The study utilized the International Classification of Diseases (ICD-10) system to identify relevant codes from the NIS database for the period 2016 to 2019. Univariate and multivariable regression analyses were conducted to evaluate the association between PCOS and gynecologic cancers. These analyses were adjusted for several factors, including age, race, hospital region, hospital teaching status, income Zip score, smoking, alcohol use, and hormonal replacement therapy. Results were summarized using odds ratios (OR) with 95% confidence intervals (CI).

  • The study analyzed data from 15,024,965 patients, with 56,183 diagnosed with PCOS and 14,968,782 without PCOS.

  • Among patients diagnosed with gynecologic cancers (n = 91,599), there were 286 with PCOS and 91,313 without PCOS.

  • PCOS was significantly associated with a higher risk of endometrial cancer (OR = 1.39, 95% CI [1.18–1.63], p < 0.0001).

  • PCOS was associated with a lower risk of ovarian cancer (OR = 0.55, 95% CI [0.45–0.67], p < 0.0001) and cervical cancer (OR = 0.68, 95% CI [0.51–0.91], p = 0.009).

  • After adjusting for confounding factors and applying the Bonferroni correction, PCOS remained significantly associated with a higher risk of endometrial cancer (OR = 3.90, 95% CI [4.32–4.59], p < 0.0001).

  • There was no significant correlation between PCOS and the risk of ovarian cancer (OR = 1.09, 95% CI [0.89–1.34], p = 0.409) or cervical cancer (OR = 0.83, 95% CI [0.62–1.11], p = 0.218).

The findings from this extensive analysis indicate that patients with PCOS have a distinct risk profile for gynecologic cancers. Specifically, the significant association between PCOS and an increased risk of endometrial cancer highlights the need for heightened vigilance and possibly earlier screening for this patient group. The lack of significant association with ovarian and cervical cancers is also noteworthy, suggesting that the cancer risks associated with PCOS may be more specific to endometrial cancer.

This first-ever NIS analysis reveals that PCOS is associated with a higher risk of endometrial cancer, while no significant increased risk was found for ovarian or cervical cancers. These findings underscore the importance of tailored cancer screening and preventive strategies for patients with PCOS.

Reference:

Abu-Zaid, A., Baradwan, S., Alyafi, M., Al Baalharith, M., Alsehaimi, S. O., Alsabban, M., Alsharif, S. A., Alqarni, S. M. S., Albelwi, H., Jamjoom, M. Z., Saleh, S. A. K., Adly, H. M., Alomar, O., & Salem, H. (2024). Association between polycystic ovary syndrome and the risk of malignant gynecologic cancers (ovarian, endometrial, and cervical): A population-based study from the U.S.A. National Inpatient Sample 2016–2019. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 299, 283–288. https://doi.org/10.1016/j.ejogrb.2024.06.031

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Could preventative drug be effective in people with migraine and rebound headache?

 A drug used to prevent migraine may also be effective in people with migraine who experience rebound headaches, according to a new study published in the June 26, 2024, online issue of Neurology®, the medical journal of the American Academy of Neurology.

People with chronic migraine who overused pain medication had fewer monthly migraine and headache days and fewer days using pain medication when taking the migraine prevention drug atogepant.

“There is a high prevalence of pain medication overuse among people with migraine as they try to manage what are often debilitating symptoms,” said study author Peter J. Goadsby, MD, PhD, of King’s College London and a member of the American Academy of Neurology. “However, medication overuse can lead to more headaches called rebound headaches, so more effective preventive treatments are needed. Our findings are encouraging, suggesting atogepant may help reduce the need for pain medication among people with chronic migraine.”

The study involved 755 participants who had chronic migraine, defined as having 15 or more headache days per month with eight or more qualifying as migraine.

Of this group, 66% met the criteria for medication overuse defined as taking pain medications such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen for 15 or more days in a month, triptans or ergots for 10 or more days a month, or any combination for 10 or more days.

At the start of the study, average monthly migraine days ranged from 18 to 19, and average monthly pain medication days ranged from 15 to 16.

For 12 weeks, participants were either given 30 milligrams (mg) of atogepant twice daily, 60 mg once daily, or a placebo. Atogepant is a calcitonin gene-related peptide receptor antagonist, or CGRP inhibitor. CGRP is a protein that plays a key role in starting the migraine process.

Participants recorded their migraines and headaches in an electronic diary, noting characteristics including duration and intensity, whether they experienced aura or nausea, and if they took other medications.

Researchers found for participants with medication overuse, those taking atogepant twice daily had an average of three fewer migraine days a month and three fewer headache days when compared to those taking placebo. Those taking the drug once a day had two fewer migraine days a month and two fewer headache days compared to placebo. Both groups also had three fewer days of taking pain medications to treat their symptoms when compared to placebo. Researchers say similar reductions were found among participants without medication overuse.

In those with medication overuse, 45% of those taking the drug twice daily and 42% of those taking it once a day had a 50% or more reduction in average monthly migraine days compared to 25% taking the placebo.

The number of people meeting the criteria for medication overuse also declined by 62% among those taking the drug twice daily and by 52% among those taking it once a day.

“Based on our findings, treatment with atogepant may potentially decrease the risk of developing rebound headache by reducing the use of pain medications,” said Goadsby. “This could lead to an improved quality of life for those living with migraine.”

Goadsby noted more studies are needed to evaluate the long-term safety and effectiveness of atogepant, as well as to assess the potential risk of medication overuse relapse among people with migraine.

A limitation of the study was that participants recorded their headaches and medication use in electronic diaries, so it is possible some participants may not have recorded all information accurately.

Reference:

Peter J. Goadsby,  Deborah I. Friedman, Dagny Holle-Lee, Genevieve Demarquay, Sait Ashina, Fumihiko Sakai, Brian Neel, Efficacy of Atogepant in Chronic Migraine With and Without Acute Medication Overuse in the Randomized, Double-Blind, Phase 3 PROGRESS Trial, Neurology, https://doi.org/10.1212/WNL.0000000000209584

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Vascular Density Predicts Fistula Risk in Salvage Laryngectomy: Study

USA: The risk of pharyngocutaneous fistula following salvage laryngectomy, a surgery performed after unsuccessful primary treatment of laryngeal cancer, remains a significant concern in clinical practice. A recent study focusing on pharyngeal mucosal margin vessel counts has shed new light on predicting this complication, offering potential advancements in postoperative care and patient outcomes.

The researchers revealed that higher blood vessel density in pharyngeal mucosal margins predicts increased fistula formation risk post-salvage laryngectomy.

The study, published in Otolaryngology-Head and Neck Surgery, established a threshold of 33.9 vessels/×10 field (62% specificity, 75% sensitivity) in identifying patients at heightened risk. Those exceeding this threshold were at a 5-fold higher likelihood of developing fistulas within 30 days post-op.

A pharyngocutaneous fistula is characterized by an abnormal connection between the pharynx and the skin of the neck and can lead to prolonged hospital stays, increased healthcare costs, and potential delays in adjuvant therapy. Andrew D.P. Prince, the University of Michigan Health System, Ann Arbor, Michigan, USA, and colleagues aimed to evaluate vessel counts in the pharyngeal mucosal margins of patients who underwent salvage laryngectomy to establish whether mucosal vascularity might predict fistula risk.

For this purpose, the researchers conducted a retrospective cohort study at a tertiary medical center. They identified patients who underwent salvage total laryngectomy at their institution between 1999 and 2015. For each patient, pharyngeal mucosal margins from laryngectomy specimens were histologically evaluated, and vessel counts were performed on 5 ×10 images.

The main outcome measure evaluated was the occurrence of fistula within 30 days following surgery, with mean vessel counts analyzed as the primary explanatory factor.

The following were the key findings of the study:

  • Seventy patients were included, and 40% developed a postoperative fistula.
  • There was a large difference in the mean vessel count in patients who did develop a fistula (48.6 vessels/×10 field) compared to those who did not (34.7 vessels/×10 field).
  • A receiver operative characteristic curve found that a cutoff value of 33.9 vessels/×10 field provided a sensitivity of 75% and specificity of 62% to predict the likelihood of fistula occurrence (area under the curve = 0.71).
  • In a binary logistic regression, patients with vessel counts greater than 33.9 had a 5-fold increased risk of developing fistula.
  • Histologically, vessels in the pharyngeal mucosa of patients who developed fistulas were more disorganized.

The findings showed that patients with higher mean mucosal margin vessel counts are at increased risk of fistula after salvage laryngectomy.

“The precise mechanism remains unclear, but vascular disorganization is theorized to play a role in impaired wound healing. Counting vessels could aid in stratifying the risk of fistula development and inform postoperative care strategies,” the researchers wrote.

Reference:

Prince ADP, Heft Neal ME, Buchakjian MR, Chinn SB, Stucken CL, Casper KA, Malloy KM, Prince MEP, Rosko AJ, McHugh JB, Spector ME. Pharyngeal Mucosal Margin Vessel Counts Predict Pharyngocutaneous Fistula in Salvage Laryngectomy. Otolaryngol Head Neck Surg. 2024 Jun 17. doi: 10.1002/ohn.865. Epub ahead of print. PMID: 38881401.

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Beans Intake Enhances Diet Quality and Reduce Waist Circumference: BMC

A recent study published in the BMC Nutrition Journal examined the role of beans in American dietary patterns and found significant evidence that including beans in the diet can improve diet quality and boost nutrient intake. This study identified common dietary patterns among adults that included beans and compared these patterns with the people who did not include beans by focusing on nutrient intake and diet quality.

The study utilized data from the National Health and Nutrition Examination Survey (NHANES) that spanned from 2001 to 2018. This research employed cluster analysis to identify different patterns of bean consumption and used the USDA food coding system to define daily bean intake. The study identified five distinct dietary patterns, four of which included both canned and dry beans, while one pattern excluded beans entirely. The beans considered in the study included kidney beans, black beans, chickpeas and pinto beans.

Adults who consumed beans, identified in Bean Dietary Patterns 1, 2, 3, and 4, demonstrated significantly higher diet quality scores as per the USDA’s Healthy Eating Index-2015. Specifically, their scores ranged from 55.2 to 61.2 when compared to a score of 48.8 for the individuals whose diet did not include beans. This indicates a higher overall diet quality among bean consumers.

Also, bean consumers showed significantly higher intakes of several essential nutrients often lacking in typical American diets. These nutrients included choline, alpha-linolenic acid, folate, iron, magnesium, and vitamin E. The intake of dietary fiber, potassium and calcium were also significantly higher among those who included beans in their diet. The study also revealed positive outcomes related to weight management. The Bean Dietary Patterns 1 and 2, which involved consuming approximately 1.7 to 2 servings of beans daily were linked to lower BMI, decreased body weight and improved waist circumference when compared to the no-bean pattern.

The findings from this comprehensive analysis highlight the significant health benefits associated with bean consumption. Dietary patterns rich in both canned and dry beans not only improve the diet quality but also ensure greater intake of vital nutrients. These patterns contribute to better weight-related health outcomes which could become a potential strategy for addressing obesity and related conditions. Overall, this study highlights the importance of promoting increased consumption of canned and dry beans within American dietary guidelines.

Reference:

Papanikolaou, Y., Slavin, J., & Fulgoni, V. L., III. (2024). Adult dietary patterns with increased bean consumption are associated with greater overall shortfall nutrient intakes, lower added sugar, improved weight-related outcomes and better diet quality. In Nutrition Journal (Vol. 23, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12937-024-00937-1

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Metformin Effective in Reducing Exacerbations in Young Asthma Patients: Study

A recent study published in the Pediatric Pulmonology analyzed the commonly used antidiabetes medication metformin and found potential benefits in reducing asthma exacerbations among the adolescents and young adults. Metformin is known for its anti-inflammatory and antioxidative properties which was previously associated with reduced risks of asthma-related hospitalizations in adults. This study by Erhan Ararat and team evaluated the impact of metformin on younger patients with asthma.

The research utilized secondary data from the Arkansas All Payers Claim Database and the Arkansas School Body Mass Index (BMI) database. This comprehensive study included a total of 464 patients of 12 to 20 years who were diagnosed with asthma and prescribed metformin. The primary objective of this study was to assess the change in annualized asthma exacerbation rates following the prescription of metformin and to determine if these changes were related to how well patients adhered to the prescribed medication regimen.

The findings revealed a significant decrease in outpatient asthma exacerbation rates post-metformin prescription. The exacerbation rate dropped from 13.4% before metformin use to 7.8% after its prescription with a p-value of .009 which indicates statistical significance. Also, the study found that the reduction in annualized asthma exacerbation rates was observed more in patients who adhered strictly to their metformin prescription (rank correlation coefficient r = −.165, p < .001).

To ensure the robustness of the results, the research was adjusted for potential confounding factors, including age, sex, BMI and the use of inhaled corticosteroids. Although this adjustment attenuated the strength of the association between metformin use and reduced asthma exacerbations, the overall trend remained clear.

The study strongly suggested that metformin prescription was associated with a reduction in asthma exacerbation rates among adolescents and young adults. The outcomes emphasized the need for larger studies that include a broader patient population by including those with asthma who have not been prescribed metformin. Such studies are essential to confirm whether the observed reduction in asthma exacerbations are directly attributable to metformin use.

This research adds to the growing body of evidence that suggests the benefits of metformin which may extend beyond diabetes management. Based on the future studies and additional findings, metformin could become a valuable addition to asthma treatment protocols for patients who undergo frequent exacerbations. Overall, this study offers a potential option to effectively manage asthma symptoms and reduce the frequency of exacerbations in young asthma patients.

Reference:

Ararat, E., Landes, R. D., Forno, E., Tas, E., & Perry, T. T. (2023). Metformin use is associated with decreased asthma exacerbations in adolescents and young adults. In Pediatric Pulmonology (Vol. 59, Issue 1, pp. 48–54). Wiley. https://doi.org/10.1002/ppul.26704

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