Nasal spray shows preclinical promise for treating traumatic brain injury, reveals study

A new study led by researchers at Mass General Brigham suggests a nasal spray developed to target neuroinflammation could one day be an effective treatment for traumatic brain injury (TBI). By studying the effects of the nasal anti-CD3 in a mouse model of TBI, researchers found the spray could reduce damage to the central nervous system and behavioral deficits, suggesting a potential therapeutic approach for TBI and other acute forms of brain injury. The results are published in Nature Neuroscience.

“Traumatic brain injury is a leading cause of death and disability-including cognitive decline-and chronic inflammation is one of the key reasons,” said lead author Saef Izzy, MD, FNCS, FAAN, a neurologist and head of the Immunology of Brain Injury Program at Brigham and Women’s Hospital (BWH), a founding member of the Mass General Brigham healthcare system. “Currently, there is no treatment to prevent the long-term effects of traumatic brain injury.”

The study examines the monoclonal antibody Foralumab, made by Tiziana, which has been tested in clinical trials for patients with multiple sclerosis, Alzheimer’s disease, and other conditions.

“This opens up a whole new area of research and treatment in traumatic brain injury, something that’s almost impossible to treat,” said senior author Howard Weiner, MD, co-director of the Ann Romney Center for Neurologic Diseases at BWH. “It also means this could work in intracerebral hemorrhage and other stroke patients with brain injury.”

Multiple experiments were done in mouse models with moderate-to-severe traumatic brain injury to explore the communication between regulatory cells induced by the nasal treatment and the microglial immune cells in the brain. Over time, researchers were able to identify how they modulate immune response.

“Modulating the neuroinflammatory response correlated with improved neurological outcomes, including less anxiety, cognitive decline, and improved motor skills,” Izzy said.

In addition to assessing the effects of the treatment, the research team was able to learn about immune response over time and compare the immune responses and effects of TBI in the mice.

The next step in the research is to translate the findings from preclinical models to human patients.

“Our patients with traumatic brain injury still don’t have an effective therapeutic to improve their outcomes, so this is a very promising and exciting time to move forward with something that’s backed up with solid science and get it to patients’ bedsides,” said Izzy.

Once in the clinical setting, Weiner said the hope is this treatment could be used on a variety of traumatic brain injury patients, including football players with repetitive concussions.

“We envision giving a nasal spray right there on the sidelines,” said Weiner. “It isn’t something we can do yet, but we see the potential.”

Reference:

Izzy, S., Yahya, T., Albastaki, O. et al. Nasal anti-CD3 monoclonal antibody ameliorates traumatic brain injury, enhances microglial phagocytosis and reduces neuroinflammation via IL-10-dependent Treg–microglia crosstalk. Nat Neurosci (2025). https://doi.org/10.1038/s41593-025-01877-7

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Obesity and Hypothyroxinemia Together Heighten Risk of LGA Births in Pregnant Women: Study Finds

China: A recent Chinese cohort study published in Reproductive Biology and Endocrinology has found that maternal obesity and isolated maternal hypothyroxinemia (IMH) in late pregnancy significantly increase the risk of large-for-gestational-age (LGA) births. IMH, defined by low free thyroxine (FT4) with normal thyroid-stimulating hormone (TSH) levels, independently raised LGA risk by 1.3 times.

Obesity alone was linked to a nearly sixfold higher LGA risk and a sevenfold increase in IMH. Notably, women with both conditions had a 7.6-fold greater risk of delivering LGA newborns, indicating a strong synergistic effect. The findings highlight the importance of monitoring BMI and thyroid function during pregnancy.

The combined impact of isolated maternal hypothyroxinemia and other contributing factors on fetal growth outcomes has not been well established. To address this gap, Bin Zhang, Nanjing Medical University, Changzhou, China, and colleagues aimed to investigate whether the presence of IMH in the third trimester—characterized by free thyroxine (FT4) levels below the 5th percentile and TSH levels within the normal range—along with elevated prenatal body mass index (BMI), jointly increases the risk of delivering large-for-gestational-age newborns.

For this purpose, the researchers conducted a retrospective analysis of 11,478 Chinese pregnant women, utilizing laboratory data, including thyroid hormone levels, routine biochemical tests, and hospitalization records from a specialized hospital.

The study led to the following findings:

  • The prevalence of obesity (BMI ≥ 30 kg/m²) and isolated maternal hypothyroxinemia (IMH) among the study population was 20.1% and 4.5%, respectively.
  • Obese women had a 6.96-fold higher risk of developing IMH compared to women with normal weight (BMI < 25 kg/m²).
  • The risk of delivering large-for-gestational-age (LGA) newborns was 5.88 times higher in obese women than in those with normal weight.
  • Women with IMH had a 1.32-fold increased risk of LGA births compared to euthyroid women.
  • These associations remained consistent in sensitivity analyses conducted among women under 35, first-time mothers, and those without pregnancy complications.
  • Women with both obesity and IMH had a 7.60-fold greater risk of delivering LGA newborns compared to euthyroid women with normal weight.
  • There was a statistically significant interaction between BMI categories and IMH on the risk of LGA births.
  • Subgroup analyses confirmed this interaction among younger women, those with multiple pregnancies, and those without pregnancy-related complications.

The researchers found that in the large cohort of Chinese pregnant women, both obesity and isolated maternal hypothyroxinemia (IMH) in late pregnancy were independently associated with an increased risk of delivering large-for-gestational-age newborns. Notably, the coexistence of these two conditions further amplified this risk.

“The findings emphasize the potential value of combining prenatal BMI assessment with thyroid hormone profiling to identify women at elevated risk for LGA births,” the authors stated. They further noted, “If confirmed in future studies, this approach could have significant clinical and public health implications, particularly given the growing concern surrounding LGA-related health outcomes.”

Reference:

Zhang, B., Xi, S., Zhan, Z. et al. Maternal obesity and the incidence of large-for-gestational-age newborns in isolated hypothyroxinemia pregnancies: a comparative cohort study. Reprod Biol Endocrinol 23, 60 (2025). https://doi.org/10.1186/s12958-025-01394-z

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Early-life exposure to air and light pollution linked to increased risk of pediatric thyroid cancer: Study

 A new study led by researchers at Yale University suggests that early-life exposure to two widespread environmental pollutants-small particle air pollution and outdoor artificial light at night-could increase the risk of pediatric thyroid cancer.

The study-a collaborative effort involving multiple Yale departments and institutions across the U.S.-found a “significant association” between exposure to ambient fine particulate matter air pollution (PM2.5) and outdoor artificial light at night (O-ALAN) and increased risk of papillary thyroid cancer in children and young adults up to 19 years old. The exposures occurred during the perinatal stage of life, typically defined as the time from when pregnancy occurs up to a year after birth.

“These results are concerning, especially given how widespread both of these exposures are,” said Dr. Nicole Deziel, PhD, MHS, an environmental epidemiologist with the Yale School of Public Health (YSPH) and the study’s lead author. “Fine particulate matter is found in urban air pollution due to automobile traffic and industrial activity, and artificial light at night is common, particularly in densely populated urban areas.”

The research team analyzed data from 736 individuals diagnosed with papillary thyroid cancer before age 20 and 36,800 matched control participants based on birth year. Using advanced geospatial and satellite modeling, the team assessed individual-level exposure to PM2.5 and O-ALAN based on residential location at birth. All of the study participants were from California.

The findings showed that for every 10 micrograms per cubic meter increase in PM2.5 exposure, the odds of developing thyroid cancer rose by 7% overall. The strongest association between exposure and thyroid cancer was found among teenagers (15–19 years of age) and Hispanic children. Similarly, children born in areas with high levels of exposure to outdoor light at night were 23–25% more likely to develop thyroid cancer, according to the study.

“Thyroid cancer is among the fastest growing cancers among children and adolescents, yet we know very little about what causes it in this population,” said Deziel, an associate professor of epidemiology (environmental health sciences) and co-director of the Yale Center for Perinatal, Pediatric, and Environmental Epidemiology. “Our study is the first large-scale investigation to suggest that these exposures early in life-specifically to PM2.5 and outdoor light at night-may play a role in this concerning trend.”

In addition to Deziel, the research team included experts from Yale’s Departments of Biostatistics, Chronic Disease Epidemiology, and Pediatrics, as well as researchers from the University of Southern California, UC Berkeley, and the American Cancer Society. Deziel and several of the study’s authors are affiliated with the Yale Cancer Center. The team’s collective expertise ranged from environmental exposure modeling and biostatistics to pediatric endocrinology and cancer epidemiology.

The impact of papillary thyroid cancer on children can be extensive.

Compared to adults, children are often diagnosed with thyroid cancer at more advanced stages with larger tumor sizes. Pediatric survivors of thyroid cancer can suffer aftereffects ranging from temperature dysregulation and headaches to physical disabilities and mental fatigue. The disease can interfere with important life milestones such as education, employment, and raising a family and it can contribute to feelings of anxiety and depression.

Both PM2.5 and O-ALAN are considered environmental carcinogens that have been shown to disrupt the body’s endocrine system, including thyroid function, in animals and adults. The particles associated with PM2.5 pose a threat because they are small enough to enter the bloodstream and can interfere with hormone signaling, including those involved in regulating cancer pathways. Outdoor artificial light at night has been shown to suppress melatonin and alter circadian rhythms, which can also influence hormone-regulated cancer pathways.

The current research raises important environmental justice concerns. Communities of color and lower-income populations are often disproportionately exposed to both air pollution and light pollution-inequities that may contribute to the higher thyroid cancer burden observed in Hispanic children.

The researchers emphasized that more work is needed to replicate and expand on their findings, ideally using improved exposure metrics and longitudinal designs.

“In the meantime,” Deziel noted, “our results point to the critical importance of addressing environmental factors in childhood cancer research. Reducing exposures to air pollution and managing light pollution could be important steps in protecting children’s health.”

Reference:

 Nicole C. Deziel, Rong Wang, Joshua L. Warren, Catherine Dinauer, Perinatal Exposures to Ambient Fine Particulate Matter and Outdoor Artificial Light at Night and Risk of Pediatric Papillary Thyroid Cancer, Environmental Health Perspectives, https://doi.org/10.1289/EHP14849.

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Menopause Age Key to Unlocking Type 2 Diabetes Risk, suggests study

Recent research indicates a potential association between age at menopause and the incidence of type 2 diabetes (T2D), yet comprehensive evidence remains limited, especially among Asian populations. A cohort study involving over 1.1 million postmenopausal Korean women aimed to clarify whether age at menopause and instances of premature menopause are linked to the onset of T2D.

Significance of Type 2 Diabetes

Type 2 diabetes represents a chronic health issue significantly contributing to cardiovascular diseases, microvascular complications, and elevated mortality rates. Despite advances in medical treatments, T2D prevalence continues to rise, emphasizing the need for effective preventative measures and the identification of at-risk populations. While men are generally at a higher risk at younger ages, the risk for women escalates post-menopause. Female-specific risk factors and their implications on health, particularly links to cardiovascular disease and T2D, are under-explored.

Data Collection Methodology

The study utilized data from the Korean National Health Insurance Service, which covers nearly the entire South Korean population, providing robust health examination records including self-reported data and clinical health assessments. A total of 3,181,150 women aged 30 and above were initially screened, with exclusions for pre-existing T2D, premenopausal status, and data inconsistencies, resulting in a final cohort of 1,125,378 participants. Age at menopause was self-reported, categorized into four groups: <40 years, 40-44 years, 45-49 years, and ≥50 years, with premature menopause defined as menopause before age 40. Identified T2D cases were defined as fasting blood glucose levels of 126 mg/dL or higher or records of antidiabetic medication claims.

Follow-Up Results

Throughout a median follow-up of 8.4 years, 113,864 new T2D cases emerged, indicating a cumulative incidence of approximately 10.1%. The results indicated that women with premature menopause had a higher incidence of T2D compared to their peers, with a hazard ratio (HR) of 1.13 after accounting for various confounders. Women experiencing menopause at an earlier age (particularly <40 years) faced a significantly increased risk for developing T2D, corresponding with the hypothesis that lower estrogen levels, due to shorter exposure periods, may contribute significantly to insulin resistance and metabolic dysregulation.

Subgroup Analysis Insights

Subgroup analyses revealed nuances in the relationship, with factors like body mass index (BMI) and depressive disorders influencing the risk association. Notably, the risk was exacerbated among individuals without obesity and those struggling with depressive disorders, suggesting a potential interaction between mental health and metabolic outcomes.

Implications of Findings

The findings support the hypothesis that both premature and early menopause can act as significant risk factors for the development of T2D. Given these associations, there is a strong argument for including menopause history in T2D screening protocols. Recommendations suggest recognizing premature menopause as a noteworthy risk factor within diabetes management guidelines, emphasizing preventive care strategies and early detection initiatives.

Conclusions and Future Directions

Overall, the study elucidates important links between menopausal age and T2D incidence, advocating for greater awareness and proactive measures in managing women’s health, particularly concerning metabolic disorders in postmenopausal populations. Further research is essential to explore these relationships across diverse demographic groups and establish effective interventions to mitigate T2D risk.

Key Points

– A cohort study involving over 1.1 million postmenopausal Korean women was conducted to investigate the association between age at menopause, instances of premature menopause, and the incidence of type 2 diabetes (T2D), particularly as evidence is lacking in Asian populations.

– Type 2 diabetes is a chronic health concern linked to cardiovascular diseases and increased mortality rates, with rising prevalence emphasizing the necessity for effective preventive strategies. The risk for women increases significantly post-menopause, making female-specific health factors critical for understanding T2D risk.

– The study analyzed comprehensive health data from the Korean National Health Insurance Service, screening 3,181,150 women aged 30 and above and narrowing the final cohort to 1,125,378. Age at menopause was categorized, and T2D was defined through specific blood glucose levels and medication records.

– Over a median follow-up of 8.4 years, 113,864 new T2D cases emerged, indicating a cumulative incidence of approximately 10.1%. Women experiencing premature menopause exhibited a higher incidence of T2D (hazard ratio of 1.13), particularly those with menopause before age 40, indicating potential metabolic dysregulation linked to lower estrogen levels.

– Subgroup analyses indicated that body mass index (BMI) and depressive disorders significantly influenced the risk association. Increased T2D risk was noted in individuals without obesity and those with depressive issues, suggesting a complex interplay between mental health and metabolic conditions.

– The study underscores the necessity of incorporating menopause history into T2D screening protocols, advocating for recognizing premature menopause as a critical risk factor in diabetes management. Recommendations emphasize the importance of preventive strategies and early detection among postmenopausal women to mitigate T2D risk.

Reference –

B. Ko et al. (2025). Age At Menopause And Development Of Type 2 Diabetes In Korea. *JAMA Network Open*, 8. https://doi.org/10.1001/jamanetworkopen.2024.55388.

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Weekly Home BP Monitoring Enhances Hypertension Detection in Hemodialysis Patients: Study Finds

Greece: Accurate blood pressure (BP) monitoring is essential for managing hypertension in patients undergoing hemodialysis. A recent study found that in hemodialysis patients, home blood pressure monitoring (HBPM) over a week was more accurate in detecting hypertension than routine BP measurements taken at dialysis centers.

“HBPM demonstrated greater diagnostic accuracy than 44-hour ambulatory BP monitoring (AUC: 0.934). With a threshold of 141.0 mmHg, HBPM achieved optimal sensitivity (85.7%) and specificity (92.9%), reinforcing its value as a reliable screening tool for this patient population,” the researchers reported in the Journal of Human Hypertension.

The best approach for diagnosing hypertension in hemodialysis patients remains a subject of debate. To address this, Panagiotis I. Georgianos, 2nd Department of Nephrology, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece, and colleagues evaluated the accuracy of home blood pressure monitoring and routine dialysis-unit BP recordings, using 44-hour ambulatory BP monitoring (ABPM) as the reference standard.

For this purpose, the researchers assessed hypertension over two weeks using three methods: (i) routine predialysis and post dialysis BP recordings averaged over six consecutive dialysis sessions, (ii) home BP monitoring (HBPM) for seven days with duplicate morning and evening measurements (Microlife WatchBP Home N), and (iii) 44-hour ambulatory BP monitoring (ABPM) with 20-minute intervals over an entire interdialytic period (Microlife WatchBPO3). The study included 70 patients (mean age: 65.3 ± 13.2 years), 87.1% receiving hypertension treatment, and an average 44-hour ambulatory systolic/diastolic BP of 120.6 ± 15.2/66.3 ± 10.1 mmHg.

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

  • The mean difference between ambulatory daytime systolic BP (SBP) and routine BP measurements was:
    • Predialysis SBP: -11.4 ± 13.4 mmHg
    • Postdialysis SBP: -4.0 ± 15.1 mmHg
    • Home SBP: -8.6 ± 10.7 mmHg
  • Home BP monitoring (HBPM) showed superior diagnostic performance for detecting ambulatory daytime SBP ≥135 mmHg:
    • Home SBP: AUC 0.934
    • Predialysis SBP: AUC 0.778
    • Postdialysis SBP: AUC 0.766
    • HBPM was significantly more accurate than both predialysis and postdialysis SBP (P = 0.02).
  • At a cut-off of 141.0 mmHg, home SBP provided the best balance of sensitivity (85.7%) and specificity (92.9%) for diagnosing hypertension.

The study findings highlight that in hemodialysis patients, home blood pressure monitoring conducted over a week is more reliable than routine dialysis-unit BP recordings averaged over two weeks in detecting ambulatory hypertension. HBPM demonstrated greater accuracy in identifying elevated blood pressure levels, making it a valuable tool for improving hypertension diagnosis in this population.

“These results suggest that integrating HBPM into routine clinical practice could enhance blood pressure management, leading to better cardiovascular outcomes for hemodialysis patients,” the authors concluded.

Reference:

Leonidou, K., Georgianos, P. I., Kollias, A., Kontogiorgos, I., Vaios, V., Leivaditis, K., Karligkiotis, A., Stamellou, E., Balaskas, E. V., Stergiou, G. S., & Liakopoulos, V. (2025). Home versus routine dialysis-unit blood pressure recordings among patients on hemodialysis. Journal of Human Hypertension, 1-7. https://doi.org/10.1038/s41371-025-01007-7

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Statins Reduce Liver Cancer and Hepatic Decompensation Risk among patients with chronic liver disease: JAMA

Researchers have found in a new cohort study that the use of statins in patients with chronic liver disease was associated with a lower risk of liver cancer and hepatic decompensation. Patients who used statins experienced a significant reduction in these risks compared to those who did not, with lipophilic statins and longer treatment duration providing even greater protective effects. Statins may help prevent hepatocellular carcinoma by slowing the progression of liver fibrosis, which is a key factor in the severity of liver disease. This study examined the relationship between the use of statins and the risk of hepatocellular carcinoma and hepatic decompensation, with a focus on how statins influence the progression of liver fibrosis. Researchers analyzed patient data from the year 2000 to the year 2023, selecting adults who were 40 years or older with chronic liver disease and an elevated baseline Fibrosis-4 score, which is a measure of liver fibrosis. Participants were categorized into those who used statins and those who did not, and their health outcomes were tracked over a ten-year period. Findings indicated that patients who used statins had a significantly lower incidence of hepatocellular carcinoma and hepatic decompensation than those who did not use statins. The protective effects were particularly pronounced among individuals who used lipophilic statins and those who had prolonged statin therapy. In addition to reducing the risks of liver cancer and hepatic decompensation, patients who used statins showed a slower progression of liver fibrosis and were more likely to improve their fibrosis risk category over time. Among patients with intermediate or high Fibrosis-4 scores at baseline, those who used statins were more likely to experience a regression in their fibrosis severity compared to those who did not use statins. This suggests that statins may not only help prevent severe liver complications but also contribute to improved liver health over time. Overall, the study supports the potential role of statins in reducing the risk of hepatocellular carcinoma and slowing the progression of liver disease. These findings highlight the need for further research on incorporating statins into treatment strategies for patients with chronic liver disease.

Reference:

Choi J, Nguyen VH, Przybyszewski E, et al. Statin Use and Risk of Hepatocellular Carcinoma and Liver Fibrosis in Chronic Liver Disease. JAMA Intern Med. Published online March 17, 2025. doi:10.1001/jamainternmed.2025.0115

Keywords:

Statins, Reduce, Liver Cancer, Hepatic, Decompensation Risk, among, patients, chronic liver disease, JAMA, Choi J, Nguyen VH, Przybyszewski E, JAMA Intern Med

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Long-Term Use of Inhaled Corticosteroids Linked to Increased diabetes, Health Risks in COPD Patients: Study

According to a study published in the Annals of Family Medicinereports that using inhaled corticosteroids for more than 24 months significantly increases the risks of diabetes, pneumonia, osteoporosis, cataracts, and fractures in adults with chronic obstructive pulmonary disease (COPD), compared to those who use them for shorter periods. Researchers also observed that these medications are frequently prescribed beyond the recommended guidelines for COPD management.

They aimed to assess long-term inhaled corticosteroid (ICS) risks in chronic obstructive pulmonary disease (COPD) management. They extracted electronic health record data for individuals aged >45 years with COPD from a data repository. The prevalent cohort required a diagnosis of COPD any time during the observation period, and the inception cohort required a diagnosis of COPD made after entry into the database. A composite outcome of any new diagnosis of type 2 diabetes, cataracts, pneumonia, osteoporosis, or nontraumatic fracture; and recurrent event outcomes of repeated pneumonia or nontraumatic fracture were compared for long-term (>24 months) vs short-term (<4 months) ICS exposure. They assessed outcomes for 318,385 and 209,062 individuals in the prevalent and inception cohorts, respectively. The composite dichotomous outcome was significantly greater for long-term vs short-term ICS use for the prevalent (hazard ratio [HR] = 2.65; 95% CI, 2.62-2.68; P <.001) and inception (HR = 2.60; 95% CI, 2.56-2.64; P <.001) cohorts. For the inception cohort, the absolute risk difference of the composite outcome was 20.26% (29.41% minus 9.15%), with a number needed to harm of 5. Hazard ratios were significantly increased in the prevalent and inception cohorts for recurrent pneumonia (HR = 2.88; 95% CI, 2.62-3.16; P <.001 and HR = 2.85; 95% CI, 2.53-3.22; P <.001, respectively) and recurrent fracture (HR = 1.77; 95% CI, 1.42-2.21; P <.001 and HR = 1.57; 95% CI, 1.20-2.06; P <.001). Long-term ICS use for COPD is associated with significantly greater rates of the composite outcome of type 2 diabetes, cataracts, pneumonia, osteoporosis, and nontraumatic fracture; recurrent pneumonia; and recurrent fracture.

Reference:

Adverse Outcomes Associated With Inhaled Corticosteroid Use in Individuals With Chronic Obstructive Pulmonary Disease

Wilson D. Pace, Elisabeth Callen, Gabriela Gaona-Villarreal, Asif Shaikh, Barbara P. Yawn

The Annals of Family Medicine Mar 2025, 23 (2) 127-135; DOI: 10.1370/afm.240030

Keywords:

Long-Term, Use, Inhaled, Corticosteroids, Linked, Increased, diabetes, Health, Risks, COPD Patient, Study, Wilson D. Pace, Elisabeth Callen, Gabriela Gaona-Villarreal, Asif Shaikh, Barbara

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Ropivacaine safe and effective alternative to lidocaine for local anesthesia in orthognathic procedures: Study

Ropivacaine safe and effective alternative to lidocaine for local anaesthesia in orthognathic procedures suggests a new study published in the Inflammopharmacology.

This triple-blind, controlled clinical trial aimed to assess the effects of ropivacaine and lidocaine on hemodynamic factors, blood loss, opioid consumption, and postoperative pain in patients undergoing orthognathic surgery. Thirty-two patients with Class III malocclusion scheduled for orthognathic surgery were included. The participants were randomly assigned to receive 0.5% ropivacaine or 2% lidocaine with 1:80,000 epinephrine for local anesthesia (n = 16). Hemodynamic parameters were recorded at various time intervals, which included heart rate (HR), systolic blood pressure, diastolic blood pressure, mean arterial pressure, oxygen saturation (SpO2), intraoperative bleeding, opioid consumption, and postoperative pain intensity.RESULTS: The participants’ mean age was 23.67 ± 4.56 years, and 75% were female. The groups were comparable in most measured outcomes. HR was significantly higher in the ropivacaine group at 30 and 60 min post-injection (P < 0.05). SpO2 percentages were comparable between the groups, except at 15 min post-anesthesia, where the lidocaine group demonstrated a significantly higher SpO2 (P = 0.029). Blood pressure, postoperative opioid consumption, intraoperative bleeding, and postoperative pain levels showed no statistically significant differences between the two groups. Within the limitations of this study, both 0.5% ropivacaine and lidocaine with epinephrine demonstrated comparable effects on hemodynamic stability, intraoperative blood loss, postoperative pain levels, and opioid consumption in patients undergoing orthognathic surgery. These findings suggest that ropivacaine may serve as a safe and effective alternative to lidocaine for local anesthesia in orthognathic procedures.

Reference:

Hosseini-Abrishami, Majid, et al. “Ropivacaine Effect On Hemostasis and Pain Level in Patients Undergoing Orthognathic Surgery: a Triple-blinded, Randomized, Clinical Trial.” Inflammopharmacology, 2025.

Keywords:

Ropivacaine, safe, effective, alternative, lidocaine, local anesthesia, orthognathic procedures, Study, Hosseini-Abrishami, Maji

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Elevated TyG-BMI Linked to Higher Short-Term Mortality in Critically Ill Ischemic Stroke Patients: Study Finds

China: A recent study published in Cardiovascular Diabetology has highlighted a significant association between elevated triglyceride glucose-body mass index (TyG-BMI) and an increased risk of short-term mortality in critically ill patients with ischemic stroke (IS). The findings suggest that TyG-BMI could serve as a simple yet effective biomarker for identifying high-risk patients, aiding in early intervention and improved clinical outcomes.

Ischemic stroke, a leading cause of disability and death worldwide, requires timely risk assessment to enhance patient management in critical care settings. The triglyceride glucose-body mass index is a widely recognized marker for evaluating insulin resistance (IR) and has been strongly linked to stroke. However, the researchers note that research in this area remains limited, and existing studies have reported inconsistent findings.

To fill this knowledge gap, Ming Yu, Department of Neurology, Suining Central Hospital, Suining, China, and colleagues aimed to explore the association between TyG-BMI and 28-day mortality in critically ill ischemic stroke patients using data from the eICU database. This study seeks to bridge existing research gaps and provide more precise biomarker references for clinical use.

For this purpose, the researchers used multivariate Cox regression models to assess the impact of TyG-BMI on 28-day hospital and ICU mortality. Restricted cubic splines (RCS) were applied to examine potential nonlinear relationships, while Kaplan-Meier (K-M) curves were used to compare outcomes across different TyG-BMI groups. Subgroup analyses were also conducted to ensure result reliability and interaction.

The following were the key findings:

  • The study included 1,362 critically ill ischemic stroke patients with a mean age of 68.41 ± 14.16 years, of whom 47.50% were male.
  • Multivariate Cox regression analysis showed that patients in the high TyG-BMI group had significantly higher 28-day hospital mortality (HR = 1.734) and ICU mortality (HR = 2.337).
  • Restricted cubic spline (RCS) analysis revealed a nonlinear positive correlation between TyG-BMI and 28-day hospital mortality.
  • Below the inflection point of TyG-BMI = 380.37, each 1-SD (≈ 25.5 units) increase in TyG-BMI was linked to a 37.3% rise in 28-day hospital mortality (HR = 1.373).
  • Above 380.37, each 1-SD increase in TyG-BMI led to an 87.9% decrease in 28-day hospital mortality (HR = 0.121).
  • The log-likelihood ratio test yielded a P-value of 0.004.
  • For 28-day ICU mortality, RCS analysis showed a significant positive linear correlation with TyG-BMI.

The researchers demonstrated that elevated TyG-BMI is significantly associated with a higher risk of short-term all-cause mortality in critically ill ischemic stroke patients in the United States. Their findings provide strong evidence to address existing uncertainties in this field, highlighting TyG-BMI as a simple and effective biomarker for identifying high-risk patients. They further emphasized that regular monitoring and managing triglycerides, blood glucose, and body weight may help reduce short-term mortality in acute IS patients or those at risk.

Reference:

Ouyang, Q., Xu, L. & Yu, M. Associations of triglyceride glucose-body mass index with short-term mortality in critically ill patients with ischemic stroke. Cardiovasc Diabetol 24, 91 (2025). https://doi.org/10.1186/s12933-025-02583-1

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RADPAD Protective Drape Reduces Radiation Exposure in Cardiac Cath Labs, Study Finds

USA: A recent systematic review and meta-analysis published in the Cureus Journal highlights the effectiveness of the RADPAD protection drape in reducing radiation exposure among interventional cardiologists in cardiac catheterization laboratories. Given the occupational hazards associated with ionizing radiation, these findings reinforce the importance of implementing protective measures to minimize health risks for healthcare professionals performing fluoroscopy-guided procedures.

M. Chadi Alraies, Cardiology, Wayne State University Detroit Medical Center, Detroit, USA, and colleagues evaluated data from six independent studies involving 892 patients, analyzing radiation exposure levels among operators using the RADPAD protection drape compared to those without it. Ionizing radiation, a known occupational hazard in interventional cardiology, has been linked to various adverse health effects, including cataracts, skin damage, and an increased risk of malignancies. The RADPAD, a sterile, lead-free, disposable radiation shield, is designed to deflect scatter radiation away from operators, reducing their overall exposure during procedures.

Key Findings

Reduction in Radiation Exposure

  • The use of the RADPAD drape significantly lowered radiation exposure for primary operators.
  • Operators using RADPAD experienced a notably lower exposure dose (OR: -0.9).

Comparable Dose Area Product (DAP) and Screening Time

  • There was no significant difference in the dose area product (DAP) between the RADPAD and No-RADPAD groups (OR: 0.008).
  • Screening time remained similar between both groups (OR: 0.13).

Relative Exposure Consistency

  • The relative exposure (E/DAP) showed no significant variation between the groups (OR: -0.47).

Protective Benefits of RADPAD

  • Despite no significant changes in DAP, screening time, or relative exposure, the substantial reduction in direct operator exposure underscores the protective advantage of the RADPAD drape.

Despite these promising results, the study acknowledges certain limitations, including small sample sizes in four of the six studies analyzed. Additionally, variability in case complexity and fluoroscopy usage could have influenced the results. Another potential factor is increased operator awareness of radiation safety when using the RADPAD, which may have contributed to reduced exposure.

The study concludes that incorporating the RADPAD protection drape into catheterization laboratories can significantly lower scatter radiation exposure for both primary and secondary operators, regardless of procedure complexity. By reducing the risk of long-term radiation-related complications, such as cancer and cataracts, the RADPAD drape presents a practical and effective solution for enhancing radiation safety in interventional cardiology.

“Given the strong evidence supporting its efficacy, researchers recommend the routine use of RADPAD protective drapes in all catheterization labs. Future research with larger sample sizes and standardized protocols may further validate these findings and refine radiation protection strategies for healthcare professionals,” the authors concluded.

Reference:

Bahar A, Khanal R, Hamza M, et al. (April 28, 2024) Assessing the Efficacy of RADPAD Protection Drape in Reducing Radiation Exposure to Operators in the Cardiac Catheterization Laboratory: A Systematic Review and Meta-Analysis. Cureus 16(4): e59215. doi:10.7759/cureus.59215

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