Reducing risks of osteoporosis fractures in Crohn’s disease with impact and resistance training

Cr. John Arano

Source from MIMS.com

A recent study shows that combined impact and resistance training exercises helps raise bone mineral density (BMD) and muscle function, which benefits patients with Crohn’s disease (CD) who has a high risk in developing osteoporosis and related fractures.

Researchers selected adults with stable CD (n=47, mean age=49.3 years) and were assigned to undergo an exercise intervention (n=23) or receive usual care alone (n=24) for 6 months. Usual care plus a combined impact and resistance training programme were given to the exercise group while patients underwent three 60-minutes sessions per week, with a gradual tapering of supervision to self-management.

Most of the patients had quiescent disease and none of the patients smoked. 216 months median time since the CD diagnosis and according to baseline BMD measurements, 12 patients had evidence of osteopaenia or osteoporosis at the lumbar spine and 20 at the left hip. The most common medications used for CD were immunosuppressants and biologics; none were on corticosteroids.

The bone mineral density (BMD) values were better in the exercise vs the control group at 6 months, with the difference significant at lumbar spine, but not at femoral neck nor at greater trochanter.

Even though there were three exercise-related adverse events (for instance light-headedness and nausea) the intervention yielded improvements in all muscle function outcomes and fatigue severity.

The findings highlight the intervention as a suitable model of exercise for reducing the future risk of osteoporotic fractures and physical disability in this high‐risk population, according to researchers.

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No adverse CV outcomes and excess risks of death from Febuxostat

Cr. Halacious

Source from MIMS.com

According to the results of a meta-analysis, the use of febuxostat does not appear to come with an increased hazard of mortality or adverse cardiovascular (CV) outcomes, for the treatment of patients with gout and hyperuricemia.

Data from 15 randomized controlled trials were collected by researchers and contributed to a total of 16,070 participants. The proportion of patients with hypertension varied between 27.7 percent and 100.0 percent, while those with diabetes ranged from 6.9 percent to 100.0 percent.

A median follow-up of 6.4 months were used across the trials, and the use of febuxostat vs control (allopurinol or placebo) did not result in a significant increase in the risk of CV mortality and all-cause mortality.

The same was true for adverse CV outcomes, as follows: major adverse CV events (risk difference [RD] 1.40 percent), myocardial infarction (RD, -0.06 percent), stroke (RD, 0.10 percent), or new-onset hypertension (RD, 1.58 percent).

Among patients with existing CV disease, the findings were consistent and the test (Egger’s regression test) did not detect significant publication bias.

The evidence were limited by the presence of low to moderate certainty, the researchers said. Recommendations of evaluating CV events and mortality as an outcome were stated by the researchers, as well as defining major adverse CV events, and comparing the outcomes among different doses of febuxostat over a longer follow-up duration in future trials.

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Therapeutic potential in COVID-19 with colchicine

Cr. Fusion Medical Animation

Source from MIMS.com

Based on a study, survival rate in patients with COVID-19 was improved with the use of colchicine, which are usually used for the treatment of gout and other inflammatory disorders as compared with standard of care (SoC).

The well-recognised anti-inflammatory effects and potential antiviral properties made it as one of the drugs that was considered for the treatment of COVID-19.  140 hospitalized patients who contracted COVID-19 had their outcomes evaluated as they were treated with SoC (hydroxychloroquine and/or intravenous dexamethasone; and/or lopinavir/ritonavir) and in 122 patients treated with colchicine and SoC.

The SoC group, have lower serum concentrations of C-reactive prottein and ferritin, as well as neutrophil count but higher PaO2/FiO2 ratio at baseline.

Survival when being compared over 21 days of follow-up, it was more favourable in the colchicine than the SoC group. A lower risk of death was strongly associated with colchicine, on Cox proprortional hazards regression (hazard ratio, 0.151).

At entry, there were a higher serum levels of ferritin, worse Pa02/Fi02 and poor survival at older age for the risk factors. 

With no treatment discontinuation due to severe adverse events, colchicine had a good safety profile. In nine patients, dosing was reduced from 1 to 0.5 mg/day due to diarrhoea.

With the aim of preventing the patient’s autoinflammatory response, the current study provides proof-of-concept data supporting the possible use of colchicine in the treatment of the early phase of COVID-19.

To determine the efficacy and safety of colchicine, properly designed trials are needed with the best protocol in terms of dosage and timing of administartion in patients with COVID-19, said the researchers.

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TB antibiotics in reaching targets

Cr. Simone van der Koelen

Source from Sciencedaily.com

Researchers have built up another technique that empowers them to envision how well antibiotics against tuberculosis (TB) reach at their pathogenic targets inside human hosts. The discoveries, published in the journal Science, boost understanding of how antibiotics work and could help direct the development of new antibiotics, which are truly necessary in the fight against drug-resistance.

TB treatment

TB stays as one of the world’s deadliest infectious diseases, with over a million TB-related deaths worldwide every year.

At the point when an individual is infected with Mtb (mycobacteria), their immune system attempts to clear the microorganism by calling upon specialised immune cells called as macrophages that perceive and engulf Mtb. However, the bacteria frequently discover ways to survive and duplicate, causing illness. Patients require at least four antibiotics for at six months to defeat the disease.

It was previously unknown whether antibiotics enter all the compartments of the macrophage where the Mtb hide and duplicate.

The method pioneered in this study, which consolidates three kinds of imaging (correlated light, electron and nano-scale ion microscopy), permits researchers to picture the circulation of TB drugs in Mtb-infected human macrophages at high resolution, for the first time.

A test-case TB drug

Utilizing bedaquiline as an test-case, the group contaminated human macrophages with Mtb, and following up after two days, they treated them with the medication. Their imaging results revealed that bedaquiline accumulated in various compartments of the cell, most eminently, inside lipid droplets.

The bacteria can interact with and consume these lipid droplets. Be that as it may, the group (Crick-led team) didn’t know whether bedaquiline would be moved to the bacteria, or whether the lipid droplets were retaining the antibiotic and keeping it from arriving at the bacteria. Including a chemical that kept lipid droplets from forming significantly decreased the measure of bedaquiline in Mtb, proposing that the lipid drops are responsible for moving antibiotic to the bacteria.

“Now that we can see exactly where antibiotics go once they enter macrophages, we can build up a much clearer picture of how they reach their targets, and harness these observations to design more effective treatments in the future, not only for TB but for other infectious diseases too” says Max Gutierrez, Crick group leader and senior author of the paper.

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Women with recurrent pregnancy loss could reduce their stress with emotion-focused strategies

Cr. Matteo Di iorio

Source from MIMS.com

According to the data presented at ESHRE 2020, perceived stress in women who had recurrent pregnancy loss (RPL) could be reduced by meditation and mindfulness interventions.

Karen Kirchheiner from Hdidovre Hospital in Denmark, stated that studies have shown perceived stress and moderate-to-severe depression are more prevalent in women with RPL than other women trying to conceive.

“A 7-week meditation and mindfulness programme significantly reduced perceived stress [vs] a standard supportive care programme for women with RPL,” she said.

The researchers in the study randomized 76 women, 1:1 to receive supportive care alone or with a 7-week meditation and mindfulness programme facilitated by an authorized instructor. Daily guided audio of meditation for 10-20 minutes were also instructed for the women in the intervention arm while women in the control arm were instructed against meditation; 63 women completed the study.

Mean perceived stress significantly dropped from baseline in both the intervention and the control arms at 7 weeks with intervention outweighed the control protocol in terms of perceived stress reduction for between-group comparison.

The between-group difference was not significant as the perceived stress levels remained low in both intervention and control arms at 12 months vs baseline.

Women in the intervention arm had a significant reduction in personal stress from baseline, which were based on COMPI-FPSS scores at week 7. No significant differences were seen in the other two domains despite the reduced scores.

Consistent numerical reductions were seen across all COMPI-FPSS domains with the intervention protocol at 12 months, 9.2 to 8.7 points, and 7.9 to 7.6 points with only the social domain score reduction was statistically significant.

At week 7, depression was reported at baseline, dropping to none for two women in the intervention and at 12 months, only one had depression. However, these reductions did not equate to statistical significance.

Kirchheiner stated that there are no any significant decrease in depression in all three timelines and underlined that the study was not powered to detect differences in Major Depression Index (MDI).

“[Nevertheless, our studies suggest that] guided self-administered meditations could be a useful tool in the care for women experiencing RPL …. We now have a documented tool to reduce perceived stress. The question now is how to implement this in our clinical practice,” she concluded.

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Study shows that having red meat before exercise does not offer any additional benefits

Cr. Victoria Shes

Source from MIMS.com

A new study has shown that people who are consuming lean red meat in line with current recommendations does not improve muscle mass, strength, nor cognitive functions of healthy community-dwelling older adults undertaking resistance-based exercise training 3 days/week compared to those consuming carbohydrates.

154 random adults aged ≥65 years was picked by the researchers as they participated in a multicomponent 3-day/week resistance-based exercise programme to either a lean red meat group, the exercise plus lean red meat or a control group receiving carbohydrates in the form of one-half cup or rice or pasta or 1 medium potato, the exercise plus carbohydrate control, on training days.

For the primary outcomes in total body lean mass, leg LM, thigh muscle cross-sectional area, leg and back muscle strength, and executive function;  there were no significant differences between-groups in exercise-induced improvements.

There were also no significant differences in improvements for the secondary outcomes of global cognition function, fat mass, physical function measures, or systolic blood pressure.

In terms of arm Lm, gait speed, muscle density, and appendicular LM in the per-protocol analysis, the improvements were greater for the Ex + meat group than the C + Ex group.

At the same time, net improvements in working memory learning after 12 weeks and 24 weeks were greater in the C + Ex group than the Ex + Meat group.

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Bleeding and cardiovascular risks heightens after consumption of NSAIDs

Cr. JESHOOTS.com

Source from MIMS.com

Researchers conducted a study that investigated the risk for cardiovascular and bleeding events according to groups of antithrombotic medications and subtypes of NSAIDs. The first diagnosed MI in the nationwide cohort study was retrieved from 108,232 patients that they have accessed the Health Insurance Review and Assessment Service database between 2009 and 2013.

Based on their prescribed antithrombotic medications, the patients were divided into groups  with the thromboembolic cardiovascular and clinically relevant bleeding events as the study outcomes.

Concomitant NSAID treatment significantly elevated the risk for cardiovascular events and bleeding events compared with no NSAID treatment over a mean follow-up of 2.3 years. Celecoxib and meloxicam showed the lowest risk of cardiovascular and bleeding events among NSAID subtypes.

The authors stated in their research that although NSAID treatment should be avoided after MI, celecoxib and meloxicam could be considered as alternative options in cases in which NSAID use is unavoidable.

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Lower risks of cancer, cardiovascular diseases and diabetes by having more fibres in your diet

Cr. Joanna Kosinka

Source from MIMS.com

A recent study suggests that to reduce the risk of several chronic diseases and mortality, higher consumption of dietary fibres (DF), particularly soluble (SF) and insoluble fibres (IF) from fruits.

The researchers sought to examine the association of intake of DFs of different types (total DF, SF and IF) and from various sources with the risk of cardiovascular disease (CVDs), cancer, type 2 diabetes (T2D), and mortality in the large-scale NutriNet-Santé prospective cohort.

107,377 participants were included in the cohort study where the usual DF intake was estimated from validated repeated 24-h dietary records over the first 2 years following inclusion in the cohort. To assess the associations between sex-specific quintiles of DF intake and the risk of chronic diseases and mortality.

With the increased intake of total DFs, it was found that T2D risk is being significantly decreased and also correlated with a lower risk of breast cancer. It is also stated that intake from fruits led to a reduced risk of several chronic diseases. . For particularly soluble (SFs), they are correlated with a reduced risk of CVD and colorectal cancer, while IFs reduce mortality from cancer or CVDs.

The investigators stated that to involve different types and sources of fibre, further studies are needed and more emphasis should be put on dietary fibres in public health nutrition policies, as DF intake remains below the recommended levels in many countries.

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Diabetic ketoacidosis in children equals to hypertension

Cr. Rene Bernal

Source from MIMS.com

Study has found that for children with diabetic ketoacidosis (DKA), hypertension is a common phenomenon.

Researchers gathered 1,258 patients who had sufficient haemodynamic data for the present analysis while using data from the Paediatric Emergency Care Applied Research Network. Out of these, 12.2 percent had documented hypertension at presentation.

In under 2 hours, hypertension were resolved quickly in 36 children and for 118 episodes, hypertension lasted for 2 hours. During DKA treatment, the blood pressure was normal at baseline in 196 patients but progressed to hypertension during DKA treatment. Developed at any time during DKA, the resulting overall rate of hypertension was at 27.8 percent.

The median duration of  hypertension was 4.0 hours and at presentation, correlated with more severe acidosis and stage 2 or 3 acute kidney injury. On the contrary, at baseline, lower glucose levels or glucose-corrected sodium concentrations were associated with hypertension at presentation.

Lower scores on the Glasgow Coma Scale and more severe acidosis correlated with the development of hypertension at any point during DKA. Severe acidosis, stage 2 acute kidney injury, and younger patient age are also directly correlated with hypertension severity.

The researchers stated that a central mechanism may be involved in causing abnormal haemodynamic regulation with the development of hypertension during DKA treatment and the association of hypertension with altered mental status.

They also added that it is necessary to better understand relationships of regional cerebral blood flow abnormalities during DKA is necessary and how these relate to life-threatening cerebral injuries in some children.

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Vaccines : Proven to be safe after a two decade study

Cr. CDC

Source from MIMS.com

There have been many doubts from naysayers who criticize the usage of vaccines as they claimed it could make their child get autistic and how it would make them get infected with the disease they are trying to prevent instead.

A recent US study that was conducted for over a 20-year period recently revealed that they have debunked the myths and shown that vaccines are relatively safe via existing postmarketing surveillance programmes, stated the authors.

The vaccines that were approved by the Food and Drug Administration (FDA) – the initial and subsequent labels – between 1 January 1996 and 31 December 2015 were included in the retrospective cohort study.

Out of the fifty-seven FDA-approved vaccines that were analysed, fifty-three (93 percent) initially had approval that were supported by randomized controlled trials, with a median cohort size of 4,161 participants.

There were similarities in the initial approval trial characteristics in vaccines with and without postmarketing, safety-related label modifications. The most common safety issue prompting label modifications was the expansion of population restrictions, followed by allergies with postmarketing surveillance as the most common source of safety data.

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