Lignan Intake Linked to Lower Mortality in Individuals with Type 2 Diabetes: Study

Researchers have demonstrated in a new study that higher levels of lignan consumption may lower the risk of mortality in a patient with type 2 diabetes mellitus (T2D), in those from minority ethnic groups. These are polyphenolic compounds mainly found in foods derived from seeds, whole grains, fruits, and vegetables. The study was conducted by Binkai Liu and colleagues published in The American Journal of Clinical Nutrition.

The study aimed at prospectively assessing the association between lignan intake after a diagnosis of diabetes and mortality risks from all causes, cardiovascular disease, and cancer-related deaths.

In analyzing data from the two large US cohorts: the Nurses’ Health Study from 1984 through 2020 and the Health Professionals Follow-up Study from 1986 to 2022, a total of 8,465 subjects with T2D provided information for 116,026 person-years of follow-up. Authors calculated average daily intake of lignan for total lignans and by types: matairesinol (MAT), secoisolariciresinol (SECO), pinoresinol (PINO), and lariciresinol (LARIC). Researchers estimated HRs and 95% CIs using multivariable-adjusted Cox models in order to obtain the association estimate.

Key Findings

During the follow-up period, 4,372 deaths were reported, of which 1,318 were CVD and 752 were cancer. The pooled results for all were as follows:

• All-Cause Mortality: The pooled HR for the highest versus lowest quintile was 0.83 (95% CI: 0.74, 0.94).

• Cardiovascular Mortality: SECO intake significantly correlated with the pooled HR of 0.78 (95% CI: 0.69, 0.87).

• Cancer Mortality: SECO intake was also inversely associated with cancer mortality, with HR of 0.78.

Individual Lignans:

• Matairesinol (MAT): HR of 0.89 (95% CI: 0.80, 0.99)

• Pinoresinol (PINO): HR of 0.91 (95% CI: 0.81, 1.01)

• Lariciresinol (LARIC): HR of 0.92 (95% CI: 0.82, 1.03)

Changes in lignan intake from pre- to post-diagnosis were also consistently associated favourably:

• Total lignans: HR of 0.83 (95% CI: 0.75, 0.93).

• MAT: HR of 0.86 (95% CI: 0.77, 0.96).

• SECO: HR of 0.81 (95% CI: 0.72, 0.90).

The associations were stronger among non-white participants, which suggests potential population-specific benefits.

Researchers concluded that high lignan intake was associated with significantly reduced risks of all-cause and cause-specific deaths, including mortality from CVD and cancer. Thus, dietary lignans may play an important role in mitigating health complications in T2D patients, especially among minorities.

Reference:

Liu, B., Hu, Y., Wang, S., Wang, M., Rimm, E. B., & Sun, Q. (2025). Lignan intake and mortality among adults with incident type 2 diabetes–prospective cohort studies. The American Journal of Clinical Nutrition. https://doi.org/10.1016/j.ajcnut.2025.01.008

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Patients with obstructive sleep apnea have increased risk of tinnitus: Study

A new study published in the journal of Sleep and Breathing found that people with obstructive sleep apnea (OSA) were 43% more likely than people without OSA to experience tinnitus. 

The ability to perceive sound without the aid of outside stimuli is known as tinnitus. Significant variation exists in the cause, intensity, and impact of tinnitus, underlining its complex character. Because of this variety, tinnitus cannot be fully explained by a single mechanism, and there is no one treatment that works for everyone. In addition to this, mental health, quality of life, and everyday functioning can all be negatively impacted by severe tinnitus.

One known risk factor for making tinnitus-related suffering worse is sleep disturbance. On the other hand, annoying tinnitus is a risk factor for poor sleep, which feeds the vicious cycle. There has been growing evidence in recent years that sleep disorders and hearing loss are related. Both population-based and clinic-based cohorts revealed that patients with an OSA diagnosis had greater rates of audiometry-measured hearing loss. So, Chao Wang and colleagues used NHANES data from 2005 to 2020 to examine the relationship between tinnitus and obstructive sleep apnea.

This study involved a total of 4871 participants who were 16 years of age or older and examined data from NHANES (National Health and Nutrition Examination Surveys) that were carried out between 2005 and 2020. The Multivariate Apnea Prediction Index and the National Health and Nutrition Examination Survey factors were used to evaluate OSA.

The participants who reported experiencing a ringing, roaring, or buzzing sound in their ears or head for 5 minutes or more during the previous 12 months were considered to have tinnitus. To investigate the relationship between OSA and tinnitus, logistic regression models were utilized. The total prevalence of tinnitus in the study cohort was 16.5%, with 46.49% of females and 53.51% of males. Tinnitus and OSA were significantly correlated after adjusting for possible variables.

Overall, based on these results, OSA may be a risk factor for tinnitus. Future studies into the possible mechanism behind the link between sleep problems and tinnitus, as well as the investigation of conjunctive therapeutic options for both challenging-to-treat disorders, will be influenced by these findings.

Reference:

Wang, C., Shi, M., Xie, L., Qin, Z., Li, W., Wang, D., Peng, W., Wu, J., & Li, Y. (2025). Association between obstructive sleep apnea and Tinnitus in the United States: NHANES 2005–2020. Sleep And Breathing, 29(1). https://doi.org/10.1007/s11325-025-03243-0

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Supine Hypertension Linked to Higher Cardiovascular Risk, JAMA Study Finds

USA: Recent research published in JAMA Cardiology has shed light on the significant role that blood pressure measurements taken in the supine position play in assessing cardiovascular risk.

The researchers revealed that individuals with elevated supine blood pressure—regardless of their seated blood pressure levels—experience a higher hazard ratio (HR) for cardiovascular risk. This indicates that supine hypertension might be an even stronger indicator of cardiovascular disease (CVD) risk than seated hypertension alone.

The study noted that elevated blood pressure during sleep, known as nocturnal hypertension, is linked to a significant rise in the risk of cardiovascular disease and mortality. While seated blood pressure has long been used as a standard metric for hypertension diagnosis, Duc M. Giao, Harvard Medical School, Boston, Massachusetts, and colleagues aimed to examine the relationship between supine hypertension and cardiovascular disease outcomes, considering the status of hypertension treatment.

For this purpose, the researchers conducted a prospective cohort study using data from the Atherosclerosis Risk in Communities (ARIC) study, established in 1987. The study analyzed supine and seated blood pressure measurements in over 13,000 middle-aged adults. The study excluded participants with a history of coronary heart disease (CHD), heart failure, or stroke and followed them for 27 years to track CVD outcomes.

Supine hypertension was defined as a systolic blood pressure ≥130 or diastolic ≥80 mm Hg. Cox proportional hazard models were used to assess the relationship between supine hypertension, seated hypertension, and incidents of CHD, heart failure, stroke, fatal CHD, and all-cause mortality.

The study revealed the following findings:

  • Among 11,369 participants without known cardiovascular disease, 16.4% without seated hypertension had supine hypertension, while 73.5% with seated hypertension had supine hypertension.
  • Supine hypertension was linked to higher risks of incident CHD (HR, 1.60), heart failure (HR, 1.83), stroke (HR, 1.86), fatal CHD (HR, 2.18), and all-cause mortality (HR, 1.43) during a median follow-up of approximately 25.7 to 28.3 years.
  • No meaningful differences in results were observed based on seated hypertension status or hypertension medication use.
  • Participants with only supine hypertension showed similar risk associations to those with hypertension in both positions, with risks significantly higher than those with seated hypertension alone, except for fatal CHD.
  • The hazard ratios for seated vs supine hypertension were lower for CHD (0.72), heart failure (0.72), stroke (0.66), and all-cause mortality (0.83).

In the cohort study conducted among middle-aged, community-dwelling adults, the authors found that supine hypertension is independently associated with an increased risk of cardiovascular disease events, regardless of medication use or seated hypertension. Notably, supine hypertension was linked to a higher risk of CVD events compared to seated hypertension.

“Future research should explore whether targeting and treating supine hypertension could potentially reduce the risk of CVD events, providing a more comprehensive approach to hypertension management, the researchers concluded.

Reference:

Giao DM, Col H, Larbi Kwapong F, et al. Supine Blood Pressure and Risk of Cardiovascular Disease and Mortality. JAMA Cardiol. Published online January 22, 2025. doi:10.1001/jamacardio.2024.5213

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Fizzy water might aid weight loss by boosting glucose uptake and metabolism: Study

Fizzy water might aid weight loss by boosting blood glucose uptake and metabolism-the rate at which the body uses and converts energy-but the effects are so small, drinking it can’t be relied on alone to shed the pounds, concludes a brief analysis published in the open access journal BMJ Nutrition Prevention & Health.

There are no quick fixes to slimming down and keeping off the weight, says the author: regular physical activity and a healthy balanced diet are still essential, added to which the long term effects of drinking large amounts of carbonated water aren’t known.

Because fizzy water is ‘filling,’ thereby helping to curb hunger pangs, and reportedly speeds up digestion and lowers blood glucose levels, it has been heralded as a potential slimming aid.

But it’s not clear exactly how carbonated water might reduce blood glucose or how this might contribute to weight management, points out the author.

To try and find out, the author compared the process of drinking fizzy water with haemodialysis, whereby blood is filtered (dialysed) to remove waste and excess water when the kidneys no longer can, drawing on previously published research.

Haemodialysis turns blood alkaline, primarily producing carbon dioxide (CO₂). Similarly, the CO₂ of fizzy water is absorbed through the stomach lining and is rapidly converted to bicarbonate (HCO3) in red blood cells. This alkalinisation process speeds up glucose absorption and use by activating key enzymes in red blood cells, explains the author.

Clinical observations during haemodialysis show that blood glucose levels fall as blood passes through the dialyser, despite a higher glucose level in the dialysate solution to start with, he adds.

While these findings suggest that fizzy water may indirectly promote weight loss by enhancing the uptake and use of blood glucose, context is key, emphasises the author.

During a typical 4 hour haemodialysis session around 48000 ml of blood flows through the dialyser, resulting in around 9.5 g of glucose being used during the session, he explains.

“Given this minimal glucose reduction, the impact of CO₂ in carbonated water is not a standalone solution for weight loss. A balanced diet and regular physical activity remain crucial components of sustainable weight management,” he insists.

“Also, drinking carbonated water can have some effects on the digestive system, particularly for individuals with sensitive stomachs or pre-existing gastrointestinal conditions. The primary concerns include bloating, gas and, in some cases, exacerbation of certain symptoms associated with digestive disorders, such as irritable bowel syndrome or gastro-oesophageal reflux disease,” he points out.

“Moderation is key to avoiding discomfort while still enjoying the possible metabolic benefits of carbonated water,” he says.

Commenting on the analysis, Professor Sumantra Ray, Executive Director, NNEdPro Global Institute for Food, Nutrition and Health, which co-owns the journal, said: “While there is a hypothetical link between carbonated water and glucose metabolism this has yet to be tested in well designed human intervention studies.

“And although this study adds to the evidence base, it doesn’t provide sufficient evidence on which to make recommendations for the preventive or therapeutic use of carbonated water. Additionally, any potential benefits must be weighed up against the potential harms of carbonated drinks which may contain sodium, glucose, or other additives.”

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Lack of essential vitamins and minerals common in people with type 2 diabetes, reveals research

Micronutrient deficiency, whereby levels of vitamins and minerals essential for healthy bodily function are far too low, is common in people with type 2 diabetes, finds a pooled data analysis of the available evidence, published in the open access journal BMJ Nutrition Prevention & Health.

A lack of vitamin D is the most common ‘missing’ micronutrient, overall, the findings indicate, with women at greater risk than men of these deficiencies, dubbed ‘hidden hunger.’

Genetic predisposition, various environmental factors, sedentary lifestyle, an unhealthy diet and obesity are risk factors for the disease, explain the researchers. And previously published research suggests that micronutrients have a key role in the development of type 2 diabetes, by potentially affecting glucose metabolism and insulin signalling pathways.

In a bid to try and quantify the global prevalence of micronutrient deficiency in people with the condition, the researchers scoured research databases for relevant studies, with the aim of pooling the data.

Their analysis included 132 studies, involving 52,501 participants, and published in several languages between 1998 and 2023. With the exception of 3 studies, the rest were hospital based.

The pooled data analysis showed that the prevalence of micronutrient deficiency (vitamins, minerals, and electrolytes) among people with type 2 diabetes varied around the world, possibly because of diverse dietary habits, lifestyle choices, and cultural practices, suggest the researchers.

But, overall, the global prevalence was 45%-40% in those with complications of their disease.

A very low level of vitamin D was the most common micronutrient deficiency, affecting 60.5% of those with type 2 diabetes. But magnesium deficiency was also common, affecting 42%, while the prevalence of iron deficiency was 28%. The global prevalence of B12 deficiency was 29%, and higher, still, among patients taking metformin.

Further stratification of the pooled data showed that prevalence was higher in women with the condition than in men at nearly 49%, and highest among patients in the Americas (54%).

Most of the included studies were cross sectional, making it difficult to establish causality, nor was it clear whether the micronutrient deficiency preceded poor glycaemic control or was a consequence of it, caution the researchers.

And as there are no valid population based studies looking at micronutrient deficiency, it’s impossible to draw comparisons between patients with type 2 diabetes and the general population, they add.

“This systematic review exemplifies the double burden of malnutrition in action, whereby nutritional deficiencies and diet-related non-communicable diseases, such as type 2 diabetes, co-exist,” comments Shane McAuliffe, Visiting Senior Academic Associate, NNEdPro Global Institute for Food, Nutrition and Health, which co-owns the journal.

“The treatment of type 2 diabetes often tends to focus on energy metabolism and macronutrients, but the identification of a higher prevalence of specific micronutrient deficiencies in those affected is a reminder that optimising overall nutrition should always be a priority.

“The findings should help to focus research and policy initiatives aimed at furthering our understanding of the causes and effects of these deficiencies and the potential for targeted and tailored interventions.”  

Reference:

Burden of micronutrient deficiency among patients with type 2 diabetes: systematic review and meta-analysis, BMJ Nutrition Prevention & Health (2025). DOI: 10.1136/bmjnph-2024-000950

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Cancer drugs linked to severe chronic peripheral nerve pain for 4 in every 10 patients

Worldwide, cancer chemotherapy is linked to persistent severe peripheral nerve pain (neuropathy) for around 4 in every 10 patients treated with these drugs, suggests a pooled data analysis of the available evidence, published in the open access journal Regional Anesthesia & Pain Medicine.

Notwithstanding wide regional variations, platinum based drugs, taxanes, and lung cancer seem to be associated with the highest rates of persistent painful neuropathy, lasting at least 3 months, the findings suggest, prompting the researchers to call for tailored approaches to pain relief.

The drugs used to treat cancer damage healthy cells and tissues, including the nervous system. The effects can manifest in movement disturbances, such as loss of balance or coordination, and sensory disturbances, such as loss of sensation; numbness, tingling, “pins and needles”; or a burning sensation on the skin.

Several factors influence the frequency and severity of chronic peripheral neuropathic pain, including type and dose of chemotherapy, pre-existing neuropathy, and the use of other drugs that can damage the nervous system, explain the researchers.

The condition is thought to be caused by direct peripheral nerve cell damage which disrupts or rewires normal nerve signalling pathways, resulting in persistent pain, they add.

Prompted by the growing number of cancer survivors and increasingly aggressive treatment of the disease, the researchers wanted to gauge the global prevalence of chronic painful peripheral neuropathy linked to chemotherapy.

They scoured research databases for relevant studies published between 2000 and 2024, focusing on potentially influential sociodemographic, clinical, and methodological (study design, funding source, for example) factors.

In all, they pooled the results of 77 eligible studies, involving 10,962 participants from 28 countries, all of whom had peripheral neuropathy that was associated with cancer drug treatment. In 4545 of these participants, this was painful and persistent, lasting for at least 3 months.

The highest number of studies were carried out in the US (13) and Japan (10), and almost half were prospective observational studies.

The cancers that featured most often were those of the bowel (25; 33%) and breast (17; 22%), while the largest proportion of studies focused on patients treated with either platinum based agents (13;17%), or taxanes (11; just over 14%), or both (6 ;8%), or the FOLFOX combination of folinic acid plus 5-fluorouracil plus oxalplatin (5; 6.5%).

Pooled data analysis of the study results showed that the overall prevalence of persistent painful peripheral neuropathy was just over 41%.

When stratified further, the analysis indicated that the highest prevalence was among patients treated with platinum based agents (40.5%) and taxanes (just over 38%). Prevalence was lowest among those treated with the FOLFOX combination (16.5%).

Prevalence was also highest among those with primary lung cancer (just over 62%), possibly because of the complexities of treatment for this disease, suggest the researchers. Prevalence was lowest among those with primary ovarian cancer (31.5%) and lymphoma (36%).

When stratified by continent, studies of patients in Asia reported the highest prevalence of persistent painful neuropathy (46.5%), while studies of patients in Europe reported the lowest (36%). Prevalence rates were similar in both men and women.

The researchers emphasise that the design and methodology of the included studies differed substantially. And the overall certainty of evidence was considered to be low.

But they write: “Understanding the prevalence and predictors of chronic painful [chemotherapy induced peripheral neuropathy] is critical for promoting early diagnosis and developing personalized treatment strategies.

“Our findings emphasize that chronic painful [chemotherapy induced peripheral neuropathy] represents a substantial global health challenge, affecting more than 40% of those diagnosed with [it].”

And they conclude: “The wide variability in prevalence rates across different countries, continents, chemotherapy regimens, and primary cancer history underscores the need for tailored strategies to address this debilitating condition.

“Future studies should focus on elucidating the mechanisms underlying these disparities and developing interventions that can reduce the burden of chronic painful [chemotherapy induced peripheral neuropathy] globally.”

Reference:

Global estimates of prevalence of chronic painful neuropathy among patients with chemotherapy induced peripheral neuropathy: systematic review and meta-analysis of data from 28 countries, 2000–24, Regional Anesthesia & Pain Medicine, DOI:10.1136/rapm-2024-106229 

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Prourokinase Shows No Advantage Over Standard Care for Mild Ischemic Stroke: PUMICE Trial Findings

China: A recent randomized clinical trial, the PUMICE study, evaluated the efficacy and safety of prourokinase compared to standard care in patients with mild ischemic stroke. Findings of the trial, published in JAMA Neurology, indicate that prourokinase did not outperform standard care in enhancing functional outcomes for patients with mild ischemic stroke treated within 4.5 hours of symptom onset, although its safety profile was comparable.

Trials to date have not established the superiority of alteplase or tenecteplase over standard care in patients with mild ischemic stroke, while also raising concerns about their safety profiles. In this context, prourokinase emerges as a potential alternative fibrinolytic agent that may offer a more favorable safety profile. However, the benefit-risk profile of prourokinase in the treatment of mild stroke remains unclear. To address this gap, Yunyun Xiong, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China, and colleagues aimed to evaluate the efficacy and safety of prourokinase in patients with mild ischemic stroke when administered within 4.5 hours of symptom onset.

For this purpose, the researchers conducted a multicenter, prospective, open-label, blinded-end point randomized clinical trial across 89 hospitals in China from November 2022 to December 2023, with a three-month follow-up. The study included patients with a baseline National Institutes of Health Stroke Scale score of 5 or less, treated within 4.5 hours of symptom onset, excluding those intended for endovascular therapy. Participants were randomized 1:1 to receive either prourokinase (35 mg) or standard care, which included antiplatelet or anticoagulant therapy.

The primary outcome was a modified Rankin Scale score of 0 or 1 at day 90, with safety outcomes including symptomatic intracranial hemorrhage and death.

The following were the key findings of the study:

  • Of 3836 patients screened, 1446 were enrolled in the trial. The median age of participants was 65.9 years, and 948 were male.
  • Seven-hundred twenty-three patients were assigned to the prourokinase group and 723 to the standard care group.
  • The primary outcome was achieved in 88.5% of patients in the prourokinase group and 91.0% in the standard care group (relative risk: 0.97).
  • Symptomatic intracranial hemorrhage occurred in 0.7% with prourokinase and 0% with standard care.
  • Mortality at 90 days was 2.3% in the prourokinase group and 1.4% in the standard care group.

“The findings of the PUMICE randomized clinical trial indicate that thrombolysis with prourokinase did not demonstrate superiority over standard care in improving functional outcomes for patients with mild ischemic stroke treated within 4.5 hours of symptom onset and exhibited a comparable safety profile,” the researchers concluded.

Reference:

Xiong Y, Meng X, Jin A, et al. Prourokinase vs Standard Care for Patients With Mild Ischemic Stroke: The PUMICE Randomized Clinical Trial. JAMA Neurol. Published online January 21, 2025. doi:10.1001/jamaneurol.2024.4688

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Use of montelukast not associated with risk of neuropsychiatric adverse events among children: JAMA

Use of montelukast not associated with risk of neuropsychiatric adverse events among children suggests a new study published in the JAMA.

Spontaneous reports have indicated that montelukast increases the risk of neuropsychiatric adverse events, and the US Food and Drug Administration added a boxed warning about these risks in 2020. However, the potential mechanism is not well understood, and the observational evidence is scarce, particularly in children. A study was done to assess the potential association between the use of montelukast and the risk of neuropsychiatric adverse events in children and adolescents. This nationwide register-based cohort study used data from Sweden from January 1, 2007, to November 30, 2021. Participants included children aged 6 to 17 years who used montelukast and long-acting β-agonists (LABA). Data analysis was performed from December 2023 to April 2024. The primary outcome, any neuropsychiatric adverse event, was a composite of secondary outcomes, including anxiety; depression; sleep-related disorders; suicide and suicidal actions; disrupted control of activity, attention, and behavior; and confusion and psychotic-like symptoms. Outcomes were defined based on diagnosis codes and the dispensing of prescription drugs for specific neuropsychiatric symptoms. Patients were followed up from drug initiation to discontinuation, and treatment and censoring weights were used to adjust for potential confounding on baseline and selection bias from informative censoring. Pooled logistic regression was used to estimate hazard ratios (HRs). Results The final cohort included 74 291 children (mean [SD] age, 12.3 [3.3] years; 35 446 female [47.7%]); 26 462 used montelukast and 47 829 used LABA. During a mean (SD) follow-up of 5.8 (3.2) months, 310 neuropsychiatric adverse events in the montelukast patients and 566 events in the LABA patients were identified. In the weighted cohort, the incidence rates of neuropsychiatric adverse events were 2.39 per 100 patient-years among the montelukast users and 2.41 per 100 patient-years among the LABA users. This translated to a weighted HR of 0.99 (95% CI, 0.84-1.16). No substantial differences were observed between the montelukast and LABA patients when analyzing the risk of specific neuropsychiatric adverse events: the HRs were 0.79 (95% CI, 0.54-1.14) for anxiety; 1.16 (95% CI, 0.70-1.95) for depression; 0.93 (95% CI, 0.76-1.13) for sleep-related disorders; 1.31 (95% CI, 0.64-2.69) for suicide and suicidal actions; 1.27 (95% CI, 0.84-1.90) for disrupted control of activity, attention, and behaviour; and 0.51 (95% CI, 0.05-5.53) for confusion and psychotic-like symptoms. The risk of the primary outcome was consistent over subgroups and a range of sensitivity analyses. In this large study of children and adolescents based on data from routine clinical practice, there was no association between the use of montelukast and the risk of neuropsychiatric adverse events. In aggregation with other robust observational studies, these results can inform the management of asthma and allergic rhinitis in this patient group.

Reference:

Wintzell V, Brenner P, Halldner L, Rhedin S, Gong T, Almqvist C. Montelukast Use and the Risk of Neuropsychiatric Adverse Events in Children. JAMA Pediatr. Published online January 21, 2025. doi:10.1001/jamapediatrics.2024.5429

Keywords:

Use, montelukast, associated, risk, neuropsychiatric, adverse, events, among, children, JAMA, Wintzell V, Brenner P, Halldner L, Rhedin S, Gong T, Almqvist C

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Old Age, High NWR, and PCT may Predict Mortality in Hemodialysis Patients with COVID-19

Old Age, High NWR, and PCT may Predict Mortality in Hemodialysis Patients with COVID-19 suggests a new study published in the BMC Nephrology.

The globally widespread coronavirus disease of 2019 (COVID-19) was first detected in Wuhan province, China, in December 2019 and is caused by the severe acute respiratory syndrome coronavirus. Older hemodialysis patients and those with obvious comorbidities are reported to be more susceptible to severe viral and bacterial respiratory infections, as has been shown with COVID-19. Exploring the risk factors for mortality of hemodialysis patients undergoing COVID-19 and the changes in mortality before and after the opening of the epidemic in northern Hunan province, China. They analyzed 230 hemodialysis patients with COVID-19 in the Yiyang Central Hospital from November 01, 2022 to February 28, 2023. Demographic data, laboratory data and public diseases were collected. Cox regression analysis was used to identify risk factors and independent predictors of mortality. The receiver operating characteristic (ROC) curve was used to determine the diagnostic value of risk factors in hemodialysis COVID-19 patients. Results: The average duration of the disease was 12.53 days. The mortality rate in our cohort was 28.70%. Independent predictors of mortality in our cohort were: age (hazard ratio [HR] 1.09; 95% confidence interval [CI], 1.05–1.14; P < 0.001), elevated procalcitonin (PCT) levels, and higher white blood cell-neutrophil ratio (NWR). Areas under the ROC curve (AUC) for age, NWR, PCT, and age*NWR were 0.70, 0.82, 0.64, and 0.89.

They discovered that old age, and high levels of NWR and PCT might be predictors of mortality, reported the causes and prognostic predictors of mortality in hemodialysis populations with COVID-19 from northern Hunan, China.

Reference:

He, Z., Peng, Z., Gao, N. et al. Risk factors for the mortality of hemodialysis patients with COVID-19 in northern Hunan province, China. BMC Nephrol 26, 26 (2025). https://doi.org/10.1186/s12882-025-03946-2

Keywords:

Old Age, High NWR, PCT, Predict, Mortality, Hemodialysis, Patients, COVID-19, BMC Nephrology, He, Z., Peng, Z., Gao, N, Hemodialysis, COVID-19, Mortality, Prognosis

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Changing Lifestyle and cutting Problematic Internet Use may reduce Dental Caries in Children, suggests study

Researchers noted in a new study that problematic internet use (PIU) and poor lifestyle habits showed significant association with multiple dental caries among the elementary school-going children. Dental caries remains a leading disease prevalent among children around the world. This study was conducted by Yamada and colleagues published in the journal of BMC Oral Health.

The study included 13,413 children with a mean age of 10.5 years from 110 elementary schools in the Toyama Safe Internet Use Project. Questionnaires were completed on lifestyle habits, anthropometric measurements, family rules for screen time, PIU (assessed using Young’s Diagnostic Questionnaire), and self-reported treated caries. Multiple caries were defined as three or more caries. Modified Poisson regression analysis was undertaken to identify significant associations between caries and various factors.

Results

  • Of the total participants, 12,146 children (90.7%) were included in the final analysis. The prevalence of multiple caries was 25.7%, with a higher prevalence in girls (27.0%) than boys (24.4%). Significant associations were found between multiple caries and various factors:

  • Sex: Girls had a higher likelihood of multiple caries (adjusted prevalence ratio [aPR] 1.13).

  • Grade: Higher grades were associated with an increased risk (5th grade: aPR 1.13; 6th grade: aPR 1.14).

Lifestyle habits:

  • Breakfast skipping (aPR 1.11).

  • Bedtime: 10–11 p.m. (aPR 1.17); ≥11 p.m. (aPR 1.23).

  • Brushing teeth infrequently:

  • Family rules: No family restriction on screen time (aPR 1.20).

  • Problematic Internet Use: PIU demonstrated a dose-response relationship, with significant effects in boys. Children with moderate PIU (YDQ score 3–4) had an aPR of 1.17, whereas severe PIU (YDQ score ≥5) increased the likelihood to 1.22.

  • Stratified analysis revealed a stronger association between PIU and caries in boys, with higher YDQ scores correlating with greater prevalence.

Researchers concluded that being female, maintaining an unhealthy lifestyle, and experiencing problematic internet use (PIU) were significantly associated with multiple self-reported dental caries. To prevent caries in children, promoting a healthy lifestyle and limiting problematic internet use is recommended.

Reference:

Yamada, M., Sekine, M., Tatsuse, T. et al. Association of self-reported dental caries with sex, lifestyle, and problematic Internet use among elementary school children in Japan. BMC Oral Health 25, 129 (2025). https://doi.org/10.1186/s12903-025-05475-8

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