Therapeutic-dose anticoagulation linked to lower mortality in COVID-19

For patients hospitalized for COVID-19, administration of therapeutic-dose versus prophylactic-dose anticoagulation with heparins is associated with lower 28-day mortality, according to a review published online Dec. 24 in the Annals of Internal Medicine.

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2020 to 2023 saw increase in buprenorphine dispensing for teens

Buprenorphine dispensing increased among adolescents and decreased among young adults between 2020 and 2023, according to a research letter published online Dec. 23 in the Journal of the American Medical Association.

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COVID-19 infection not linked to changes in MS symptom severity

COVID-19 infection is not associated with immediate changes in multiple sclerosis (MS) symptom severity or disability, according to a study published online Dec. 23 in Neurology.

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Could AI plus lasers help catch very early breast cancers?

Very early-stage breast cancers are notoriously tough to spot via mammograms, but new technology might make detection easier.

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Neurological outcomes worsen with gestational HTN, preeclampsia, eclampsia

Gestational hypertension, preeclampsia, and eclampsia are associated with an increased risk for neurological outcomes in the months or years after giving birth, according to a study published online Dec. 23 in JAMA Neurology.

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RG Kar Rape-Murder: Protesting medicos visit Bengal secretariat, demand speedy probe

Kolkata: The protesting doctors marched to the West Bengal secretariat on Thursday, urging the issuance of a “no-objection certificate” to facilitate the CBI’s investigation into the RG Kar Medical College and Hospital case.

According to the PTI report, some doctors also went to the CBI’s CGO Complex office and met the officers of the central agency to stress their demand to complete the probe into the R G Kar incident quickly.

“The chief secretary did not meet us. We went to meet him and submit our demand that the state government issues a clearance so that the CBI could complete its investigation in the financial irregularity case of RG Kar Medical College and Hospital,” one of the agitating doctors said.

Also Read:RG Kar Rape-Murder: Calcutta HC directs parents to seek clarification on fresh probe

Police had recovered the body of a woman doctor from inside RG Kar Hospital on August 9.

The CBI has filed a chargesheet against prime accused Sanjay Roy for the rape and murder of the on-duty doctor.

Medical Dialogues had earlier reported that the Calcutta High Court on Tuesday instructed the counsel for the parents of the woman PG trainee doctor, who was raped and murdered at RG Kar Medical College & Hospital in August, to seek clarification from the Supreme Court and a division bench of the High Court regarding their petition for a fresh investigation into the case. As the petition for a fresh probe, filed by the parents of the victim, came up for hearing at the single-judge bench of Justice Tirthankar Ghosh, he observed that first there is a need for clarification on whether the ongoing probe in the matter by Central Bureau of Investigation (CBI) in the matter is monitored by the Supreme Court or not.

Also Read:’ No evidence of possible struggle’ inside seminar hall, says Forensic Report in RG Kar Case

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AstraZeneca Tagrisso approved in EU for patients with unresectable EGFR-mutated lung cancer

Cambridge: AstraZeneca‘s Tagrisso (osimertinib) has been approved in the European Union (EU) for the treatment of adult patients with locally advanced, unresectable non-small cell lung cancer (NSCLC) whose tumours have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 (L858R) substitution mutations and whose disease has not progressed during or following platinum-based chemoradiation therapy (CRT).

The approval by the European Commission follows the positive opinion of the Committee for Medicinal Products for Human Use and is based on results from the LAURA Phase III trial, which were published in The New England Journal of Medicine.

In the trial, Tagrisso reduced the risk of disease progression or death by 84% compared to placebo (hazard ratio 0.16; 95% confidence interval 0.10-0.24; p<0.001) as assessed by blinded independent central review. Median progression-free survival (PFS) was 39.1 months in patients treated with Tagrisso versus 5.6 months for placebo.

Overall survival (OS) results remain immature, and the trial is continuing to assess OS as a secondary endpoint.

Each year in Europe, there are more than 450,000 people diagnosed with lung cancer, and approximately 80-85% have NSCLC. Among those with NSCLC in Europe, about 10-15% have tumours with an EGFR mutation.
Manuel Cobo, MD, Specialist Physician of the Medical Oncology Service at the Carlos Haya University Hospital, Malaga, Spain, and investigator for the trial, said, “The approval marks a major breakthrough for patients in the EU with unresectable, EGFR-mutated non-small cell lung cancer, delivering the first targeted treatment in this setting. Osimertinib reduced the risk of disease progression or death by an unprecedented 84 per cent in the LAURA trial, setting a new benchmark for outcomes and underscoring the importance of testing for EGFR mutations upon diagnosis.”

Dave Fredrickson, Executive Vice President, Oncology Business Unit, AstraZeneca, said, “Tagrisso is now the first and only EGFR inhibitor and targeted treatment approved in the EU for locally advanced, unresectable lung cancer, providing a new standard of care to patients who have historically experienced early progression after chemoradiation therapy. The powerful results from the LAURA trial show Tagrisso improves outcomes for patients in the unresectable setting, reinforces the importance of timely EGFR testing and solidifies Tagrisso as the backbone therapy in EGFR-mutated non-small cell lung cancer.”

The safety and tolerability of Tagrisso in the LAURA trial was consistent with its established profile and no new safety concerns were identified.

This is the fifth major approval for Tagrisso based on the LAURA trial following recent approvals in the US, Switzerland, South Korea and Australia. Regulatory applications are also currently under review in China, Japan and several other countries.

Tagrisso is approved as monotherapy in more than 100 countries including in the US, EU, China and Japan. Approved indications include 1st-line treatment of patients with locally advanced or metastatic EGFRm NSCLC, locally advanced or metastatic EGFR T790M mutation-positive NSCLC, and adjuvant treatment of early-stage EGFRm NSCLC. Tagrisso is also approved in combination with chemotherapy in the US, China and several other countries for 1st-line treatment of patients with locally advanced or metastatic EGFRm NSCLC.

Read also: Pfizer, AstraZeneca and several other drugmakers in race to join weight loss drug market

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700-bed Civil hospital coming up in Gurugram, Health Minister reviews progress

Chandigarh: Haryana Chief Minister, Sh. Nayab Singh Saini on Tuesday chaired a review meeting regarding the construction process of the 700-bed civil hospital to be built in Gurugram. 

The hospital will be constructed as part of efforts to improve healthcare services in the region.

During the meeting, the Additional Chief Secretary, Health Department, Sh. Sudhir Rajpal while providing an update on the construction progress of the civil hospital in Civil Lines shared that the hospital will be built on 7.73 acres of land at a cost of around Rs. 990 crore.

The hospital will consist of a 13-story building, including a basement, ground floor, and 11 floors. The hospital will include 60 ICU beds, 12 operation theaters, and an emergency helipad, among other important facilities.

Also Read:Gurugram to get 700-bed Govt Hospital named after Guru Nanak Dev

He further shared that at present there is a nearby government school built on approximately 1.5 acres of land to provide more space for the hospital’s future needs and improve public access to the facility. The state government can think of shifting the school building on the opposite side of the road to a 2.5-acre plot of land owned by the Education Department.

Meanwhile, after receiving a detailed report on the progress of the hospital’s construction, the Chief Minister directed that arrangements should be made according to the project’s timeline. He further directed the officers to ensure that the hospital meets the future medical needs of the city. He also directed that the new building for the school, proposed by the Education Department, be constructed in a multi-story design. He said that the school should continue to operate in its current building until the new one is ready.

Union Minister of State Rao Inderjit Singh, Health Minister, Kumari Arti Singh Rao, Industries & Commerce, Environment, Forest & Wildlife Minister, Rao Narbir Singh, Pataudi MLA, Bimla Chaudhary, Sohna MLA Tejpal Tanwar, Gurugram MLA Mukesh Sharma and other officers also remained present during this.

Also Read:Haryana Govt to enhance health facilities for Soldiers, Ex-Servicemen

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NT-proBNP levels useful tool to predict increased risk of Atrial Fibrillation, reveals research

A recent groundbreaking study
found that NT-proBNP levels are associated with an increased risk of atrial
fibrillation in older adults, as per results that were published in the journal
Heart.

N-terminal pro-B-type natriuretic
peptide (NT-proBNP) is a widely recognized and established biomarker for
cardiac conditions like heart failure. However, there is ambiguity in
establishing its role or predicting atrial fibrillation. Hence, researchers
from China conducted a study to evaluate the association between NT-proBNP
levels and the incidence of AF and explore the potential of NT-proBNP in
enhancing AF risk prediction models.

A systematic review and
meta-analysis were conducted by searching databases like PubMed, Embase,
Cochrane Library, Web of Science, and Scopus from inception to August 2024. All
the prospective studies that reported the association between baseline
NT-proBNP levels and incident AF were included. Random effects models were used
to pool the Hazard ratios and relative risks with 95% confidence intervals.

Findings:

  • About 136 089 participants from 16 cohorts were
    included in the meta-analysis.
  • Among them, there were 8017 incident AF cases.
  • Higher NT-proBNP levels were significantly associated
    with an increased risk of developing AF, with a relative risk of 3.84 when
    comparing the top and bottom quartiles.
  • It also showed a 1.70 relative risk per standard
    deviation increment.
  • A significant non-linear dose-response
    relationship was seen (Pnon-linearity<0.05).
  • The association was stronger in older
    populations and when serum samples were used.
  • Incorporating NT-proBNP levels into traditional AF
    risk models increased the predictive accuracy.

Thus, the study highlighted the
potential value of adding NT-proBNP levels in the risk stratification of atrial
fibrillation. The study underscores the importance of using NT=proBNP as a
valuable biomarker for identifying individuals at potential risk of developing
AF. Due to its predictive accuracy, the researchers suggested adding this to
the AF risk assessment tools.

The study also highlights the
potential of using NT-proBNP levels for more intensive screening and early
identification of Atrial fibrillation. Personalized treatment approaches can be
used due to early identification by using NT-proBNP levels for AF and also developing
a preventive strategy for at-risk individuals.

Further reading: Wang W, Zhou T, Li J,
et al
. Association between NT-proBNP levels and risk of atrial
fibrillation: a systematic review and meta-analysis of cohort studies. Heart Published
Online First: 06 December 2024. doi:10.1136/heartjnl-2024-324685

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High-protein diet may enhance glycemic control by boosting peripheral insulin levels, finds study

A study published in Diabetes, Obesity, and Metabolism found that a high-protein diet may enhance glycemic control by boosting peripheral insulin levels.

High-protein diets have been recognized as a potential strategy in the nutritional management of type 2 diabetes (T2D). Mycoprotein is a high-fibre, high-protein food ingredient previously shown to improve acute glycaemic control.

We determined whether incorporating mycoprotein into a high-protein vegan diet would improve glycaemic control to a greater extent than an isonitrogenous omnivorous diet in people with T2D.

Seventeen adults (f = 5, age = 58.3 ± 8.3 years, BMI = 32.9 ± 4.7 kg∙m−2, HbA1c = 60 ± 15 mmol∙mol−1) with T2D were randomly allocated to a 5-week eucaloric high-protein (30% energy from protein) diet, either an omnivorous diet (OMNI; 70% protein from omnivorous sources) or an isonitrogenous, mycoprotein-rich, vegan diet (VEG; 50% protein from mycoprotein). Glycaemic control was assessed using a two-step hyperinsulinaemic-euglycaemic clamp (HEC) with D-[6,6-2H2] glucose infusion, a mixed-meal tolerance test (MMTT) and continuous glucose monitoring.

Results: The rate of glucose disappearance (RdT), glucose disposal rate and endogenous glucose production, as well as postprandial time-course of blood glucose, serum insulin and C-peptide were assessed during the HEC and MMTT, respectively. Both groups had improved peripheral insulin sensitivity (intervention effect, p = 0.006; increased RdT/Insulin of 1.0 ± 0.6 and 1.0 ± 0.3 mg kg−1 min−1 in OMNI and VEG, respectively), HbA1c (intervention; p = 0.001) and glycaemic variability (intervention; p = 0.040; increased time in-range of 11.8 ± 9.3% and 23.3 ± 12.9% in OMNI and VEG). There were no improvements in hepatic insulin sensitivity or in postprandial blood glucose and serum C-peptide (p > 0.05) during the MMTT.

Conclusions

High-protein diets, whether predicated on vegan or omnivorous proteins, can improve glycaemic control by increasing peripheral insulin sensitivity in people with T2D.

Reference:

Whelehan G, Dirks ML, West S, et al. High-protein vegan and omnivorous diets improve peripheral insulin sensitivity to a similar extent in people with type 2 diabetes. Diabetes Obes Metab. 2024; 1-10. doi:10.1111/dom.16100

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