Extreme Heat Poses Threat to Mental Health, reveals research

Rising temperatures across Australia could increase the burden of mental and behavioural disorders (MBD) by almost 50 per cent by 2050, according to a new study from the University of Adelaide. The research highlights the urgent need to act now to protect mental health as the climate warms.

Published in Nature Climate Change, the study shows that high temperatures contributed to an annual loss of 8458 disability-adjusted life years (DALYs), representing 1.8 per cent of total MBD burden in Australia. Young Australians aged 15 to 44 are particularly affected, with most losses linked to living with poor mental health.

“The detrimental impacts of climate change on good mental health and emotional states have been increasingly recognised worldwide, and it’s only going to get worse unless we act,” said lead author Professor Peng Bi, from the University’s School of Public Health.

MBDs encompass a broad spectrum of symptoms associated with distress or impairment in important functional areas, including an individual’s emotional regulation, cognition or behaviour, and include anxiety, depressive, bipolar affective, schizophrenia, alcohol, drug use and other mental and substance use disorders.

“From mild distress to serious conditions like schizophrenia, rising temperatures are making things harder for millions,” said Professor Bi.

The study, based on data from the Australian Burden of Disease database, found that warmer regions, like those closer to the equator, face higher risks.

The Northern Territory had the highest predicted relative risk as well as highest average threshold temperature while South Australia and Victoria had the highest proportion of burden attributable to high temperature, with 2.9 per cent (62.6 DALYs per 100,000) and 2.2 per cent (51.1 DALYs per 100,000), respectively.

“These results underscore the crucial role of policymakers in developing focused public health interventions to minimise the emergence of mental health impacts of climate change, given its significant human, social and financial consequences,” said Professor Bi.

“About 8.6 million Australians aged 16 to 85 will experience an MBD within their lifetime. Factors like income, access to healthcare, and local conditions shape how heat affects mental health, with some areas hit harder than others.”

“Our findings show that climate change will drive up mental health challenges beyond what population growth alone would cause,” said first author Dr Jingwen Liu.

“Young people, who often face these issues early in life, are especially at risk as the climate crisis worsens.”

The researchers call for immediate action, including a heat-health action plans to prepare healthcare systems for rising mental health needs, localised solutions, like community programs and green spaces to build resilience and support for vulnerable groups, ensuring those most at risk get the care they need during hot periods.

“Policymakers must step up with targeted, people-centred strategies to protect mental health as temperatures climb,” said Professor Bi.

Reference:

Liu, J., Varghese, B.M., Hansen, A. et al. Increasing burden of poor mental health attributable to high temperature in Australia. Nat. Clim. Chang. (2025). https://doi.org/10.1038/s41558-025-02309-x.

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Baricitinib Shows Long-Term Safety in Severe Alopecia Areata: 4-Year Trial Data

USA: In a significant advancement for the treatment of severe alopecia areata (AA), long-term data from two phase III clinical trials—BRAVE-AA1 and BRAVE-AA2—have confirmed that baricitinib maintains a consistent and favorable safety profile even after up to four years of use.

The findings, published in the American Journal of Clinical Dermatology, highlight that the drug is well-tolerated over extended periods with low incidence rates of serious adverse events (IR 2.6) and no reported cases of serious infections, cardiovascular events, deep vein thrombosis, pulmonary embolism, or death. Additionally, rates of herpes zoster (IR 1.9) and malignancies (IR 0.2) remained stable throughout the follow-up period, reinforcing the long-term safety of baricitinib for patients managing this chronic autoimmune condition.

Baricitinib, a Janus kinase (JAK) inhibitor, is one of the first systemic treatments approved for severe alopecia areata and works by targeting the underlying immune dysfunction associated with the condition. Brett King, Department of Dermatology, Yale School of Medicine, New Haven, CT, USA, and colleagues present pooled safety findings on baricitinib treatment for severe alopecia areata based on data from the BRAVE-AA1 (Phase II/III) and BRAVE-AA2 (Phase III) trials, encompassing both the long-term extension and bridging extension phases.

For this purpose, the researchers assessed safety data from two groups: patients on continuous baricitinib (2 mg or 4 mg) and all patients who received any dose during the trials. They evaluated treatment-emergent adverse events, key safety concerns, and lab abnormalities. Incidence rates per 100 patient years were calculated based on risk duration. Data cutoffs were May 22, 2023 (BRAVE-AA1), and May 8, 2023 (BRAVE-AA2), with a follow-up of at least 152 weeks.

The key findings of the study were as follows:

  • Safety data included 1,303 patients treated with baricitinib, accounting for 2,789.7 patient-years of exposure (median duration: 825 days; maximum: 1,460 days).
  • Most treatment-emergent adverse events were mild to moderate in intensity.
  • The incidence rate (IR) of serious adverse events was low at 2.6 per 100 patient-years.
  • Discontinuation due to adverse events occurred at a low rate (IR = 1.7).
  • These rates were consistent with previously reported data through at least 104 weeks.
  • No new cases of serious infections, opportunistic infections, major cardiovascular events, deep vein thrombosis, or pulmonary embolism were reported during an additional year of follow-up.
  • Rates of non-melanoma skin cancer (IR = 0.1) and other malignancies (IR = 0.2) remained stable.
  • Herpes zoster incidence remained consistent with earlier data (IR = 1.9).
  • Laboratory test changes showed stable trends over time.
  • There were no deaths in either BRAVE-AA1 or BRAVE-AA2 trials.

“The long-term safety findings from the BRAVE-AA1 and BRAVE-AA2 trials align with earlier data from the baricitinib clinical program for alopecia areata, showing no new safety concerns or signals even with treatment durations extending up to four years,” the authors concluded.

Reference:

King, B., Mostaghimi, A., Shimomura, Y. et al. Safety of Baricitinib in Adults with Severe Alopecia Areata from Two Phase III Trials Over a Median of 2.3 Years and Up to 4 Years of Treatment. Am J Clin Dermatol (2025). https://doi.org/10.1007/s40257-025-00932-0

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Postoperative Rehabilitation demonstrated preventive role against relapse after osseous temporomandibular joint ankylosis surgery: Study

A new study published in the journal of BMC Oral Health showed that during the unusually long clinical follow-up period of 24 months, postoperative rehabilitation was found effective for prevention of  recurrence following TMJA surgery.

Temporomandibular joint ankylosis (TMJA) is a disorder in which the temporomandibular joint (TMJ) becomes permanently stuck in a forced position due to an intracapsular lesion, resulting in significantly reduced mandible motion. As a result, not only severe trismus, but also masticatory function and facial deformities might impair aesthetics in afflicted people.

TMJA is classified into fibrous ankylosis and bony ankylosis, with the latter frequently causing a severe condylar dysfunction and impairing quality of life (QOL). Gap arthroplasty (GA), which involves excising any bony adhesion between the joint space and mandibular condyle without inserting it into the resulting gap, and interpositional gap arthroplasty (IPG), which involves creating a gap and then inserting an artificial material or temporalis myofascial flap (TMF) for example, are two related surgical procedures that have been reported.

The goal of surgical therapy for TMJA is to improve patient quality of life by reducing ankylosis, restoring condylar function, avoiding ankylosis recurrence, and enhancing facial attractiveness. Thus, this study sought to clarify and analyze the association between the operational method, the rehabilitation time, and maximum incisal opening (MIO), with an emphasis on mouth opening following surgical treatment for TMJA.

12 patients who had surgery for gap or interpositional arthroplasty were included. The course of maximal incisal opening in patients was split by surgical procedure, gap size, and rehabilitation duration, with a focus on relapse of maximal incisal opening. The average recurrence of maximum incisal opening following surgery in patients with a gap size ≥ 15 mm was 12.0 ± 11.2 mm, whereas in those with a gap size < 15 mm was 8.9 ± 12.6 mm.

The average relapse of maximum incisal opening following surgery in patients with gap arthroplasty was 12.3 ± 7.6 mm, whereas those with interpositional arthroplasty was 7.5 ± 15.2 mm. After surgery, patients with less than 12 months of rehabilitation had an average relapse of 14.1 ± 10.7 mm, whereas those with more than 12 months had an average recurrence of 7.4 ± 16.3 mm.

Overall, the findings of this retrospective study over a relatively long clinical follow-up period of 24 months demonstrate the relevance of postoperative rehabilitation in avoiding recurrence following TMJA surgery.

Source:

Ezoe, Y., Nogami, S., Otake, Y., Chiba, M., Takahashi, T., & Yamauchi, K. (2025). Clinical course of jaw function recovery following surgical treatment in patients with temporomandibular joint ankylosis- correlation with mouth opening rehabilitation. BMC Oral Health, 25(1), 423. https://doi.org/10.1186/s12903-025-05806-9

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Golden eyes: How gold nanoparticles may one day help to restore people’s vision

 A new study by Brown University researchers suggests that gold nanoparticles-microscopic bits of gold thousands of times thinner than a human hair-might one day be used to help restore vision in people with macular degeneration and other retinal disorders.

In a study published in the journal ACS Nano and supported by the National Institutes of Health, the research team showed that nanoparticles injected into the retina can successfully stimulate the visual system and restore vision in mice with retinal disorders. The findings suggest that a new type of visual prosthesis system in which nanoparticles, used in combination with a small laser device worn in a pair of glasses or goggles, might one day help people with retinal disorders to see again.

“This is a new type of retinal prosthesis that has the potential to restore vision lost to retinal degeneration without requiring any kind of complicated surgery or genetic modification,” said Jiarui Nie, a postdoctoral researcher at the National Institutes of Health who led the research while completing her Ph.D. at Brown. “We believe this technique could potentially transform treatment paradigms for retinal degenerative conditions.”

Nie performed the work while working in the lab of Jonghwan Lee, an associate professor in Brown’s School of Engineering and a faculty affiliate at Brown’s Carney Institute for Brain Science, who oversaw the work and served as the study’s senior author.

Retinal disorders like macular degeneration and retinitis pigmentosa affect millions of people in the U.S. and around the world. These conditions damage light-sensitive cells in the retina called photoreceptors-the “rods” and “cones” that convert light into tiny electric pulses. Those pulses stimulate other types of cells further up the visual chain called bipolar and ganglion cells, which process the photoreceptor signals and send them along to the brain.

This new approach uses nanoparticles injected directly into the retina to bypass damaged photoreceptors. When infrared light is focused on the nanoparticles, they generate a tiny amount of heat that activates bipolar and ganglion cells in much the same way that photoreceptor pulses do. Because disorders like macular degeneration affect mostly photoreceptors while leaving bipolar and ganglion cells intact, the strategy has the potential to restore lost vision.

In this new study, the research team tested the nanoparticle approach in mouse retinas and in living mice with retinal disorders. After injecting a liquid nanoparticle solution, the researchers used patterned near-infrared laser light to project shapes onto the retinas. Using a calcium signal to detect cellular activity, the team confirmed that the nanoparticles were exciting bipolar and ganglion cells in patterns matched the shapes projected by the laser.

The experiments showed that neither the nanoparticle solution nor the laser stimulation caused detectable adverse side effects, as indicated by metabolic markers for inflammation and toxicity. Using probes, the researchers confirmed that laser stimulation of the nanoparticles caused increased activity in the visual cortices of the mice-an indication that previously absent visual signals were being transmitted and processed by the brain. That, the researchers say, is a sign that vision had been at least partially restored, a good sign for potentially translating a similar technology to humans.

For human use, the researchers envision a system that combines the nanoparticles with a laser system mounted in a pair of glasses or goggles. Cameras in the goggles would gather image data from the outside world and use it to drive the patterning of an infrared laser. The laser pulses would then stimulate the nanoparticles in people’s retinas, enabling them to see.

The approach is similar to one that was approved by the Food and Drug Administration for human use a few years ago. The older approach combined a camera system with a small electrode array that was surgically implanted in the eye. The nanoparticle approach has several key advantages, according to Nie.

For starters, it’s far less invasive. As opposed to surgery, “an intravitreal injection is one of the simplest procedures in ophthalmology,” Nie said.

There are functional advantages as well. The resolution of the previous approach was limited by the size of the electrode array — about 60 square pixels. Because the nanoparticle solution covers the whole retina, the new approach could potentially cover someone’s full field of vision. And because the nanoparticles respond to near-infrared light as opposed to visual light, the system doesn’t necessarily interfere with any residual vision a person may retain.

More work needs to be done before the approach can be tried in a clinical setting, Nie said, but this early research suggests that it’s possible.

“We showed that the nanoparticles can stay in the retina for months with no major toxicity,” Nie said of the research. “And we showed that they can successfully stimulate the visual system. That’s very encouraging for future applications.”

Reference:

Jiarui Nie, Kyungsik Eom, Hafithe M. AlGhosain, Intravitreally Injected Plasmonic Nanorods Activate Bipolar Cells with Patterned Near-Infrared Laser Projection, ACS Nano, DOI: 10.1021/acsnano.4c14061.

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Vaginal Birth Linked to Higher Risk of Midlife Urinary Incontinence: SWAN Cohort Study

Canada: A recent longitudinal analysis based on the Study of Women’s Health Across the Nation (SWAN) cohort has shed light on how childbirth experiences—particularly the number of children a woman has and the mode of delivery—can influence the risk of urinary incontinence (UI) during midlife.

The analysis showed that vaginal births significantly raised the risk of stress (OR 2.11) and mixed urinary incontinence (OR 1.89) in midlife compared to cesarean deliveries. Women with both vaginal and cesarean births had even higher odds of mixed incontinence (OR 2.17). In contrast, urge incontinence was more closely linked to aging than childbirth.

The findings were published online in Scientific Reports on 07 April 2025.

Parity has been shown to increase the risk of urinary incontinence, but the extent of this risk appears to vary based on the mode of delivery. To explore this relationship further, Nikki L Stephenson, Department of Obstetrics & Gynecology, University of Calgary, Calgary, AB, Canada, and colleagues examined how different delivery methods—vaginal versus cesarean—were associated with the prevalence of urge, stress, and mixed urinary incontinence during midlife.

For this purpose, the researchers examined the association between mode of delivery and subtypes of urinary incontinence using data from the SWAN cohort. They compared women who had undergone vaginal, cesarean, or a combination of both delivery types with those who had never given birth, aiming to understand how different childbirth experiences influence the risk of urge, stress, and mixed incontinence in midlife.

The key findings of the study were as follows:

  • Women who delivered vaginally had a significantly higher prevalence of all types of urinary incontinence compared to those who were nulliparous or delivered via other modes.
  • No significant differences in urinary incontinence were observed when comparing parous women (regardless of delivery type) with nulliparous women overall.
  • Compared to cesarean deliveries, vaginal births were associated with significantly higher odds of stress urinary incontinence in midlife.
  • Women who had both vaginal and cesarean deliveries faced significantly increased odds of developing mixed urinary incontinence compared to those who delivered exclusively via cesarean section.
  • Urge urinary incontinence was more strongly linked to aging rather than childbirth history.
  • Vaginal deliveries raised the risk of both stress and mixed urinary incontinence in midlife compared to cesarean births.
  • A combination of vaginal and cesarean deliveries further elevated the risk of mixed urinary incontinence during middle age.

“Parity and mode of delivery emerge as key factors influencing urinary incontinence in midlife. Parous women face a higher risk of stress and mixed incontinence, while the likelihood of urge incontinence appears lower compared to nulliparous women,” the authors noted. They further observed that “among multiparous women, vaginal delivery is associated with a greater risk of stress and mixed incontinence than cesarean birth.”

“These findings highlight the need for further research to validate the results across diverse populations and to better understand the underlying mechanisms driving these associations,” they concluded.

Reference:

Stephenson, N. L., Brenner, D., Brennand, E., Robert, M., Prisnie, K., & Metcalfe, A. (2025). Longitudinal analysis of the association between parity, mode of delivery and urinary incontinence in midlife using the SWAN cohort data. Scientific Reports, 15(1), 1-8. https://doi.org/10.1038/s41598-025-85603-0

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Young people with mental disorders less likely to become parents, reveals research

Using Finnish register data from over 1,2 million participants, the study found that both young men and women diagnosed with mental disorders are less likely to become parents compared to those without such diagnoses. The strongest associations were found for schizophrenia: persons diagnosed with this disorder were highly unlikely to have their first child by age 39 years.

Common mental disorders, such as depression and anxiety, also reduced the likelihood of parenthood. For example, men diagnosed with depression were 38% less likely to become fathers compared to those without depression diagnosis. Among women, depression was associated with 19% lower likelihood of becoming a mother when compared to persons without depression disorder diagnosis. The similar difference between men and women were also observed for anxiety disorder.

“The differences between men and women were clear for many disorders, with men having a lower likelihood of having a first child compared to women with the same disorder”, says Dr. Kateryna Golovina, university researcher and first author of the study.

The role of partnership status

The study also explored the role of partnership status in the link between mental disorders and parenthood. Since stable relationships are often a key factor in having children, difficulties in forming or maintaining partnerships may partially explain lower parenthood rates among people with mental disorders.

“We found a clear pattern: men with mental disorders were significantly less likely to cohabit than women with similar diagnoses”, says Associate Professor Christian Hakulinen, PI of the project.

The importance of accessible mental health services

The findings highlight the need for accessible, high-quality mental health services for young people. Providing long-term support may be particularly crucial in helping people with mental disorders navigate life decisions, including family formation.

“Our research underscores the importance of well-functioning mental health services with low-threshold access, ensuring young people receive the support they need for both their well-being and life aspirations,” says Kateryna Golovina.

Reference:

Kateryna Golovina, Ripsa Niemi, Mai Gutvilig, Markus Jokela, Marko Elovainio, Christian Hakulinen, Mental Disorders and Having a First Child Among Young Adults: A Nationwide Register-Based Cohort Study, BJOG An International Journal of Obstetrics & Gynaecology, https://doi.org/10.1111/1471-0528.18151.

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Opioid-sparing anesthesia significantly improves early postoperative recovery after cardiac surgery: A retrospective cohort study

Announcing a new article publication for Cardiovascular Innovations and Applications journal. Mounting evidence indicates that opioid-sparing anesthesia (OSA) decreases opioid-related adverse events. This article examines whether OSA might improve initial recovery after cardiac surgery.

Data from patients who underwent elective heart surgery between July 2023 and July 2024 were analyzed. Eligible patients were divided into an OSA group or a control group. Patients in the OSA group received 0.5 to 1 μg·kg−1 sufentanil and ultrasound-guided nerve block after anesthetic induction, whereas patients in the control group received traditional high-dose opioid management. Patients in both groups were managed with the same sedatives, muscle relaxants, and other drugs. The main outcome was the overall 15-item Quality of Recovery (QoR-15) survey score 24 hours after surgery.

A total of 1916 patients were scanned, and 1218 patients were included in the analysis: 392 in the OSA group and 826 in the control group. The QoR-15 global score measured 24 hours after surgery was 119.29 ± 3.25 in the OSA group and 113.87 ± 3.44 in the control group (P < 0.001). The OSA group had lower numeric rating scale scores 24 hours and 72 hours after surgery (P < 0.001) than the control group. The median (interquartile range) postoperative mechanical ventilation time was 1.0 (0–5) hours in the OSA group and 8.0 (6–14) hours in the control group (P < 0.001), and the duration of hospitalization was 11.5 (9–14) days and 12 (10–14) days, respectively (P = 0.012).

OSA based on ultrasound-guided nerve blocks significantly improved QoR-15 scores after cardiac surgery and is expected to be a reasonable analgesic protocol to improve the prognosis of cardiac patients.

Reference:

Dou Dou, Lu Wang and Su Yuan et al. Opioid-sparing Anesthesia Significantly Improves Early Postoperative Recovery after Cardiac Surgery: A Retrospective Cohort Study. CVIA. 2025. Vol. 10(1). DOI: 10.15212/CVIA.2024.0069.

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Hearing impairment may be sign of increased risk of Parkinson’s disease, reports research

There may be a link between hearing impairment and an increased risk of developing Parkinson’s according to research led by Lancaster University.

This is one of the first studies to examine whether sensory impairments, such as hearing loss, might increase the risk for Parkinson’s or serve as an early warning sign.

Parkinson’s UK reports that an estimated 153,000 people in the UK currently live with Parkinson’s, which is the fastest-growing neurological condition in the world. It is estimated that 1 in 37 people in the UK will be diagnosed with Parkinson’s in their lifetime.

The study entitled “Speech-in-noise hearing impairment is associated with increased risk of Parkinson’s: A UK Biobank Analysis” is published in Parkinsonism and Related Disorders 

Researchers analysed data from the UK Biobank, a biomedical database containing data from half a million participants across the UK. They looked at data from 159,395 individuals who had previously undergone a hearing test measuring their ability to detect speech in noisy environments and had no history of Parkinson’s at the time of the assessment.

Over an average follow-up period of 14.24 years, 810 participants were subsequently diagnosed with Parkinson’s disease. The analysis revealed a 57% increased risk of Parkinson’s for every 10-decibel increase in baseline hearing impairment.

Dr Megan Readman, ESRC Post Doctoral Research Fellow from Lancaster University’s Department of Psychology, led the study.

She said: “These findings are incredibly important; first, this is one of the first studies to look at how hearing impairments may increase risk for Parkinson’s or be an early warning sign of Parkinson’s.

“Secondly, as our findings suggest, hearing loss is intricately related to Parkinson’s so it may be beneficial for auditory functioning and the management of auditory impairment to be considered at the time of diagnosis and follow-up care.”

However, Dr Readman stressed that it is not clear if the link between Parkinson’s and hearing loss is causal or if there is simply a correlation.

“We do not know whether hearing loss can cause Parkinson’s, or if there is a common underlying cause for both conditions.”

The other authors included Yang Wang and Fang Wan, Sally Linkenauger, Trevor Crawford and Christopher Plack plus Ian Fairman who has Parkinson’s and hearing impairment.

Professor Plack said: “It is increasingly clear that hearing loss is not an isolated condition but is associated with several other disorders. Understanding these links is vital if we are to provide effective patient care, improving independence and quality of life for the individuals concerned.”

By identifying factors that might contribute to its onset, such as hearing impairment, researchers hope to pave the way for new strategies in prevention and care.

Dr Readman said: “Our findings suggest hearing impairment is intricately related to Parkinson’s and underscore the potential benefits of addressing auditory function in Parkinson’s diagnosis and follow-up care.”

Reference:

Readman, Megan Rose et al., Speech-in-noise hearing impairment is associated with increased risk of Parkinson’s: A UK biobank analysis, Parkinsonism & Related Disorder, DOI:10.1016/j.parkreldis.2024.107219 

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OSA Patients Face Double the Risk of RSV Infection and Severe Complications: Study Finds

Taiwan: Patients with obstructive sleep apnea (OSA) may face a significantly increased risk of contracting respiratory syncytial virus (RSV) and experiencing severe outcomes, according to a large retrospective cohort study conducted using data from the TriNetX US Collaborative Database. The findings were published online in the Journal of Medical Virology on 07 April 2025.

Renin Chang, Division of Medical Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, and colleagues conducted a retrospective cohort study to assess the link between obstructive sleep apnea and the risk of respiratory syncytial virus infection, along with associated complications, utilizing data from the TriNetX US Collaborative Database.

They examined the health records of over 1 million individuals diagnosed with OSA and compared them with a control group of nearly 3.5 million individuals without the condition. To ensure a fair comparison, the groups were matched using propensity score techniques that accounted for 19 different variables, helping to balance their baseline characteristics.

Key Findings:

  • Individuals with obstructive sleep apnea were more than twice as likely to contract respiratory syncytial virus compared to those without OSA (0.18% vs. 0.08%).
  • The hazard ratio (HR) for RSV infection among OSA patients was 2.194, indicating a significantly increased risk.
  • Patients with OSA had a higher likelihood of developing respiratory failure following RSV infection, with an HR of 1.291.
  • The risk of hospitalization due to RSV was also elevated in the OSA group, with an HR of 1.114.
  • The need for admission to intensive care units was greater among OSA patients with RSV, as reflected by an HR of 1.329.

The findings were consistent across multiple sensitivity analyses, which considered different follow-up durations, database subgroups, and study timeframes. Subgroup evaluations based on age and sex further supported the overall results, emphasizing the consistency and robustness of the observed associations.

The authors suggest that these findings may have important clinical implications. Recognizing OSA as a potential risk factor for RSV infection and its complications could help guide preventive strategies, early interventions, and risk stratification efforts.

Given the increasing awareness of RSV’s impact on adult populations—especially those with underlying health conditions—the researchers recommend further investigation to confirm these findings and evaluate whether patients with OSA should be classified as a high-risk group for RSV.

“The large-scale, real-world data analysis adds a new dimension to the understanding of RSV vulnerability and highlights the broader systemic impacts of obstructive sleep apnea beyond its well-known effects on sleep quality and cardiovascular health,” the authors concluded.

Reference:

Ssu-Yu Chen, S., Ting-An Lin, T., Chiang, L., Chen, Y., Chen, Y., Hung, M., & Chang, R. (2025). Obstructive Sleep Apnea and Risk of Respiratory Syncytial Viral Infection: A Retrospective Multi-Institution Cohort Study. Journal of Medical Virology, 97(4), e70323. https://doi.org/10.1002/jmv.70323

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Bariatric Surgery cost effective and Improves Survival in Obese Patients with Compensated Cirrhosis: JAMA

Researchers have found in a new study that Bariatric surgery in patients with obesity and compensated cirrhosis is linked to improved overall survival while maintaining a highly acceptable health care cost, making it a viable treatment option.

Obesity and steatotic liver disease are associated with excess morbidity and mortality from cardiovascular, pulmonary, metabolic, and hepatic causes. Bariatric surgery has demonstrated long-term benefits in terms of weight loss and mortality rates, but barriers to its utilization persist. A study was done to evaluate the impact of bariatric surgery on outcomes and cost-effectiveness among patients with obesity, focusing on those with cirrhosis.This economic evaluation was a retrospective cohort study including US veterans older than 18 years with a body mass index (BMI) higher than 35 or with a BMI higher than 30 and more than 1 major metabolic comorbidity. These veterans were referred to a structured lifestyle modification program (MOVE!), and a subset proceeded to bariatric surgery, including sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) from 2008 to 2020. Risk set matching was used to match bariatric surgery cases 1:5 with nonsurgical controls. Data were analyzed from September 2008 to September 2023. The primary outcomes were the incremental cost-effectiveness ratio (ICER) of SG or RYGB vs MOVE! over 10 years. Secondary outcomes included overall survival, quality-adjusted survival, and weight loss achieved. Results The final cohort included 4301 SG, 1906 RYGB, and 31 055 MOVE! participants, among whom 64, 8, and 354, respectively, had cirrhosis. The median (IQR) age of the cohort was 52 (44-59) years; there were 25 581 male patients (68.7%) and 11 681 female (31.3%). Compared with MOVE!, bariatric surgery was associated with longer observed survival (9.67 years vs 9.46 years overall; 9.09 years vs 8.23 years in cirrhosis). The ICER was $132 207 for SG and $159 027 for RYGB in the overall cohort, and $18 679 for SG and $44 704 for RYGB in the cirrhosis cohorts. Bariatric surgery was cost-effective at a willingness-to-pay threshold of $100 000 per quality-adjusted life-year among patients with cirrhosis. Bariatric surgery was associated with improved survival and expected weight loss and was cost-effective. These findings support the expanded use of bariatric surgery in appropriately selected patients, including those with cirrhosis, to improve outcomes and reduce long-term health care costs.

Reference:

Bansal S, Bader A, Mahmud N, Kaplan DE. Survival and Cost-Effectiveness of Bariatric Surgery Among Patients With Obesity and Cirrhosis. JAMA Surg. Published online April 02, 2025. doi:10.1001/jamasurg.2025.0490

Keywords:

Bansal S, Bader A, Mahmud N, Kaplan DE, Survival, Cost-Effectiveness, Bariatric Surgery, Among, Patients, Obesity, Cirrhosis

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