Archive for category: News

Led by Dr. Till Uhlig and colleagues, the study included 211 patients with gout, predominantly male with an average age of 56.4 years. Over the 2-year duration, anthropometric measures remained relatively stable, whereas cholesterol and low-density lipoprotein cholesterol (LDL-C) showed a noticeable decrease by the end of the first year. Notably, high waist circumference (WC) and lipid levels emerged as strong predictors of unfavorable gout outcomes at the end of the 2-year period.

Patients with a recent gout flare and elevated serum urate levels received comprehensive gout education and were initiated on a ‘treat-to-target’ urate-lowering therapy over a year. Anthropometric measures including body mass index (BMI), waist circumference (WC), and waist-height ratio (WHR) were recorded yearly alongside lipid level assessments for the 2-year duration.

• Proportion of Patients: Anthropometric measures remained largely unchanged over the 2-year study duration.
• Cholesterol Levels: Demonstrated a reduction at the end of the first year.
• Low-Density Lipoprotein Cholesterol (LDL-C): Showed a noticeable decrease by the end of the first year.
• Association with Gout Outcomes: High waist circumference (WC) and elevated lipid levels were predictors of unfavorable gout outcomes after the 2-year study period.
• Odds Ratio for Achieving sUA Target at Year 2:
• WC: 0.96 per cm (95% CI: 0.93 to 0.99)
• High-density lipoprotein cholesterol: 5.1 per mmol/L (95% CI: 1.2 to 22.1)
• Odds Ratio for Gout Flare during Year 2:
• High LDL-C: 1.8 per mmol/L (95% CI: 1.2 to 2.6)

The study’s findings underscore the significance of monitoring anthropometric measures and lipid levels in patients receiving continuous treatment for gout. Predictive relationships between high waist circumference, lipid levels, and unfavorable gout outcomes highlight the importance of managing these factors to optimize gout management strategies.

Reference:

Uhlig T, Karoliussen LF, Sexton J, Kvien TK, Haavardsholm EA, Hammer HB. Lifestyle factors predict gout outcomes: Results from the NOR-Gout longitudinal 2-year treat-to-target study. RMD Open. 2023;9(4):e003600. Published 2023 Dec 1. doi:10.1136/rmdopen-2023-003600

As winter approaches,
it’s crucial to understand how the changing weather can affect our breathing
and overall health. This overview breaks down the impact of seasonal shifts on
our respiratory well-being, focusing on things like the transition from warm to
cold weather, how it can affect people with existing lung problems and the
challenges posed by winter air pollution.

It is expected that there will be an
increase in respiratory issues, especially for kids, those with chronic lung
diseases, and older adults. In such times, children are more sensitive to air
quality, and parents should be mindful of outdoor plans.

Additionally, getting
vaccinated against various illnesses, is highlighted as a crucial step for
protection. Here are some practical tips to stay healthy, and avoid falling
prey to such illness, by taking care of your lungs and adopting healthy habits,
to enjoy a safe and healthy winter season.

1. Climate Impact on
Respiratory Health:

 
– Seasonal changes, especially from summer to winter, can lead to
increased viral replication in the upper respiratory tract.

 
– The transition from winter to warmer seasons may also trigger
respiratory issues, affecting both upper and lower airways.

2. Vulnerable Populations:

 
– Individuals with chronic lung diseases like asthma and COPD are at
higher risk of exacerbations during seasonal transitions.

 
– Hospitalization rates tend to rise significantly during the winter
period.

3. Air Pollution and Winter
Challenges:

 
– Post Diwali, air pollution intensifies due to a phenomenon called
‘temperature inversion.’

 
– Cold air traps pollutants at the earth’s surface, leading to poor air
quality and higher respiratory ailments.

4. 2023 Outlook:

 
– Anticipated increase in respiratory ailments in the next two months,
especially affecting children, those with chronic lung diseases, and the
elderly.

5. Additional Threats:

 
– New virus strains, including the reported COVID variants, pose risks,
particularly for individuals with comorbidities.

 
– Post-COVID symptoms may persist, with a continued risk of lung-related
issues for the next two years.

6. Preventive Measures:

 
– Avoid sudden temperature changes to prevent breathing passage spasms
and viral replication.

 
– Steer clear of chilled drinks and abrupt temperature shifts, such as
going from sweating to air conditioning.

 
– Quit smoking to protect both personal and public health.

7. Healthy Lifestyle Practices:

 
– Maintain a nutritious diet and engage in regular exercise.

 
– Exercise indoors during poor air quality to minimize exposure to
outdoor pollutants.

 
– Use masks, especially when the air quality index exceeds 150, to
mitigate the impact of pollutants.

8. Children’s Health
Considerations:

 
– Children are particularly vulnerable to ambient air particulate
matter, influencing school holiday schedules.

 
– Parents should stay vigilant and adapt plans based on air quality
conditions.

9. Vaccination Recommendations:

 
– Encourage vaccination against pneumonia, influenza, shingles,
pertussis, and stay updated on COVID vaccination guidelines.

10. Closing Thoughts:

 
– Emphasize the importance of healthy breathing and a positive
lifestyle.

 
– Wishing everyone a safe and healthy winter season.

The cohort study of 17 182 preschool-aged children in Shanghai, China, revealed a negative association between the incident and stable sleep disturbances and resolved emotional and behavioural difficulties (EBDs), and a positive association with incident EBDs after adjustment. Resolved sleep disturbances were positively associated with resolved EBDs.

“These findings underscore the association between sleep disturbances and emotional and behavioural difficulties among preschool-aged children and the importance of sleep health in promoting their mental well-being,” the researchers wrote in the study.

Mental health problems are the foremost cause of the global disease burden in children and adolescents. In preschool years, psychological disorders may have an early onset with documented changes in brain structure and function involved in emotion processing. Emotional and behavioural difficulties deserve particular attention in preschool-aged children due to their high prevalence and harmful effects on optimal mental health and functioning throughout childhood and later life.

Although EBDs may resolve with the growth of the child, 49.9% of young children still exhibit persistence one year after initial presentation. Furthermore, while early intervention in a clinical setting can improve childhood EBDs, multiple barriers such as stigma, high training demands, availability, and cost of services prevent children from receiving treatment.

Therefore, there is a need to identify both protective and risk factors that are modifiable in large community samples to prioritize more scalable and effective intervention and prevention strategies for EBDs in early childhood. Yujiao Deng, Shanghai Jiao Tong University, Shanghai, China, and colleagues investigated the association between the natural history of sleep disturbances and resolved and incident emotional and behavioural difficulties.

The researchers used data from the SCHEDULE-P, a prospective and population-based longitudinal cohort study of children enrolled in preschools in Shanghai, China. 20 324 children (3-4 years) were recruited from the junior class, of these 17 233 participated in the 2-year follow-up. The association between the development of sleep disturbances and the occurrence of incident and resolved EBDs were evaluated.

Sleep disturbances were evaluated using the Children’s Sleep Habit Questionnaire and EBDs were assessed using the Strengths and Difficulties Questionnaire.

Based on the study, the researchers reported the following findings:

• The cohort included 17 182 participants, with a mean age of 3.73 years at enrollment; 52.0% were boys.
• The prevalence of EBDs at school entry and graduation years was 27.8% and 18.7%, respectively, while the prevalence of sleep disturbances was 41.3% and 31.5%, respectively.
• Among those with EBDs at the entry year, 35.0% maintained stability in the graduation year, while sleep disturbances were stable in 50.0% of those with sleep disturbances.
• After controlling for confounding factors, the odds ratio (OR) for resolved EBDs was lower in the incident sleep disturbance (ISD) group (OR, 0.50) and stable sleep disturbance (SSD) group (OR, 0.47) compared with the group with no sleep disturbances.
• The ORs for incident EBDs among the ISD group (OR, 2.58) and SSD group (OR, 2.29) were higher than among the group with no sleep disturbances.

“Our findings support the consistent integration of questions concerning sleep into routine developmental screenings in contexts of primary care and school,” the researchers wrote.

Furthermore, they suggest the need for intervention that targets symptoms of both sleep disturbance and EBDs to determine whether addressing these comorbidities can prevent their progression and effects on a child’s well-being.

Reference:

Deng Y, Zhang Z, Gui Y, et al. Sleep Disturbances and Emotional and Behavioral Difficulties Among Preschool-Aged Children. JAMA Netw Open. 2023;6(12):e2347623. doi:10.1001/jamanetworkopen.2023.47623

Diabetes is a
chronic condition that affects millions of people worldwide. Apart from its
well-known impact on blood sugar levels, diabetes can have a profound effect on
the vascular system. The interplay between diabetes and vascular health is
crucial, as individuals with diabetes are at a significantly higher risk of
developing vascular complications.

Vascular diseases include a range of
conditions such as atherosclerosis, peripheral artery disease (PAD), coronary
artery disease, and stroke, among others. Understanding how to prevent vascular
complications in diabetes is essential for improving the overall well-being of
those affected. This comprehensive guide will explore the steps you can take to
protect your vascular health and reduce the risk of complications associated
with diabetes.

The Diabetes-Vascular Disease Connection:

Before diving into prevention strategies, it’s crucial to comprehend
the link between diabetes and vascular complications. Diabetes, both type 1 and
type 2, can have detrimental effects on the vascular system. The elevated blood
sugar levels characteristic of diabetes can lead to a cascade of events that
damage blood vessels over time. Here’s how it happens:

High Blood Sugar Levels:

Uncontrolled diabetes results in consistently high levels of glucose
in the bloodstream. This excess sugar can injure the delicate inner lining of
blood vessels, leading to inflammation and the formation of fatty deposits.

Atherosclerosis:

Atherosclerosis, often referred to as “hardening of the
arteries,” is a condition where fatty deposits accumulate on the walls of
blood vessels. Over time, these deposits, known as plaques, can narrow and
block blood flow, increasing the risk of heart disease and stroke.

Microvascular Complications:

Diabetes can also affect the small blood vessels throughout the
body. This may lead to microvascular complications such as retinopathy (eye
damage), nephropathy (kidney damage), and neuropathy (nerve damage).

Preventing Vascular Complications:

Preventing vascular complications in diabetes involves a combination
of medical management, lifestyle changes, and proactive self-care. Here are
essential strategies for safeguarding your vascular health:

1. Blood Sugar Control

The cornerstone of diabetes management is controlling blood sugar
levels. Regular monitoring, medication adherence, and following your healthcare
provider’s guidance are crucial in maintaining optimal glucose levels.

2. Healthy Eating

A balanced diet that’s low in saturated and trans fats, cholesterol,
and sodium can significantly reduce the risk of atherosclerosis. Focus on
incorporating whole grains, fruits, vegetables, lean proteins, and healthy fats
into your meals.

3. Regular Physical Activity

Exercise plays a pivotal role in vascular health. It helps manage
blood sugar, lowers blood pressure, and keeps your weight in check. Aim for at
least 150 minutes of moderate-intensity exercise per week.

4. Medications

Your healthcare provider may prescribe medications to manage risk
factors such as high blood pressure, cholesterol, or blood-thinning agents.
Complying with your medication regimen is crucial.

5. Smoking Cessation

Smoking damages blood vessels and accelerates atherosclerosis. If
you smoke, seeking support to quit is one of the most significant steps you can
take to protect your vascular health.

6. Regular Check-Ups

Frequent check-ups with your healthcare provider are essential for
monitoring your vascular health. They can conduct tests to assess your risk
factors and identify issues in their early stages.

7. Foot Care

For individuals with diabetes, foot care is paramount. Nerve damage
can lead to reduced sensation in the feet, making them susceptible to injuries
and infections. Regularly inspect your feet, keep them clean and moisturized,
and choose appropriate footwear.

8. Medication Management

If you’ve been prescribed medications, follow your healthcare
provider’s instructions carefully. This includes taking prescribed dosages,
adhering to schedules, and reporting any side effects or concerns.

Conclusion:

Preventing vascular complications in diabetes is a proactive and
ongoing process. By adopting a comprehensive approach that combines medical
management, a heart-healthy lifestyle, and vigilant self-care, individuals with
diabetes can significantly reduce their risk of vascular issues.

Keep in mind
that personalized guidance from your healthcare provider is indispensable in
crafting a plan that suits your unique needs and circumstances. Protecting your
vascular health is an investment in your overall well-being and longevity.