National Institute of Siddha gives Varmam Therapy to 567 people, sets Guinness World Record

New Delhi: The National Institute of Siddha (NIS) has set a Guinness World Record for providing Varmam therapy to 567 individuals simultaneously.

The event held at the NIS campus in Tambaram, Chennai, highlights the growing recognition of Siddha medicine and its non-invasive, drug-free therapeutic methods, particularly through the practice of Varmam therapy. The Union State Minister of Ayush (Independent Charge) Shri Prataprao Ganpatrao Jadhav appreciated the efforts of NIS in a written message.

The event saw 567 trained Varmanis (Varmam healers) simultaneously providing therapy to 567 individuals, underscoring the therapeutic reach and effectiveness of this traditional practice. The Guinness World Record not only demonstrated the therapeutic potential of Siddha medicine but also showcased the growing interest in traditional healing systems.

Also Read:Siddha Wellness and Awareness Campaign: Bikers 20-day Rally from Delhi to Kanyakumari

Secretary, Ministry of Ayush, Vaidya Rajesh Kotecha congratulated the NIS team for this historic achievement and said that “This type of event is not just about achieving an award; it’s about raising awareness among the new generation and helping them understand the science and value behind such wonderful practices”. He also added, “The Siddha system of medicine is gaining significant attention both globally and within India. We are committed to sustaining this momentum. In recent years, the National Institute of Siddha has seen great progress.”

Prof. Dr. R.Meenakumari, Director of National Institute of Siddha, said that “Siddha Varmam therapy is a very unique, non invasive, cost effective, non pharmacological form of treatment. It’s used in treating complicated neurological diseases,ortho and musculoskeletal diseases, autism spectrum disease, and cerebral palsy in children. This Guinness world record will help the Siddha system of medicine to get a lot of attention from the world and within India”.

National Institute of Siddha

National Institute of Siddha Sets Guinness World Record for Mass Varmam Therapy

The Guinness World Record event is a part of the NIS’s ongoing efforts to bring global attention to the benefits of Siddha medicine and Varmam therapy. The Institute has expressed its commitment to further promoting these traditional healing practices, ensuring that they reach a wider audience both within India and internationally.

Varmam therapy, a unique and traditional healing modality within the Siddha system of medicine, has long been revered for its effectiveness in treating various health conditions. It is particularly renowned for its ability to provide rapid relief for musculoskeletal pain, injuries, and neurological disorders.

While Varmakalai (the martial art form associated with Varmam) is often misunderstood as a combat technique, in Siddha medicine, it is a scientifically grounded therapeutic practice used to treat acute and chronic diseases, including stroke, arthritis, and trauma-related injuries. As the National Institute of Siddha (NIS) celebrates this historic achievement, the Guinness World Record for Mass Varmam Therapy serves as a testament to the growing global recognition of Siddha medicine and its healing potential.

Also Read:AYUSH Ministry prohibits ‘Miraculous’ claims in advertisements for Ayurveda, Siddha drugs

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NTRUHS Notifies On Reporting Deadline For Round 2 PG Medical Admissions, Details

Andhra Pradesh- Through a letter, Dr NTR University of Health Sciences (Dr NTRUHS) has informed that the Phase-II counselling for admissions into PG(Medical) courses under Management Quota seats is completed on 19 December 2024 and candidates have to report at the respective Medical Colleges on or before 03.00 PM on 26 December 2024.

This letter has been issued by the Registrar of Dr NTRUHS to the Principals of all private medical colleges having PG courses affiliated with Dr NTRUHS, Andhra Pradesh.

In this regard, all the Principals are directed to constitute a “Committee” consisting of 2 or 3 Professors and the Principal as chairman of the Committee shall arrange to verify the Original certificates of the Candidates before completing the process of admission. All the Original certificates must be verified very carefully and any discrepancies must be brought to the notice of the University immediately. Further, it has also been requested to verify more particularly the local area i.e., AP/Others and NEET cut-off score as per the Category of the candidate.

Also Read: Dr NTRUHS Begins Special Stray Vacancy Round for BDS Management Quota Seats

The “Committee” to be constituted at the colleges should verify the printouts of the following-

1 Online Application form.

2 Provisional Allotment Order.

3 Original certificates of the candidates.

Any deviation should be brought to the University’s notice immediately. Along with this, it has also been instructed to observe remarks if any on the provisional verification form before admitting the candidate. Meanwhile, the list of documents to be verified at the time of admission. Further, it has been urged to freeze the data of Not Reported/Reported candidates by 04.00 PM on 26 December 2024 duly following the instructions of the Service Provider.

TUITION FEE

The following is the Tuition fee structure for the academic year 2024-25 to be payable for the Competent Authority Quota seats in Private Un-aided Medical Colleges.

S.NO

NAME OF THE COURSE

FEE FOR CATEGORY-B (MQ) SEATS

FEE FOR CATEGORY-C NRI/INTERNATIONAL QUOTA SEATS

1

Clinical Degree/Diploma.

₹. 9,93,600/-

₹.57,50,000/-

2

Para Clinical Degree/Diploma.

₹.3,10,500/-

₹.17,25,000/-

3

Pre-Clinical Degree/Diploma.

₹.1,40,760/-

₹.9,20,000/-

IMPORTANT POINTS

While admitting the candidates, the following guidelines are to be followed-

1 The candidates have to download the allotment letter online after paying a requisite fee of Rs.49,600/- The last date for reporting at the allotted colleges is 03.00 PM on 26-12-2024. Candidates who have already paid ₹.49,600/- (during Phase-I counselling) need not pay again for downloading the allotment order if a seat is allotted in this Phase-II counselling.

2 The Candidates who have already joined a college allotted in the Phase-I of counselling can join in the college allotted in this Phase-II of counselling after obtaining a relief letter (by e-mail/In-person) & Custodian certificate from the college (by e-mail/In-person) in which already joined.

3 The Principals of the colleges where the candidates already joined in Phase-I and now allotted a seat in another college in Phase-II are to be relieved by giving a relieving order by e-mail/In person. The fee paid by the candidate must be transferred to the allotted college/refunded to the candidate of the Phase-II counselling.

4 The selected candidates shall produce all the Original certificates, pay the Tuition fee, necessary bonds etc., and complete the process of admission. If the candidate does not fulfil the criteria as per regulations to complete the admission process on the specified dates of admission, their admission will be cancelled automatically.

5 The verification of original certificates will be conducted at the time of admission in the respective College and in case of any discrepancy, the Provisional allotment will be cancelled and action will be initiated.

6 Candidates can also slide among subcategories (1), (2) & (3) in Phase-II and in such case, the tuition fee already paid in any category will be returned/adjusted to the candidate so that he/she can pay the requisite fee of the slid seat in the college to which the candidate is slide.

7 After the cutoff date for reporting i.e., by 03.00 PM on 26-12-2024, no candidate should be admitted and their Provisional admission is deemed to be cancelled without any further intimation.

8 Principals have to upload the Reported/Not Reported data by 04.00 PM on 26-12-2024.

9 If any discrepancy is found with regard to the above, the same may please be brought to the notice of the University, through e-mail.

10 Candidates already reported under Phase-I Competent Authority Quota, if allotted a seat in Phase-II under Management Quota, and upon reporting the Phase-II MQ seat, the Phase-I CQ seat will be automatically cancelled. The candidate has no right to claim the said cancelled seat. 11 Principals are requested to ensure that an allotted candidate can report at any one college/course either in CQ or MQ in case the candidate got a seat in both CQ & MQ of Phase-I/Phase-II counselling. The Principals are requested to honour the decision of the candidate in choosing the allotted seat of admission. There shall not be any dual reporting of any candidate in CQ & MQ at different/same colleges.

12 The University fee once paid shall not be refunded under any circumstances.

To view the letter, click the link below

https://medicaldialogues.in/pdf_upload/dr-ntruhs-notifies-on-reporting-deadline-for-phase-ii-pg-medical-admissions-details-265743.pdf

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Intermittent Fasting Shows Promise for Weight loss and improved Metabolic Health in new research

China: A recent comprehensive umbrella review has emphasized the potential benefits of intermittent fasting (IF), particularly time-restricted eating (TRE), as an effective strategy for weight management and metabolic health. The review, which synthesized data from multiple studies, highlights the growing interest in IF as a promising intervention for adults dealing with overweight or obesity and those seeking to improve their overall metabolic function.

The umbrella review, published in Diabetes, Obesity and Metabolism, found that IF, particularly TRE, was especially beneficial for overweight and obese adults.

Intermittent fasting, which involves alternating between periods of eating and fasting, has gained popularity due to its simplicity and potential health benefits. Among the various approaches to IF, TRE, which restricts eating to a specific time window each day, has been found to offer significant improvements in weight loss and metabolic health markers. Studies suggest that TRE can lead to reductions in body fat, improved insulin sensitivity, and better control of blood sugar levels, all of which contribute to a healthier metabolic profile.

Against the above background, Zixin Hua MPharm, Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China, and colleagues provide a comprehensive and updated evaluation of the quality and evidence linking intermittent fasting (IF) to various health outcomes based on existing studies.

For this purpose, the researchers conducted a systematic search across PubMed, Web of Science, Cochrane Library, and Embase databases, covering literature up to June 2024. The review included meta-analyses and systematic reviews involving adult populations that quantitatively analyze health outcomes related to intermittent fasting (IF) interventions. For studies with complete data, the researchers reanalyzed the effect sizes and 95% confidence intervals using random-effects models.

The quality of the articles and the certainty of the evidence were assessed using the A Measurement Tool to Assess Systematic Reviews (AMSTAR-2), the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, and a standardized credibility grading system.

The following were the key findings:

  • Twelve meta-analysis studies and 122 health outcome associations with intermittent fasting (IF) were identified.
  • High-quality evidence showed significant associations between time-restricted eating (TRE) and weight loss, fat mass reduction, and decreases in fasting insulin and glycosylated hemoglobin levels in overweight or obese adults.
  • High-quality evidence also indicated an association between the 5:2 diet and reduced low-density lipoprotein cholesterol levels.
  • Moderate-to-low-quality evidence suggested that modified alternate-day fasting improved body weight, lipid profile, and blood pressure.
  • High-to-low-quality evidence demonstrated that IF regimens effectively improved liver health in non-alcoholic fatty liver disease.

The authors of this umbrella review emphasize that intermittent fasting, particularly time-restricted eating (TRE), is a promising intervention for weight and metabolic health, with notable benefits for overweight or obese adults. However, they also stress the need for further extensive research to explore the long-term effects, individualized IF plans, and potential adverse outcomes in diverse populations.

Reference:

Hua Z, Yang S, Li J, Sun Y, Liao Y, Song S, Cheng S, Li Z, Li Z, Li D, Guo H, Yang H, Zheng Y, Li X. Intermittent fasting for weight management and metabolic health: An updated comprehensive umbrella review of health outcomes. Diabetes Obes Metab. 2024 Dec 1. doi: 10.1111/dom.16092. Epub ahead of print. PMID: 39618023.

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Long-Term Statin Use Linked to Lower Risk of Adverse Events in Newly Diagnosed Atrial Fibrillation Patients: Study

Taiwan: A recent study published in the Journal of the American Heart Association suggests that statins could play a crucial role in improving long-term outcomes for patients newly diagnosed with atrial fibrillation (AF).

“Statin use was linked to a 9% reduced risk of composite adverse outcomes, including ischemic and hemorrhagic strokes and transient ischemic attacks. Additionally, statin therapy was associated with a 67% decrease in all-cause mortality and a 36% reduction in major adverse cardiovascular events,” the researchers reported.

According to the authors, this study represents the largest observational cohort of patients newly diagnosed with atrial fibrillation (AF) to explore the preventive effects of statin use on cardiovascular events. The key findings are as follows: regular statin use was linked to a significant reduction in the risk of stroke or transient ischemic attack (TIA); statin users consistently showed lower risks of all-cause mortality and major adverse cardiovascular events (MACEs) compared to nonusers, even after adjusting for important variables. Furthermore, a time-dependent analysis was performed to account for the timing of statin use, and the results consistently demonstrated a significant risk reduction.

The role of statins in preventing adverse cardiovascular events in individuals with atrial fibrillation has been unclear. Therefore, Ting‐Chun Huang, Institute of Clinical Medicine, College of Medicine National Cheng Kung University Tainan Taiwan, and colleagues aimed to determine whether statin use could improve outcomes in individuals with AF.

For this purpose, the researchers enrolled 397,787 patients with atrial fibrillation (AF) between 2012 and 2020. Participants were categorized into two groups: statin users and statin nonusers. The study analyzed the risks of composite outcomes—such as ischemic stroke, hemorrhagic stroke, and transient ischemic attack—along with all-cause mortality and major adverse cardiovascular events, including cardiovascular death, myocardial infarction, stroke, and heart failure hospitalization.

Among these, 288,958 patients had newly diagnosed AF (mean age 73 years; 44% women; mean CHA2DS2-VASc score 3.5). The researchers reported the following findings:

  • Statin users had lower risks of composite endpoints compared to nonusers (adjusted HR, 0.91).
  • Statin use was associated with a 67% reduction in all-cause mortality compared to nonusers (adjusted HR, 0.33).
  • Statin use was linked to a reduced incidence of major adverse cardiovascular events (adjusted HR, 0.64).
  • In subgroup analysis stratified by CHA2DS2-VASc scores, statin therapy was most effective for composite endpoints in patients, with scores between 0 and 3.
  • Statin use consistently reduced all-cause mortality and major adverse cardiovascular events across all CHA2DS2-VASc score categories.

“Regular use of statins lowers the risk of stroke, mortality, and major adverse cardiovascular events in patients with newly diagnosed atrial fibrillation. However, further randomized trials are needed to confirm these findings,” the researchers concluded.

Reference:

Huang TC, Yap LH, Chen CY, Lin HW, Lin SH, Li YH. Long-Term Statin Use Is Associated With Reduced Rates of Adverse Events in Patients With Newly Diagnosed Atrial Fibrillation. J Am Heart Assoc. 2024 Dec 17;13(24):e035827. doi: 10.1161/JAHA.124.035827. Epub 2024 Dec 14. PMID: 39673286.

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Acute Pancreatitis in Youth Linked to Diabetes Risk: Study Identifies Key Predictors

USA: A study published in Digestive and Liver Disease suggests that youths who experience acute pancreatitis may face an increased risk of developing prediabetes or diabetes. Key factors associated with this risk include the severity of the condition, levels of C-reactive protein and interleukin-6, and subcutaneous fat area.

“Within three months, 15.3% of participants developed prediabetes, and 0.7% developed diabetes. At the one-year mark, these rates were 12.5% and 3.5%, respectively,” the researchers reported.

Acute pancreatitis (AP) has been linked to an elevated risk of diabetes mellitus (DM). Maisam Abu-El-Haija, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA, and colleagues aimed to identify clinical, laboratory, and imaging predictors of prediabetes (preDM) and DM in youth following an initial episode of AP.

For this purpose, the researchers conducted a prospective cohort study involving patients aged ≤21 with an initial admission for acute pancreatitis, followed by evaluations at 3 and/or 12 months. Clinical laboratory values, imaging findings, admission course details, and plasma chemokine and cytokine levels collected during the index admission were analyzed for their association with the development of prediabetes or diabetes mellitus. A multivariable regression model was employed to identify predictors of preDM/DM.

The study led to the following findings:

  • Of the 187 enrolled participants, 137 (73%) underwent diabetes screening at 3 months, 144 (77%) at 12 months, and 137 (73%) had imaging data available.
  • At 3 months, 16% developed prediabetes/diabetes (preDM: 21; DM: 1).
  • At 12 months, 16% developed prediabetes/diabetes (preDM: 18; DM: 5).
  • Univariate associations with preDM/DM at 12 months included:
  • Severe acute pancreatitis (SAP): 52% in the preDM/DM group vs. 17% in the no DM group.
  • Median IL-6 levels: 910 pg/ml in the preDM/DM group vs. 196 pg/ml in the DM group.
  • Median CRP levels: 4.16 mg/L [IQR 1.67–10.7] in the preDM/DM group vs. 1.55 mg/L in the no DM group.
  • The optimal multivariable model using clinical variables to predict preDM/DM included severe acute pancreatitis (SAP), C-reactive protein (CRP), interleukin-6 (IL-6), and age [AUC = 0.80].
  • When imaging markers were included, the ideal model incorporated SAP, CRP, IL-6, subcutaneous fat area, age, and autoimmune disease presence [AUC = 0.82].

The authors noted that their predictive model could be valuable during the initial acute pancreatitis episode, as this is believed to be the point when the underlying injury leading to prediabetes or diabetes begins. “Utilizing this model may assist in planning follow-up care and identifying specific patients at higher risk for developing prediabetes or diabetes, enabling targeted future testing,” the researchers concluded.

Reference:

Ginzburg, G., Debnath, P., Zhang, Y., Ata, N. A., Farrell, P. R., Garlapally, V., Kotha, N., Thompson, T., Vitale, D. S., Trout, A. T., & Abu-El-Haija, M. (2024). Clinical and imaging predictors for the development of diabetes mellitus following a single episode of acute pancreatitis in youth. Digestive and Liver Disease. https://doi.org/10.1016/j.dld.2024.10.009

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Urinary Biomarker confirms CV benefit with Moderate wine intake: PREDIMED Trial

Spain: The large PREDIMED trial demonstrated that moderate wine consumption was linked to cardiovascular benefits even when self-reported data was excluded. The findings from the trial were published online in the European Heart Journal on December 18, 2024.

“Drinking 12-35 glasses of wine per month was associated with a lower risk of combined heart failure, myocardial infarction, stroke, and cardiovascular death over a median follow-up of nine years,” the researchers reported. This finding aligns with prior epidemiological research suggesting cardiovascular benefits from moderate wine consumption.

To ensure accurate measurement of wine intake, the researchers used tartaric acid as a surrogate marker, given its specificity to grapes and the limited consumption of alternative dietary sources.

Previous studies have linked moderate wine consumption to a reduced risk of cardiovascular disease (CVD) in older populations. However, self-reported wine consumption is often subject to measurement errors due to its reliance on subjective assessments. To address this, Inés Domínguez-López, Institut de Nutrició i Seguretat Alimentària (INSA), Universitat de Barcelona (UB), Santa Coloma de Gramanet, Spain, and colleagues sought to examine the relationship between urinary tartaric acid—an objective biomarker of wine intake—and the incidence of composite clinical CVD events.

For this purpose, the researchers designed a case-cohort study nested within the PREDIMED trial, involving 1,232 participants: 685 incident cases of CVD and a random subcohort of 625 participants, with 78 overlapping cases. Wine consumption was evaluated using validated food frequency questionnaires, while urinary tartaric acid levels were measured at baseline and after one year of intervention using liquid chromatography-tandem mass spectrometry. Weighted Cox regression models were employed to estimate CVD hazard ratios (HRs).

The investigation uncovered the following findings:

  • Tartaric acid showed a moderate correlation with self-reported wine consumption at baseline [r = 0.46].
  • Five post hoc categories of urinary tartaric acid excretion were used to better represent risk patterns.
  • Urinary tartaric acid concentrations of 3–12 μg/mL and 12–35 μg/mL, reflecting approximately 3–12 and 12–35 glasses of wine per month, were linked to lower CVD risk [HR 0.62 and HR 0.50, respectively].
  • Associations between self-reported wine consumption and CVD risk were less pronounced.

“Using an objective and reliable urinary biomarker, we found that light-to-moderate wine consumption was linked to a reduced incidence of clinical cardiovascular events in a Mediterranean population at high cardiovascular risk,” the researchers wrote.

The study authors, however, noted that their findings might not be applied to populations outside the older, Mediterranean PREDIMED cohort. Despite efforts to adjust for confounding factors, the study’s observational nature leaves the possibility of residual confounding.

They acknowledged that the exact mechanisms behind wine’s cardiovascular benefits remain unclear but suggested that polyphenols might play a significant role. “Polyphenols offer various health benefits, including anti-inflammatory effects, which could contribute to the cardioprotective properties of wine,” they wrote, adding that “multiple mechanisms may underlie these cardioprotective effects.”

Reference:

M, R., Razquin, C., Galkina, P., M, Á., Fitó, M., Fiol, M., Lapetra, J., Sorlí, J. V., Castañer, O., Liang, L., Hu, F. B., Ros, E., Ángel, M., & Estruch, R. Urinary tartaric acid as a biomarker of wine consumption and cardiovascular risk: The PREDIMED trial. European Heart Journal. https://doi.org/10.1093/eurheartj/ehae804

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Drinking multiple cups of coffee may help prevent mental decline in people with atrial fibrillation: Study

Consuming multiple cups of coffee daily may help prevent cognitive decline in individuals with atrial fibrillation (AFib), according to new research published on December 14, 2024, in the Journal of the American Heart Association.

“Many myths are around, but our study found no reason to discourage or forbid a patient with AFib from drinking coffee. Instead, say, ‘Enjoy, it may even be good for you!’” said Jürg H. Beer, M.D., senior author of the study and professor of medicine and hematology at the University of Zürich in Switzerland.

Atrial fibrillation is the most common heart rhythm disorder in adults, affecting more than 5 million people in the U.S., according to the American Heart Association. The2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation noted that abstaining from caffeine to prevent heart rhythm disturbances is of no benefit to people with AFib. The guideline also notes that abstaining from coffee could reduce symptoms in patients who report that caffeine triggers or worsens their AFib symptoms, which can include rapid heartbeat, dizziness, fatigue and more.

“It is known that regular coffee consumption benefits cognitive performance among healthy people. The most frequent cardiac arrhythmia, atrial fibrillation, is known to independently increase the risk of dementia,” said Massimo Barbagallo, M.D., lead author of the study and a resident in the neuro intensive care unit at the University Hospital Zürich. “Thus, the question is whether coffee might offset the increased risk of cognitive impairment in people with AFib.”

According to the U.S. federal dietary guidelines, three to five 8-ounce cups of coffee per day can be part of a healthy diet, but that only refers to plain black coffee. The American Heart Association warns that popular coffee-based drinks such as lattes and macchiatos are often high in calories, added sugar and fat.

The Swiss Atrial Fibrillation Cohort Study (Swiss-AF) follows more than 2,400 people in Switzerland diagnosed with atrial fibrillation. Patients were enrolled between 2014 and 2017, completed several cognitive tests, and reported how many cups of caffeinated coffee they drank during the last 12 months-regardless of added sweeteners, creams or flavors. Cup size was not standardized.

In this study, researchers analyzed those cognitive assessments and examined whether drinking coffee might avoid the cognitive decline that is a known hazard of AFib. Because Alzheimer’s disease and AFib are associated with systemic inflammation, researchers also analyzed markers of inflammation.

The study found:

  • Overall, higher cognitive test scores were associated with higher coffee consumption.
  • Specifically, scores for processing speed, visuomotor coordination and attention improved significantly by 11% among coffee consumers compared to non-consumers.
  • Cognitive age was calculated to be 6.7 years younger among those who drank the most coffee compared to those who drank the least.
  • Inflammatory markers were more than 20% lower in participants drinking five cups daily than in participants drinking less than one cup daily.
  • Researchers did not find any interaction between age, sex and coffee consumption.

“There was a very clear and consistent “dose-response” association between drinking more coffee and doing better on several different sophisticated cognitive tests,” Beer said. “Inflammatory markers decreased with higher coffee consumption, an association that remained after considering variables such as age, sex, body mass index, smoking status, physical activity and a history of stroke.”

Researchers noted that previous studies suggest that the protective effects of regular coffee consumption against cognitive decline in the elderly may be attributed to caffeine and other active ingredients including magnesium and vitamin B3 (Niacin); or, that it may be due to coffee’s role in reducing chemicals that cause inflammation.

José A. Joglar, M.D., FAHA, chair of the 2023 joint guideline on the management of atrial fibrillation, cautioned that this observational study cannot conclude that coffee actually prevents long-term cognitive decline.

“Other studies have shown coffee has cognitive-enhancing functions across the board. This, however, is not specific to the AFib population. We cannot conclude that coffee prevents long-term cognitive decline,” said Joglar, professor of Internal Medicine at UT Southwestern Medical Center in Dallas. “Coffee does not seem to worsen AFib so there is no need to stop drinking it. However, we cannot say starting to drink coffee would prevent AFib or prevent long-term cognitive decline.”

The study’s limitations include the fact that researchers measured participants’ cognitive ability and coffee consumption at the same point in time. This means that the study could not evaluate differences in cognitive decline with age, and that the reported current coffee drinking may not reflect changes in consumption over the previous years. As a cross-sectional study taking place at one point, it cannot establish a cause-and-effect relationship between drinking coffee and cognitive performance. Additionally, the study may not be generalizable to other populations as it included a mostly white population in Switzerland, where people tend to drink espressos.

“To detect a relevant cognitive decline, a follow-up of at least 5-10 years is required. However, the nutritive habits including coffee consumption reported by participants reflect exposure over many years and we likely see here the results of this,” Barbagallo said.

Study details, background or design:

  • The study included 2,413 people (average age 73; 27% women) with atrial fibrillation enrolled in Swiss Atrial Fibrillation Cohort Study (Swiss-AF) between 2014 and 2017. Swiss-AF is ongoing at 14 centers across all language regions in Switzerland.
  • Participants had undergone at least eight years of monitoring for stroke, mini-stroke, inflammation blood markers and blood-clotting, brain imaging and repeated cognitive testing. Patients were excluded from the analysis if they had experienced only brief episodes of AFib that had resolved without treatment, or if they were unable to give informed consent.
  • At enrollment, participants reported their caffeinated coffee consumption over the past year, with responses summarized as less than one cup a day, one cup a day, two- to three-cups a day, four- to five-cups a day and more than five cups a day. Size of cup or concentration of caffeine per cup was not quantified. The addition of creams, sugars or flavors was not considered.
  • At enrollment, participants completed various cognitive tests measuring verbal skills, executive functioning, memory, processing speed, visual-motor coordination and attention. These were combined into an overall rating of cognitive ability called the Cognitive Construct (CoCo). Participants also completed a 30-point screening test for cognitive impairment, the Montreal Cognitive Assessment, gauging visuospatial and executive functions, naming objects, memory, attention, language and abstraction abilities.
  • Participants were also evaluated for depression using the Geriatric Depression Scale so researchers could evaluate whether cognitive performance had likely been altered by depression.

Reference:

Massimo Barbagallo, Anne Springer, Chiara Vanetta,  Meret Allemann, Coffee Consumption Correlates With Better Cognitive Performance in Patients With a High Incidence for Stroke, Journal of the American Heart Association, https://doi.org/10.1161/JAHA.124.034365

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Rare Case of Acute Renal Failure Linked to Lethal Caffeine Overdose Highlights Risks of Intoxication

Japan: A recent case report published in BMC Nephrology has highlighted the severe and potentially life-threatening effects of caffeine overdose, particularly its association with acute kidney injury (AKI).

The researchers reported a case of acute kidney injury diagnosed as a result of potentially lethal caffeine intoxication. Along with the findings from a renal biopsy, multiple pathophysiological mechanisms underlying caffeine-induced AKI were considered in understanding the condition.

Energy drinks and non-drowsy medications, which are both affordable and easily accessible, have become increasingly popular. However, as the market for these products grows, there have been reported cases of suicide attempts involving the ingestion of large amounts of caffeine, some of which have been fatal. In response to rising concerns about caffeine addiction, certain countries have implemented laws to limit the amount of caffeine that can be purchased.

While caffeine intoxication has become more common, leading to various health complications, AKI caused by caffeine overdose remains rare, and the exact mechanisms behind it are not yet fully understood. Ayaka Mitomo, Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa, Japan, and colleagues described the case of a female patient in her 20s who ingested an over-the-counter drug containing a lethal dose of caffeine, leading to secondary non-oliguric acute kidney injury (AKI).

Upon hospitalization, the patient was diagnosed with acute intoxication due to a caffeine overdose. On day 19, a renal biopsy was performed to investigate the cause of her prolonged renal dysfunction. Light microscopy showed normal glomeruli, mild inflammatory cell infiltration, and acute tubular damage. Myoglobin staining within the tubules revealed scattered myoglobin columns, indicating rhabdomyolysis. Electron microscopy further revealed the loss of glomerular epithelial foot processes and enlarged tubular mitochondria. The patient underwent hemodialysis and continuous hemodiafiltration, which helped stabilize her condition. Following a psychiatric consultation, she was discharged on the 34th day of hospitalization.

The researchers concluded that caffeine’s ability to antagonize adenosine receptors, stimulate ryanodine receptors, and elevate catecholamines likely contributes to the onset of acute kidney injury. The development of AKI, in this case, was hypothesized to result from a combination of factors: (1) caffeine-induced disruption of the tubular oxygen supply-demand ratio, leading to ischemia; (2) tubular damage caused by rhabdomyolysis and subsequent ryanodine receptor stimulation; and (3) renal artery constriction due to increased catecholamine levels. These mechanisms together may explain the renal dysfunction observed in caffeine intoxication.

“Caffeine is affordable and readily available without needing a doctor’s consultation or prescription. However, as demonstrated by this case, excessive caffeine intake can lead to severe renal dysfunction. Consequently, manufacturers of caffeine-based products should include prominent warnings about the potential risk of kidney injury associated with overconsumption,” the researchers wrote.

Reference:

Mitomo, A., Ishioka, K., Yanai, M. et al. Non-oliguric acute renal failure secondary to a potentially lethal dose of caffeine with acute intoxication: a case report. BMC Nephrol 25, 451 (2024). https://doi.org/10.1186/s12882-024-03905-3

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Older age linked to increased complications after breast reconstruction, reveals research

A study published in the January issue of Plastic and Reconstructive Surgery®, reports that older age is linked to a slight but significant increase in certain complications following breast reconstruction after mastectomy. 

Older women may be less satisfied with the appearance of the reconstructed breasts, but may have better psychologic adjustment after breast reconstruction compared to younger patients, according to the new research by Jonas A. Nelson, MD, MPH, and colleagues of Memorial Sloan Kettering Cancer Center, New York. “These findings clarify how age affects the outcomes of breast reconstruction, which may help in minimizing the risks and maximizing the benefits for older women considering reconstructive surgery after mastectomy,” Dr. Nelson comments.

Increased complications of breast reconstruction in older women

Breast reconstruction has important benefits for women undergoing mastectomy for treatment of breast cancer. Previous studies have suggested that age “should not be a deterring factor” to post-mastectomy breast reconstruction (PMBR), but the true impact of age on patient outcomes remains unclear. While about one-half of patients undergo breast reconstruction after mastectomy, only about six percent are older than 60 years.

Toward “a more thorough and rigorous assessment” of how age affects breast reconstruction outcomes, Dr. Nelson and colleagues analyzed 4,730 patients who underwent PMBR at the authors’ cancer center between 2017 and 2022. After adjustment for other factors, older patients were at higher risk of three types of complications: infection, breakdown (necrosis) of the skin flap used for reconstruction, and fluid buildup (seroma) under the wound.

For all three complications, risk increased slightly per year of age. For every 10-year increase in age, infection risk increased by 10% while skin necrosis and seroma risk increased by 20%.

Mixed effects of age on patient-reported outcomes of PMBR

The study also looked at how age affected patient satisfaction and quality-of-life outcomes, assessed using the validated BREAST-Q questionnaire. Older age was associated with lower scores in satisfaction with the breasts, such as the natural appearance of the breasts and clothing fit.

In contrast, older age was linked to higher scores for psychosocial well-being, addressing factors such as body image and confidence in social settings. The researchers suggest that older patients may have fewer concerns about factors such as their career and finances, and a more “matter-of-fact” attitude toward aging and their cancer diagnosis. Age was unrelated to physical well-being related to the chest, such as pain or activity limitations, or to sexual well-being.

Subgroup analyses suggested some differences in complications and patient-reported outcomes for women undergoing implant-based reconstruction versus autologous reconstruction using the patients’ own tissues. There were also differences in outcomes for older women who had other health conditions associated with frailty.

“Our findings suggest that age should be considered alongside other factors when determining whether an older patient is a suitable candidate for breast reconstruction,” Dr. Nelson comments. The increased complication rates associated with older age may reflect risk factors such as high blood pressure and diabetes. The researchers suggest that optimized care for these conditions might help to reduce the risk of complications.

The study also provides insights into age-related differences in patient-reported outcomes – viewed as an important factor in assessing the benefits versus risks of breast reconstruction. Dr. Nelson adds: “This comprehensive analysis may also help to maximize postoperative physical functioning and patient satisfaction among older women who opt for PMBR.”

Reference:

Kim M, Ali B, Zhang K, Vingan P, Boe L, Ly CL, Allen RJ Jr, Matros E, Cordeiro PG, Mehrara B, Nelson JA. 61. Age Impacts Clinical And Patient Reported Outcomes Following Post Mastectomy Breast Reconstruction. Plast Reconstr Surg Glob Open. 2024 May 10;12(Suppl 5):36. doi: 10.1097/01.GOX.0001018256.

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Sixth vital sign, Walking speed may predict metabolic health in obese individuals: Study

Walking speed can provide insights into health, extending beyond mere mobility, so much so that it is considered to be the “sixth vital sign.” Past studies have suggested that a slow walking speed is correlated with the development of cardiovascular diseases and an increased risk of mortality in the elderly.

A recent study led by Prof. Kojiro Ishii from Doshisha University has found that Walking speed offers valuable insights into overall health, going beyond mobility to be regarded as the “sixth vital sign.” Previous studies have linked slower walking speeds to an increased risk of cardiovascular disease and higher mortality rates in older adults.

The researchers explored the connection between subjective walking speed and metabolic diseases risk, particularly in individuals with obesity. The study’s findings, published in volume 14 of Scientific Reports on November 15, 2024, suggest that assessing how a person perceives their walking pace relative to peers could become a vital tool for public health.

“This study clarified that even individuals with obesity, who are at higher risk for metabolic diseases, have lower odds of hypertension, diabetes mellitus, and dyslipidemia if they report a fast subjective walking speed,” notes Prof. Ishii.

The study involved 8,578 individuals with obesity (defined by body mass index), 9,626 individuals with high waist circumference, and 6,742 meeting both criteria. The participants were asked a single question in a health questionnaire: “Is your walking speed faster than that of your age and sex?” Based on their responses, they were categorized as either “fast” or “slow” walkers. The results showed that individuals who identified as faster walkers had significantly lower risks of diabetes (30% lower) and smaller but notable reductions in the risks of hypertension and dyslipidemia.

“This questionnaire is included in a standardized protocol by the Ministry of Health, Labor and Welfare in Japan,” Dr. Ishii explains. “This allowed for a quick and easy assessment without requiring specialized equipment.”

The simplicity and accessibility of this measure makes it ideal for application in clinical and public health settings. Subjective walking speed is self-reported and readily incorporated into standard examinations unlike objective walking speed, which needs resources, time, and space to assess. This aligns with the Japanese health examination guidelines, which emphasize screening for metabolic syndrome and obesity.

The researchers attributed their findings to the relationship between walking speed and overall health. Faster walkers often demonstrate better cardiorespiratory fitness, which is associated with lower levels of inflammation and oxidative stress-two key drivers of metabolic diseases.

According to the study, individuals who walk quickly may be more fit and have a lower risk of metabolic diseases. In addition to lowering the risk of metabolic diseases, encouraging faster walking, even subjectively, could help prevent the “metabolic domino effect,” where obesity leads to lifestyle-related diseases. Obesity is the first step in this cascade, which then advances to diseases like dementia and cardiovascular disease.

Dr. Ishii emphasizes, “Promoting a faster walking pace may be a helpful individual behavior to help prevent metabolic diseases, particularly in individuals with obesity.” Despite being cross-sectional and unable to establish causation, the study’s findings align with previous research on walking pace and health outcomes. Future long-term research could validate these findings and investigate the precise processes behind the noted correlations.

Overall, the study highlights how subjective walking speed measurements could revolutionize the identification of high-risk individuals and help prevent metabolic disorders linked to obesity, especially when incorporated into routine health examinations. As it turns out, a simple question like “Is your walking speed faster than your peers?” could provide life-saving insights.

Reference:

Yamamoto, Y., Ikeue, K., Kanasaki, M. et al. Association between subjective walking speed and metabolic diseases in individuals with obesity: a cross-sectional analysis. Sci Rep 14, 28228 (2024). https://doi.org/10.1038/s41598-024-78541-w

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