Archive for month: December, 2024

A recent study published in the Nature Scientific Reports found that no causal relationship between undergoing an appendectomy and the risk of developing gastrointestinal cancers in the European population. The study used advanced genetic analysis methods which combine data from the UK Biobank and FinnGen study cohorts to provide significant insights into this medical question.

This research employed two-sample Mendelian randomization (TSMR), a robust method to assess causal relationships using genetic data, to estimate the impact of appendectomy on gastrointestinal cancer risks. This approach minimizes biases inherent in traditional observational studies by offering a clearer view of potential associations.

The study was conducted in two parts, the first one being a discovery phase which was followed by a replication phase. In the discovery cohort, the research team used data from the UK Biobank to identify 50,105 individuals who had undergone appendectomy. Genetic variants associated with the procedure were selected as instrumental variables (IVs) to assess causality. The risk of gastrointestinal cancers, including colorectal, stomach, pancreatic, and esophageal cancers, was then evaluated using summary data from the FinnGen study.

To validate these findings, the replication cohort analyzed data from the FinnGen study which comprised of 28,601 appendectomy cases. Instrumental Variables (IVs) were derived and compared against gastrointestinal cancer data from the UK Biobank, ensuring consistency and reproducibility.

The final step involved meta-analysis to combine the causal estimates from both cohorts. Across all analyses, this study found no evidence suggesting that appendectomy increases or decreases the risk of gastrointestinal cancers. These findings align with conclusions from prior observational studies, further reinforcing the notion that appendectomy has no significant impact on cancer risk in the gastrointestinal system.

Instrumental Variables (IVs) were genetic markers associated with appendectomy, used to explore causality in a scientifically rigorous manner. he Discovery Cohort (UK Biobank) filtered 50,105 appendectomy cases and analyzed them to identify potential cancer risk. No causal links were found. In the Replication Cohort (FinnGen Study) a total of 28,601 appendectomy cases were examined to confirm the discovery cohort’s results. No associations were observed in this as well.

The combined data from both cohorts conclusively demonstrated no causal relationship between appendectomy and gastrointestinal cancers. Overall, the results from these study provide reassurance to patients and clinicians, suggesting that appendectomy does not influence long-term risks of gastrointestinal cancers.

Reference:

Wang, S., Zhang, T., Sun, Y., Yang, D., & Cao, X. (2024). No genetic causality between appendectomy and gastrointestinal cancers: a Mendelian randomization study and meta-analysis in European population. In Scientific Reports (Vol. 14, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1038/s41598-024-77600-6

A minimally invasive procedure provides significant relief from knee pain and may prevent the need for knee replacement surgery in people with osteoarthritis, according to a study being presented this week at the annual meeting of the Radiological Society of North America (RSNA).

“This study addresses osteoarthritis, which is a significant public health issue and the leading cause of chronic pain and disability worldwide,” said the study’s lead author, Florian Nima Fleckenstein, M.D., interventional radiologist at Charité – University Hospital Berlin in Germany. “With millions of people affected by knee osteoarthritis, particularly in aging populations, finding effective, minimally invasive treatments is critical.”

Osteoarthritis, a chronic, degenerative and progressive condition, is the most common cause of chronic joint disorders. According to the World Health Organization, knee osteoarthritis affects over 365 million adults worldwide.

Most available therapies, such as pain medication and steroid injections, only mask the symptoms of osteoarthritis. They don’t slow progression of the disease. As osteoarthritis worsens and conservative treatments become ineffective, many people turn to joint replacement surgery.

Genicular artery embolization (GAE) is an innovative minimally invasive therapy for patients with symptomatic knee osteoarthritis. The genicular arteries have several branches that form a network around the knee joint. These vessels are altered in patients suffering from osteoarthritis. In GAE, an interventional radiologist injects small particles into selected branches that correspond to the site of knee pain to block blood flow to that area. Embolization of the abnormal blood vessels helps to disrupt the cycle of inflammation, cartilage destruction and sensory nerve growth that characterizes osteoarthritis.

For the study, Dr. Fleckenstein and colleagues conducted a retrospective analysis of 403 cases from patients (age 40 to 90) with moderate to severe knee osteoarthritis that didn’t respond to conservative treatments. All patients underwent GAE at the Charité-University Hospital Berlin. The study was designed to evaluate both the safety and efficacy of GAE across a broad spectrum of osteoarthritis severities. The effectiveness of the procedure was measured using the Visual Analog Scale and the Knee Injury and Osteoarthritis Outcome Score. These standardized scores, which measure pain and quality of life, were recorded at baseline and during follow-up visits at six weeks, three months, six months and one-year post-procedure.

Technical success was achieved in 100% of procedures. Temporary slight skin discoloration and mild knee pain immediately after the procedure were noted in 18% of all cases. No severe complications were reported. The quality-of-life index and pain score improved by 87% and 71%, respectively, at one-year follow-up.

The findings show that GAE is a safe and effective treatment option across all severity grades of knee osteoarthritis, including advanced cases where other treatments have very limited efficacy.

“Our study found that GAE can effectively reduce knee pain and improve quality of life early after the treatment, with these benefits being maintained over the long term, especially for people who haven’t had success with other treatments like physical therapy or pain medications,” Dr. Fleckenstein said. “This could potentially offer a new lease on life for many patients who suffer from debilitating pain and mobility issues, caused by osteoarthritis.”

However, the study also showed that GAE is particularly effective in the early stages of knee osteoarthritis. This indicates that early intervention could potentially delay or even prevent disease progression, reducing the need for more invasive treatments, such as surgery.

The researchers hope that by demonstrating the procedure’s success in a large and diverse patient population, the study could influence medical practice and policy, encouraging broader adoption of GAE in clinical settings worldwide.

“GAE has the potential to reduce the need for more invasive surgeries, lower health care costs and significantly improve the quality of life for countless individuals suffering from knee osteoarthritis,” Dr. Fleckenstein said.

Reference:

Minimally invasive procedure relieves knee arthritis, Radiological Society of North America, Meeting: 110th Scientific Assembly and Annual Meeting of the Radiological Society of North America.