Archive for category: News

A new study has determined that increased concentrations of methylglyoxal (MGO), a potent reactive byproduct of glucose metabolism, can independently cause the onset of liver fibrosis among obese individuals. The finding is consistent with mounting evidence indicating that MGO and similar compounds not only initiate inflammation and produce deleterious advanced glycation end products (AGEs), but also are key players in liver injury involved with metabolic dysfunction-associated steatotic liver disease (MASLD).

For most children, influenza (flu) usually means unpleasant symptoms like a fever, sore throat, and achy muscles. But for a small subset of kids, the flu can trigger a rare but serious complication called influenza-associated acute necrotizing encephalopathy (ANE). This form of brain inflammation typically occurs in response to a virus — such as those that cause the flu-and can lead to lasting neurological problems and brain damage. Now, findings of a multicenter study, published today in JAMA, led by Molly Wilson-Murphy, MD, and Rachel Walsh, MD, in Boston Children’s Neuroimmunology Center suggest that ANE is often fatal in these children-despite intensive treatment.

Revealing the risks of influenza-associated ANE

During the 2024-5 U.S. flu season, clinicians at large pediatric centers reported an increased number of children with influenza-associated ANE. This anecdotal rise in cases prompted Wilson-Murphy and her colleagues at Stanford University and elsewhere to collect data on pediatric patients who had been diagnosed with ANE between 2023 and 2025.

After analyzing data on 41 patients from 23 U.S. pediatric hospitals, the team found that influenza-associated ANE carried a high risk of morbidity and mortality. Although most children were previously healthy and didn’t have a significant medical history prior to diagnosis, Wilson-Murphy and her colleagues found that influenza-associated ANE had a 27 percent mortality rate. Those patients died within an average of just three days of exhibiting symptoms, typically from brain herniation.

Of the 30 children who survived influenza-associated ANE, several still experienced neurological difficulties such as epilepsy three months later. Likewise, just 43 percent had regained the ability to walk unassisted.

“While rare, ANE is potentially devastating and can progress very quickly. It is incredibly important for providers to be able to recognize ANE and to act immediately, as rapid treatment may save lives and minimize long-term difficulties,” says Wilson-Murphy. “Vaccination may be important in helping to prevent ANE.”

Vaccination remains key

In addition to shedding light on the severity of influenza-associated ANE, the study highlights the importance of vaccinating children against the flu. Of the 41 patients included in the review, only six had received an age-appropriate flu vaccine for the season during which they developed influenza-associated ANE. Only one of the 11 children who died had received a flu shot. These findings support those from previous research, including a large Japanese epidemiologic study, which showed that mass vaccination of school-aged children significantly reduced death from influenza-associated encephalopathy, likely through decreased community transmission.

Along with the role of flu vaccination in prevention, Wilson-Murphy and her colleagues point to the importance of prompt diagnosis and treatment of influenza-associated ANE. Because death occurred quickly in fatal cases, rapid, intense management of the condition — including neuroprotective critical care and immunotherapy — is key.

“There is still so much we have yet to learn about ANE, but we hope this study has helped raise awareness and pave the way for more surveillance and recognition and, ultimately, to advances in treatment,” says Wilson-Murphy.

Reference:

Influenza-Associated Acute Necrotizing Encephalopathy (IA-ANE) Working Group. Influenza-Associated Acute Necrotizing Encephalopathy in US Children. JAMA. Published online July 30, 2025. doi:10.1001/jama.2025.11534.

A new study published in the Nature Scientific Reports showed that compared to kidney recipients who got preemptive transplants, individuals who experienced dialysis prior to transplantation are at a higher risk of developing long-term visual problems, including dry eye and diabetic retinopathy.

For individuals with end-stage renal disease, kidney transplantation is the only proven therapy option, and its success rate has grown over time. The patient survival has increased and the rejection rate has decreased thanks to improvements in surgical methods, immunosuppressive medications, and excellent postoperative care. Uremia, anemia, and oxidative stress are metabolic variables that might lead to ocular consequences from renal disease.

Furthermore, the link between alterations in the retinal microvasculature and microalbuminuria, a symptom of kidney glomerulus damage, raises the possibility that endothelial dysfunction is happening concurrently in the kidney and retinal blood vessels. Thus, this study evaluated the long-term ocular issues and determine the variables influencing these difficulties in dialysis and preemptive kidney transplant patients.

Nearly, 548 individuals who had a full ophthalmologic examination at least a year following kidney donation were included. Two groups of patients were created: Group 1 consisted of individuals who had previously had dialysis, and Group 2 consisted of those who had not. Hypertension and diabetes mellitus were identified as possible causes of retinopathy. Refractive error, intraocular pressure (IOP), best corrected visual acuity (BCVA), and results from dilated fundus and slit-lamp exams were among the data gathered.

Pterygium, corneal calcification, arcus lipoides, macular drusen, hypertensive retinopathy, central serous chorioretinopathy (CSC), diabetic retinopathy, pinguecula, lens opacity, and refractive error were among the ocular abnormalities that were noted. Every patient was receiving mycophenolate mofetil, calcineurin inhibitors, steroids, and mTOR inhibitors as part of maintenance immunosuppressive treatment.

A total of 291 patients in Group 2 (without dialysis) and 257 in Group 1 (with previous dialysis) were enrolled in the study. The groups’ requirements for myopic and hyperopic correction were comparable. Group 1 had a noticeably higher prevalence of dry eye. There were no discernible variations in the rates of glaucoma, cataract, pterygium, arcus lipoides, or pinguecula.

While other posterior segment findings, such as macular drusen, hypertensive retinopathy, and CSC, were similar between groups, diabetic retinopathy was considerably more prevalent in Group 1. The most common ocular problems were retinopathy, cataracts, and dry eye The patients who had previously had dialysis were much more likely to develop diabetic retinopathy and dry eye.

Overall, patients who had dialysis before transplantation were more likely to acquire and advance diabetic retinopathy than those who received preemptive transplantation.

Source:

Çetinkaya Yaprak, A., Avanaz, A., Erkan Pota, Ç., Arabacı Tur, K. T., & Yaprak, M. (2025). Long-term ocular complications after kidney transplantation. Scientific Reports, 15(1), 15222. https://doi.org/10.1038/s41598-025-99847-3

In a recent study investigating the effects of prostaglandin E1 (PGE1) on reducing inspired oxygen concentration during one-lung ventilation (OLV), several key findings and outcomes were identified. The study included 120 patients undergoing thoracic surgery, randomly assigned to four groups receiving different FiO2 levels and PGE1 nebulization. The primary outcome was oxygenation during OLV, with secondary outcomes including inflammatory markers, postoperative complications, and hospital stay duration.

Results and Impacts of PGE1 Administration

The results showed that pre-OLV nebulization of PGE1 reduced the required FiO2 during OLV, leading to improved oxygenation and lower incidence of hypoxemia. The nebulized PGE1 groups exhibited delayed decreases in PaO2 and improvements in PaO2/FiO2 ratio compared to the control group. Furthermore, PGE1 inhalation resulted in lower Qs/Qt, reduced inflammatory cytokine levels, and improved clinical pulmonary infection scores. The study concluded that the combined impact of reduced FiO2 and PGE1 administration decreased the risk of hypoxemia and systemic inflammatory responses during OLV.

Importance of Lung Protection and Oxygenation Management

Additionally, the study highlighted the importance of lung protection and oxygenation management during OLV. Clear guidelines on optimal FiO2 levels during OLV are currently lacking, emphasizing the need for strategies to minimize oxidative stress while ensuring adequate oxygenation. The study findings supported the use of PGE1 to optimize oxygenation and reduce systemic inflammation by lowering FiO2 requirements during OLV.

Study Limitations and Recommendations for Further Research

However, the study also identified limitations that warrant further investigation. These include the need for larger sample sizes focused on postoperative complications, exploration of different PGE1 doses, and validation in populations with impaired lung function. Future studies should aim to explore long-term outcomes, diverse PGE1 doses, and the applicability of the recommended regimen across various patient populations.

Conclusive Findings on PGE1 Administration

In conclusion, the study demonstrated that pre-OLV PGE1 administration reduces the required FiO2 during OLV, leading to improved oxygenation, decreased hypoxemia risk, and lowered systemic inflammatory responses. This approach holds promise for optimizing patient outcomes during thoracic surgery by balancing oxygenation needs and minimizing oxidative stress-related complications associated with high FiO2 levels.

Key Points

– Pre-OLV nebulization of prostaglandin E1 (PGE1) reduced the needed FiO2 during one-lung ventilation (OLV), enhancing oxygenation and decreasing hypoxemia.

– Patients receiving PGE1 showed delayed decreases in PaO2, improved PaO2/FiO2 ratio, lower Qs/Qt values, reduced inflammatory cytokine levels, and better clinical pulmonary infection scores.

– Lung protection and oxygenation management during OLV are crucial, with the study underlining the lack of clear guidelines on optimal FiO2 levels.

– The study suggests that PGE1 administration can optimize oxygenation, lower systemic inflammation, and diminish hypoxemia risk by reducing FiO2 requirements during OLV.

– Study limitations include the need for larger sample sizes, exploration of different PGE1 doses, and validation in populations with impaired lung function.

– Conclusively, PGE1 administration pre-OLV holds promise in enhancing patient outcomes during thoracic surgery by balancing oxygenation requirements and minimizing complications related to high FiO2 levels.

Reference –

Lingxi Xing et al. (2025). The Impact Of Different Inspired Oxygen Concentrations Combined With Nebulized Prostaglandin E1 On Oxygenation In Patients Undergoing One-Lung Ventilation: A Randomized Controlled Trial. *BMC Anesthesiology*, 25. https://doi.org/10.1186/s12871-025-03081-3.