Uric Acid to HDL Ratio may predict Metabolic Syndrome in Type II Diabetes Patients

In a significant stride toward personalized diabetes care, a recent study has spotlighted the potential of the uric acid to HDL ratio (UHR) as a key predictor for the onset of metabolic syndrome in individuals with type II diabetes. The study found that UHR can be used as a significant sensitive marker in predicting the development of diabetes considering the high potential of developing metabolic syndrome in diabetic patients.

The study results were published in the journal Nutrition, Metabolism & Cardiovascular Diseases.

Also Read:Early Metabolic Syndrome Linked to High Pancreatic Cancer Risk: Lancet

The escalating global prevalence of diabetes mellitus has emerged as a significant focus for public health initiatives. The impact of metabolic syndrome on diabetes mellitus has garnered considerable attention in recent times. The Uric Acid to High-Density Lipoprotein (UA to HDL) ratio has recently gained prominence as a predictor for diabetes mellitus and the occurrence of metabolic syndrome in individuals with type II diabetes. Hence, researchers conducted a study to investigate the reliability of UHR to predict metabolic syndrome in diabetic patients.

The study, conducted in 2021 at the diabetes clinic of Ali-Ibn Abi-Talib Hospital in Rafsanjan City, engaged 300 patients with type II diabetes. Employing a convenient sampling method, the research delved into demographic, clinical, and laboratory parameters, unraveling a wealth of insights into the intricate relationship between UHR and metabolic syndrome.

Findings:

  • A striking revelation emerged as 74.33% of the participants were found to harbor metabolic syndrome, underscoring the urgency of nuanced predictive tools for early detection and intervention.
  • Further analysis delved into the differences between patients with and without metabolic syndrome. Those with the syndrome exhibited significantly higher mean UHR ratios and triglyceride levels (p=0.002 and p<0.001, respectively).
  • The crux of the study lay in the identification of a UHR threshold – 8.118% – showcasing an impressive sensitivity of 70.32% and specificity of 55.08% in diagnosing the development of metabolic syndrome in type II diabetes.
  • The receiver operating characteristic (ROC) analysis painted a vivid picture of UHR’s potential as a moderate yet valuable predictive tool (AUC: 0.621, P=0.001, 95%CI: 0.549–0.694).
Also Read: Pomegranate Peel Extract Improves Non-Alcoholic Fatty Liver Disease Outcomes
    Thus, as we absorb the impact of these findings, it becomes evident that UHR could emerge as a game-changer in routine monitoring for individuals with type II diabetes. The study advocates for regular monitoring of laboratory tests, positioning UHR as a crucial component in the arsenal against metabolic syndrome.
    The study not only fills a crucial gap in our understanding of metabolic syndrome but also invites further exploration into the nuanced role of UHR as a predictive biomarker. This breakthrough could pave the way for more targeted interventions and personalized approaches in managing the complex interplay of diabetes and metabolic syndrome.
    Further reading: Uric acid to HDL ratio: a marker for predicting the incidence of metabolic syndrome in patients with type II diabetes. DOI: https://doi.org/10.1016/j.numecd.2023.12.022

    Powered by WPeMatico

    Is it Safe to Continue Aspirin in Percutaneous Nephrolithotomy?

    In a groundbreaking study, researchers have delved into the peri-operative outcomes of patients on chronic aspirin therapy undergoing percutaneous nephrolithotomy (PCNL), challenging conventional wisdom regarding the discontinuation of aspirin in these cases. The research found that using aspirin during the perioperative period does not increase bleeding complications in PCNL patients.

    The study results were published in the journal Urology.

    Anti-coagulation and anti-platelet therapy are typically avoided during PCNL to mitigate bleeding risks. Due to the potential cardiovascular risks associated with peri-procedural aspirin withdrawal, researchers aimed to carry out a study to investigate whether continuing aspirin therapy posed any risk for PCNL.

    Also Read: Patients with kidney stones undergoing ‘Mini-PCNL’ surgery have higher likelihood of achieving stone-free status

    Conducted through a retrospective review of patients between January 2014 and May 2019, the study enrolled 325 patients on chronic aspirin therapy undergoing PCNL. These patients were stratified based on whether they continued or discontinued aspirin for more than 5 days preoperatively. Logistic regression models were used to assess Hematologic complications, transfusions, and thrombotic complications.

    The findings:

    • Among the participants, 85 chose to continue aspirin, while 240 opted for discontinuation.
    • Contrary to expectations, no significant differences were observed in key parameters such as hemoglobin change, estimated blood loss, transfusions, creatinine change, thrombotic complications, and other relevant outcomes.
    • While patients who continued aspirin did experience a slightly longer length of stay (1.6 vs. 1.9 days, P = .03), this was not accompanied by an increase in postoperative complications, challenging the existing guidelines that advocate for discontinuation due to bleeding concerns.
    • Factors associated with the decision to continue aspirin included an American Society of Anesthesiologists (ASA) score of 3 or 4, a Black race, and a history of smoking.
    • On the other hand, a body mass index (BMI) ≥30 was linked to aspirin discontinuation.
    • One of the noteworthy revelations from the study was the increased risk of postoperative hematologic complications in patients on additional anticoagulation medication, emphasizing the importance of carefully evaluating the overall anticoagulation strategy in these surgical scenarios.
    Also Read: FURL or all-seeing needle-assisted PCNL, which is better for treating calyceal diverticulum stones?

    In conclusion, the study challenges traditional protocols by demonstrating that the continuation of aspirin in patients undergoing PCNL does not increase the risk of postoperative complications. This finding carries substantial implications for clinical practice, suggesting that the potential cardiovascular risks associated with aspirin withdrawal should be carefully weighed against bleeding risks in the context of PCNL.

    As the medical community grapples with evolving paradigms in peri-operative care, this study prompts a reevaluation of the current guidelines and opens the door to a more nuanced approach to managing chronic aspirin therapy during PCNL, potentially improving outcomes for patients with kidney stones and cardiovascular comorbidities.

    Further reading: Agrawal-Patel S, Brar H, Elia M, et al. Is it Safe to Continue Aspirin in Patients Undergoing Percutaneous Nephrolithotomy? Urology. 2024;183:32-38. doi:10.1016/j.urology.2023.09.022

    Powered by WPeMatico

    Two-step screening protocol can predict and prevent heart failure among adults with diabetes

    USA: In a recent study published in Circulation, the researchers have described a two-step screening protocol that combines clinical risk assessment with biomarker testing for more effective identification of patients with type 2 diabetes who need medication to prevent heart failure. A

    According to the study led by UT Southwestern Medical Center researchers, the new strategy is the best approach for predicting heart failure in patients with diabetes-even in those deemed low-risk following clinical risk assessment only. 

    “Diabetes often leads to cardiovascular disease, with heart failure being one of the most common manifestations,” said Ambarish Pandey, M.D., Associate Professor of Internal Medicine in the Division of Cardiology at UT Southwestern and corresponding author of the study. “In recent years, many physicians have relied on one-step screening approaches, like clinical risk scores, biomarker tests, or echocardiography, to identify those at high risk for developing heart failure. But even patients considered low-risk by these single-step risk assessment tools sometimes develop heart failure. Furthermore, testing all individuals with diabetes with often expensive biomarker or echo assessments is often not feasible or cost-effective.”

    Dr. Pandey and his colleagues found that combining these risk assessment strategies sequentially by adding a second step – such as giving low-risk patients by clinical risk score a blood test for natriuretic peptide levels, a biomarker for cardiovascular disease – is the most efficient and potentially cost-effective strategy for screening for heart failure. Natriuretic peptides are proteins produced by the heart when there is stressful stretching of the heart muscle. The research could lead to more patients being accurately screened and receiving proven preventive therapies, such as sodium-glucose cotransporter 2 inhibitors (SGLT2i), to protect their heart health.

    The study included data from 6,293 diabetes patients who had taken part in seven cohort studies. Of those, 4,889 had no signs of atherosclerotic cardiovascular disease (ASCVD). All patients had undergone screening to determine their level of risk for heart failure. By comparing screening methods and downstream risk of heart failure episodes at a five-year follow-up, researchers were able to determine the methods and sequence that best predicted those at risk.

    “Our study found that 30% to 50% of the total heart failure events in the population without prevalent ASCVD occurred in individuals marked low-risk with a single screening strategy,” Dr. Pandey said. “But when a second step was added, approximately 85% of the actual heart failure cases were identified. This suggests a substantial percentage of patients with diabetes who could benefit from more aggressive preventive treatment are being overlooked.”

    Different two-step screening strategies were evaluated incorporating WATCH-DM, blood tests including natriuretic peptides, and echocardiography. “We found that assessing the WATCH-DM risk score in all individuals, followed by natriuretic peptides only among individuals who were considered low-risk based on the WATCH-DM risk score, was the most efficient of the two-step screening strategies to assess heart failure risk and target preventive therapies,” said study first author Kershaw Patel, M.D., Assistant Professor of Cardiology at the Houston Methodist Academic Institute.

    Although echocardiographic screening can be a beneficial risk determinant after clinical assessment, it is more expensive and time-consuming than a natriuretic peptide blood test. That makes the echocardiogram less likely to be checked unless a patient is already considered high-risk or has another indication for testing.

    “The key to improving our ability to identify those most in need of preventive treatment is using cost-effective screening tools that can be easily implemented in the clinic,” Dr. Pandey said. “Our finding advances the field by demonstrating an efficient and effective approach that gives physicians a better idea of their patients’ actual risk. We hope that further study of this two-step strategy will enable us to evaluate both its clinical success and its cost-effectiveness to develop a consistent approach for patients.”

    Reference:

    Kershaw V. Patel, Matthew W. Segar, David C. Klonoff, Muhammad Shahzeb Khan, Muhammad Shariq Usman, Carolyn S.P. Lam, Subodh Verma, Andrew P. DeFilippis, Optimal Screening for Predicting and Preventing the Risk of Heart Failure Among Adults With Diabetes Without Atherosclerotic Cardiovascular Disease: a Pooled Cohort Analysis, https://doi.org/10.1161/CIRCULATIONAHA.123.067530

    Powered by WPeMatico

    High glucose-to-lymphocyte ratio associated with poor prognosis in patients with sepsis-associated AKI

    A recently published investigation delves into the potential link between the glucose-to-lymphocyte ratio (GLR) and the prognosis of patients with sepsis-associated acute kidney injury (SA-AKI). The study underscores GLR’s potential as an independent risk factor for predicting 28-day mortality in SA-AKI patients. Elevated GLR levels were associated with poorer prognosis, indicating its value as a prognostic marker in this critical medical condition.

    This study was published in the journal Zhonghua Wei Zhong Bing Ji Jiu Yi Xue by Zhang L. and colleagues. The study aimed to evaluate whether GLR levels could serve as a predictor of patient outcomes in this critical medical condition. The study examined 1,524 SA-AKI patients, aged 18 years and above, utilizing the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. Patients were categorized into three groups based on GLR levels: GLR1 (≤ 4.97×10[-9] mmol), GLR2 (4.97×10[-9] mmol < GLR < 9.75×10[-9] mmol), and GLR3 (≥ 9.75×10[-9] mmol). The study assessed mortality rates at 28 days, 90 days, 180 days, and 1 year among the patient groups. Additionally, multivariate logistic regression analysis and receiver operator characteristic curve (ROC curve) analysis were employed to determine GLR’s predictive efficacy for 28-day mortality.

    • Mortality Rates: Mortality rates, at various time points, increased incrementally with higher GLR levels. For instance, at 28 days, mortality was 11.64%, 22.00%, and 33.86% in GLR1, GLR2, and GLR3 groups, respectively.

    • Association with Mortality: The GLR demonstrated a direct association with mortality, as higher GLR levels were significantly linked to increased mortality rates within 28 days.

    • Predictive Value: The area under the ROC curve (AUC) for GLR in predicting 28-day mortality was 0.674, indicating moderate predictive ability. When combined with acute physiology score III (APS III) and sequential organ failure assessment (SOFA) score, the predictive performance improved substantially, with an AUC of 0.806.

    The findings highlight the importance of assessing GLR alongside other established scores (APS III, SOFA) for a more accurate prediction of mortality risk in SA-AKI patients. This extensive investigation provides clinicians with a novel insight into utilizing GLR as a potential prognostic indicator in the assessment and management of SA-AKI patients, potentially aiding in tailored interventions and improved patient outcomes.

    Reference:

    Zhang, L., Liu, F., Li, Q., Li, Y., Shao, Q., Tao, W., Hu, P., Qian, K., & Lu, Y. (2023). Association between blood glucose-to-lymphocyte ratio and prognosis of patients with sepsis-associated acute kidney injury. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue, 35(12). https://doi.org/10.3760/cma.j.cn121430-20230901-00725

    Powered by WPeMatico

    Regular use of hearing aids may lower mortality risk in adults with hearing loss

    USA: A mortality follow-up study of a cross-sectional cohort study has shed light on the association between hearing aid use and mortality in adults with hearing loss in the USA. 

    Tne new study from Keck Medicine of USC published in The Lancet Healthy Longevity revealed that adults with hearing loss who regularly used hearing aids had a 24% lower risk of mortality than those who never wore them. 

    Hearing loss affects approximately 40 million American adults, yet only one in 10 people who need hearing aids use them, research shows.

    According to the study, those who don’t use hearing aids but should want to make wearing them one of their New Year’s resolutions, the study showed. 

    “We found that adults with hearing loss who regularly used hearing aids had a 24% lower risk of mortality than those who never wore them,” said Janet Choi, MD, MPH, an otolaryngologist with Keck Medicine and lead researcher of the study. “These results are exciting because they suggest that hearing aids may play a protective role in people’s health and prevent early death.”

    Previous research has shown that untreated hearing loss can result in a reduced life span (as well as other poor outcomes such as social isolation, depression and dementia). However, until now, there has been very little research examining if the use of hearing aids can reduce the risk of death. The study represents the most comprehensive analysis to date on the relationship between hearing loss, hearing aid use and mortality in the United States, according to Choi.

    Choi and her fellow researchers used data compiled by the National Health and Nutrition Examination Survey between 1999-2012 to identify almost 10,000 adults 20 years and older who had completed audiometry evaluations, a test used to measure hearing ability, and who filled out questionnaires about their hearing aid use. Researchers followed their mortality status over an average follow-up period of 10 years after their evaluations.

    A total of 1,863 adults were identified as having hearing loss. Of these, 237 were regular hearing aid users, which were characterized as those who reported wearing the aids at least once a week, five hours a week or half the time, and 1,483 were identified as never-users of the devices. Subjects who reported wearing the devices less than once a month or less frequently were categorized as non-regular users.

    Researchers found that the almost 25% difference in mortality risk between regular hearing aid users and never-users remained steady, regardless of variables such as the degree of hearing loss (from mild to severe); age, ethnicity, income, education and other demographics; and medical history. There was no difference in mortality risk between non-regular users and never users, indicating that occasional hearing aid use may not provide any life-extending benefit.

    While the study did not examine why hearing aids may help those who need them live longer, Choi points to recent research linking hearing aid use with lowered levels of depression and dementia. She speculates that the improvements in mental health and cognition that come with improved hearing can promote better overall health, which may improve life span.

    Choi hopes this study will encourage more people to wear hearing aids, even though she acknowledges that factors, including cost, stigma and difficulty finding devices that fit and function well, are barriers to use.

    Choi can personally relate to these challenges. She was born with hearing loss in her left ear, but did not wear a hearing device until her 30s. It then took her several years to find ones that worked effectively for her.

    She is currently working on an AI-driven database that categorizes hearing aid choices and tailors them to individual patient needs. She also advocates for larger studies to further understand the link between regular hearing aid use and a lower mortality risk and to promote hearing care. 

    Reference:

    Janet S Choi, Meredith E Adams, Eileen M Crimmins, Frank R Lin, Jennifer A Ailshire, Association between hearing aid use and mortality in adults with hearing loss in the USA: a mortality follow-up study of a cross-sectional cohort, The Lancet Healthy Longevity, DOI:https://doi.org/10.1016/S2666-7568(23)00232-5.

    Powered by WPeMatico

    Propranolol could be new treatment for sickle cell cardiomyopathy

    A beta blocker typically used to treat heart problems, hemangioma, migraines and anxiety could be a new therapeutic for patients with sickle cell disease. Researchers led by Ankit A. Desai, MD, associate professor of medicine at the Krannert Cardiovascular Research Center (KCVRC) at Indiana University School of Medicine, have been awarded a $3 million grant by the U.S. Department of Defense to evaluate the efficacy of this drug.

    Patients with sickle cell disease, a red blood cell disorder that can cause harm to multiple organs when red blood vessels are blocked or when the cells break down, are at risk of major complications when they also develop heart damage. The median age of death is 43 years old.

    “Cardiomyopathy or heart damage can predispose patients to a fatal rhythm disturbance called ventricular tachycardia,” Desai said. “We believe that inflammation plays a key role in both, creating this injurious heart and exacerbating it. We are deeply interested in translating this potential therapeutic to patients, developing a clinical trial and trying to understand the impact R-propranolol, given that propranolol appears to be well tolerated in patients otherwise.”

    Propranolol is a mixture of two chemical formulations-R-prop and S-Propranolol, which are similar in composition. The only difference is that R-prop does not demonstrate as much beta blocker activity. The team also plans to evaluate potential for toxicity before introducing R-prop in a clinical trial.

    “Evaluating a therapeutic that has already been consumed by millions for other diseases could help accelerate the potential use in patients with sickle cell more quickly,” said Desai, principal investigator of the study, a cardiologist at IU Health and leader of KCVRC’s Cardiopulmonary Research Program. “This grant will allow us to study heart injury as well as rhythm disturbance impact in preclinical models of sickle cell disease. The study funds a disease that is underrecognized and underrepresented and supports a broader goal at closing health care gaps.”

    Desai will collaborate with Bum-Rak Choi, PhD, associate professor of medicine at Rhode Island Hospital and Brown University. He will work closely with Choi on data related to the development of fatal arrhythmias in sickle cell disease.

    “While new therapies are being explored, cleverly repurposed drugs that have already had human exposure with strong safety profile, such as R-propranolol, stand to make major headway in solving a long-standing health issue affecting the heart and cardiovascular system in the United States and abroad,” said Rohan Dharmakumar, PhD, executive director of the KCVRC.

    Powered by WPeMatico

    High fibrinogen-to-albumin ratio tied to stroke recurrence and poor functional outcome in LAA stroke patients

    The fibrinogen-to-albumin ratio (FAR), a new inflammatory marker, is a potential prognostic indicator for vascular diseases.

    A high baseline fibrinogen‐to‐albumin ratio level is associated with an increased stroke recurrence risk, poor functional outcome, and dependence in patients with acute large artery atherosclerosis (LAA) stroke. Yafei Wang and colleagues mentioned in their study published in the Journal of the American Heart Association. This study aimed to assess FAR’s association with LAA stroke.

    Total 809 patients within 72 hours of LAA stroke were included in the study. These were followed up for one year. FAR was calculated as fibrinogen/albumin (unit:g/L). The multivariate Cox regression or logistic regression analysis determined the associations of FAR with clinical outcomes. The recurrence of stroke, all‐cause death, poor functional outcome and dependence were included in the clinical outcomes.

    The findings from the study are:

    · Among 809 patients with acute LAA stroke, the median FAR was 0.075.

    · At 1 year, 12.7% (104 patients) had stroke recurrence, 13.0%(105 patients) had poor functional outcomes, and 9.8% (76 patients) had dependence.

    · 29 patients, constituting 3.6%, died.

    · After adjusting for confounding factors, the high FAR level was associated with stroke recurrence, poor functional outcome and dependence with a hazard ratio of 2.57, 3.30 and 3.49, respectively.

    They said, “Fibrinogen-to-albumin ratio may serve as a predictor of adverse outcomes in acute large artery atherosclerosis stroke. Appropriate treatment might be considered in patients with high FAR levels to reduce the occurrence of poor outcomes.”

    Our research found that high levels of fibrinogen were associated with an increased stroke recurrence risk. Albumin, an inflammation biomarker, has anticoagulant and antiplatelet properties, and previous studies have linked low albumin levels to an increased stroke risk.

    The Natural Science Foundation of Hebei Province funded the study.

    Reference:

    Wang, Y. et al. Fibrinogen‐to‐Albumin ratio and clinical outcomes in patients with large artery atherosclerosis stroke. Journal of the American Heart Association, 12(24). https://doi.org/10.1161/jaha.123.030837

    Powered by WPeMatico

    Study reveals association between maternal prenatal infections and risk of biliary atresia in offspring

    Taiwan: A recent study published in JAMA Network Open has suggested an association between prenatal intestinal infection and genitourinary tract infection in mothers and the occurrence of biliary atresia (BA) in offspring.

    The case-control study of 447 infants with a BA diagnosis and 2912 controls revealed offspring born to mothers with prenatal intestinal infection and genitourinary tract infection had a significantly greater risk of BA development compared to offspring who were not exposed to such maternal infections.

    Biliary atresia is a rare, devastating hepatobiliary disease which is the primary cause of pediatric liver transplant. The underlying aetiology of BA remains elusive despite substantial research. According to current theories, the principal pathomechanism of BA involves fibrosis and inflammation of cholangiocytes and hepatocytes, particularly after exposure to viral infections during the early neonatal period. However, studies have shown that BA may begin in utero. There is no clear understanding of the association of maternal infections during pregnancy with the development of BA in offspring.

    To fill this knowledge gap, Wei-Hao Wang, Department of Pediatrics, Changhua Christian Hospital, Changhua, Taiwan, and colleagues aimed to examine the association between prenatal infections in mothers and the development of biliary atresia in their offspring.

    For the population-based case-control study, the researchers obtained administrative data from the Taiwan National Health Insurance Research Database with linkage to the Taiwan Maternal and Child Health Database, capturing medical and demographic information on the nearly 23 million Taiwanese population.

    The cohort included 2 905 978 singleton live births among mother-infant dyads between 2004 and 2020 in Taiwan. The case group of BA infants was identified from the use of International Classification of Diseases diagnostic codes for BA and subsequent liver transplant or Kasai procedure. The control group was randomly selected from infants without BA, representing about 1 in 1000 study population.

    Prenatal maternal infections included influenza, intestinal infection, pneumonia, soft-tissue infection, upper airway infection, and genitourinary tract infection.

    The study’s primary outcome was exposure to prenatal maternal infections. Inverse probability weighting analysis was performed by building a logistic regression model to estimate the probability of the exposure observed for a particular infant and using the estimated probability as a weight in subsequent analyses. The risk of BA in offspring after prenatal maternal infections was assessed using the weighted odds ratio (OR) estimated by logistic regressions.

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

    • Among the mother-infant dyads included, 447 infants with BA were cases (51.9% females) and 2912 infants without BA were controls (52.0% males). The mean maternal age at childbirth was 30.7 years.
    • Offspring exposed to prenatal intestinal infection (weighted OR, 1.46) and genitourinary tract infection (weighted OR, 1.22) in mothers exhibited a significantly higher risk of BA.
    • Maternal intestinal infection (weighted OR, 6.05) and genitourinary tract infection (weighted OR, 1.55) that occurred during the third trimester were associated with an increased risk of BA in offspring.

    “We observed an association between prenatal intestinal infection and genitourinary tract infection in mothers and BA occurrence in their offspring,” the researchers wrote. “the exact underlying mechanism for which warrants further exploration.”

    “The findings also suggest the importance of additional BA surveillance in the offspring of pregnant women with these diseases,” they concluded.

    Reference:

    Wang W, Chiu F, Kuo T, Shao YJ. Maternal Prenatal Infections and Biliary Atresia in Offspring. JAMA Netw Open. 2024;7(1):e2350044. doi:10.1001/jamanetworkopen.2023.50044

    Powered by WPeMatico

    Study Suggests Association Between Helicobacter pylori Infection and Alzheimer’s Disease Risk

    A comprehensive population-based study conducted over nearly three decades has shed light on a potential link between clinically apparent Helicobacter pylori infection (CAHPI) and the risk of developing Alzheimer’s disease (AD). This study was published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association journal. The study, utilizing the United Kingdom’s Clinical Practice Research Datalink (UK CPRD), aimed to investigate whether there exists an association between CAHPI and the onset of AD in individuals aged 50 years and above.

    The study involved a vast cohort of over 4 million dementia-free subjects. Through a nested case-control approach, researchers matched each newly diagnosed case of AD with 40 controls. The analysis used conditional logistic regression to estimate the odds ratios (ORs) and their 95% confidence intervals (CIs) for AD risk associated with CAHPI compared to no CAHPI, specifically considering a time frame of two or more years preceding the index date. Additionally, salmonellosis served as a negative control exposure for comparative purposes.

    The findings unveiled a noteworthy association between CAHPI and an increased risk of AD, with the OR for AD risk being 1.11 (95% CI, 1.01–1.21) when compared to individuals without CAHPI. Intriguingly, salmonellosis did not exhibit any significant association with the risk of AD, as indicated by an OR of 1.03 (95% CI, 0.82–1.29).

    Key highlights from the study include:

    • CAHPI was linked to an 11% heightened risk of developing AD among individuals aged 50 years and above.

    • The risk of AD peaked at 24% approximately a decade after the onset of CAHPI.

    • The study noted no substantial effect modification by age or sex, suggesting a consistent association across demographic groups.

    • Rigorous sensitivity analyses aimed at addressing potential biases consistently supported the association between CAHPI and AD risk.

    This comprehensive investigation provides compelling evidence suggesting a moderate association between clinically apparent Helicobacter pylori infection and the risk of developing Alzheimer’s disease. However, the study authors caution that further research is needed to establish a causal relationship and unravel the underlying mechanisms driving this association.

    Reference:

    Douros, A., Ante, Z., Fallone, C. A., Azoulay, L., Renoux, C., Suissa, S., & Brassard, P. Clinically apparent Helicobacter pylori infection and the risk of incident Alzheimer’s disease: A population‐based nested case‐control study. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association,2023. https://doi.org/10.1002/alz.13561

    Powered by WPeMatico

    Revolutionising Ultrasound: Advancements in Hand Imaging with Lateral Approach Water Baths

    Traditional water baths in ultrasound exams often present limitations due to patient manipulation requirements and potential motion artifacts. Addressing these concerns, the lateral approach water bath method offers a novel technique for ultrasound imaging without submerging the probe. A recent study was published in The American Journal Of Emergency Medicine by Jennifer Cotton and colleagues. This study aimed to compare the imaging quality and clinical utility of this new method against traditional water bath techniques.

    Twenty images from each method were compared, ensuring standardized conditions with the same model and operator. Blinded ultrasound fellowship-trained reviewers rated the images for quality and their potential for aiding clinical decisions on a scale of 1 to 5.

    Key Findings

    • Enhanced Imaging Quality:

    The lateral approach water bath displayed significantly better image quality (average rating: 4.2) compared to the traditional method (average rating: 2.6) (p < 0.001).

    Reviewers consistently rated lateral bath images higher for clinical decision-making adequacy (average rating: 4.0) compared to traditional bath images (average rating: 2.6) (p < 0.001).

    The lateral approach bath demonstrated a smaller range in image quality, ensuring greater consistency.

    The lateral approach water bath technique showcased superior imaging quality, consistency, and clinical usefulness over traditional water baths in ultrasound examinations. This innovative method holds promise in revolutionizing ultrasound imaging practices for enhanced diagnostics and decision-making.

    Reference:

    Cotton, J., Bahner, D., & Prats, M. The lateral approach water bath: A novel method of ultrasound imaging of the hand. The American Journal of Emergency Medicine,2023. https://doi.org/10.1016/j.ajem.2023.11.005 

    Powered by WPeMatico