Partial Cardiac Denervation Reduces Postoperative Atrial Fibrillation Risk After CABG: pCAD-POAF trial

China: A recent clinical trial has demonstrated that partial cardiac denervation (pCAD) is an effective strategy for reducing the incidence of postoperative atrial fibrillation (POAF) in patients undergoing isolated coronary artery bypass grafting (CABG). The findings from the pCAD-POAF Randomized Clinical Trial, published in JAMA Cardiology, suggest that this innovative approach may be a valuable tool for cardiac surgeons aiming to minimize this common and challenging complication.

POAF, a frequent issue after cardiac surgery, is associated with increased morbidity, prolonged hospital stays, and higher healthcare costs. Despite the availability of medications and other preventive measures, managing POAF remains a significant clinical challenge. Therefore, effective strategies to prevent postoperative atrial fibrillation after coronary artery bypass grafting remain a clinical necessity. Considering this, Ziang Yang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China, and colleagues aimed to evaluate whether partial cardiac denervation, performed by severing the ligament of Marshall (LOM) and removing the fat pad along the Waterston groove, can effectively lower the risk of POAF in patients undergoing CABG.

For this purpose, the researchers conducted a single-center, randomized clinical trial in China, enrolling adult patients scheduled for isolated CABG between August 15, 2022, and December 13, 2023. Follow-up visits occurred 30 days after discharge. Participants were randomly assigned to either the intervention group (CABG plus partial cardiac denervation) or the control group (CABG only) in a 1:1 ratio. All participants were closely monitored for the occurrence of postoperative atrial fibrillation (POAF) until six days after the surgery.

The primary outcome was the incidence of POAF within six days, defined as a supraventricular arrhythmia lasting more than 30 seconds.

The trial revealed the following findings:

  • The trial enrolled 430 patients, with a mean age of 61.9 years, including 18.4% females.
  • The 6-day incidence of POAF was significantly lower in the intervention group (18.1%) than the control group (31.6%), with a risk ratio of 0.57.
  • A sensitivity analysis using Kaplan-Meier survival curves further confirmed this reduction in POAF occurrence (hazard ratio, 0.53).
  • Safety assessments showed no significant differences between the two groups, and the intervention group had reduced postoperative medical costs.

This randomized controlled trial found that partial cardiac denervation, achieved by cutting the LOM and removing the fat pad along the Waterston groove, effectively reduced the occurrence of POAF after isolated CABG.

“These findings suggest that partial cardiac denervation could be a viable option for cardiac surgeons to consider in reducing the risk of POAF following CABG,” the researchers concluded.

Reference:

Yang Z, Tiemuerniyazi X, Xu F, et al. Partial Cardiac Denervation to Prevent Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting: The pCAD-POAF Randomized Clinical Trial. JAMA Cardiol. Published online November 17, 2024. doi:10.1001/jamacardio.2024.4639

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Psychiatric Comorbidities and Healthcare Utilization increase 5 years prior in Idiopathic Generalized Epilepsy: Study

A recent study found that Idiopathic
generalized epilepsy has a prodromal phase marked by higher utilization of healthcare
services and prescription medications at least about five years before the
first seizure, as per the results that were published in the journal Neurology.

Idiopathic Generalized Epilepsies
are associated with specific behavioral characteristics, frontal lobe
dysfunction, and coexisting psychiatric conditions. There is ambiguity as to
whether the psychiatric symptoms are part of the disease or are secondary to
the burden of the disease. Hence, researchers from Denmark conducted a study to
identify and explore the timeline of psychiatric and epilepsy symptoms in
patients with IGE.

Also Read: Folate supplementation in pregnant women on antiseizure medicines may improve cognitive and behavioral outcomes among children: JAMA

A register-based case-control
study included individuals aged 10-25 with an IGE diagnosis. Two distinct
cohorts were established. One cohort was identified through Danish health
registers. This cohort included IGE identified through ICD 10 and first-time
diagnoses of IGE between 2005 and 2018. The other cohort included patients treated
at Odense University Hospital and the Danish Epilepsy Centre in the same
period. Each patient was matched with 10 matched controls from the normal
population controls of the Danish registers. These included individuals
matched to age, sex, and geography. The social status, health care utilization,
and psychiatric diagnoses of the individuals between the two age groups were compared.
This comparison was observed for at least 5 years before the epilepsy diagnosis,
during the diagnosis, and at the end of the study period. Wilcoxon rank sum
test and confirmatory logistic regression models were used for the statistical
analysis.

Findings:

  • About 1,009 patients were identified for the
    register-based cohort. Among them, 55.1% were female, with a mean age at
    diagnosis [SD]: 15.9 [±3.8] years, and were matched with 10.090 controls.
  • The hospital-based cohort included about 402
    patients. Of them, 56.2% were female, with a mean age at diagnosis [SD] of 18.3
    [±7.4] years. They were matched to 4020 controls.
  • IGE cohorts and controls did not differ at
    birth.
  • About 5 years before the IGE diagnosis, registered
    patients had more hospital visits and increased visits to their general
    practitioners. Also, they received more prescriptions for psychiatric
    medications compared with controls.
  • Registered Patients also showed a higher rate of
    psychiatric comorbidity at the end of the study than controls.
  • Data were similar in the hospital-based cohort.
Also Read: Systematic Review Highlights No Major Risks to Offspring from Would-be-Fathers Taking Epilepsy Medications

Thus, the study concluded that a
prodroma phase exists approximately 5 years before the IGE diagnosis, when
patients utilize healthcare facilities and medications more. These highlight
the importance of mental health challenges that develop before the diagnosis of
IGE. The study also stresses the importance of early monitoring and optimum
mental health care to be taken for individuals with epilepsy.

Further reading: Gesche J,
Rubboli G, Beier CP. Prodromal Phase of Idiopathic Generalized Epilepsy: A
Register-Based Case Control Study. Neurology. 2024;103(8):e209921.
doi:10.1212/WNL.0000000000209921

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Mindfulness-Based Interventions Improve Psychotic Symptoms and Functioning, suggests study

Researchers have found that mindfulness-based interventions (MBIs) significantly improve psychotic symptoms, global functioning, insight, and mindfulness in patients with schizophrenia spectrum disorders. A recent study was published in the journal of Psychiatry Research conducted by Chuntana and colleagues.

A systematic search of nine electronic databases, including PubMed, Cochrane, and Web of Science, was conducted up to March 2024. Experimental or quasi-trial studies published in English, investigating the effects of MBIs on schizophrenia spectrum disorders, were considered for eligibility. A random-effects model calculated effect sizes, while heterogeneity was examined through Funnel plots, Q statistics, and I². Subgroup analyses probed moderators of outcomes like patient age, intervention format, and practice duration.

The meta-analysis comprised 24 studies and had a total of 1,632 participants: 796 schizophrenia patients received MBIs, and 836 participants were controls. There was a predominance of male participants (69%, s = 7), with mean age ranging from 24.4 to 59.5 years.

Key Findings

• Psychotic Symptoms: Psychotic symptoms were significantly decreased (g = 0.70, 95% CI 0.04–1.36, I² = 96%).

• Global Functioning: Global functioning was enhanced with a notable improvement of g = 1.28, 95% CI 0.50–2.05.

• Insight: The patients’ insight significantly improved (g = 1.21, 95% CI 0.88–1.55).

• Mindfulness: MBIs increased mindfulness levels (g = 0.56, 95% CI 0.15–0.97).

Subgroup Analysis:

• Psychotic symptoms worsened with each additional year of mean patient age (slope = -0.071, p = 0.016).

• Daily MBI practice improved psychotic symptoms (slope = 0.012, p = 0.033), functioning (slope = 0.013, p = 0.017), and insight (slope = 0.001, p = 0.043).

• Mixed-format interventions (individual plus group) had a greater effect on insight (g = 1.538) than individual-only MBIs (g = 0.889).

• MBIs with home assignments showed superior improvements in insight (g = 1.517) compared to those without (g = 0.787).

Mindfulness-based interventions resulted in highly significant improvements in psychotic symptoms, global functioning, insight, and mindfulness in patients with schizophrenia spectrum disorders. The most significant effects were obtained when MBIs had home assignments and mixed formats. MBIs should be considered by clinicians as a complementary treatment to improve the outcomes of patients with schizophrenia.

Reference:

Reangsing C, Wongsuraprakit S, Punsuwun S, Oerther S. Effects of mindfulness-based interventions (MBIs) on psychotic symptoms and psychological outcomes in patients with schizophrenia spectrum disorders: A systematic review and meta-analysis. Psychiatry Res. 2024 Nov 18;342:116272.

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Focal High-Intensity Focused Ultrasound with intraoperative prostate compression promising for patients with localized prostate cancer: Study

A recent study published in the Prostate Cancer and Prostatic Diseases evaluated focal therapy with high-intensity focused ultrasound (HIFU) combined with intraoperative prostate compression demonstrates promising outcomes for patients with localized prostate cancer (PC). This minimally invasive treatment showed high rates of cancer control while preserving urinary and sexual functions in the medium term.

The study included a total of 240 patients with localized prostate cancer who had prostate-specific antigen (PSA) levels ≤20 ng/mL. Clinically significant prostate cancer (CSPC) was identified through advanced imaging techniques, including MRI-transrectal ultrasound fusion-guided target biopsy and a 12-core systematic biopsy. Focal HIFU therapy was directed at visible lesions identified on MRI, with biochemical failure determined using the Phoenix ASTRO criteria. Pathological failure was defined as the presence of CSPC in a biopsy performed during biochemical failure.

The participants were categorized by the D’Amico risk classification into 3 groups: low-risk (n=51), intermediate-risk (n=107), and high-risk (n=82). The patients were followed for a median of 48 months, with follow-up periods ranging from 24 to 84 months. The study reported the following outcomes:

  • Low-risk group: 93.7% biochemical disease-free survival and 92.2% pathological disease-free survival.
  • Intermediate-risk group: 88.5% biochemical disease-free survival and 91.6% pathological disease-free survival.
  • High-risk group: 84.8% biochemical disease-free survival and 86.6% pathological disease-free survival.

Urinary and sexual function were temporarily affected post-treatment, with noticeable deterioration at one month. However, both functions returned to pre-treatment levels within 3 to 6 months, underlining the ability of this treatment to minimize long-term side effects.

The findings suggest that focal HIFU therapy with intraoperative prostate compression is an effective treatment for localized prostate cancer by offering strong medium-term oncological control with minimal functional deterioration. These results are particularly promising for patients seeking alternatives to radical treatments, which often involve more significant risks of long-term complications. Overall, the study highlighted the potential of HIFU as a targeted and patient-friendly therapy for localized prostate cancer. With continued research and longer-term follow-ups, this approach could help redefine the treatment protocols for patients at varying risk levels.

Source:

Shoji, S., Naruse, J., Ohno, S., Aoki, M., Takahashi, K., Yuzuriha, S., Kuroda, S., Umemoto, T., Nakajima, N., Hasegawa, M., Kawamura, Y., Kajiwara, H., Hashida, K., Uemura, K., Hasebe, T., & Tajiri, T. (2024). Focal therapy using high-intensity focused ultrasound with intraoperative prostate compression for patients with localized prostate cancer: a multi-center prospective study with 7 year experience. In Prostate Cancer and Prostatic Diseases. Springer Science and Business Media LLC. https://doi.org/10.1038/s41391-024-00921-0

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Music training boosts children’s cognitive development, reveals research

Learning to play a musical instrument can help children improve their “inhibition control,” the ability to focus on a task and resist distractions and automatic or impulsive reactions.

That’s what a new meta-analysis done at Université de Montréal and published in the November issue of the journal Cognition, suggests.

Supervised by psychology professor Simone Dalla Bella, doctoral student Kevin Jamey reviewed 22 studies from nine countries published between 1980 and 2023 involving 1,734 children aged 3 to 11. Eight of the studies were randomized controlled trials (RCTs), the gold standard in research, and 14 were longitudinal studies.

Based on the data, Jamey found that music training has a “moderate to large” positive effect on inhibition control. The RCTs had an average effect size of 0.60, a statistically significant result. “Starting from an effect size of 0.4, we can begin making public policy recommendations, for example,” said Jamey.

The longitudinal studies, which followed groups of children over time, showed a more modest but still-significant effect size of 0.36.

“These findings exceed those of previous meta-analyses of the transfer effect of music training on executive function,” Dalla Bella said. “They also show greater effectiveness than other cognitive training methods such as video games.”

One-on-one lessons best

The positive effects were observed regardless of the children’s age, the intensity of training, or the method of musical instruction.

“Our meta-analysis looked at various music learning formats, including private and group lessons, and we found that one-on-one lessons, especially outside a school setting, seemed to have the strongest impact, since there are fewer distractions for both student and teacher,” said Jamey.

The data also indicated that a total of 300 minutes of music training is enough to see an improvement in inhibition control. It therefore appears that even a moderate amount of music practice can be beneficial.

The authors caution that their analysis does not show that music training is a miracle solution. “To be truly effective, musical learning must be guided and use scientifically proven methods,” Dalla Bella stressed. “While music doesn’t improve everything, it does appear to have benefits for certain cognitive functions that deserve further study.”

Jamey and Dalla Bella are optimistic about the potential of music training for children with developmental disorders. “Specific types of music training could benefit children with autism spectrum disorder or attention deficit disorder with or without hyperactivity,” they suggested.

Further randomized controlled trials will be needed to confirm these results. Jamey plans to pursue this research when he joins a four-year research project as a postdoctoral fellow at the Brain and Creativity Institute at USC Dornsife in Los Angeles.

Dalla Bella and Jamey also support reintroducing music education in primary schools. “We are very close to being able to make a formal recommendation,” they said. “The potential benefits are too great to ignore.”

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Functional exercise training better than stretching exercises for reducing pain in fibromyalgia patients, finds study

A new study published in the journal of BMC Advances in Rheumatology found that functional exercise training was more helpful than stretching exercises in lowering pain and improving quality of life in fibromyalgia patients. Fibromyalgia is a non-inflammatory disease marked by widespread muscular pain and associated symptoms. A low pain threshold (allodynia) and heightened sensitivity to pain stimuli (hyperalgesia) are common symptoms of fibromyalgia, which is regarded as a pain-regulation illness.

Numerous types of physical training for this group have been investigated using high-quality randomized clinical studies that included strength, flexibility, aerobic conditioning, and multicomponent exercise therapies. Thus, Giovana Fernandes and colleagues investigated the efficacy of a functional exercise program in lowering pain, improving functional capacity, increasing muscular strength and enhancing flexibility, balance, and quality of life in fibromyalgia patients.

82 women with fibromyalgia were randomly assigned to two groups. The functional exercise group had 45-minute sessions twice a week for 14 weeks. The stretching exercise group engaged in flexibility exercises of the same duration and frequency. The outcome measurements included the visual analog scale for widespread pain, the Fibromyalgia Impact Questionnaire for health-related quality of life, the Timed Up and Go test for functional performance, the one-repetition maximum for muscular strength, and the Sit and Reach test on the Wells bench for flexibility. The Berg Balance Scale measured balance, whereas the SF-36 measured overall quality of life.

By comparing the functional exercise group to the stretching exercise group after the intervention, the former showed a statistically significant decrease in pain (interaction p = 0.002), an improvement in health-related quality of life as assessed by the Fibromyalgia Impact Questionnaire (interaction p < 0.001), and an improvement in the general health state domain of the SF-36 (interaction p = 0.043). Improved functional capability, muscular strength, flexibility, and balance did not significantly differ across groups. Overall, this study showed that, after 7 weeks, the functional exercise training program may reduce pain and improve disease-related quality of life in people with FM, and that these improvements persisted for up to 12 weeks beyond the conclusion of the intervention.

Source:

Fernandes, G., Nery, M., Meireles, S. M., Santos, R., Natour, J., & Jennings, F. (2024). A functional exercise program improves pain and health related quality of life in patients with fibromyalgia: a randomized controlled trial. In Advances in Rheumatology (Vol. 64, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s42358-024-00422-7

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Imbalances in numerous circulating and urinary metabolites linked to development and progression of allergic diseases: Study

Researchers have found that imbalances in both circulating and urinary metabolites may play a crucial role in the pathogenesis and progression of allergic diseases including asthma, atopic dermatitis, and allergic rhinitis. A new study was recently published in the journal Respiratory Research. This study was conducted by Junhao and colleagues in China.

Allergic diseases significantly impact global health, necessitating deeper exploration into their underlying causes. Current treatments focus on symptom management, but there is a growing interest in addressing the root causes. Metabolites (small molecules involved in various physiological processes) have been implicated in immune and inflammatory responses. This study aimed to identify causal links between metabolites and allergic diseases to advance therapeutic approaches.

The researchers performed a two-sample MR analysis to assess causal interactions between 486 circulating metabolites and 55 urinary metabolites with allergic diseases. Data for allergic conditions, including asthma, AD, and AR, were drawn from two major biobanks: FinnGen (Europe, cohort 1) and Biobank Japan (Asia, cohort 2). It combined the findings of both the cohorts into a meta-analysis to improve the robustness of the results.

The main findings were:

Metabolites in Circulation:

  • Cohort 1 identified 50 circulating metabolites associated with allergic diseases, while cohort 2 identified 54.

  • Stearoylcarnitine emerged as the most reliable causal metabolite for asthma (OR 8.654; 95% CI: 4.399−17.025; P = 4.06E-10).

  • 1-arachidonoylglycerophosphoinositol was identified as a significant causal factor for AR (OR 2.178; 95% CI: 1.388−3.419; P = 7.15E-04).

Urinary Metabolites:

  • Six urinary metabolites were linked to allergic diseases in cohort 1, and two in cohort 2.

  • Histidine showed a protective effect against asthma (OR 0.734; 95% CI: 0.594−0.907; P = 0.004).

  • Tyrosine was protective against AD (OR 0.601; 95% CI: 0.380−0.952; P = 0.030).

  • Alanine reduced the risk of AR (OR 0.280; 95% CI: 0.125−0.628; P = 0.002).

The metabolite imbalances in circulation and urine are observed to be key issues in the manifestation of allergic diseases. Identification of stearoylcarnitine, 1-arachidonoylglycerophosphoinositol, histidine, tyrosine, and alanine as significant contributors provided insights into possible targets for innovative treatment strategies.

Reference:

Tu, J., Wen, J., Luo, Q., Li, X., Wang, D., & Ye, J. (2024). Causal relationships of metabolites with allergic diseases: a trans-ethnic Mendelian randomization study. Respiratory Research, 25(1). https://doi.org/10.1186/s12931-024-02720-6

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Certain HRT tablets linked to increased heart disease and VTE risk, suggests study

Researchers at Uppsala University have analysed the effects of seven different hormone treatments for menopausal symptoms on the risk of blood clots, stroke and heart attack. The study, which involved around one million women aged between 50 and 58, shows that the risks differ depending on the active substance and how the medicine is taken. Published in the scientific journal BMJ, this is the largest and most comprehensive study of currently prescribed hormonal substances in the world.

“There is concern among women that menopausal hormone therapy increases the risk of cardiovascular disease. This concern is based on older studies conducted more than 20 years ago that only looked at one type of treatment. Since then, many new preparations have been introduced and our study shows that the previous conclusions do not apply to all types of treatments,” says Therese Johansson, postdoctoral researcher and lead author of the study, which was part of her thesis at Uppsala University.

Most women go through menopause between the ages of 50 and 60. Levels of the hormone oestrogen fall sharply, increasing the risk of osteoporosis. The low levels can also contribute to health problems such as hot flushes, mood swings and difficulty sleeping. To counteract these health effects, women may be prescribed hormone replacement therapy involving medicines containing hormones or hormone-like substances.

In Sweden alone, hundreds of thousands of women currently use hormone replacement therapy and this type of treatment has been available since the 1970s. At that time, there was only one type of hormone replacement therapy and when a major study in the 1990s showed that it increased the risk of cardiovascular disease, its use rapidly declined. Since then, new preparations have entered the market, and following this, the use of hormone replacement therapy in connection with menopause has increased significantly in recent years.

In the new study, the researchers looked at seven different types of currently used hormone replacement treatments, administered via tablets, hormone patches or hormone-releasing IUDs. The study is based on all prescriptions for hormone replacement therapy in Sweden from 2007 to 2020 and covers nearly one million women aged 50 to 58. The women were monitored for two years after starting hormone replacement therapy. The risk of blood clots and cardiovascular disease was compared between women who had and had not collected a prescription medicine for hormone replacement therapy.

The results show clearly that the risks of hormone replacement therapy vary depending on the type of treatment.

For example, the synthetic hormone tibolone, which mimics the effects of the body’s natural hormones, was linked to an increased risk of both heart attack and stroke, but not to an increased risk of blood clots. The risk of heart attack or stroke due to tibolone is estimated at one in a thousand women.

Combined preparations containing both oestrogen and progesterone instead increase the risk of blood clots, including deep vein thrombosis. Blood clots form in the veins and can break loose and travel with the circulation to the lungs, leading to pulmonary embolism. The researchers estimate that the risk of deep vein thrombosis resulting from this combined preparation is about seven per thousand women per year.

“It is important that both doctors and women are aware of the risks of menopausal hormone therapy and, in particular, that the existing drugs carry different risks of blood clots and cardiovascular disease. Tibolone in particular was associated with an increased risk of stroke and heart attack. Tibolone is used in Europe but is not approved in countries such as the United States. We hope that our study will lead to the drug being withdrawn from use here as well,” says Åsa Johansson, research group leader at Uppsala University and SciLifeLab, and the study’s senior author.

During the period of the study, 2007–2020, an increase in the use of hormone patches of about 50 per cent was observed, and these preparations were not linked to the same higher risk. The increased use of safer alternatives, such as patches, is an important step forward in reducing the risk of cardiovascular disease among menopausal women.

“The next step in our research will be to develop strategies to identify which women are at increased risk of certain diseases in connection with using hormonal drugs. In this way, we can guide patients to the most appropriate medicine for each individual and drastically reduce the number of side effects,” Åsa Johansson says.

Reference:

Johansson T, Karlsson T, Bliuc D, Schmitz D, Ek W E, Skalkidou A et al. Contemporary menopausal hormone therapy and risk of cardiovascular disease: Swedish nationwide register based emulated target trial BMJ 2024; 387 :e078784 doi:10.1136/bmj-2023-078784

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Mid pregnancy PlGF Screening: A Promising Tool for Identifying Risk of Early Preterm Birth, Study Reveals

Canada: In a recent study, researchers have found that screening for low placental growth factor (PlGF) levels in mid-pregnancy could offer valuable insight into the risk of early preterm birth. The study, published in JAMA Network Open, suggests that measuring PlGF during routine gestational diabetes screenings could become an essential tool for identifying pregnant individuals at high risk for early preterm birth, particularly when it comes to iatrogenic births.

The placental growth factor is a protein involved in blood vessel development within the placenta. PlGF levels in pregnant individuals can indicate how well the placenta is functioning, and lower levels have been linked to complications like preeclampsia and intrauterine growth restriction. Early preterm birth, defined as birth before 32 weeks of gestation, poses significant risks for both the mother and the newborn. Premature infants often face complications such as respiratory distress syndrome, neurological issues, and long-term developmental challenges. However, a universal screening strategy has not yet been established, hindering the ability to deliver targeted and effective interventions.

Against the above background, Rachel A. Gladstone, Department of Obstetrics & Gynecology, University of Toronto, Toronto, Ontario, Canada, and colleagues aimed to assess the effectiveness of mid-pregnancy PlGF screening in identifying pregnancies with the highest risk of early preterm birth.

For this purpose, the researchers conducted a prospective cohort study at an urban, tertiary care center between 2020 and 2023, involving pregnant individuals with singleton pregnancies who received routine prenatal care. Participants underwent a PlGF test during gestational diabetes screening at 24-28 weeks. The study analyzed data from January to May 2024.

The primary outcome was early preterm birth (before 34 weeks), with secondary outcomes including iatrogenic and spontaneous preterm birth, preeclampsia, stillbirth, and small-for-gestational-age birth weight.

The investigation revealed the following findings:

  • Among 9,037 pregnant individuals, 156 (1.7%) experienced early preterm birth (52 spontaneous, 104 iatrogenic).
  • The area under the curve (AUC) for PlGF and early preterm birth was 0.80.
  • Low PlGF level was associated with early preterm birth, showing:
    • Positive likelihood ratio (LR): 79.4
    • Negative LR: 0.606
    • Specificity: 99.5%
    • Negative predictive value: 98.9%
  • Time to birth was significantly reduced for those with PlGF levels below 100 pg/mL, with more than 50% delivering within 50 days.
  • Individuals with low PlGF levels accounted for over 30% of subsequent stillbirths (adjusted relative risk [aRR], 36.78).
  • More than 50% of patients requiring iatrogenic early preterm birth had low PlGF levels (aRR, 92.11).
  • The AUC for iatrogenic early preterm birth was 0.90.

The findings indicate that mid-pregnancy PlGF testing could be a potential screening tool for identifying individuals at high risk for early preterm birth.

“Further randomized trials are necessary to assess the impact of widespread implementation of PlGF screening,” the researchers concluded.

Reference:

Gladstone RA, Ahmed S, Huszti E, et al. Midpregnancy Placental Growth Factor Screening and Early Preterm Birth. JAMA Netw Open. 2024;7(11):e2444454. doi:10.1001/jamanetworkopen.2024.44454

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Higher Risk of Meniere’s Disease found in Atopic Dermatitis Patients, Especially Among Older Adults and Women: Study

South Korea: A recent nationwide cohort study has identified a significant association between atopic dermatitis (AD) and an elevated risk of developing Meniere’s disease (MD), a disorder affecting the inner ear and often characterized by vertigo, hearing loss, and tinnitus. The findings were published online in The Laryngoscope.

In the study, which tracked participants over an extended period, individuals with atopic dermatitis were found to have a 1.44-fold higher likelihood of developing Meniere’s disease compared to those without AD. Additionally, factors such as older age, female gender, and coexisting conditions like allergic rhinitis, allergic contact dermatitis, and allergic conjunctivitis were found to heighten the risk of developing Meniere’s disease.

Atopic dermatitis is a long-term inflammatory skin disorder marked by recurring flare-ups and periods of remission. While AD is widely recognized for its links to other allergic conditions, its connection to Meniere’s disease remains largely unexplored. Consequently, the Eun Jung Lee, Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Jeonbuk National University, Jeonju, Republic of Korea, and colleagues set out to investigate the potential association between AD and Meniere’s disease.

For this purpose, the researchers used data from the National Health Insurance Service-National Sample Cohort, a comprehensive population-based database. The AD group was drawn from a cohort of one million individuals randomly selected from this database, while a matched non-AD group was created using Propensity Score Matching.

The study’s findings include the following key points:

  • The study included 84,579 individuals in the AD group, with an equal number in the non-AD (control) group.
  • The overall hazard ratio (HR) for developing Meniere’s disease in the AD group was 1.44.
  • Subgroup analysis revealed adjusted HRs for Meniere’s disease as follows:
    • Males: 0.42
    • Middle-aged group (40–59 years): 4.99
    • Older age group (≥60 years): 8.21
  • Patients with additional allergic conditions had higher adjusted HRs for Meniere’s disease:
    • Allergic rhinitis: 1.18
    • Allergic contact dermatitis: 1.32
    • Allergic conjunctivitis: 1.54

The long-term follow-up showed that individuals in the AD group had a 1.44 times higher prevalence of Meniere’s disease compared to the control group. Additionally, factors such as older age, female gender, and coexisting conditions like allergic rhinitis, allergic contact dermatitis, and allergic conjunctivitis were found to increase the likelihood of developing Meniere’s disease.

“Given the high prevalence of atopic dermatitis globally, these findings could have considerable implications for public health. An improved understanding of the connection between chronic inflammatory conditions and vestibular disorders may lead to better preventive measures and early interventions for those at higher risk,” the researchers concluded.

Reference:

Yeo, C. D., Lee, J., Kim, J. S., & Lee, E. J. Association Between Atopic Dermatitis and Meniere’s Disease: Nationwide Cohort Study. The Laryngoscope. https://doi.org/10.1002/lary.31906

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