Stop-smoking pill varenicline to be offered by the UK’s NHS

For the first time since 2021, a pill used to help people quit smoking—varenicline—will again be available from the NHS.

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High cardiorespiratory fitness linked to lower risk of dementia

High cardiorespiratory fitness is associated with better cognitive performance and lower risk of dementia in the long term, including in people with a genetic predisposition to dementia, show the findings of a study published online in the British Journal of Sports Medicine.

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Reframing cerebral palsy as a lifelong physical disability could improve adult care, researchers say

In the United States, there are currently more adults living with cerebral palsy than children. Despite this, the Centers for Disease Control and Prevention still label cerebral palsy as “the most common motor disability in childhood.”

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A new strategy to enhance gene therapy for sickle cell disease

Researchers described a promising new approach for using gene therapy to treat sickle cell disease in the journal Human Gene Therapy. To improve the efficacy of gene therapy when using anti-sickling beta globin gene transfer, they added cyclosporin (CsH) to increase transduction by inhibiting lentiviral restriction factors.

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Low-dose ketamine shows promise for pain relief in emergency department patients

A study that investigates low-dose ketamine (LDK) as an adjunct to morphine for treating acute pain has been published in the Academic Emergency Medicine journal.

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Rajasthan Govt focuses on affordable healthcare, directs implementation of Health schemes

Jaipur: Rajasthan Chief Minister Bhajanlal Sharma reiterated that the state government’s top priority is to ensure affordable, accessible, and quality healthcare for the people.

According to the PTI report, he instructed officials to ensure all the budgetary announcements related to the health sector should be completed at a fast pace with an effective action plan to realise the ‘Apno Swasth Rajasthan’ concept.

Sharma was chairing a review meeting of the Medical and Health Department in the Chief Minister’s Office on Tuesday.

Also Read:Govt to complete work on medical colleges on priority: Rajasthan CM Bhajanlal Sharma

Medical and Health Minister Gajendra Singh Khinvsar was also present in the meeting. He informed the chief minister that the process of recruitment on about 48,000 posts by the Medical and Health Department is going on at mission mode and so far appointment have been made on about 8000 posts.

Chief Minister Sharma said that to provide quality health services in small cities and towns, the state government has decided to build Ayushman Model CHCs across the state, news agency PTI reported.

The chief minister said that free treatment is being provided to the general public under the Chief Minister Ayushman Arogya Yojana.  

The government has decided to include pediatric packages under this scheme and rationalise the rates of some packages. He instructed the officials to widely publicise the new provisions added to the scheme.  

Medical Dialogues team had earlier reported that in a move to improve healthcare access for patients in remote areas, the state health department is set to launch hemodialysis services at 182 centres, including 11 district hospitals and 102 community health centres, within the next month. This initiative aims to bring much-needed relief to kidney failure patients who previously had to travel long distances for regular dialysis. 

Also Read:Rajasthan officials to visit Delhi AIIMS to study Queue Management System

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Hyderabad Doctor loses Rs 69 lakh in online trading scam

Hyderabad: Based on crucial evidence gathered during an investigation, the Jagtial police arrested three accused from Jalandhar, Punjab, for their involvement in a trading fraud that defrauded a doctor of Rs 69 lakh.  

According to the police, the three suspects in this case are members of a cybercriminal gang who allegedly cheated the doctor. Although the police managed to capture the trio, the main accused is absconding and a search is on to nab the accused. 

The accused have been identified as Sumesh Kapoor, Rajeev Singh, and Jitender Kumar and the main accused name is Raju. 

The incident took place after Kapoor who was a loan agent, two others were lured by another agent named Raju into the scam. The three accused opened a bank account in a fictitious construction firm’s name and supplied the account details to Raju. 

Also read- SGPGI doctor’s mother put under digital arrest, loses Rs 18 lakh in 7 days

Using the firm’s fraudulent bank account, they lured the doctor into transferring Rs 24 lakh. Following this, they withdrew the amount and handed over the cash to Raju and, in turn, received 2 lakh cash as commission.

Speaking to TOI, a police officer said, “Kapoor was a loan agent, while the other two were working as sales managers at a poultry firm. Lured by another agent, Raju, Kapoor, with the help of the other two accused, opened a bank account in a fictitious construction firm’s name and supplied the account details to Raju. When the doctor fell into the trap, he transferred 24 lakh to Kapoor’s account. They withdrew the amount and handed over the cash to Raju and, in turn, received 2 lakh cash as commission. The three were brought to Jagtial on a transit warrant and remanded to judicial custody.”  

The three accused were arrested after a police investigation into the payment details of the doctor when he transferred the amount to the fraudster’s account. This led to the tracing of bank accounts in Punjab, where the account holder was subsequently identified.

A special team was formed to investigate the case based on the doctor’s complaint. After two months of investigation, the team received a tip-off about their location and nabbed them a few days ago from Jalandhar. The team seized bank passbooks, debit cards, and other material from the trio. They were kept under judicial remand in Jagtial.

Police said, “The doctor has received a refund of 10 lakh and the remaining amount will be returned to him soon.”

Also read- AIIMS Jodhpur doctor duped of Rs 18 lakh by fake cardiologist on dating app

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Novel Oral Drug Muvalaplin Lowers Lipoprotein (a) Levels: Clinical Trial Findings

A late-breaking clinical trial has shown that muvalaplin, an innovative oral medication, can safely and effectively lower elevated levels of lipoprotein (a), a key cardiovascular risk factor. These findings were presented at the American Heart Association’s Scientific Sessions 2024, held from November 16-18 in Chicago, a premier global event showcasing cutting-edge advancements in cardiovascular science.

The study, simultaneously published in JAMA: The Journal of the American Medical Association, highlights the potential of muvalaplin as a promising new therapy in cardiovascular care, addressing a significant unmet need for individuals with high lipoprotein (a) levels.

Lipoprotein(a), or Lp(a), is a type of inherited cholesterol level that is a common, independent risk factor for cardiovascular disease, affecting about 1 in 5 people worldwide. Black individuals of African descent and South Asian populations often have the highest Lp(a) levels, according to the American Heart Association’s 2021scientific statement “Lipoprotein(a): A Genetically Determined, Causal, and Prevalent Risk Factor for Atherosclerotic Cardiovascular Disease.” It is different from low-density lipoprotein (LDL), or “bad” cholesterol. Lp(a) numbers of 50 mg/dL (125 nmol/L) or higher promote clotting and inflammation, significantly increasing the risk of heart attack, stroke, aortic stenosis and peripheral artery disease, especially for people who also have cardiovascular disease or familial hypercholesterolemia.

There are several injectable medications undergoing clinical evaluation as treatments to lower Lp(a) levels. However, none have yet been approved by the U.S. Food and Drug Administration.

“Most medications being developed to lower Lp(a) are injectable. Muvalaplin is the first oral agent being developed to lower Lp(a) levels and acts by disrupting formation of the Lp(a) particle,” said study author Stephen Nicholls, MBBS, Ph.D., director of the Victorian Heart Institute at Monash University in Melbourne, Australia.

The KRAKEN clinical trial included 233 adults around the world who were identified at high risk of having a cardiovascular event due to very high Lp(a) levels (greater than 175 nmol/L). Researchers evaluated the effects of muvalaplin at different doses—10 mg, 60 mg or 240 mg, taken daily-compared with a daily placebo for 12 weeks. The researchers tested Lp(a) levels using both the traditional Lp(a) blood test and a new test that more specifically measures the levels of intact Lp(a) particles in the blood.

At week 12, the study found:

  • Compared to placebo, muvalaplin treatment reduced Lp(a) by up to 70% as measured by the traditional blood test, and by up to 85.5% as measured by the new intact Lp(a) particle test. Participants who received either 60 or 240 mg of muvalaplin had similar reductions in Lp(a) levels, both of which were greater than the reductions in Lp(a) levels of participants who received 10 mg of muvalaplin.
  • Muvalaplin treatment resulted in approximately 97% of participants achieving Lp(a) lower than 125 nmol/L, as measured by the intact Lp(a) particle test, or approximately 82% of participants as measured with the traditional blood test.
  • Compared to placebo, muvalaplin lowered apoB, one of two major proteins that make up Lp(a), by as much as 16%, with no notable change in levels of high-sensitivity C-reactive Protein (hsCRP), which is a way to measure heart attack and stroke risk.

“We were encouraged by the degree of Lp(a)-lowering in these patients who are most likely to benefit from its use and by the safety and tolerability,” Nicholls said. “While muvalaplin appears to be an effective approach to lowering Lp(a) levels, we still need to study whether Lp(a) lowering will result in fewer heart attacks and strokes.”

The study had limitations, including that it was relatively small and trial participants were treated for only 12 weeks. “Larger, more diverse and longer-term studies are needed,” Nicholls noted.

Reference:

Stephen J. Nicholls et al, Oral Muvalaplin for Lowering of Lipoprotein(a): A Randomized Clinical Trial, JAMA (2024). DOI: 10.1001/jama.2024.24017

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Increased Physical Activity and Reduced Sedentary Behavior tied to Improved Vascular Health in RA: Study

Brazil: A recent study found that sedentary behavior (SB) is negatively associated with vascular health in postmenopausal women with rheumatoid arthritis (RA), and light physical activity (PA) is positively associated with vascular health.

The research, published online in the American Journal of Physiology: Heart and Circulatory Physiology, highlights the significant role that physical activity and reduced sedentary time can play in improving vascular function among individuals with RA.

Rheumatoid arthritis is a chronic autoimmune condition that affects the joints and increases the risk of cardiovascular disease. This heightened risk is partly due to systemic inflammation, which can damage blood vessels and lead to poor vascular health. Traditionally, treatment for RA focuses on controlling inflammation and managing joint symptoms, but there is growing recognition of the importance of improving cardiovascular health in these patients. While physical activity is widely recommended for managing cardiovascular health in RA, there is limited evidence on the specific relationships between objectively measured PA and vascular health markers in individuals with RA. 

To fill this knowledge gap, T. Peçanha, Manchester Metropolitan University, Manchester, UK, and colleagues conducted a cross-sectional study involving 82 postmenopausal women with rheumatoid arthritis, averaging 62 ± 7 years. The participants underwent ultrasound assessments to evaluate vascular function and structure. These assessments included measurements of the brachial and superficial femoral artery (BA and SFA) flow-mediated dilation, baseline and post-hyperemia peak diameters, and carotid intima-media thickness, key indicators of vascular health.

Participants also completed a 7-day accelerometer-based assessment to measure physical activity and sedentary behavior. To examine the relationships between vascular health and PA outcomes, regression models were applied, adjusting for factors such as age, body mass index, and disease activity.

The regression analyses revealed the following key findings:

Sedentary Behavior:

  • Prolonged bouts of sedentary behavior (>60 minutes) and total sedentary time were negatively associated with both baseline and peak brachial artery (BA) diameters.
  • For each additional hour of sedentary behavior, there was a decrease of 0.08-0.1mm in both baseline and peak BA diameters.
  • Total sedentary time was negatively associated with peak superficial femoral artery (SFA) diameters, with a β value of -0.14.

Physical Activity:

  • Light-intensity physical activity and stepping time were positively associated with baseline and peak BA diameters.
  • For each additional hour of light-intensity PA, the diameters of the BA increased by 0.10-0.24mm.
  • Standing time was positively associated with peak SFA diameter, with a β value of 0.11.

Moderate-to-Vigorous PA:

  • There were no significant associations between moderate-to-vigorous physical activity and vascular outcomes.

“These findings suggest that reducing sedentary behavior and increasing light-intensity physical activity may positively impact vascular health in postmenopausal women with rheumatoid arthritis,” the researchers concluded.

Reference:

Meireles, K., Peçanha, T., Pinto, A. J., Santos, L. P., Mazzolani, B. C., Smaira, F. I., Rezende, D., M. Ribeiro, A. C., S. Pinto, A. L., Lima, F. R., D. Silva, J. N., Forjaz, L. M., Gualano, B., & Roschel, H. (2024). Improved vascular health linked to increased physical activity levels and reduced sedentary behavior in rheumatoid arthritis. American Journal of Physiology-Heart and Circulatory Physiology. https://doi.org/H-00640-2024

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Choline Metabolites Linked to 15-Year Diabetes Risk in Diverse Middle-Aged Adults, CARDIA Study Reveals

USA: A new study from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort has found that certain choline metabolites may be associated with an increased risk of developing type 2 diabetes over 15 years. The research, published in Diabetes Care, provides new insights into how the body processes choline, a nutrient commonly found in foods like eggs, liver, and soybeans, and its role in diabetes development.

According to the study, the findings align with existing research highlighting choline metabolism’s role in diabetes. However, the study expands on the current literature by examining a racially diverse, population-based cohort of early middle-aged adults, a group for whom preventive measures could be particularly impactful.

There has been growing interest in the potential role of choline metabolism in the development of diabetes. Most previous studies examining circulating choline metabolites and their link to diabetes risk have focused on older adults, often with a high prevalence of risk factors. Considering this, Katie A. Meyer, Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC, and colleagues aimed to explore the association between choline metabolism and the risk of developing diabetes in a diverse cohort of early middle-aged adults, a population where preventive measures may be especially effective.

For this purpose, the researchers used data from year 15 of follow-up (2000-2001) in the CARDIA Study, which included 3,133 participants aged 33–45 years. Plasma levels of choline metabolites (choline, betaine, and trimethylamine N-oxide [TMAO]) were measured. The researchers quantified the associations between these metabolites and the 15-year risk of incident diabetes (n = 387) among participants who were free of diabetes at baseline.

Cox proportional hazards regression models were used to adjust for sociodemographic factors, health behaviors, and clinical variables in the analysis.

The findings of the study are as follows:

  • Betaine was inversely associated with the 15-year risk of incident diabetes, with a hazard ratio of 0.76 per 1-SD increase in betaine levels.
  • TMAO was positively associated with the 15-year risk of incident diabetes, with a hazard ratio of 1.11 per 1-SD increase in TMAO levels.
  • Choline was not significantly associated with the 15-year risk of incident diabetes, with a hazard ratio of 1.05 per 1-SD increase in choline levels.

“Given existing literature and findings from the population-based study in early middle-aged adults, further research is needed to identify factors that may influence the link between plasma betaine and diabetes risk. Notably, the inverse association between betaine and diabetes risk in men but not women requires validation in larger samples. Additionally, studies like Mendelian randomization and larger trials are needed to assess causality and explore whether dietary modifications of betaine could reduce diabetes risk,” the researchers wrote.

“These results suggest that higher levels of circulating betaine may help reduce the risk of diabetes, potentially through the adoption of recommended healthy lifestyle changes,” they concluded.

Reference:

Jessica K. Sprinkles, Anju Lulla, Autumn G. Hullings, Isis Trujillo-Gonzalez, Kevin C. Klatt, David R. Jacobs, Ravi V. Shah, Venkatesh L. Murthy, Annie Green Howard, Penny Gordon-Larsen, Katie A. Meyer; Choline Metabolites and 15-Year Risk of Incident Diabetes in a Prospective Cohort of Adults: Coronary Artery Risk Development in Young Adults (CARDIA) Study. Diabetes Care 21 October 2024; 47 (11): 1985–1994. https://doi.org/10.2337/dc24-1033

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