Family Medicine
Cohort study | Professional soccer players are at increased risk of Alzheimer’s disease and other dementias
21 Mar, 2023 | 13:46h | UTCSummary: The article reports on a cohort study conducted in Sweden to investigate whether male soccer players in the top division are at increased risk of neurodegenerative disease compared to matched controls from the general population. This is a topic of concern as there is a hypothesis that the repetitive mild head trauma sustained through heading the ball and concussions might cause neurodegenerative disease.
The study included 6007 football players and 56,168 controls and used nationwide registers to identify diagnoses of neurodegenerative disease. The study revealed that male professional soccer players in Sweden had a higher risk of neurodegenerative disease, particularly Alzheimer’s disease and other dementias, and outfield players had a higher risk than goalkeepers.
News Release: Elite football players are more likely to develop dementia, suggests Swedish study – Lancet
Commentaries:
Dementia risk higher for outfield players than goalkeepers – study – BBC
Neurodegenerative Diseases Are the Cost of Sports – Health Policy Watch
Related:
Dementia risk in former professional footballers is related to player position and career length.
Study: Neurodegenerative Disease Mortality Increased Among Former Professional Soccer Players
The paradox of endurance training: higher coronary plaque prevalence found in lifelong athletes
21 Mar, 2023 | 13:42h | UTCSummary: The Master@Heart study aimed to investigate the relationship between lifelong endurance exercise and coronary atherosclerosis measured by computed tomography coronary angiography (CTCA) in a cohort of 191 lifelong master endurance athletes, 191 late-onset athletes, and 176 healthy non-athletes. All participants were male with a low cardiovascular risk profile.
The study found that lifelong endurance sport participation was not associated with a more favorable coronary plaque composition compared to maintaining a healthy lifestyle. In fact, lifelong endurance athletes exhibited a higher prevalence of coronary plaques, including more non-calcified plaques in proximal segments, than fit and healthy individuals with a similarly low cardiovascular risk profile.
Further research is needed to understand how these findings on CTCA might translate into clinical events in endurance athletes.
Article: Lifelong endurance exercise and its relation with coronary atherosclerosis – European Heart Journal
Commentaries:
Lifelong Endurance Exercise and Coronary Atherosclerosis – American College of Cardiology
MASTER@HEART: Long-term Endurance Athletes Not Immune to Atherosclerosis – TCTMD
RCT | Time-restricted eating not more effective than daily calorie restriction for managing nonalcoholic fatty liver disease
21 Mar, 2023 | 13:38h | UTCSummary: The TREATY-FLD randomized clinical trial investigated the effects of time-restricted eating (TRE) versus daily calorie restriction (DCR) on intrahepatic triglyceride (IHTG) content and metabolic risk factors in patients with obesity and nonalcoholic fatty liver disease (NAFLD).
Participants were randomly assigned to either TRE (eating only between 8:00 am and 4:00 pm) or DCR (habitual meal timing) and instructed to maintain a diet of 1500 to 1800 kcal/d for men and 1200 to 1500 kcal/d for women for 12 months.
The study found that the IHTG content was reduced by 6.9% in the TRE group and 7.9% in the DCR group after 12 months, a difference that was not statistically significant. Furthermore, TRE did not produce additional benefits for reducing body weight, liver stiffness, or metabolic risk factors compared with DCR.
The study supports that the main focus of a diet for managing NAFLD is caloric restriction, which can be achieved both with a TRE strategy or without a TRE strategy with similar results.
Commentary on Twitter
TREATY-FLD RCT found that time-restricted eating did not produce additional benefits for reducing intrahepatic triglyceride content, body fat and metabolic risk factors vs daily-calorie-restriction among adults with obesity and NAFLD. https://t.co/it2n4o9Th1
— JAMA Network Open (@JAMANetworkOpen) March 17, 2023
M-A | Comparison of mental health symptoms before and during the covid-19 pandemic
21 Mar, 2023 | 13:40h | UTCEditorial: Mental health and the covid-19 pandemic – The BMJ
News Release: Study suggests little deterioration in mental health linked to the pandemic – BMJ Newsroom
Commentaries:
A patient’s perspective on mental health and the pandemic – The BMJ
World’s most comprehensive study on COVID-19 mental health – McGill University
M-A | The efficacy of Kangaroo-Mother care to the clinical outcomes of LBW and premature infants
21 Mar, 2023 | 13:35h | UTCSummary: Kangaroo-Mother Care (KMC) is a method that involves skin-to-skin contact between the mother and newborn, frequent exclusive or almost exclusive breastfeeding, and early discharge. KMC is an alternative to traditional care interventions for low birthweight (LBW) infants, and the World Health Organization has recommended its use for LBW infants for over a decade.
The authors conducted a meta-analysis including 17 randomized clinical trials involving 17,668 participants. They found that KMC can significantly reduce neonatal mortality, lower hypothermia and sepsis rates, and reduce the duration of hospital stay. The authors suggest that KMC should be promoted, popularized, and standardized in clinical practice.
Related:
Kangaroo mother care to reduce morbidity and mortality in low birthweight infants – Cochrane Library
Consensus on complementary feeding in pediatrics
21 Mar, 2023 | 13:30h | UTC
SR | Topical antibiotics modestly improve resolution of acute bacterial conjunctivitis
21 Mar, 2023 | 13:33h | UTCSummary: The Cochrane Review evaluated the benefits and potential side effects of antibiotic therapy in treating acute bacterial conjunctivitis. The authors included 21 randomized controlled trials, with a total of 8,805 participants. The trials evaluated the effectiveness of topical antibiotic treatments in the form of drops or ointments, and were heterogeneous in terms of eligibility criteria, antibiotic drug class, duration of treatment, and outcomes assessed.
The review found that antibiotics likely improved clinical cure by 26% compared with placebo, with no evidence of serious systemic side effects reported in either the antibiotic or placebo group. Fluoroquinolones were found to have fewer ocular side effects compared to non-fluoroquinolones.
Overall, the review suggests that the use of topical antibiotics may be considered to achieve better clinical and microbiologic efficacy than placebo in treating acute bacterial conjunctivitis.
Article: Antibiotics versus placebo for acute bacterial conjunctivitis – Cochrane Library
RCT | Closed-loop insulin delivery system enhances blood sugar control in young children with type 1 diabetes
20 Mar, 2023 | 13:54h | UTCSummary: The study enrolled 102 young children between ages 2 and 5, randomized in a 2:1 ratio to either a closed-loop control system of insulin delivery (“artificial pancreas”) or a standard care comparison group. During the 13 weeks of study follow-up, participants in the artificial pancreas group spent 12% more time within their target blood glucose range compared to the standard care group.
The closed-loop group experienced two cases of severe hypoglycemia, while the standard-care group had one case. In the closed-loop group, one case of diabetic ketoacidosis occurred due to a problem with the insulin pump.
Article: Trial of Hybrid Closed-Loop Control in Young Children with Type 1 Diabetes – New England Journal of Medicine (link to abstract – $ for full-text)
News Releases:
Commentary on Twitter
In children 2 to younger than 6 years of age with type 1 diabetes, a closed-loop control system was associated with a greater percentage of time in the target glycemic range than standard care. https://t.co/rAOLXRNuub#pediatrics #T1D pic.twitter.com/Nzwl3aFr1w
— NEJM (@NEJM) March 17, 2023
Cohort Study | Early childhood respiratory infections linked to increased risk of premature respiratory disease mortality in adulthood
20 Mar, 2023 | 13:52h | UTCSummary: The study aimed to determine the link between lower respiratory tract infections (LRTIs) in early childhood and premature adult death from respiratory disease. The study used data from a nationally representative cohort recruited at birth in Great Britain in 1946 and followed participants across eight decades.
After adjusting for multiple markers of childhood social disadvantage and adult smoking, the study found that individuals who had an LRTI by age 2 years were 93% more likely to die prematurely from respiratory disease as adults than those who did not have early childhood LRTI, accounting for one-fifth of these deaths and an estimated 179,188 excess deaths across England and Wales between 1972 and 2019.
However, it is important to note that this observational study cannot establish causality, but rather suggests that early childhood LRTI is a marker of increased risk of respiratory-cause deaths later in life.
News Release: Respiratory disease in early childhood linked to higher risk of death for adults – Imperial College London
Commentaries:
Childhood bronchitis, pneumonia tied to premature respiratory death in adults – CIDRAP
Early childhood lower respiratory tract infection: a key determinant of premature adult respiratory mortality – The Lancet (free registration required)
Commentary from the author on Twitter (thread – click for more)
1/ Great to see the interest in our @TheLancet paper linking lower respiratory tract infections in early childhood to the risk of premature adult death from respiratory disease across Great Britain.
A🧵exploring our study (1/21)
Full paper link below:https://t.co/LlGQJC1wAP
— James P Allinson (@JPAllinson) March 11, 2023
COVID-19 pandemic measures may have caused reduced cognitive abilities among German students, study shows
20 Mar, 2023 | 13:50h | UTCSummary: This study investigated the impact of the COVID-19 pandemic on the cognitive abilities of secondary school students in Germany. The study compared the intelligence test performance of 424 students in Grades 7 to 9, tested after the first six months of the pandemic, to the results of two highly comparable student samples tested in 2002 and 2012.
The study found that the 2020 sample had substantially lower intelligence test scores than both the 2002 and 2012 samples. The study also retested the 2020 sample after another full school year of COVID-19-affected schooling in 2021 and found no signs of catching up to previous cohorts or further declines in cognitive performance.
It can be inferred from the article that the lower intelligence test scores of the 2020 sample may have been caused by the prolonged disruption of regular schooling due to the COVID-19 pandemic, including lockdowns and school closures.
The study highlights the potential negative impact of the COVID-19 pandemic on the cognitive abilities of secondary school students and suggests that these consequences should be taken into account when conducting intelligence assessments in the post-pandemic era. It also recommends that appropriate compensatory measures be implemented to address any learning loss or cognitive deficits that may have resulted from the disruption of regular schooling during the pandemic.
Review | Diseases affecting middle-aged and elderly individuals with trisomy 21
20 Mar, 2023 | 13:44h | UTC
Study | Public health policies should recommend introducing peanut products to infants at 4-6 months of age to prevent peanut allergy
20 Mar, 2023 | 13:33h | UTCCommentary: Expert reaction to research on giving peanut products to babies – Science Media Centre
Related study: Early Introduction of Allergenic Foods Can Prevent Food Allergies in High Risk Infants
Related Guidelines:
AAP Updated Recommendations for Dietary Interventions to Prevent Atopic Disease
Timing of introduction of allergenic solids for infants at high risk – Canadian Paediatric Society
Commentary from the author on Twitter
Latest paper from #LEAPStudy is now published in @JACIonline. We have looked at what happens if peanut products are introduced into the infant diet at different ages across the whole population. https://t.co/zpOlrNHOSihttps://t.co/xDIgYjezyS
More details below. @GoAllergy 1/12 pic.twitter.com/jY5MvdJ2AZ— Graham Roberts (@ProfGRoberts) January 12, 2023
Review | The latent phase of labor
20 Mar, 2023 | 13:28h | UTCThe latent phase of labor – American Journal of Obstetrics & Gynecology
Commentary on Twitter
AJOG Expert Review in Labor: The latent phase of labor- Management of a prolonged latent phase of labor https://t.co/ep0rPrldAn @acog @RCObsGyn @SOGCorg @ranzcog @ISUOG pic.twitter.com/fm7cUaQsOr
— AJOG (@AJOG_thegray) March 17, 2023
M-A | Primary prevention of cardiovascular disease in women with a Mediterranean diet
20 Mar, 2023 | 13:20h | UTCNews Release: Mediterranean diet may cut women’s CVD and death risk by nearly 25% – BMJ Newsroom
Commentary:
Expert reaction to study looking at Mediterranean diet and women’s cardiovascular disease and death risk – Science Media Centre (Recommended reading – “Observational studies of nutrition have been notoriously misleading… Nutritional measures are strongly patterned by social factors and behavioral dispositions, leading to very substantial confounding”)
Cross-sectional study | Impact of different alcoholic beverages on serum urate levels
20 Mar, 2023 | 13:16h | UTC
Commentary on Twitter
Beer and wine was associated with high and moderate increases in serum urate levels, respectively; sake was associated with a modest increase in serum urate levels, in patients getting routine checkups in Japan. https://t.co/J8OqKJI9fQ
— JAMA Network Open (@JAMANetworkOpen) March 17, 2023
M-A | Global prevalence of diabetic retinopathy in pediatric type 2 diabetes
20 Mar, 2023 | 13:12h | UTC
Post-hoc analysis | Could SGLT2 inhibitors have a beneficial effect on gout symptoms?
17 Mar, 2023 | 13:02h | UTCRelated: Post-hoc analysis | Can SGLT2 inhibitors reduce the risk of hyperuricemia and gout?
Associations of relative fat mass, a new index of adiposity, with type-2 diabetes in the general population
17 Mar, 2023 | 13:04h | UTC
Cohort Study | Leukotriene-receptor antagonist use during pregnancy not linked to neuropsychiatric events in offspring
17 Mar, 2023 | 12:56h | UTCCommentary: In utero exposure to asthma medication not tied to risks of neurodevelopmental disorders – MDedge
SR | Planned hospital birth compared with planned home birth for pregnant women at low risk of complications
17 Mar, 2023 | 12:51h | UTCSummary: Planned hospital birth versus planned home birth – Cochrane Library
M-A | Prevalence of perinatal depression in low- and middle-income countries
17 Mar, 2023 | 12:49h | UTC
Commentary on Twitter
Depression amongst women, during pregnancy and up to a year postpartum, in low- and middle-income countries is common. Urgent action is required improve health outcomes for women and babies. https://t.co/xMSiqaOmiu @PerinatalEpi @mercyperinatal @UniMelb
— JAMA Psychiatry (@JAMAPsych) March 8, 2023
Cohort Study | Timing of antidepressant discontinuation during pregnancy and postpartum psychiatric outcomes
17 Mar, 2023 | 12:48h | UTC
Commentary on Twitter
A population-based study of 57,934 pregnant women in Denmark and Norway found that women who were previously stable antidepressant users but discontinued treatment late in pregnancy presented an elevated probability of postpartum initiating psycholeptics. https://t.co/k42OhXwgfi
— JAMA Psychiatry (@JAMAPsych) March 9, 2023
FDA issues new information on cases of squamous cell carcinoma and lymphomas around breast implants
16 Mar, 2023 | 13:28h | UTCSummary: The US Food and Drug Administration (FDA) has provided an update on reports of squamous cell carcinoma (SCC) in the scar tissue (capsule) that forms around breast implants. The FDA is aware of 19 cases of SCC in the capsule around the breast implant from published literature, including 3 reports of deaths from the disease.
While the FDA continues to believe that occurrences of SCC in the capsule around the breast implant may be rare, the cause, incidence, and risk factors remain unknown. Health care providers and people who have or are considering breast implants should be aware that cases of SCC and various lymphomas in the capsule around the breast implant have been reported to the FDA and in the literature.
The FDA continues to ask health care providers and people with breast implants to report cases of SCC, lymphomas, or any other cancers around breast implants.
FDA Safety Communication: Reports of Squamous Cell Carcinoma (SCC) in the Capsule Around Breast Implants – FDA Safety Communication – U.S. Food & Drug Administration
Related:
FDA Report: 660 Cases of Breast Implant-Associated Anaplastic Large Cell Lymphoma
Study: Long-term Outcomes of Silicone Breast Implants
RCT | Pre-hospital rule-out of NSTE-ACS by ambulance paramedics with point-of-care troponin is feasible and cost-saving
16 Mar, 2023 | 13:27h | UTCSummary: Using a point-of-care (POC) troponin measurement, this randomized trial in the Netherlands assessed the safety and healthcare costs of a pre-hospital rule-out strategy for patients with suspected non-ST-segment elevation acute coronary syndrome (NSTE-ACS).
The study included only patients considered at low risk with a HEAR (History, ECG, Age, Risk factors) score ≤3. A total of 863 low-risk participants were randomized to direct transfer to the ED or a pre-hospital rule-out strategy with POC troponin measurement.
The trial found that pre-hospital rule-out of NSTE-ACS in low-risk patients using a single POC troponin measurement is feasible, significantly reduces healthcare costs, and is associated with a low incidence of major adverse cardiac events.
The HEAR score, combined with a POC troponin measurement by ambulance paramedics, accurately identifies low-risk patients for whom ED evaluation is unnecessary. Implementing this pre-hospital rule-out strategy in low-risk patients could significantly reduce healthcare costs through more efficient use of ambulance services and fewer ED visits. It is worth noting, however, that further studies in other localities are necessary before the widespread use of this strategy can be implemented.
Commentaries:
JC: Can we rule out ACS by a single prehospital troponin measurement? – St. Emyln’s
Rule-Out of NSTE-ACS by a Prehospital Troponin Measurement – American College of Cardiology
AACC Guidance document on cervical cancer detection: screening, surveillance, and diagnosis
16 Mar, 2023 | 13:21h | UTC