Maternal childhood trauma may lead to early metabolic changes in male children: Study

Adverse situations experienced by the mother during childhood – such as neglect or physical, psychological or sexual violence – can trigger excessive weight gain in male children as early as the first two months of life. This was shown in a study that followed 352 pairs of newborns and their mothers in the cities of Guarulhos and São Paulo, Brazil. The results were published in the journal Scientific Reports.

The analyses indicated the occurrence of very early metabolic alterations in babies that not only led to weight gain above that expected for their age but also have the potential to increase the future risk of developing obesity and diabetes.

This is the first article resulting from a Thematic Project supported by FAPESP and the National Institutes of Health (NIH) in the United States. Using a database of 580 vulnerable pregnant women, the group is studying intergenerational trauma, i.e., negative effects that can be passed on to future generations, even if the offspring have not lived through such experiences.

Conducted by researchers from Columbia and Duke Universities, both in the United States, and the School of Medicine of the Federal University of São Paulo (EPM-UNIFESP) in Brazil, the study focuses on issues related to mother-baby interaction, development, and mental and physical health.

“We observed that although the babies were born weighing within the expected parameters, in the first few days of life they showed altered weight gain, far above what’s recommended as ideal by the World Health Organization [WHO],” says Andrea Parolin Jackowski, professor at UNIFESP and coordinator of the project in Brazil.

According to the WHO, the ideal weight gain in the first stage of life is up to 30 grams per day. However, the male babies in the study had an average weight gain of 35 grams per day – with some gaining up to 78 grams per day.

“The babies who took part in the study were born full-term, healthy and within the ideal weight range. All of the pregnancies we followed were low-risk, but our data showed that every adversity the mother experienced during childhood increased the babies’ weight gain by 1.8 grams per day. And this was limited to males,” the researcher reports.

According to Jackowski, there are many factors that can influence a baby’s weight in early life, and maternal childhood trauma appears to be one of them. For this reason, the analysis took care to control for so-called confounders – variables related to the mothers’ stress levels that could influence the results. Some examples include lifetime trauma experiences (the effects of which are cumulative) and current trauma, as well as education level and socioeconomic status.

“It’s also important to note that 70% of the babies who took part in the study were exclusively breastfed. The other 30% were on mixed feeding [a combination of breast milk and formula]. This means that they weren’t eating filled cookies or other foods that could actually change their weight. Therefore, the results suggest the occurrence of an early metabolic alteration in these babies,” she says.

Why only boys?

According to the researcher, maternal trauma during childhood only had an impact on the weight of male babies because of physiological variations in the placenta associated with the sex of the fetus.

The placenta is a temporary organ composed of maternal and fetal tissue that shows structural differences and differences in the regulation and expression of steroids and proteins depending on the sex of the baby. “Male fetuses develop strategies to maintain constant growth in the face of an adverse intrauterine environment, leading to a greater risk of prematurity and fetal death,” explains the researcher.

In addition, she adds, childhood adversity is known to increase the risk of depression and anxiety during pregnancy, which can lead to increased levels of pro-inflammatory cytokines and cortisol in the intrauterine environment. “It appears that the placenta of female fetuses adapts to protect them, slowing down the growth rate without restricting intrauterine growth [i.e., the size of the baby is within the expected range at the end of pregnancy] and allowing for a higher survival rate,” she explains.

Another important issue is that the placenta of male fetuses tends to be more susceptible to fluctuations in substances and metabolites present in the maternal bloodstream compared to female placentas. “As a result, in these cases of trauma, it can become more permeable, causing the male fetus to be more exposed to inflammatory factors resulting from high levels of stress, such as cortisol and interleukins, for example.”

The work now published is the first to identify intergenerational trauma as a trigger for physical changes at such an early age. “It’s already known that adverse events in the mother’s childhood can trigger psychological and developmental problems, but our study is pioneering in showing that they can affect physical problems, such as weight gain, as early as the first two months of life,” says Jackowski.

Now, the research team, which includes Vinicius O. Santana and FAPESP postdoctoral fellow Aline C. Ramos, will follow the weight development of the children of mothers who suffered adversity in childhood until they are 24 months old. “We’re going to follow them for longer because we want to investigate the impact of the introduction of food, which usually occurs at 6 months of age,” she says.

As the researchers explain, the research suggests that metabolic changes can be modified. “It’s not a matter of determinism. We need to monitor how the metabolism and inflammatory factors behave in these babies over a longer period of time to understand how to modulate this process. It’s important to know that all of this is modifiable, and we’re now going to look at how we can intervene,” she says.

Reference:

Santana, V.O., Ramos, A.C., Cogo-Moreira, H. et al. Sex-specific association between maternal childhood adversities and offspring’s weight gain in a Brazilian cohort. Sci Rep 15, 2960 (2025). https://doi.org/10.1038/s41598-025-87078-5.

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Machine Learning may predict Treatment outcomes in early childhood caries, suggests study

Researchers have found in a new study that Machine learning shows promise in predicting treatment outcomes in early childhood caries. Further Key identified predictors can help guide targeted management strategies.

Early childhood caries (ECC) is a major oral health problem among preschool children that can significantly influence children’s quality of life. Machine learning can accurately predict the treatment outcome but its use in ECC management is limited. The aim of this study is to explore the application of machine learning in predicting the treatment outcome of ECC. This study was a secondary analysis of a recently published clinical trial that recruited 1,070 children aged 3- to 4-year-old with ECC. Machine learning algorithms including Naive Bayes, logistic regression, decision tree, random forest, support vector machine, and extreme gradient boosting were adopted to predict the caries-arresting outcome of ECC at 30-month follow-up after receiving fluoride and silver therapy. Candidate predictors included clinical parameters (caries experience and oral hygiene status), oral health-related behaviours (toothbrushing habits, feeding history and snacking preference) and socioeconomic backgrounds of the children. Model performance was evaluated using discrimination and calibration metrics including accuracy, recall, precision, F1 score, area under the receiver operating characteristic curve (AUROC) and Brier score. Shapley additive explanations were deployed to identify the important predictors. Results: All machine learning models showed good performance in predicting the treatment outcome of ECC. The accuracy, recall, precision, F1 score, AUROC, and Brier score of the six models ranged from 0.674 to 0.740, 0.731 to 0.809, 0.762 to 0.802, 0.741 to 0.804, 0.771 to 0.859, and 0.134 to 0.227, respectively. The important predictors of the caries-arresting outcome were the surface and tooth location of the carious lesions, newly developed caries during follow-ups, baseline caries experience, whether the children had assisted toothbrushing and oral hygiene status.

Machine learning can provide promising predictions of the treatment outcome of ECC. The identified key predictors would be particularly informative for targeted management of ECC.

Reference:

Wu, Y., Jia, M., Fang, Y. et al. Use machine learning to predict treatment outcome of early childhood caries. BMC Oral Health 25, 389 (2025). https://doi.org/10.1186/s12903-025-05768-y

Keywords:

Machine, Learning, predict, Treatment, outcomes, early, childhood, caries, suggests, study, Wu, Y., Jia, M., Fang, Y, Machine learning, Early childhood caries, Predictor, Support vector machine, Extreme gradient boosting, SHAP

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BMI tied to CV risk in ACPA-positive but not ACPA-negative RA patients: Study

Researchers have identified in a new study that body mass index (BMI) affects cardiovascular risk in rheumatoid arthritis (RA) patients differently based on their ACPA (anticitrullinated protein antibody) status and biologic therapy use. The results indicate that greater BMI is associated with decreased cardiovascular risk in ACPA-negative patients receiving biologics but is linked with increased cardiovascular risk in ACPA-positive patients, independent of biologic therapy. These findings underscore the intricate interconnection between immune activity, body composition, and cardiovascular events in patients with RA. The study was conducted by George A. K. and colleagues published in BMJ Rheumatic & Musculoskeletal Diseases.

Rheumatoid arthritis is a chronic autoimmune disorder that not just targets joints but also poses a greater risk of cardiovascular events like strokes and heart attacks. Obesity is usually regarded as a risk factor for heart disease, yet the contribution of BMI to cardiovascular events in RA is less well established, particularly in light of the effects of inflammation, immune factors such as ACPA, and biologic drug therapy.

This global observational study included data from 3,982 RA patients. The authors used two categories to assess cardiovascular outcomes:

  • Major Adverse Cardiovascular Events (MACE): such as myocardial infarction, stroke, or cardiovascular mortality

  • All cardiovascular events: including MACE, in addition to angina, revascularization procedures, transient ischemic attack (TIA), peripheral arterial disease, and heart failure

Multivariable Cox regression models stratified by center risk were used to assess how BMI, ACPA status, and biologic therapy individually and collectively impacted the risk of cardiovascular events.

Key Findings

  • Participants: 3,982 RA patients

  • MACE events: 192

  • Total cardiovascular events: 319

In ACPA-negative biologic users:

  • MACE risk decreased by 62% with increased BMI (HR = 0.38)

  • All cardiovascular event risk decreased by 33% (HR = 0.67)

In ACPA-positive patients (any biologic use):

  • MACE risk increased by 4% per BMI unit (HR = 1.04)

  • All cardiovascular event risk increased by 3% per BMI unit (HR = 1.03)

Three-way interaction significant:

  • MACE (p < 0.001)

  • All cardiovascular events (p = 0.028)

This research determines that the effect of BMI on cardiovascular risk in RA is not uniform. Increased BMI decreased cardiovascular risk in ACPA-negative patients on biologics, whereas increased BMI enhanced cardiovascular risk in ACPA-positive patients regardless of biologic therapy. These results emphasize the need for personalized RA treatment and prevention of cardiovascular disease according to the immune status of the patient and treatment approach.

Reference:

Karpouzas, G. A., Gonzalez-Gay, M. A., Corrales, A., Myasoedova, E., Rantapää-Dahlqvist, S., Sfikakis, P. P., Dessein, P., Hitchon, C., Pascual-Ramos, V., Contreras-Yáñez, I., Colunga-Pedraza, I. J., Galarza-Delgado, D. A., Azpiri-Lopez, J. R., Semb, A. G., van Riel, P. L. C. M., Misra, D. P., Patrick, D., Bridal Logstrup, B., Hauge, E.-M., … for An inTernationAl Cardiovascular Consortium for Rheumatoid Arthritis (ATACC-RA). (2025). Influence of body mass index on cardiovascular risk in rheumatoid arthritis varies across anti-citrullinated protein antibody status and biologic use. RMD Open, 11(2), e005464. https://doi.org/10.1136/rmdopen-2025-005464

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Antithrombotic Therapy Significantly Increases Risk of Reoperation for Hematoma After Thyroidectomy: S6

A recent study has identified that patients who receive thyroidectomy when on antithrombotic therapy are at a much increased risk of needing reoperation from postoperative hematoma (POH). The study was conducted by Bassam A. and colleagues published in the American Journal of Otolaryngology. The findings of the study suggest a fivefold increased risk of POH in patients treated with anticoagulants, supporting the importance of personalized treatment planning in this group.

Postoperative hematoma is a rare yet life-threatening condition following thyroid surgery, requiring in many cases urgent treatment. To analyze the effect of antithrombotic treatment on the occurrence and severity of POH, scientists divided patients into three main groups according to perioperative drug exposure: Group 1 had thyroidectomy with no antithrombotic medication, Group 2 received antiplatelet drugs, and Group 3 received anticoagulant drugs. POH was also divided into Group A (those with hematoma) and Group B (those without hematoma). The primary aim was to measure the impact that the application of antithrombotic therapy has on hematoma risk, as well as the need for reoperation following it.

Researchers performed a comparison of thyroidectomy patients, segregating them into three groups founded on treatment. The incidence of postoperative hematoma was considered the main point of interest, with cases further divided depending on whether the hematoma necessitated conservative treatment or surgical reoperation. Risk factors including hyperthyroidism, substernal goiter, and hypertension were also recorded to see how they affect the risk of bleeding. The rates of reoperation were determined for all three groups to find the effect of drug type on outcomes of surgery.

Key findings

  • The total postoperative incidence of hematoma was 6%, and only 0.1% of these cases needed reoperation, while the rest of 5.9% were treated conservatively.

  • 83% of the hematoma reoperations were within the first 24 hours after surgery, highlighting the importance of early monitoring.

  • The risk of POH was significantly enhanced by the use of antithrombotic medication 3.4 times for patients taking antiplatelet medication and 5.2 times for those taking anticoagulants.

  • Among those who had developed hematoma (Group A), hyperthyroidism was seen in 32% of cases versus 7% in non-hematoma cases (Group B).

  • Substernal goiter and hypertension were seen in 33% and 52% of Group A patients respectively, versus 11% and 27% in Group B.

  • Antithrombotic drug therapy was seen in 30% of hematoma cases and just 9% of non-hematoma cases.

  • Reoperation rates also significantly differed by drug category.

  • In patients on no blood thinners (Group 1), reoperation was required in only 0.08%.

  • The rate increased to 0.23% among patients on antiplatelet therapy (Group 2) and increased further to 1% among those on anticoagulant therapy (Group 3).

  • These data definitely indicate a direct relationship between the use of antithrombotic drugs and risk for severe bleeding complications following thyroidectomy.

Patients operated on for thyroidectomy under antithrombotic therapy have a very high risk of postoperative hematoma needing reoperation. This observation emphasizes the significance of careful preoperative assessment and potential adjustment of anticoagulant or antiplatelet treatment before surgery. Monitoring soon after surgery during the first 24 hours is also significant, as this is the most risk-prone duration for severe bleeding episodes.

Reference:

Abboud, B., Abboud, C., & Meouche, M. (2025). Reoperation for hematoma in patients on perioperative antithrombotic drugs underwent thyroidectomy. American Journal of Otolaryngology, 46(4), 104636. https://doi.org/10.1016/j.amjoto.2025.104636

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FIB-4 Score Positively Linked to Gallstone Risk in US Adults, confirms study

Researchers have discovered in a new study that a greater fibrosis-4 index (FIB-4) score, a noninvasive marker traditionally used to assess liver fibrosis, is strongly associated with an increased risk of gallstones among adults. Gallstones are among the most prevalent gastrointestinal diseases, but their association with markers of fibrosis in the liver such as FIB-4 is poorly understood. The new analysis offers valuable information regarding how biomarkers of the liver may be associated with risk for gallbladder disease in the general population. The study was published in BMC Gastroenterology by Huqiang Dong and colleagues.

The research used 2017–2020 National Health and Nutrition Examination Survey (NHANES) data and involved 7,771 participants. It is one of the largest nationally representative analyses to examine this association in US adults. The investigators examined the association of FIB-4 levels with the presence of gallstones based on data from NHANES, a well-established US population-based survey. The FIB-4 index was derived from age, AST, ALT, and platelet count.

Participants were categorized into quartiles according to their FIB-4 levels, and multivariate logistic regression models were used to examine the association with risk of gallstones. Restricted cubic spline (RCS) analysis was employed to check for nonlinear trends, and threshold effects analysis was utilized to identify inflection points at which risk levels altered. Subgroup analyses were conducted to test consistency within various demographic and health subgroups, and Bonferroni correction was implemented to preserve statistical precision.

Results

The weighted prevalence of gallstones in the study population was 11%. There was a clear and statistically significant positive association between FIB-4 levels and risk of gallstones:

  • For every unit increase in FIB-4, there was a 19% increase in the odds of gallstones (Odds Ratio [OR] = 1.19; 95% Confidence Interval [CI]: 1.10 to 1.29).

  • When quartiled, individuals in the uppermost FIB-4 quartile (Q4) had a 60% increased risk of gallstones (OR = 1.60; 95% CI: 1.25 to 2.03) than those in the lowest quartile (Q1).

  • The RCS analysis found a nonlinear positive relationship between FIB-4 and risk for gallstones with a statistically significant nonlinear trend (p = 0.015). Risk increased sharply beyond an inflection point at a FIB-4 score of 2.43 (p = 0.001).

  • Subgroup analysis validated that the positive correlation between FIB-4 and gallstones persisted strongly among non-Hispanic whites, subjects without heart failure or coronary artery disease, and among alcohol users and smokers. Following Bonferroni adjustment, these correlations persisted statistically significantly (p < 0.00217).

This research firmly determines a strong, nonlinear relationship between FIB-4 elevation and increased gallstone risk in US adults. These findings point to the potential of FIB-4 as an inexpensive, noninvasive gallstone risk marker that is rapid. As gallstones are typically asymptomatic until complications are formed, the value of FIB-4 as an adjunct tool to screening could improve earlier diagnosis and prevention efforts, particularly in high-risk patients.

Reference:

Dong, H., Zhang, Z., Fu, C. et al. Association between fibrosis-4 index (FIB-4) and gallstones: an analysis of the NHANES 2017–2020 cross-sectional study. BMC Gastroenterol 25, 229 (2025). https://doi.org/10.1186/s12876-025-03809-y

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Low-Dose Sirolimus as Effective as High-Dose for Kaposiform Hemangioendothelioma Treatment, suggests study

Researchers have found in new research that low-dose sirolimus is noninferior to high-dose sirolimus in the treatment of Kaposiform Hemangioendothelioma (KHE), suggesting that lower doses may be a viable treatment option.

It remains unknown whether low-dose sirolimus can replace high-dose sirolimus for the treatment of kaposiform hemangioendothelioma (KHE) without the Kasabach–Merritt phenomenon (KMP). A study was done to evaluate the noninferiority and safety of low-dose versus high-dose sirolimus in Kaposiform Hemangioendothelioma patients. This randomized, multicenter, open-label, noninferiority trial was conducted from February 2021 to August 2022. Participants received either a low-dose sirolimus regimen (blood trough concentration 5-8 ng/mL) or a high-dose sirolimus regimen (blood trough concentration 10-15 ng/mL). The primary endpoint was the difference in the proportion of patients between groups who achieved an objective response, defined as a ≥20% reduction in Kaposiform Hemangioendothelioma volume at month 12. Results: In this study, 39 were in the low-dose group, and 40 were in the high-dose group. At 1 year of treatment, 90.0% in the high-dose group and 89.7% in the low-dose group achieved an objective response (difference, 0.3%; 95% confidence interval -13.1 to 13.6). The incidences of total adverse events (AEs) and serious adverse events were similar between the two groups, but respiratory, skin and mucosal adverse events were less common in the low-dose group. Low-dose sirolimus is noninferior to high-dose sirolimus in treating Kaposiform Hemangioendothelioma.

Reference:

Efficacy and Safety of High- vs Low-Dose Sirolimus in Patients with Kaposiform Hemangioendothelioma: A Randomized Clinical Trial Zhou, Jiangyuan et al. Journal of the American Academy of Dermatology, Volume 0, Issue 0

Keywords:

Efficacy, Safety, High, Low, Dose, Sirolimus, Patients, Kaposiform, Hemangioendothelioma, Trial Zhou, Jiangyuan

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Ampicillin and Gentamicin Combo bests ampicillin for managing PROM at term: Study

Israel: A recent randomized clinical trial has provided compelling evidence that a combination of ampicillin and gentamicin prophylaxis is more effective than ampicillin alone in managing prelabor rupture of membranes (PROM) at term.

Researchers found that using ampicillin and gentamicin for prophylaxis in term premature rupture of membranes, compared to ampicillin alone, leads to lower rates of clinical chorioamnionitis, maternal postpartum complications, and neonatal adverse outcomes. The finding, published in the American Journal of Obstetrics and Gynecology, suggests the need to reassess the current antimicrobial prophylactic regimen for better maternal and neonatal outcomes.

When the water bag breaks before labor begins, a condition known as PROM, increases the risk of infections in both the mother and baby. Doctors often prescribe ampicillin for patients whose group B Streptococcus (GBS) status is unknown, especially if PROM lasts more than 18 hours. The researchers, however, note that some bacteria, like ampicillin-resistant Enterobacteriaceae, can also cause infections in mothers and newborns. Current guidelines for antibiotic use during labor mainly focus on preventing GBS infections but do not fully address the risk posed by these resistant bacteria.

Against the above background, Maya Frank Wolf, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel, and colleagues aimed to evaluate the risk of infections in mothers and newborns when treated with two different antibiotic regimens: ampicillin plus gentamicin versus ampicillin alone.

For this purpose, the researchers conducted a randomized-controlled trial at a university hospital between November 2022 and March 2024. They included women with term pregnancies (>37 weeks), unknown GBS status, and PROM without active labor, while excluding those with allergies, contraindications for vaginal delivery, or prior antibiotic use. Participants were randomly assigned to receive either ampicillin plus gentamicin (n=102) or ampicillin alone (n=102).

The primary outcome was clinical chorioamnionitis, while secondary outcomes included maternal infections and neonatal complications: microbiologic analysis and statistical methods assessed risk factors and treatment effectiveness, including multivariate regression.

The key findings of the study were as follows:

  • Fewer cases of clinical chorioamnionitis were seen with ampicillin and gentamicin (1.0% vs. 7.8%).
  • Lower incidence of fever during labor (8.0% vs. 18.0%).
  • Reduced overall risk of infections around childbirth (1.0% vs. 9.8%).
  • To prevent one case of clinical chorioamnionitis, 15 patients need treatment with ampicillin and gentamicin.
  • Fewer postpartum complications in mothers (0% vs. 5.9%).
  • Lower neonatal complications (10.8% vs. 21.6%).
  • Fewer sepsis evaluations in newborns (7.8% vs. 17.6%).
  • Shorter NICU stays (3.0 vs. 3.5 days).
  • Lower presence of resistant bacteria in chorioamniotic samples (20% vs. 51%).Bottom of Form

In term PROM, using ampicillin and gentamicin together significantly reduces the risk of clinical chorioamnionitis, maternal postpartum complications, and neonatal adverse outcomes compared to ampicillin alone.

“These findings highlight the need to reassess the current antibiotic regimen for better infection prevention in mothers and newborns,” the authors concluded.

Reference:

Abu Shqara, R., Glikman, D., Goldinfeld, G., Braude, O., Assy, S., Hassan, D., Sgayer, I., Ganem, N., Shasha-Lavsky, H., Yefet, E., Matanis, M., Lowenstein, L., & Frank Wolf, M. (2025). Ampicillin and gentamicin prophylaxis is superior to ampicillin alone in patients with prelabor rupture of membranes at term: The results of a randomized clinical trial. American Journal of Obstetrics and Gynecology. https://doi.org/10.1016/j.ajog.2025.03.011

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Swedish Study significantly links bronchial Asthma with Diabetes

A significant association was found between asthma and type 2 diabetes (T2D), even after adjusting for body mass index (BMI). Additionally, individuals with a sibling affected by one condition had an increased likelihood of having the other condition, indicating shared genetic and environmental factors.

Asthma and type 2 diabetes are two important causes of morbidity globally. They examined both the association of type 2 diabetes with asthma in Swedish adults and the familial co-aggregation of the diseases. They conducted a cross-sectional study of all adults aged 25–85 in Sweden between 2009 and 2013. Asthma and type 2 diabetes status were ascertained from the health registers. Models were adjusted for sex, age, education level, income and country of birth and in a subset, for body mass index (BMI). They further conducted a familial coaggregation analysis to determine if shared familial factors could explain any observed findings. Results The study included 5,299,245 participants, 25,292 (0.5%) had both asthma and type 2 diabetes. In the total population, the OR for the association between type 2 diabetes and asthma was 1.47 (95% CI 1.45 to 1.49); in the population of men (1.30 (95% CI 1.27 to 1.32)) and women (1.63 (95% CI 1.60 to 1.66)). The ORs were slightly higher among men (1.51 (95% CI 1.45 to 1.56)) and women (2.04 (95% CI 1.96 to 2.11)) for whom BMI measurements were available but attenuated with adjustment for BMI (1.45 (95% CI 1.40 to 1.51)) and (1.76 (95% CI 1.68 to 1.84)). Diabetes was more likely if a full sibling had asthma than if the sibling did not (1.13 (95% CI 1.10 to 1.15)). They found an association between asthma and type 2 diabetes that was sustained after adjusting for BMI, indicating that BMI alone does not explain this relationship. They also found that the two conditions coaggregate in siblings, indicating that the association is partly due to shared familial genetic and environmental risk factors.

Reference:

Mubanga M, Gong T, Smew AI, et al. Association between asthma and type 2 diabetes in a Swedish adult population: a register-based cross-sectional study. Thorax Published Online First: 23 March 2025. doi: 10.1136/thorax-2024-222819

Keywords:

Mubanga M, Gong T, Smew AI, Thorax, Association, asthma, type, 2 diabetes, Swedish, adult, population, register-based, cross-sectional, study

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Menopause symptoms associated with future memory and neuropsychiatric problems: Study

Women who exhibit more menopausal symptoms are more likely to later have poorer cognitive function and mild behavioral impairments-both markers of dementia. That is the conclusion of a study of 896 postmenopausal females published March 5, 2025, in the open-access journal PLOS One by Zahinoor Ismail of University of Calgary, Canada, and colleagues.

Females are known to have a three-fold greater risk of developing Alzheimer’s disease and related dementias, and will be disproportionately affected by the increasing global dementia burden. A proposed factor that may confer special risk to females is the loss of estradiol at menopause.

In the new study, researchers used data from the ongoing Canadian Platform for Research Online to Investigate Health, Quality of Life, Cognition, Behaviour, Function, and Caregiving in Aging (CAN-PROTECT) study. Data on 896 respondents who completed demographic, cognitive, and behavioral assessments and reported being post-menopausal were included. Participants had an average age of 64.2 years and an average age at menopause onset of 49.4 years.

Menopausal symptom burden was assessed by summing the total number of recalled perimenopausal symptoms, including irregular periods, hot flashes, chills, vaginal dryness, weight gain, slowed metabolism, night sweats, sleep problems, mood symptoms, inattention or forgetfulness, and other unnamed symptoms. The study found that women who reported more perimenopausal symptoms had greater cognitive impairment, with higher ECog-II total scores (b [95% confidence interval (CI)] = 5.37 [2.85, 7.97]). They also had more mild behavioral impairment symptoms in mid- to late life, with higher MBI-C total scores (b [95% CI] = 6.09 [2.50, 9.80]). Hormone therapy was not significantly associated with cognitive function but was linked to fewer behavioral symptoms.

The authors conclude that a higher menopausal symptom burden may indicate susceptibility to cognitive and behavioral changes later in life. The study acknowledges the need for further investigation to confirm these findings in a larger dataset, ideally with a longitudinal design to allow for determination of causality. Further segregation of the participants to account for confounding risk factors, including age of menopausal onset or surgical menopause intervention, would also benefit future studies.

The authors add: “Greater menopausal symptom burden may be associated with greater cognitive and behavioral decline in later life, both risk markers of dementia. Estrogen-based hormone therapy may contribute to mitigating clinical symptoms, particularly behavioral symptoms.”

Reference:

Jasper F. E. Crockford,Dylan X. Guan,Gillian Einstein,Clive Ballard,Byron Creese,Anne Corbett,Ellie Pickering,Adam Bloomfield,Pamela Roach,Eric E. Smith,Zahinoor Ismail, Menopausal symptom burden as a predictor of mid- to late-life cognitive function and mild behavioral impairment symptoms: A CAN-PROTECT study, PLOS One, https://doi.org/10.1371/journal.pone.0301165.

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Over-the-counter pain relievers linked to improved recovery from concussion, finds study

 People who take over-the-counter pain relievers after a concussion may recover faster than those who do not take pain relievers, according to a preliminary study released today, March 5, 2025, that will be presented at the American Academy of Neurology’s 77th Annual Meeting taking place April 5–9, 2025, in San Diego and online.

The study does not prove that pain relievers improve recovery after concussion; it only shows an association.

“These results are exciting as there are limited treatment options for concussion, and over-the-counter pain relievers are readily available and inexpensive,” said study author Kyle Arnold, MD, of the University of Washington in Seattle and a member of the American Academy of Neurology. “If these results can be confirmed by a controlled study, they could guide us to possible treatment options for people after a concussion.”

The cohort study was conducted by the NCAA and US Department of Defense CARE Consortium and looked at NCAA athletes and military cadets who had concussions. A total of 813 people took over-the-counter pain relievers such as acetaminophen or ibuprofen and other non-steroidal anti-inflammatory drugs after their concussion and 848 people did not take any pain relievers.

Researchers looked at the amount of time it took the athletes to be cleared to return to activities with no restrictions at both 50% recovery and 90% recovery, meaning when 50% of the athletes in the study recovered and then later when 90% recovered.

People who took the pain relievers were 20% more likely to have a faster time before they were cleared to return to activities with no restrictions than those who did not take pain relievers. Those who took the medications were cleared at 50% recovery an average of two days faster, and at 90% recovery an average of seven days faster than those who took no medication.

People who took pain relievers were also about 15% more likely to return to having no symptoms more quickly than those who did not take pain relievers. At 50% recovery, those taking the medications had no symptoms one day sooner than those not taking the medications. At 90% recovery, they had no symptoms three days sooner.

Those who took pain relievers also had lower scores on tests of how severe their symptoms were overall and how severe their headaches were.

The researchers also found that the earlier people took the pain relievers after the injury, the faster they recovered. For instance, at 50% recovery, those who started using pain relievers on the first day of their injury returned to play and had resolution of symptoms approximately eight days faster than those who started taking them after five or more days.

There was no difference between the type of pain reliever taken and how quickly people recovered.

“Early medication use appeared to be linked to shorter recovery times, but these findings require further validation through controlled trials,” Arnold said. “In the meantime, these preliminary results may help inform potential treatment options for people recovering from concussions, but additional studies are needed to provide more definitive recommendations.”

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