Congenital cataract with persistent fetal vasculature without anterior segment pathology associated with best postoperative visual acuity: Study

Congenital cataract with persistent fetal vasculature (PFV)
represents a complex and challenging condition in paediatric ophthalmology.
PFV, formerly known as persistent hyperplastic primary vitreous, is a rare
developmental anomaly characterized by incomplete regression of the primary
vitreous and embryonal hyaloid vasculature, leading to a spectrum of ocular
abnormalities, including cataract and retinal detachment. In the worst case,
the persistent hyaloidal stalk is integrated anteriorly into the posterior lens
capsule and posteriorly to the vascular bundle of the optic nerve head (ONH)
and exerts tractional forces radially in all directions. Ultimately, tractional
retinal detachment (TRD) may occur due to retrolental fibrovascular tissue
proliferation and contraction. In PFV eyes, concomitant retrolental stalk,
avascular peripheral retina, and regional capillary dropout have been observed
with fluorescein angiography examination.

The management of unilateral congenital cataract with PFV
poses unique therapeutic challenges. Surgical intervention is often required to
address the congenital cataract and associated PFV-related anterior and/or
posterior segment complications, with techniques such as lensectomy,
vitrectomy, membranectomy, and retinal detachment repair. And in many cases
multiple surgical interventions are needed. However, in cases with advanced
pathology, including ONH hypoplasia, severe tractional retinal detachment, or
microphthalmia, surgery is generally not a preferred choice since post-operative
vision is often modest. Postoperatively, achieving optimal visual outcomes in
the PFV cases can be hindered by factors including amblyopia, nystagmus,
glaucoma, proliferative vitreoretinopathy (PVR), and refractive errors. Case
selection for surgical treatment is of great importance, since long-standing
complications such as sympathetic ophthalmia, ie, bilateral granulomatous
panuveitis, may occur postoperatively and need to be considered.

Authors carried out a real-world single-centre study with
the aim to provide a comprehensive overview of the clinical features,
management strategies and final visual outcomes for eyes with unilateral
congenital cataract and PFV. By elucidating the complexity of this rare
paediatric condition, clinicians could enhance their understanding and improve
the individually tailored management of affected children, ultimately
optimizing visual outcomes and quality of life

Retrospective observational single-center study was
conducted between January 1, 2009, and December 31, 2019, at Helsinki
University Hospital. The national cohort encompassed 82 children aged from
birth to 15 years who underwent lensectomy, 3-port vitrectomy, or a combined
procedure, with the objective of achieving visual rehabilitation. Among the
surgical cohort, paediatric cases with International Classification of Disease
(ICD-10) codes Q14.0 for PFV and Q12.0 for congenital cataract were identified
and analyzed. Data were collected through a comprehensive review of medical
records, encompassing clinical history (birth weight), gender distribution,
ocular parameters (laterality, intraocular pressure [IOP], visual acuity [VA]),
details of cataract and vitreoretinal surgical interventions, indications for
surgery, postoperative ophthalmic complications, as well as evaluations of
functional and anatomical outcomes.

The cohort consisted of 11 children, ranging in age from 6
months to 12 years. Surgical intervention resulted in the attainment of at
least light perception vision in nine of the operated eyes, representing 81.8%
of cases. Among these, two eyes (18.2%) achieved hand motion vision, while 5
eyes (55.6%) achieved vision of finger counting or better. Additionally, two
eyes (18.2%) achieved visual acuity measurable on the Snellen chart. However,
one eye (9.1%) experienced complete vision loss, while the contralateral eye
developed sympathetic ophthalmia.

Congenital cataract with PFV devoid of anterior segment
pathology tends to correlate with the most favorable postoperative visual
outcomes. Conversely, eyes presenting with anterior segment pathology, such as
microphthalmia, or exhibiting complex posterior segment pathologies like macular
TRD, optic nerve hypoplasia, or foveal hypoplasia, are associated with a less
promising visual prognosis. Most children undergoing surgical intervention
achieve only modest improvements in vision. Given the potential occurrence of
sympathetic ophthalmia following surgery, meticulous case selection for
surgical management is paramount. Furthermore, delving deeper into the
pathogenesis of PFV is imperative to enhance our understanding of this
condition.

Source: Loukovaara; Clinical Ophthalmology 2024:18

https://doi.org/10.2147/OPTH.S472028

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Younger age, lower income and higher stress levels linked to increased risk of PCOS, suggests study

Recent study aimed to investigate the associations of polycystic ovarian syndrome (PCOS) risk with various factors among women in Saudi Arabia. The research was a cross-sectional study conducted across different regions in Saudi Arabia. Data were collected using anonymous, self-administered questionnaires distributed through social media platforms. The study found that factors associated with PCOS risk included age, region of residence, income, weight status, smoking status, presence of chronic conditions, medication and herbal remedy use, and perceived stress. Younger age, lower income, and higher stress levels were linked to an increased risk of PCOS. Additionally, chronic conditions were significantly associated with PCOS diagnosis rates.

Participants’ Profile and PCOS Risk Analysis

The participants’ profile revealed that most were younger than 30 years, single, urban residents, educated, employed or students, and non-smokers. A significant portion had no chronic illnesses, with an average stress level of 19.71. Regarding PCOS risk, 41.3% were at low risk, 33.3% at suspected risk, 2.9% at high risk, and 22.5% diagnosed with PCOS. The study highlighted the impact of PCOS on women’s health, with potential complications like metabolic syndromes, gestational diabetes, and cardiovascular diseases.

Factors Influencing PCOS Risk and Necessary Interventions

Sociodemographic factors like age, region of residence, and income status were significantly associated with PCOS risk. Health behaviors such as smoking were linked to PCOS risk. Furthermore, the presence of chronic physical and psychological conditions, medication use, herbal remedy use, and perceived stress were also associated with PCOS risk. The study emphasized the need for tailored interventions addressing lifestyle, stress, and comorbid disease management to reduce the risk of PCOS and enhance women’s health outcomes.

Study Sample Size, Limitations, and Implications

The study had a large and robust sample size of 1,068 women with a high response rate of 95.9%. Limitations included the convenience sample and reliance on self-reported diagnoses for chronic illnesses. The findings highlight the importance of understanding the multifactorial nature of PCOS risk in Saudi women, providing valuable insights for healthcare professionals and policymakers to develop targeted interventions and support strategies for improving women’s health and well-being.

Key Points

1. Factors associated with PCOS risk in Saudi women included age, region of residence, income, weight status, smoking status, chronic conditions, medication and herbal remedy use, and perceived stress. Younger age, lower income, and higher stress levels were linked to an increased risk of PCOS, while chronic conditions were significantly associated with PCOS diagnosis rates.

2. Participants in the study were mostly younger than 30 years, single, urban residents, educated, employed or students, and non-smokers. A significant portion had no chronic illnesses, with an average stress level of 19.71. The distribution of PCOS risk among participants was categorized as 41.3% low risk, 33.3% suspected risk, 2.9% high risk, and 22.5% diagnosed with PCOS.

3. Significant sociodemographic factors influencing PCOS risk included age, region of residence, and income status, while health behaviors like smoking were also associated with increased PCOS risk. Chronic physical and psychological conditions, medication use, herbal remedy use, and perceived stress played a role in PCOS risk, indicating the complex interplay of various factors in PCOS development.

4. The study emphasized the importance of tailored interventions addressing lifestyle modifications, stress management, and comorbid disease management to reduce PCOS risk and improve women’s health outcomes. This highlights the need for comprehensive approaches to address the multifactorial nature of PCOS and its potential complications like metabolic syndromes, gestational diabetes, and cardiovascular diseases.

5. The research had a robust sample size of 1,068 women with a high response rate of 95.9%, providing valuable insights into the factors influencing PCOS risk among Saudi women. Limitations included the convenience sample and reliance on self-reported diagnoses for chronic illnesses, indicating potential bias in the findings.

6. The study’s findings have implications for healthcare professionals and policymakers in Saudi Arabia, suggesting the need for targeted interventions and support strategies to mitigate PCOS risk and enhance women’s overall health and well-being. Understanding the multifaceted nature of PCOS risk is crucial for developing effective public health initiatives and personalized healthcare interventions for Saudi women.

Reference –

E. Alenzi et al. (2024). Risk Of Polycystic Ovary Syndrome: A Population-Based Analysis Of Sociodemographic Factors, Healthcare Access, Health Behaviors, And Health Status. *BMC Women’S Health*, 24. https://doi.org/10.1186/s12905-024-03446-9.

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Antibiotics alone to treat children with appendicitis cost-effective and safe alternative to surgery, study shows

Using antibiotics alone to treat children with uncomplicated appendicitis is a cost-saving alternative to surgery, according to a study published in the Journal of the American College of Surgeons (JACS).

Appendicitis is the fifth most common reason for hospitalization among children in the U.S., and appendectomy is the most common surgical procedure performed during inpatient hospitalizations in children, according to theNational Institutes of Health.

Appendectomy is also one of the costliest surgical procedures performed during hospital stays; however, treating appendicitis with intravenous antibiotics alone, known as nonoperative management, has been shown to be a safe and effective alternative in previous studies.

“We know that nonoperative management of appendicitis is safe and effective, so what surgeons want to know is whether nonoperative management is cost-effective. Our study helps answer that question,” said study coauthor Peter C. Minneci, MD, FACS, chair of the department of surgery at Nemours Children’s Health in Wilmington, Delaware. “This cost analysis demonstrates that nonoperative management for pediatric uncomplicated acute appendicitis is the most cost-effective management strategy over one year, compared to upfront surgery.”

Antibiotics vs. Urgent Surgery

The analysis was based on a review of data from more than 1,000 patients, age 7 to 17, who were treated for uncomplicated acute appendicitis at several hospitals throughout the Midwest region between 2015 and 2018. Parents were given the choice of two treatment strategies — antibiotics alone or urgent laparoscopic appendectomy. Nonoperative management consisted of at least 24 hours of intravenous antibiotics. Patients whose symptoms did not resolve underwent laparoscopic appendectomy during the same hospital admission.

Ratio of costs-to-charges-based data (cost divided by the charges) for the initial hospitalization, readmissions, and unplanned emergency department visits were extracted from the Pediatric Health Information System, which captures data from approximately 50 children’s hospitals. Patient-reported health-related quality-of-life scores and disability days (a measure of time off from school and pain) were determined at 30 days and 1 year after treatment respectively. Using a standardized survey, children were asked how they were doing in daily life and how they felt about their quality of life.

For these analyses, researchers looked at quality-of-life scores after 30 days and converted them to datapoints. Quality-adjusted life year scores ranged from zero to one, with one being perfect health and no issues and lower scores reflecting worsening health and dysfunction, with a zero score reflecting death. A quality-adjusted life year score indicating normal health without issues would be about .95. Quality-adjusted life year scores were evaluated for each patient and compared. Patients were followed for one year, and total average costs for each strategy were calculated in 2023 dollars.

Key Findings

  • Of 1,068 patients, 370 chose antibiotics alone and 698 opted for urgent laparoscopic appendectomy.
  • The results show an average cost of $9,791 and 0.884 quality-adjusted life years per patient for laparoscopic appendectomy and $8,044 and 0.895 quality-adjusted life years per patient for nonoperative management.
  • Nonoperative management was both less costly and more effective in three analyses, including an analysis using disability days and alternative methods of calculating quality of life and cost over one year.

“Our study findings add an additional benefit to the antibiotics-only approach being safe and effective for children in that this strategy is shown to be cost effective,” Dr. Minneci said. “In short, nonoperative management is a safe and cost-effective initial therapy and a reasonable alternative to surgery.”

Study authors said the next step is to investigate rates of treatment failure and cost-effectiveness of outpatient nonoperative management and laparoscopic appendectomy with same-day discharge.

Some limitations of the study are the one-year follow-up period and the fact that the analysis only includes patients treated at children’s hospitals across the Midwest region. As a result, these findings may not apply to other patient populations, the authors said.

Reference:

Gil, Lindsay A MD, MPHa,b; Asti, Lindsey MPH, PhDa,c; Chen, Huey-Fen MHA, PhDa; Saito, Jacqueline M MD, FACS, MSCI, MBAd; Pattisapu, Prasanth MD, MPHa,e; Deans, Katherine J MD, FACS, MHScc; Minneci, Peter C MD, FACS, MHScc; for the Midwest Pediatric Surgery Consortium. Cost-Effectiveness of Nonoperative Management vs Upfront Laparoscopic Appendectomy for Pediatric Uncomplicated Appendicitis Over 1 Year. Journal of the American College of Surgeons ():10.1097/XCS.0000000000001232, November 19, 2024. | DOI: 10.1097/XCS.0000000000001232

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Xanomeline-trospium found efficacious among schizophrenia patients experiencing acute psychosis: JAMA

Researchers discovered that xanomeline-trospium, a new-generation antipsychotic devoid of D2 dopamine receptor blocking activity, has shown potency and tolerance in patients with schizophrenia who present with acute psychosis. A recent study was conducted by Inder Kaul and colleagues. This study was published in JAMA Psychiatry.

Schizophrenia affects millions of people worldwide, with current treatments often limited by side effects, including weight gain, sedation, and movement disorders due to D2 dopamine receptor blockade. Xanomeline-trospium combines xanomeline, a dual M1/M4 muscarinic receptor agonist, with trospium chloride, a peripheral muscarinic receptor antagonist, to enhance tolerability.

The EMERGENT-3 clinical trial was a 5-week, multicenter, double-blind, randomized, placebo-controlled study performed at 30 inpatient sites in the US and Ukraine. A total of 256 adults with schizophrenia and acute psychosis were randomized 1:1 to xanomeline-trospium (maximum dose: 125 mg/30 mg) or placebo. The main measure of outcome was the change in Positive and Negative Syndrome Scale (PANSS) total score at week 5 compared with baseline. Secondary measures were changes in PANSS subscale scores and Clinical Global Impression–Severity (CGI-S) scores.

Key findings of the study were:

Primary Outcome:

  • PANSS total score change at week 5 compared with baseline was reduced by 20.6 points with Xanomeline-trospium, and by a reduction of 12.2 points with placebo.

  • The least squares mean difference was −8.4 (95% CI: −12.4 to −4.3; P < .001).

Secondary Outcomes:

  • Both PANSS positive and negative subscale scores and PANSS Marder negative factor scores improved significantly.

  • More participants in the xanomeline-trospium group than in the placebo group showed a reduction of at least 30% in PANSS total score.

Safety Profile:

  • Treatment-emergent adverse events (TEAEs) prompted discontinuation in 6.4% of the xanomeline-trospium and 5.5% of the placebo participants

  • Common TEAEs were nausea in 19.2% vs 1.6%, dyspepsia in 16.0% vs 1.6%, vomiting in 16.0% vs 0.8%, and constipation in 12.8% vs 3.9%

  • No between-group differences were observed for extrapyramidal symptoms, weight gain, or somnolence.

Xanomeline-trospium has been shown to be effective and well tolerated in the treatment of acute psychosis associated with schizophrenia with minimal D2 dopamine receptor blockade. This new therapy provides hope to transform the treatment landscape for schizophrenia, overcomes the limitations of current drugs, and brings about new possibilities for millions of patients around the world.

Reference:

Kaul, I., Sawchak, S., Walling, D. P., Tamminga, C. A., Breier, A., Zhu, H., Miller, A. C., Paul, S. M., & Brannan, S. K. (2024). Efficacy and safety of xanomeline-trospium chloride in schizophrenia: A randomized clinical trial. JAMA Psychiatry (Chicago, Ill.), 81(8), 749. https://doi.org/10.1001/jamapsychiatry.2024.0785

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Older Adults with Celiac Disease Have Increased Risk of Frailty: Study

A new Swedish study published in the American Journal of Gastroenterology revealed that older adults diagnosed with celiac disease (CeD) are significantly more prone to frailty when compared to their peers without the condition. The nationwide cohort study examined individuals aged 60 and older diagnosed with CeD between 2004 and 2017 and matched them with non-CeD controls of similar age, sex, and location. The findings illuminate the heightened vulnerability faced by older adults with CeD by raising concerns about the long-term health impacts of the disease.

This research analyzed frailty levels within 3 years prior to diagnosis using the Hospital Frailty Risk Score, a tool that stratifies individuals into low, intermediate, and high frailty risk categories. Of the 4,646 CeD patients included, 54.4% were classified as frail at baseline when compared to 29.7% of the 21,944 matched controls. Also, frailty was more prevalent across all categories for CeD patients where 43.4% were at low-risk when compared to 23.8% of controls, 10.3% were at intermediate-risk when compared to 5.4%, and 0.8% were at high-risk versus 0.6% among controls.

For individuals without baseline frailty, this study found a stark 66% increased likelihood of developing frailty over the subsequent 5 years for the individuals with CeD. This translated to a significantly higher risk of functional decline and potential complications in this population.

This study also explored the role of mucosal healing where follow-up biopsies that indicated mucosal healing did not correlate with a reduced risk of frailty by suggesting that frailty in older CeD patients may be driven by broader systemic effects of the disease rather than localized gut damage alone. The study suggests that frailty, characterized by decreased resilience and increased susceptibility to adverse health outcomes, poses challenges ranging from reduced mobility to higher risks of hospitalization and mortality.

Overall, this study highlights the need for further research into the mechanisms linking CeD and frailty, as well as interventions tailored to the unique needs of older patients. Proactive measures such as comprehensive care plans and targeted therapies may help manage frailty risk and improve the quality of life for this patient popult.

Source:

Zylberberg, H. M., Lebwohl, B., Söderling, J., Kochar, B., Jylhävä, J., Green, P. H. R., & Ludvigsson, J. F. (2024). Older Adults with Celiac Disease Are At Increased Risk of Frailty:A Nationwide Cohort Study. In American Journal of Gastroenterology. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.14309/ajg.0000000000003217

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Roxadustat effective in patients with CKD with varying blood CRP levels, reveals research

A new study published in the journal of BMC Nephrology showed that the effectiveness of roxadustat is comparable at varying blood C-reactive protein (CRP) levels. A variety of diseases can cause chronic kidney disease (CKD), which is a progressive disorder that eventually results in irreparable changes to the structure and function of the kidneys. By blocking hypoxia-inducible factor prolyl hydroxylase, these medications stabilize hypoxia-inducible factor (HIF).

The patients with chronic kidney illness frequently have chronic inflammation, which contributes to the development of renal anemia and is indicated by elevated blood C-reactive protein levels. This systematic review is to look at how CRP affects how well hypoxia-inducible factor-prolyl hydroxylase inhibitors (HIF-PHIs) work to treat renal anemia in CKD patients.

Until May 19, 2022, this study searched a wide range of electronic databases, including Pubmed, Embase, Web of Science, CNKI, Wanfang, the Cochrane Library, and the International Clinical Trials Registry Platform (ICTRP). This research conducted a comprehensive analysis of the data from randomized controlled trials that used HIF-PHIs to treat renal anemia. Using a random-effects model, the meta-analysis result was the mean difference (MD) in changes in hemoglobin concentration (∆Hb) before and after therapy. The groups having CRP levels below the upper limit of normal (ULN) and above or equal to the ULN were compared. Further, a comparison between erythropoiesis-stimulating agents (ESA) and HIF-PHIs was carried out in the CRP≥ULN group.

The study comprised 7 papers from 6 publications, where a total of 524 participants from 4 trials were included in the study to compare the CRP ≥ ULN group with the CRP < ULN group. The main treatment for every patient was roxadustat. There was no discernible difference in ΔHb between patients with baseline CRP ≥ ULN and those with baseline CRP < ULN, according to the pooled data. Also, 3 trials with 1399 patients assessed the effectiveness of erythropoiesis-stimulating drugs (ESAs) and roxadustat within the CRP ≥ ULN group. The findings showed that patients treated with ESAs and HIF-PHIs did not significantly vary in their ΔHb levels.

Regarding medicine dosage, several studies showed that the ESA dose increased with time, especially in the CRP‥ULN group. The roxadustat dose remained constant over time and was unaffected by the baseline CRP levels. Overall, the effectiveness of roxadustat is consistent throughout a range of CRP values. Furthermore, roxadustat can sustain effectiveness equivalent to ESA in the CRP≥ ULN group without the need for dosage escalation.

Source:

Luo, X., Li, G., Yang, H., Chen, L., Gao, Y., Cong, J., Luo, H., & Zhang, W. (2024). Impact of C-reactive protein on the effect of Roxadustat for the treatment of anemia in chronic kidney disease: a systematic review of randomized controlled trials. In BMC Nephrology (Vol. 25, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12882-024-03474-5

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Sound of traffic increases stress and anxiety, study finds

Manmade sounds such vehicle traffic can mask the positive impact of nature soundscapes on people’s stress and anxiety, according to a new study published November 27, 2024, in the open-access journal PLOS ONE by Paul Lintott of the University of the West of England, U.K., and Lia Gilmour of the Bat Conservation Trust, U.K.

Existing research shows that natural sounds, like birdsong, can lower blood pressure, heart, and respiratory rates, as well as self-reported stress and anxiety.

Conversely, anthropogenic soundscapes, like traffic or aircraft noise, are hypothesized to have negative effects on human health and wellbeing in a variety of ways.

In the new study, 68 student volunteers listened to three 3-minute soundscapes: a nature soundscape recorded at sunrise in West Sussex, U.K., the same soundscape combined with 20 mile per hour road traffic sounds, and the same soundscape with 40 mile per hour traffic sounds.

General mood and anxiety were assessed before and after the soundscapes using self-reported scales.

The study found that listening to a natural soundscape reduced self-reported stress and anxiety levels, and also enhanced mood recovery after a stressor.

However, the benefits of improved mood associated with the natural soundscape was limited when traffic sounds were included.

The natural soundscape alone was associated with the lowest levels of stress and anxiety, with the highest levels reported after the soundscape that included 40 mile per hour traffic.

The authors conclude that reducing traffic speed in urban areas might influence human health and wellbeing not only through its safety impacts, but also through its effect on natural soundscapes.

The authors add: “Our study shows that listening to natural soundscapes can reduce stress and anxiety, and that anthropogenic sounds such as traffic noise can mask potential positive impacts. Reducing traffic speeds in cities is therefore an important step towards more people experiencing the positive effects of nature on their health and wellbeing.”

Reference:

Lia R. V. Gilmour, Isabelle Bray, Chris Alford, Paul R. Lintott. Natural soundscapes enhance mood recovery amid anthropogenic noise pollution. PLOS ONE, 2024; 19 (11): e0311487 DOI: 10.1371/journal.pone.0311487.

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Study Reveals Gender Differences in Bell’s Palsy Prognosis and Recovery Factors

Korea: A recent retrospective study in Clinical Otolaryngology has revealed notable gender differences in the clinical manifestations and recovery outcomes of Bell’s palsy, a condition characterized by sudden, temporary facial paralysis due to nerve inflammation.

“Milder initial facial paralysis and favorable electromyography (EMG) findings were linked to improved prognosis in both men and women with Bell’s palsy. However, younger age at onset and early steroid treatment significantly enhanced recovery rates in women, but not in men,” the researchers reported.

Bell’s palsy is commonly treated with corticosteroids to reduce inflammation and swelling of the facial nerve, improving the chances of recovery. While numerous studies have examined the clinical characteristics and factors influencing treatment outcomes of Bell’s palsy, few have specifically focused on gender differences. To address this gap, Seung Geun Yeo, Department of Convergence Medicine, College of Medicine, Kyung Hee University, Seoul, Korea, and colleagues investigated whether the clinical features, treatment outcomes, and the factors influencing them vary between men and women with Bell’s palsy.

For this purpose, the researchers conducted a retrospective study involving 1,708 patients (791 men and 917 women) who presented with facial palsy at the otolaryngology department between January 1986 and December 2022. They analyzed and compared the clinical features and treatment outcomes of men and women diagnosed with Bell’s palsy.

The key findings of the study were as follows:

  • Age distribution, side affected by facial palsy, House-Brackmann (HB) grade, underlying diseases such as diabetes and hypertension, electroneuronography (ENoG) results, EMG results, and treatment methods did not differ significantly between men and women with Bell’s palsy.
  • Milder initial facial palsy and better EMG results were significantly associated with a better prognosis in men.
  • Younger age, milder initial facial palsy, and better EMG results were significantly associated with a better prognosis in women.
  • Women had a significantly better prognosis than men when treated with steroids within 3 days of the onset of paralysis.

These findings have important implications for clinical practice, emphasizing the need for personalized approaches to managing Bell’s palsy. Understanding the factors that influence recovery in men and women can help clinicians tailor treatment strategies to maximize each patient’s recovery potential. It also highlights the importance of public awareness about the condition, encouraging individuals to seek medical attention promptly when experiencing symptoms such as sudden facial weakness or paralysis.

“The study provides valuable insights into the role of gender, age, and early treatment in the prognosis of Bell’s palsy. By identifying key predictors of recovery and recognizing gender-specific differences, it paves the way for more effective and individualized care for patients affected by this condition,” the researchers concluded.

Reference:

Yon, D. K., Kim, D., Yoo, M. C., Kim, S. S., Rim, H. S., Kim, S. H., Byun, J. Y., & Yeo, S. G. A Retrospective Study on the Gender Differences in Clinical Manifestations of Bell’s Palsy. Clinical Otolaryngology. https://doi.org/10.1111/coa.14259

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Tooth Occlusion and Dementia: Study Links Posterior Occlusal Contact Loss to Higher Dementia Risk

A recent study published in the Scientific reports suggests that posterior occlusal contact loss is linked to higher dementia risk.

This study examines the association between posterior occlusal contact and the risk of dementia development in the Japanese population, utilizing Eichner classification to evaluate occlusal status. Data from Japanese health insurance claims were analyzed for the period from April 2016 to March 2022. Participants had undergone specific health checkups, had no prior history of dementia, and were classified according to their dental occlusal contact. Dementia diagnoses were determined using ICD-10 codes, and participants were divided into three groups—A, B, and C—based on the Eichner classification, which indicates the extent of occlusal contact. Over an average follow-up period of 35.6 months, 691 dementia were identified among 931,309 participants. Those diagnosed with dementia were more likely to belong to Eichner B and C groups, signifying reduced occlusal contact. After adjusting for covariates, the hazard ratios (95% confidence intervals) for Eichner B and C were 1.73 (1.31–2.28) and 2.10 (1.35–3.26), respectively. Sensitivity analyses confirmed these findings in adults aged 60–75. These findings suggest that reduced posterior occlusal contact correlates with an increased risk of dementia. Since the study is limited to participants under the age of 75, further research is required to determine its generalizability to older populations.

Reference:

Miyano, T., Tamada, Y., Kusama, T. et al. Longitudinal association between posterior occlusal contact and dementia development in a large retrospective cohort study using a Japanese claims database. Sci Rep 14, 27513 (2024). https://doi.org/10.1038/s41598-024-79399-8

Keywords:

Miyano, T., Tamada, Y., Kusama, T, Dementia, Oral health, Occlusal contacts, Eichner classification, Healthcare administrative claims

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Introduction of HPV vaccine linked to reduced deaths due to cervical cancer among young women: JAMA

Cervical cancer deaths have plunged dramatically among women under age 25, and researchers at MUSC Hollings Cancer Center believe this is likely due to HPV vaccination.

Their study, published in JAMA, is the first to suggest the impact of HPV vaccination on cervical cancer deaths.

“We observed a substantial reduction in mortality – a 62% drop in cervical cancer deaths over the last decade, likely due to HPV vaccination,” said senior author Ashish Deshmukh, Ph.D., co-leader of the Cancer Prevention and Control Research Program at MUSC Hollings Cancer Center. “We cannot think of any other reason that would have contributed to such a marked decline.”

The human papillomavirus, or HPV, causes nearly all cases of cervical cancer. The HPV vaccine was introduced in 2006. At first, it was available only to adolescents, but eligibility has since been expanded to include adults up to age 45 in some cases.

Previous studies have looked at the rates of HPV infection, precancer and cervical cancer incidence since the introduction of the vaccine, and all of those indicators have declined. The next logical step was to look at death rates, Deshmukh said.

Although cervical cancer is rare in women under age 25, it does occur. By examining deaths in this age group, researchers were able to see the early impact of the vaccine. Women who were 25 in 2021, the final year included in this study, would have been 10 years old when the vaccine was introduced.

The researchers looked at cervical cancer deaths in three-year blocks of time. Through the 1990s, there were between 50 and 60 cervical cancer deaths nationally in women under the age of 25 in each three-year block of time. During the 2019-2021 time period, there were only 13 deaths.

However, the team sounded an alarm. Healthy People 2030 has a goal of reaching an 80% HPV vaccination rate, but the Centers for Disease Control and Prevention reported earlier this year that only about 60% of 13to 15 year olds have received the recommended doses.

“There has been a decline in HPV vaccination post COVID-19 in the most recent generation of U.S. adolescents. This is troubling as a decline in vaccination uptake would potentially lead to smaller gains,” Deshmukh said.

Reference:

Dorali P, Damgacioglu H, Clarke MA, et al. Cervical Cancer Mortality Among US Women Younger Than 25 Years, 1992-2021. JAMA. Published online November 27, 2024. doi:10.1001/jama.2024.22169.

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