Race-aware models improve disease risk prediction accuracy but may yield limited clinical net benefits

A cross-sectional study analyzed survey data of U.S. adults to compare the benefits of race-aware versus race-unaware predictions for disease risk. The analysis found that the clinical net benefit of race-aware models over race-unaware models was smaller than expected. The researchers provide a widely adaptable framework for deciding whether to include or exclude race from disease risk predictions. The findings are published in Annals of Internal Medicine.

Powered by WPeMatico

Research team finds shortcomings in documentation of time-to-event analyses in systematic reviews

Systematic reviews with time-to-event (TTE) analyses provide fundamental insights in many areas of research. TTE data indicate not only whether events (e.g. deaths) have occurred, but also how much time has elapsed between the start of a study and the occurrence of an event. Well-known examples are survival curves, which show how the proportion of patients who survive changes over time, or hazard ratios, which compare the mortality rates of two groups.

Powered by WPeMatico

Genomics research focuses on health solutions in the tropics

Scientists believe the lives of much of the world’s population could be improved if DNA technology is applied in an integrated way in three areas critical to the tropics.

Powered by WPeMatico

Surface protein study highlights a potential link between dental caries and renal lesions

IgA nephropathy (IgAN) is an immune response disease affecting the filtering units of the kidneys. It is an intractable disease with a complex physiological process. Streptococcus mutans, a dental caries-causing bacterial pathogen, has been linked to IgAN disease progression. Now, researchers from the Okayama University, Japan, have uncovered a virulent role of Cnm—a surface collagen-binding protein expressed on S. mutans in IgAN development—highlighting a potential link between dental caries and renal lesions.

Powered by WPeMatico

Indoco Remedies enters into distribution partnership with Clarity Pharma

Mumbai: Indoco Remedies Limited, a fully integrated, research
based pharma company has announced a strategic
collaboration between Indoco Remedies and Clarity Pharma, UK.

The company will launch around 20 products over
the next 18 months through Clarity Pharma, its distributor in the UK. The Company will
continue to supply all the products under existing B2B partnership to its clients.
Aditi Panandikar, Managing Director, Indoco Remedies Ltd., commented, “This
collaboration with Clarity Pharma is a significant milestone for Indoco as this will further
strengthen our foothold in the UK pharma market. By combining Indoco’s robust portfolio of
high-quality, affordable pharmaceutical products with Clarity Pharma’s strong distribution
network and market expertise, we are poised to deliver innovative healthcare solutions to a
broader patient base.”
Steve Soper, CEO of Clarity Pharma commented, ‘Today is the beginning of a truly exciting
journey between Indoco and Clarity and is the result of several years’ hard work in putting
this market access project together. The range of Indoco products is exciting and extensive
and will deliver significant savings to the market once launched, we look forward to a bright
future of collaboration, growth, and making a difference in the affordability of a wide range
of medicines’.
Indoco is a fully integrated, research-oriented pharmaceutical company with a strong global
presence. The Company’s turnover is US$ 212 million. The Company has 11 manufacturing facilities, 7 for FDFs and 4 for APIs, supported by a state-of-the-art R&D Centre and a CRO facility. The facilities have been approved by most of the Regulatory Authorities including USFDA and UK-MHRA. Indoco develops and manufactures a wide range of pharmaceutical products for the Indian and international markets. It generates more than 106 million prescriptions annually from over 2,35,000 doctors belonging to various specialties. Indoco has 8 domestic marketing divisions a strong brand portfolio in various therapeutic segments including Gastro-intestinal, Respiratory, Anti-Infective, Stomatologicals, Ophthalmic, Nutritionals, Cardiovascular, Anti-Diabetics, Pain Management, Gynaecology etc.
Read also: Indoco Remedies Varenicline Tablets gets USFDA nod to aid smoking cessation treatment

Powered by WPeMatico

Dr Ashok Yadav takes charge as New Dean of MGM Medical College Indore

Indore: Dr
Sanjay Dixit has stepped down from his position as the Dean of MGM Medical College, passing on the leadership to Dr Ashok Yadav, a renowned doctor from MY Hospital. This change in leadership marks a significant transition for the institution, which has experienced tremendous growth
and transformation under Dr Dixit’s leadership.

Dr Sanjay Dixit’s tenure has
been nothing less than incredible. Over the past 37 years, he dedicated much of his life to improving healthcare services in the region, leaving an indelible mark on the institution and the medical community. He had many
achievements, including completing Super Specialty Hospital and the
redevelopment of MTH Hospital. Dr. Dixit’s leadership was particularly pivotal
during the second wave of the COVID-19 pandemic. 

Also Read:PGI’s former Dean Dr Digambar Behera takes charge as president of National Academy of Medical Sciences

Dr Dixit took over as the
dean of MGM Medical College in 2020. Dr. Dixit is an accomplished expert in
Community Medicine/Public Health. He served as the head of the
Department of Community Medicine Department at MGM Medical College before
serving as the Dean of the Medical College in Ratlam where he was appointed in
2017. 

Dr Ashok Yadav has
taken over as the Dean of MGM Medical College on Sunday, reports Free Press Journal. Dr Ashok Yadav served as the
Professor and Head of the Department of Transfusion Medicine (I.H.B.T) and
Director of the State of Art Model Blood Bank at M.G.M Medical College and
Associated Hospitals, bringing over 20 years of teaching and working experience
in the field of transfusion medicine. He specialises in General Medicine and
has contributed significantly to the academic community with more than 30
national and international journal publications, earning two gold medals for
his national paper publications.

Under his leadership, the
department established five NMC-recognized MD seats, the first of its kind in
Madhya Pradesh in 2020, and has been at the forefront of blood donation
initiatives, collecting the highest number of donations in the state for over five
years. The Model Blood Bank, equipped with a Blood Mobile Bus provided by
NACO/MPSACS, organises around 160 voluntary blood donation camps annually and
has upgraded to a State of Art Model Blood Centre, collecting over 50,000 units
per year.

Also Read:MGM Medical college gets a new dean in Dr Sanjay Dixit

Dr Yadav has pioneered
the introduction of several advanced modalities in transfusion medicine,
including a bone marrow transplant unit, NAT testing facility, blood
irradiation unit, plasmapheresis, plateletpheresis, and a fully equipped
six-bedded therapeutic procedural inpatient unit. He has also successfully
organized TRANSMEDCON 2022 in Indore and has extensive experience conducting
theory and practical examinations in MPMSU for over 18 years, showcasing his
exceptional administrative and communication skills in managing academic,
administrative, and professional activities.

Powered by WPeMatico

Low Free Triiodothyronine Levels Linked to Increased Risk of Diabetic Peripheral Neuropathy in Type 2 Diabetes: Study

China: Recent research published in Diabetes, Metabolic Syndrome and Obesity suggests that lower levels of free triiodothyronine (FT3) may heighten the risk of diabetic peripheral neuropathy (DPN) in individuals with type 2 diabetes (T2DM).

In a study examining T2DM patients, those with DPN had significantly lower FT3 levels than those without the condition. Furthermore, reduced FT3 levels were independently associated with impaired conduction of motor and sensory fibers, particularly in the ulnar and tibial nerves.

Yang Chen, University of Science and Technology of China, Hefei, People’s Republic of China, and colleagues aimed to investigate the potential involvement of free triiodothyronine, a key bioactive compound found in thyroid hormones (THs) in the pathogenesis of diabetic peripheral neuropathy in patients diagnosed with type 2 diabetes mellitus.

For this purpose, the researchers recruited 121 patients with T2DM, who were then divided into a control group and a DPN group. Clinical parameters were collected for each participant, and nerve conduction velocity was assessed using neurophysiological techniques. To analyze the relationship between FT3 concentrations and diabetic peripheral neuropathy, the researchers employed correlation and regression analyses.

The investigation led to the following findings:

  • Compared to 57 patients without DPN, 64 patients with DPN had higher HbA1c and low-density lipoprotein cholesterol (LDL-C) levels and lower FT3 concentrations.
  • FT3 levels were positively correlated with motor and sensory fiber conduction velocity in the ulnar nerve (R=0.205) and motor conduction velocity in the tibial nerve (R=0.191), both with and without adjustment for HbA1c and LDL-C.
  • Multiple linear regression analysis showed lower FT3 levels were associated with reduced conduction velocity in the ulnar nerve (β=0.795; β=0.909) and tibial nerve (β=0.727).
  • Binary logistic regression analysis identified decreased FT3 levels as a significant risk factor for DPN in T2DM patients (OR=0.542).

According to the authors, the study is the first to establish a connection between FT3 levels and diabetic peripheral neuropathy (DPN), specifically regarding nerve fiber damage in patients with type 2 diabetes mellitus (T2DM). It identifies lower FT3 concentrations as a risk factor for DPN in T2DM patients without diagnosed thyroid diseases (other than thyroid nodules). Furthermore, reduced FT3 levels may influence peripheral neuropathy, particularly the motor and sensory conduction velocities of the ulnar nerve and the motor conduction velocity of the tibial nerve in euthyroid T2DM patients.

“The study also highlights the potential interactive effects of FT3 and DPN in this population, urging further research to define appropriate reference ranges for thyroid hormones, including FT3, in the context of DPN,” they concluded.

Reference:

Chen Y, Sun L, Chen M, Zhang H, Song B, Wang H, Jiang A, Zhang L, Li S, Wang J, Wang W, Zhang H. Lower Free Triiodothyronine is a Risk Factor of Diabetic Peripheral Neuropathy in Patients with Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes. 2024;17:4407-4415

https://doi.org/10.2147/DMSO.S489204

Powered by WPeMatico

Cardiovascular Risk Starts Early: T2DM Linked to Two-Fold More CVD Events Decades Before Diagnosis, Study Reveals

Denmark: A recent nationwide registry study has revealed alarming findings regarding cardiovascular disease (CVD) risk in individuals before their diagnosis of type 2 diabetes (T2D). The results, published in the Journal of the American College of Cardiology, highlighted that those who later developed T2D experienced a significantly higher incidence of cardiovascular events—twice as many—compared to those without diabetes, beginning as early as 30 years before their T2D diagnosis.

The relationship between type 2 diabetes mellitus and an increased risk of CVD is well-established. Still, the timeline for when CVD events begin to occur relative to T2DM diagnosis has remained unclear. In this context, Christine Gyldenkerne, Aarhus University Hospital, Denmark, and colleagues sought to explore the incidence of CVD events up to 30 years before and 5 years after a T2DM diagnosis, comparing individuals diagnosed with the disease to matched individuals from the general population. This study aimed to clarify how far in advance the elevated risk for cardiovascular issues emerges in those who eventually develop T2DM.

For this purpose, the researchers conducted a combined case-control and cohort study, which included all individuals diagnosed with type 2 diabetes mellitus in Denmark between 2010 and 2015, alongside age- and sex-matched comparisons from the general population. Cardiovascular disease was defined as either myocardial infarction or ischemic stroke.

To assess the prevalence of CVD over 30 years before the diagnosis of T2DM, conditional logistic regression was used to calculate odds ratios (ORs). For the incidence of CVD in the five years following T2DM diagnosis, Cox proportional hazard regression models were applied to compute hazard ratios (HRs).

The study findings are as follows:

  • The study involved 127,092 individuals diagnosed with type 2 diabetes mellitus (T2DM) and 381,023 matched comparisons from the general population.
  • Over 30 years before T2DM diagnosis, 11.2% of individuals with T2DM and 4.7% comparisons experienced cardiovascular disease (CVD).
  • CVD prevalence was consistently higher in those with T2DM compared to the matched comparisons throughout the entire 30-year period before diagnosis.
  • Odds ratios (ORs) for CVD prevalence ranged from 2.18 in the period 25–30 years before diagnosis to 2.96 in the final years (<5 years before diagnosis).
  • In the five years following T2DM diagnosis, the incidence of CVD was similarly elevated in individuals with T2DM, with a hazard ratio (HR) of 2.20 compared to the general population.

“The findings showed that individuals with type 2 diabetes mellitus experienced twice the number of cardiovascular disease events compared to matched individuals, beginning as far back as 30 years before their T2DM diagnosis. This suggests that preventive strategies could be implemented much earlier in individuals at risk for T2DM,” the researchers concluded.

Reference:

Gyldenkerne C, Kahlert J, Thrane PG, et al. 2-fold more cardiovascular disease events decades before type 2 diabetes diagnosis: a nationwide registry study. J Am Coll Cardiol. 2024;84:2251-2259.

Powered by WPeMatico

Insulin Resistance Linked to Lung Abnormalities and Disease Risk: Insights From Framingham Study

USA: A recent study from the Framingham Offspring Study has revealed a significant association between insulin resistance (IR), radiographic lung abnormalities, and the incidence of lung disease.

The research published in Diabetes Care found that insulin resistance is associated with radiographic lung abnormalities and an increased risk of incident lung disease. These findings suggest a potential link between metabolic dysfunction and lung health, emphasizing the need for deeper phenotyping to understand better the mechanisms driving IR-associated lung injury.

Insulin resistance has been suggested as a potential risk factor for lung disease, though objective evidence remains limited. To address this gap, Tianshi David Wu, Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX, and colleagues investigated the relationship between longitudinal IR levels, radiographic imaging findings, and examiner-confirmed incident lung disease within the Framingham Offspring Study cohort.

For this purpose, the researchers analyzed data from participants without baseline lung disease, who underwent repeated measurements of fasting insulin and glucose levels over an average of 13.6 years. From these measurements, time-weighted average HOMA-IR values were calculated. Each participant then received a cardiac-gated whole-lung computed tomography (CT) scan, which was evaluated for emphysema, interstitial lung abnormalities (ILAs), and quantitative airway features.

A study examiner identified incident lung disease. To estimate the relationship between HOMA-IR and these outcomes, researchers used models adjusted for factors such as demographics, BMI, and lifetime smoking history.

The following were the key findings of the study:

  • Researchers analyzed data from 875 participants with longitudinal IR data and outcomes.
  • The participants had a mean age of 51.5 years and an average BMI of 26.7 kg/m².
  • HOMA-IR values showed temporal instability, with a within-person standard deviation (SD) of approximately two-thirds of the between-person SD.
  • In adjusted models, a 1 SD increase in log(HOMA-IR) z score was linked to higher odds of qualitative emphysema (odds ratio [OR] 1.33).
  • The same increase was associated with higher odds of interstitial lung abnormalities (ILAs) (OR 1.35).
  • Modest increases in airway wall thickness and wall area percentage were also observed with higher HOMA-IR levels.
  • A positive association between HOMA-IR and the incidence of lung disease supported these radiographic findings.

The findings also stress the broader implications of managing insulin resistance. Early detection and intervention could not only improve metabolic outcomes but also potentially reduce the risk of lung disease. As rates of metabolic disorders continue to climb, these insights could guide strategies to improve systemic and lung health.

“The Framingham Offspring Study sheds light on a previously underexplored link between insulin resistance and lung disease. The evidence underscores the importance of continued research to uncover the mechanisms of IR-associated lung injury and develop targeted interventions to mitigate its impact on respiratory health,” the researchers concluded.

Reference: Sarath Raju, Paula Sierra, Vickram Tejwani, Kristen A. Staggers, Meredith McCormack, Dennis T. Villareal, Ivan O. Rosas, Nicola A. Hanania, Tianshi David Wu; Association of Insulin Resistance With Radiographic Lung Abnormalities and Incident Lung Disease: The Framingham Offspring Study. Diabetes Care 2024; dc241754. https://doi.org/10.2337/dc24-1754

Powered by WPeMatico

CABG Offers Superior Outcomes Over PCI in High-Risk NSTEMI Patients, reveals research

Researchers have reported better long-term results of coronary artery bypass grafting (CABG) than of percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation myocardial infarction (NSTEMI) and multivessel disease, especially in the high-risk subgroups. A recent study was conducted by Elmir O. and colleagues which was published in the European Heart Journal.

The participants were NSTEMI patients treated with multivessel disease from January 2005 and June 2022. Of the 57,097 participants, 42,190 (73.9%) were subjected to PCI, and 14,907 (26.1%) were given CABG. All-cause mortality was evaluated as the first and secondary endpoint and included outcomes such as MI, stroke, new revascularization, and heart failure. Controlling confounding variables used multilevel logistic regression and instrumental variable methods in the analysis.

Patients who underwent PCI were older and had a history of more prior cardiovascular events, whereas CABG patients were more likely to have diabetes, hypertension, left main or three-vessel disease, and reduced ejection fraction.

Key Findings

  • Mortality Risk: PCI was associated with a 67% higher risk of death compared to CABG (adjusted odds ratio [aOR] 1.67; 95% confidence interval [CI] 1.54–1.81).

  • Myocardial Infarction: Patients who underwent PCI had a 51% increased risk of MI (aOR 1.51; 95% CI 1.41–1.62).

  • Stroke: No significant difference in stroke risk was observed between PCI and CABG.

  • Repeat Revascularization: Patients who underwent PCI were three times more likely to require repeat revascularization (aOR 3.01; 95% CI 2.57–3.51).

  • Heart Failure: CABG was associated with a 15% reduced risk of heart failure (aOR 1.15; 95% CI 1.07–1.25).

  • Survival Benefit: CABG conferred longer survival, especially in patients under 70 years of age, or in the presence of left main disease, or with left ventricular dysfunction. This survival benefit was abated in patients with poorer survival probabilities.

Although a superior long-term outcome exists for CABG compared to PCI in patients with multivessel disease and NSTEMI, this comes at the expense of losing the survival advantage in severely ill or high-risk subjects with reduced life expectancy and thus should be used carefully in clinical practice.

Reference:

Omerovic, E., Råmunddal, T., Petursson, P., Angerås, O., Rawshani, A., Jha, S., Skoglund, K., Mohammad, M. A., Persson, J., Alfredsson, J., Hofmann, R., Jernberg, T., Fröbert, O., Jeppsson, A., Hansson, E. C., Dellgren, G., Erlinge, D., & Redfors, B. (2024). Percutaneous vs. surgical revascularization of non-ST-segment elevation myocardial infarction with multivessel disease: the SWEDEHEART registry. European Heart Journal, ehae700. https://doi.org/10.1093/eurheartj/ehae700

Powered by WPeMatico