Medical Bulletin 19/ April/ 2025

A new study published in Science Advances reveals that individuals suffering from chronic pain—defined as lasting three months or more—are up to four times more likely to develop depression. Chronic pain affects nearly 30% of people worldwide, and those with pain in multiple body sites face an even higher risk of depression compared to those with pain in a single area.

To reach these findings, the researchers analyzed data from 431,038 participants in the UK Biobank, following their health outcomes over 14 years. Participants reported pain in areas including the head, neck, back, hips, knees, and more. The researchers assessed the relationship between pain reports and depression diagnoses, alongside measuring inflammation levels to better understand potential underlying mechanisms.

The study also points to inflammation as a possible biological link. The team identified elevated levels of inflammatory markers, such as C-reactive protein (CRP), in individuals experiencing both chronic pain and depression. This suggests that inflammation may play a key role in connecting the two conditions.

Researchers from Yale University emphasized the close link between physical and mental health. “Pain isn’t only physical,” said Dr. Dustin Scheinost, Associate Professor at Yale School of Medicine. “Our study adds to the evidence that physical conditions can have mental health consequences.”

“We often think of brain health or mental health as separate from cardiac or liver health,” said Scheinost. “But all of these body systems influence each other.”

The findings underscore the need for integrated approaches in healthcare, recognizing how chronic physical conditions like pain can significantly impact mental well-being.

Reference: https://medicine.yale.edu/news-article/inflammation-may-be-the-link-between-chronic-pain-and-depression/

A new study by Imperial College London and Lund University has found that thousands of heart attacks, strokes, and deaths could be prevented annually with the early use of two affordable cholesterol-lowering drugs—statins and ezetimibe. The research, published recently, underscores the potential of this low-cost combination therapy to save lives and ease healthcare burdens worldwide.

Cardiovascular disease is the leading cause of death globally, with heart attacks being the most common event. Survivors are at the highest risk of a second heart attack in the first year due to increased blood vessel sensitivity. While statins are widely used, ezetimibe is often not prescribed early due to concerns about side effects. However, researchers found that the combination therapy is both safe and significantly more effective when started promptly.

To investigate this, scientists analyzed data from 36,000 Swedish heart attack patients treated between 2015 and 2022. Using advanced statistical models to emulate a clinical trial, they compared patients who received statins and ezetimibe within 12 weeks of a heart attack to those who began later or used only statins. Early dual therapy was linked to reduced risk of further heart attacks, strokes, and death.

“This study shows we could save lives with two low-cost drugs, yet many patients globally don’t receive them together,” said Prof. Kausik Ray of Imperial. “It’s time for care pathways to change.”

Co-author Dr. Margret Leosdottir added that global treatment guidelines should be updated to reflect the benefits of early combination therapy that has minimal side effects. The study calls for immediate action to improve post-heart attack care and prevent unnecessary suffering.

Reference: https://pharmaceutical-journal.com/article/news/earlier-treatment-with-combination-of-drugs-could-prevent-5000-heart-attacks-per-decade-study-results-suggest#:~:text=Based%20on%20Swedish%20registry%20data,a%20better%20prognosis%20and%20less

Climate change may significantly impact arsenic levels in paddy rice, a staple food for millions across Asia, reveals a new study from Columbia University’s Mailman School of Public Health. The research shows that increased temperatures above 2°C, coupled with rising carbon dioxide (CO2) levels, lead to higher concentrations of inorganic arsenic in rice, potentially raising lifetime health risks for populations in Asia by 2050. The findings are published in The Lancet Planetary Health.

By measuring the effects of rising temperatures and CO2 on 28 rice strains over ten years in the field using FACE (Free-Air CO2 Enrichment) methodology, and combining advanced modeling techniques, the team estimated inorganic arsenic doses and health risks for seven Asian countries: Bangladesh, China, India, Indonesia, Myanmar, the Philippines, and Vietnam.

Health risks were calculated for cancer and non-cancer outcomes. Estimates of rice availability in 2021 by country, as reported in Food and Agriculture Organization of the United Nations (FAO) food balance sheets, were used as the starting point for estimating rice ingestion. The standard deviation of rice ingestion per kg bodyweight from the U.S. Environmental Protection Agency data was used to create a normal distribution for each country.

The study’s projections for 2050 suggest a sharp rise in lifetime cancer cases, particularly lung and bladder cancers. China is projected to see the highest number of cases, with an estimated 13.4 million cancers linked to rice-based arsenic exposure.

Lewis Ziska, PhD, Columbia Mailman School associate professor of Environmental Health Sciences explained that the higher arsenic levels are likely due to climate-related changes in soil chemistry that favor arsenic that can more easily be absorbed into rice grain.

“From a health perspective, the toxicological effects of chronic iAs exposure are well established; and include cancers of the lung, bladder, and skin, as well as ischemic heart disease, Emerging evidence also suggests that arsenic exposure may be linked to diabetes, adverse pregnancy outcomes, neurodevelopmental issues, and immune system effects. In fact, “ingesting rice in regions like southern China and Southeast and South Asia is already a significant source of dietary arsenic and cancer risk,” said Ziska.

“Based on our findings, we believe there are several actions that could help reduce arsenic exposure in the future,” Ziska noted. “These include efforts in plant breeding to minimize arsenic uptake, improved soil management in rice paddies, and better processing practices. Such measures, along with public health initiatives focused on consumer education and exposure monitoring, could play a critical role in mitigating the health impacts of climate change on rice consumption.”

“Our study underscores the urgent need for action to reduce arsenic exposure in rice, especially as climate change continues to affect global food security,” says Ziska.

Reference: Impact of climate change on arsenic concentrations in paddy rice and the associated dietary health risks in Asia: an experimental and modelling study, Wang, Dongming et al. The Lancet Planetary Health, Volume 0, Issue 0