Woman loses Rs 2.10 lakh to Fake UK doctor on social media

Lucknow: A healthcare
worker from Lucknow has been duped of Rs. 2.10 lakh by a man posing as an
England-based doctor on social media on the pretext of sending her gifts. The cybercrime wing has registered a case and launched an investigation into the incident.

Also Read:Kerala Doctor loses Rs 4.43 crore in WhatsApp Trading fraud

According to India Today,
the victim has been identified as a resident of Bigahu village in Kakori, and
she came across a man identifying himself as “Dr. Sameer” on Facebook on July
20. Introducing himself as a doctor from England, he initiated conversations
around health-related issues to gain her trust. Days later, he added her to a WhatsApp
group and claimed he was sending her a gift. Though Sandhya initially refused,
she eventually relented after repeated messages from him.

Soon afterwards, the
victim received a phone call from someone claiming to be a customs officer at
Mumbai Airport. The caller told her that to release the parcel supposedly being
sent by Dr. Sameer, she would have to pay taxes and processing charges.
Believing the claim, she transferred Rs. 2.10 lakh in three separate payments.
However, when the promised package never arrived, she realised that she had
been conned and approached the police.

Kakori Inspector Satish
Rathore confirmed that a formal complaint has been lodged and efforts are
underway to identify and apprehend the culprits. Police also issued a public
advisory urging people to remain vigilant on social media, avoid sharing personal
information with unknown individuals, and be wary of fraudulent schemes
involving parcels or gifts.

Also Read:Doctor loses Rs 2 crore to drug parcel scam

Medical
Dialogues had earlier reported that in a similar cyber fraud case, a doctor at Ameen
Hospital in Rayachoti allegedly fell victim to a drug parcel scam, losing a
staggering Rs 2 crore to scammers posing as police officers. The scam began when the doctor received a phone call from a number showing the
photo of a police officer. The caller claimed that a drug package had been sent
in his name from London and that a case had been filed against him.

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Saliva testing may reveal early signs of diabetes and obesity, reveals research

Measuring elevated levels of insulin in blood, called hyperinsulinemia, is a proven way to measure metabolic health and can show risk of developing future health concerns, including Type 2 diabetes, obesity and heart disease.

Now, a team of UBC Okanagan researchers has found that measuring insulin levels in saliva offers a non-invasive way to do the same test-without the need for needles or lab-based blood work.

Dr. Jonathan Little, Professor with UBC Okanagan’s School of Health and Exercise Sciences, says that a simple spit test goes a bit further. It can also be used to detect early metabolic changes linked to obesity and other health risks.

The study, recently published in Applied Physiology, Nutrition, and Metabolism, included 94 healthy participants with a range of body sizes. After a period of fasting, each participant drank a standardized meal-replacement shake, then provided saliva samples and underwent a finger-prick blood glucose test.

“People living with obesity had much higher insulin levels in their saliva than those who were slightly overweight or had lower body weight-even though their blood sugar levels were the same,” he says. “This suggests that saliva testing could be a simple, non-invasive way to identify people at risk of Type 2 diabetes before symptoms appear.”

Type 2 diabetes affects about 400 million people worldwide and is diagnosed by high blood glucose levels. But Dr. Little notes that prediabetes conditions—such as insulin resistance and hyperinsulinemia-may develop 10 to 20 years before a person is diagnosed.

“If hyperinsulinemia can be detected before blood glucose levels start to rise, people at risk for Type 2 diabetes could be identified early, allowing for lifestyle changes and other treatments to be introduced long before glucose levels rise.”

Taking preventive steps at an early stage is important because hyperinsulinemia is a known predictor of several chronic conditions, including Type 2 diabetes, hypertension, cardiovascular disease, stroke, cancer, and most recently, it has been linked to obesity.

Co-author Dr. Hossein Rafiei explains that the study aimed to help develop a practical non-invasive test for hyperinsulinemia, but they also found an interesting result following the consumption of the meal-replacement drink.

Dr. Rafiei’s previous research at UBC Okanagan showed that saliva insulin levels closely follow plasma insulin levels across the day following high and low-carbohydrate mixed meals.

“This suggests that saliva insulin may help distinguish between high and low plasma insulin responses, and could play a role in predicting the severity of hyperinsulinemia and possibly insulin resistance.”

During the study, participants provided saliva tests 30, 60 and 90-minutes after drinking the beverage.

Dr. Rafiei notes that, interestingly, some participants with lower body weight also experienced large saliva insulin spikes after the meal. This suggests they may be at heightened risk for Type 2 diabetes, even without excess weight and having normal blood glucose levels.

“The finding that some people who are lean have high insulin is intriguing,” says Dr. Rafiei. “This indicates that saliva insulin may be more useful than measuring someone’s weight or waist size.”

The study also looked at the relationship between waist circumference, BMI, age and sex, and found that waist size had the strongest link to saliva insulin levels.

“These findings suggest that waist circumference could be a more reliable indicator of hyperinsulinemia than age or overall body weight when using saliva insulin,” he says. “Our results also suggest that saliva insulin may be better than blood glucose at distinguishing between those who are more metabolically healthy and those who are more likely to live with hyperinsulinemia.”

Reference:

Hossein Rafiei and Jonathan Peter Little. 2025. Saliva insulin concentration following ingestion of a standardized mixed meal tolerance test: influence of obesity status. Applied Physiology, Nutrition, and Metabolism. 50: 1-8. https://doi.org/10.1139/apnm-2024-0532.

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Amiodarone Linked to Higher Risk of Thyrotoxicosis in AF Patients: Study

A new study published in the journal of Heart Rhythm showed that in individuals with atrial fibrillation, amiodarone therapy was independently linked to a higher incidence of thyrotoxicosis.

A common treatment for potentially fatal arrhythmias is amiodarone. Despite the fact that amiodarone has few adverse effects, 15-20% of patients may experience thyroid dysfunction. Amiodarone-induced thyrotoxicosis (AIT) is a serious side effect that can exacerbate heart failure and lead to arrhythmia recurrence.

While type II AIT is a destructive thyroiditis that reacts to glucocorticoids, type I AIT is often treated with thionamides and occurs in people who already have thyroid disease. There is a mixed kind that is linked to increased mortality, particularly in older persons with heart disease. For individuals who are intolerant or resistant to medical therapy, thyroidectomy is regarded as a last resort.

Research on the possibility of amiodarone-treated individuals developing thyrotoxicosis instead of hypothyroidism is yet lacking. Thus, this study evaluated the relationship between amiodarone and thyrotoxicosis in individuals who were diagnosed with hypothyroidism concurrently with atrial fibrillation (AF).

This research used the Clalit Health Services database to do a population-based retrospective cohort analysis. 2 distinct cohorts, 1 for hypothyroidism and the other for normal thyroid function, were identified from patients who received a new diagnosis of AF between 2010 and 2023. Amiodarone exposure was investigated as a time-dependent variable using Cox proportional hazard regression, which allowed participants to switch between exposure groups throughout follow-up.

The hypothyroidism cohort comprised 23,854 AF patients, of whom 107 (66 of 8,212 amiodarone users and 41 of 15,622 non-users) had thyrotoxicosis during follow-up.

This represents a crude incidence rate of 3.43 and 0.63 per 1000 person-years for amiodarone users and non-users, respectively. Amiodarone had an adjusted-HR of 5.18 (95% CI, 3.48-7.69) and was independently linked to an elevated incidence of thyrotoxicosis in this sample.

With an adjusted-HR of 15.02 (95% CI, 13.56-16.64) and an incidence rate of 19.78 and 1.14 per 1000 person-years for amiodarone users and non-users, respectively, the amiodarone impact was more pronounced in individuals with normal thyroid function. Overall, although amiodarone has a less impact on thyrotoxicosis risk in hypothyroidism patients, the risk is still high and should be used with caution.

Source:

Ryan, D., Gershinsky, R., Gronich, N., Yahav, A., Barnett-Griness, O., Schliamser, J. E., Saliba, W., & Danon, A. (2025). Association between amiodarone and thyrotoxicosis in patients with atrial fibrillation and hypothyroidism. Heart Rhythm: The Official Journal of the Heart Rhythm Society. https://doi.org/10.1016/j.hrthm.2025.08.003

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Thigh Muscle Fat May Signal Greater Metabolic and Heart Disease Risk: Study Shows

Spain: A study in The Journal of Clinical Endocrinology & Metabolism suggests that intermuscular fat — though not visible like abdominal visceral fat — is metabolically active and may contribute to chronic inflammation, insulin resistance, and muscle dysfunction, increasing the risk of metabolic and cardiovascular diseases.

The research, led by Alba Camacho-Cardenosa from the Sport and Health University Research Institute (iMUDS), University of Granada, examined how fat stored between muscle fibres in different parts of the body relates to blood sugar control and cardiometabolic health in adults with excess weight.
The multicentre cross-sectional study involved 189 adults (50% women, average age 46.8 years) with overweight or obesity, all with a mean BMI of 32.9 kg/m². Magnetic resonance imaging (MRI) was used to measure intermuscular adipose tissue (IMAT) in the abdominal and mid-thigh regions. Participants wore continuous glucose monitoring (CGM) devices for 14 days to track blood sugar levels throughout the day and night. Researchers also calculated a cardiometabolic risk score based on fasting HDL cholesterol, triglycerides, glucose, waist circumference, and blood pressure.
The following were the key findings of the study:
  • Fat stored in the abdominal muscles showed no significant link to glucose control or cardiometabolic risk.
  • Higher levels of mid-thigh IMAT were consistently associated with elevated 24-hour, daytime, and nighttime glucose levels.
  • Increased mid-thigh IMAT was also linked with higher cardiometabolic risk scores.
  • Participants with greater thigh IMAT than abdominal IMAT had significantly higher average blood glucose levels.
  • Greater thigh IMAT accumulation was linked to worse overall cardiometabolic profiles.
“These results indicate that the location of intermuscular fat matters — and that hidden fat in the lower body may be a stronger signal of cardiometabolic risk than abdominal IMAT in people with obesity,” the authors noted.
Vicente Javier Clemente-Suárez, PhD, professor of sports sciences at the European University of Madrid, commented on the broader implications, stating that intermuscular fat plays a significant role in cardiovascular disease development. He emphasised the need for both clinicians and the public to look beyond conventional measures such as BMI and waist circumference. According to him, the findings also highlight the potential dangers in “patients with apparent normal weight but hidden metabolic risk.”
The researchers acknowledged some limitations, including the cross-sectional design, which prevents conclusions about causality. All participants were of Caucasian descent, which may limit applicability to other ethnic groups with different fat distribution patterns. Additionally, while two types of CGM devices were used, the team noted that accuracy in this relatively stable, non-diabetic group was consistent with other real-time systems.
“The study highlights the importance of assessing fat deposits in specific body regions when evaluating cardiometabolic risk. Mid-thigh intermuscular fat, in particular, may offer a more sensitive marker of early risk than traditional measures, potentially enabling earlier interventions to prevent metabolic and cardiovascular complications,” the authors concluded.
Reference:
Gatti, A., Concepción, M., Manuel, V., J, J., Cabeza, R., Idoate, F., L, J., García Pérez, P. V., Ruiz, J. R., & Labayen, I. Impact of Abdominal and Thigh Intermuscular Adipose Tissue on Glucose and Cardiometabolic Risk in Adults With Obesity. The Journal of Clinical Endocrinology & Metabolism. https://doi.org/10.1210/clinem/dgaf362

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FDA Approves Tonmya for Fibromyalgia

The U.S. Food and Drug Administration has approved Tonmya (TNX-102 SL), a sublingual formulation of cyclobenzaprine HCl for the treatment of adults with fibromyalgia. This marks the first new drug approval for fibromyalgia in over 15 years, offering a much-needed option for patients. Tonmya is designed to target two core aspects of the condition-nonrestorative sleep and chronic pain-making it a significant advancement in the management of fibromyalgia.

The FDA is expected to assign the NDA a Prescription Drug User Fee Act (PDUFA) target action date in a Day 74 Letter. At that time, the FDA will also communicate to Tonix whether Priority Review has been granted. TNX-102 SL was granted Fast Track designation for fibromyalgia by the FDA in July of 2024. Fast Track is designed to expedite FDA review of important new drugs to treat serious conditions and fill an unmet medical need.

“The FDA’s acceptance of our NDA represents another step forward as we pursue our goal of delivering the first member of a new class of medicines for the management of fibromyalgia, a condition affecting over 10 million adults in the U.S.,” said Seth Lederman, M.D., Chief Executive Officer of Tonix Pharmaceuticals. “The fibromyalgia community, comprised of patients and their families and support groups, has been waiting for a new drug for over 15 years. Analysis of insurance claims in the U.S., commissioned by Tonix, have shown that 18 months after diagnosis, fibromyalgia patients were more likely to be prescribed addictive opioids than all three of the FDA-approved drugs combined.”

Dr. Lederman continued, “We look forward to working closely with the FDA throughout the NDA review period with the goal of bringing TNX-102 SL to the market to address the significant unmet needs of the fibromyalgia community as quickly as possible. Furthermore, this is an important milestone as we advance our commercial preparations in anticipation of a potential approval in 2025 with an accomplished commercial leadership team already in place, supporting our marketed products Zembrace® SymTouch® (sumatriptan injection) 3 mg and Tosymra® (sumatriptan nasal spray) 10 mg for the treatment of acute migraine with or without aura in adults.”

The NDA is supported by data from two 14-week double-blind, randomized, placebo-controlled Phase 3 clinical trials evaluating the safety and efficacy of TNX-102 SL as a bedtime treatment for fibromyalgia. The first Phase 3 trial, RELIEF, of TNX-102 SL 5.6 mg in fibromyalgia, completed in December 2020, met its pre-specified primary endpoint of significantly reducing daily pain compared to placebo (p=0.010). In the confirmatory Phase 3 RESILIENT study in fibromyalgia, completed in December 2023, TNX-102 SL again met the pre-specified primary endpoint of significantly reducing daily pain compared to placebo (p =0.00005). In both trials, TNX-102 SL was generally well tolerated with an adverse event profile comparable to prior studies and with no new safety signals observed. In both pivotal studies, the most common treatment-emergent adverse event was tongue or mouth numbness at the administration site, which was temporally related to dosing, self-limited, never rated as severe, and rarely led to study discontinuation (one participant in each study). Excluding COVID-19, systemic adverse events in each of the two studies was lower than 4.0%. Tonix believes the submitted dossier contains the requisite safety and efficacy data from two adequate and well-controlled studies to support NDA approval.

About Fibromyalgia

Fibromyalgia is a common chronic pain disorder that is understood to result from amplified sensory and pain signaling within the central nervous system, called central sensitization. Brain imaging studies have localized the functional disorder to the brain’s insula and anterior cingulate cortex. Fibromyalgia afflicts more than 10 million adults in the U.S., the majority of whom are women. Symptoms of fibromyalgia include chronic widespread pain, non-restorative sleep, fatigue, and brain fog (or cognitive dysfunction). Other associated symptoms include mood disturbances, including depression, anxiety, headaches and abdominal pain or cramps. Individuals suffering from fibromyalgia often struggle with their daily activities, have impaired quality of life, and frequently are disabled. Physicians and patients report common dissatisfaction with currently marketed products. Fibromyalgia is now recognized as the prototypic nociplastic syndrome. Nociplastic pain is the third primary type of pain in addition to nociceptive pain and neuropathic pain.

Many patients present with pain syndromes that are a spectrum of mixtures of the three primary types of pain. Nociplastic syndromes are associated with central and peripheral sensitization. Fibromyalgia can occur without any identifiable precipitating event. However, many fibromyalgia cases follow one or more precipitating event(s) including: post-operative pain, acute or chronic nociceptive or neuropathic pain states; recovery from an infectious illness; a cancer diagnosis or cancer treatment; a metabolic or endocrine stress; or a traumatic event. In the cases of recovery from an infectious illness, fibromyalgia is considered an Infection-Associated Chronic Condition. In addition to fibromyalgia cases associated with other conditions or stressors, the U.S. National Academies of Sciences, Engineering, and Medicine, has concluded that fibromyalgia is a diagnosable condition that can occur after recovery from COVID-19 in the context of Long COVID. Fibromyalgia is also recognized as a Chronic Overlapping Pain Condition, which is a group of related conditions including, chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), irritable bowel syndrome, endometriosis, low back pain, post-concussive syndrome (also known as mild traumatic brain injury), chronic Lyme Disease, chronic diabetic neuropathy and chronic post-herpetic neuralgia.

About TNX-102 SL

TNX-102 SL is a centrally acting, non-opioid investigational drug, designed for chronic use. The tablet is a patented sublingual formulation of cyclobenzaprine hydrochloride developed for bedtime dosing for the management of fibromyalgia. Cyclobenzaprine potently binds and acts as an antagonist at four different post-synaptic neuroreceptor subtypes: serotonergic-5-HT2A, adrenergic-α1, histaminergic-H1, and muscarinic-M1-cholinergic receptors. Together, these interactions are believed to target the non-restorative sleep characteristic of fibromyalgia that was identified by Professor Harvey Moldofsky in 1975. Cyclobenzaprine is not associated with risk of addiction or dependence.

The TNX-102 SL tablet is based on a eutectic formulation of cyclobenzaprine HCl and mannitol that provides a stable product which dissolves rapidly and delivers cyclobenzaprine by the transmucosal route efficiently into the bloodstream. The eutectic protects cyclobenzaprine HCl from interacting with the basifying agent that is also part of the formulation and required for efficient transmucosal absorption. Patents based on TNX-102 SL’s eutectic composition and its properties have issued in the U.S., E.U., Japan, China and many other jurisdictions around the world and provide market protection into 2034. The European Patent Office’s Opposition Division maintained Tonix’s European Patent EP 2 968 992 in unamended form after an Opposition was filed against it by a Sandoz subsidiary, Hexal AG. Hexal AG did not appeal that decision.

The formulation of TNX-102 SL was designed specifically for sublingual administration and transmucosal absorption for bedtime dosing to target disturbed sleep, while reducing the risk of daytime somnolence. Clinical pharmacokinetic studies indicated that relative to oral cyclobenzaprine, TNX-102 SL results in higher levels of exposure during the first 2 hours after dosing and in deceased levels of the long-lived active metabolite, norcyclobenzaprine in both single dose and multiple dose studies, consistent with bypassing first pass hepatic metabolism. At steady state after 20 days of dosing TNX-102 SL, the dynamic peak level of cyclobenzaprine is higher than the background level of norcyclobenzaprine. In contrast, after 20 days of dosing oral cyclobenzaprine, the simulated peak level of cyclobenzaprine is lower than the simulated background level of norcyclobenzaprine.

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Neutrophil-to-lymphocyte ratio Linked to Poor Outcomes in CKD and MACE: Study

A new study published in the journal of BMC Nephrology showed that neutrophil-to-lymphocyte ratio (NLR) shows a significant association with all-cause mortality, major adverse cardiovascular events (MACE), cardiovascular mortality, and adverse renal outcomes in chronic kidney disease (CKD). 

About 10% of people worldwide suffer from chronic kidney disease (CKD), a progressive illness linked to higher rates of morbidity and death, especially from cardiovascular events and end-stage renal disease (ESRD). According to studies, advanced chronic kidney disease (CKD) frequently exhibits a microinflammatory state, which is linked to consequences such anemia, vascular calcification, cardiovascular events, and all-cause mortality.

One indicator of systemic inflammation and immunological dysregulation that has shown promise as a predictive tool is the neutrophil-to-lymphocyte ratio (NLR). A pro-inflammatory state linked to endothelial dysfunction and oxidative stress is reflected in elevated NLR. The predictive significance of NLR for all-cause mortality, MACE, and progression to ESRD or dialysis in CKD is reevaluated in this meta-analysis, which also updates the data base through 2025.

Up until March 8, 2025, PubMed, Web of Science, Embase, and the Cochrane Library were searched for pertinent material. This research assessed cardiovascular death, major adverse cardiovascular events (MACE), all-cause mortality, and progression to dialysis or end-stage renal disease (ESRD). The 95% CI and odds ratios (OR) were employed to estimate the impact.

There were 36 trials with 26,074 subjects. High NLR was found to be significantly linked to a higher risk of cardiovascular mortality (OR = 1.21, 95% CI: 1.09–1.35; p = 0.0004), MACE (OR = 1.42, 95% CI: 1.14–1.77; p = 0.002), all-cause mortality (OR = 1.22, 95% CI: 1.15–1.29; p < 0.00001), and ESRD (OR = 1.68, 95% CI: 1.17–2.43; p = 0.005), according to the meta-analysis.

The patients who died from cardiovascular causes (SMD = 1.44, 95% CI: 0.77–2.11; p < 0.0001) and all causes (SMD = 0.84, 95% CI: 0.58–1.11; p < 0.00001) had significantly higher NLR levels than survivors. The robustness of the findings was confirmed by sensitivity and subgroup analysis. In the GRADE system, every indication received an extremely low rating.

Overall, these results show that NLR is substantially linked to cardiovascular mortality, MACE incidence, all-cause mortality, and poor renal outcomes in CKD. Despite stable results, high heterogeneity and publication bias limit clinical applicability. Therefore further large-scale prospective studies are needed to validate NLR as a prognostic marker in CKD. 

Source:

Xu, Y., Chen, Y., Mai, X., & Zhang, M. (2025). Prognostic value of neutrophil-to-lymphocyte ratio for the clinical outcomes of chronic kidney diseases: an update systematic review and meta-analysis. BMC Nephrology, 26(1), 419. https://doi.org/10.1186/s12882-025-04363-1

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Barbed Sutures Improve Laparoscopic Tubal Anastomosis Outcomes, suggests study

Researchers have found in a new study that use of barbed sutures in laparoscopic tubal anastomosis is associated with shorter operation times and improved reproductive outcomes compared to conventional sutures.

This study aimed to compare reproductive outcomes after laparoscopic tubal anastomosis using conventional (non-barbed) and barbed sutures. This retrospective cohort study was conducted at a single center between January 2016 and December 2021.

Thirty-nine women undergoing laparoscopic tubal anastomosis were divided into two groups: a non-barbed suture (5 − 0 polyglactin suture) group (16 women), and a barbed suture (5 − 0 unidirectional barbed suture) group (23 women). Demographic data, operation times, reversal operation success rates, pregnancy rates, and other factors were compared between the two groups.

Results: The mean operation time was significantly shorter in the barbed suture group (55.8 ± 7.33 min) than in the non-barbed suture group (108.7 ± 17.27 min) (p = 0.001). The overall pregnancy rate was significantly higher in the barbed suture group (87%) than in the non-barbed suture group (56.3%) (p = 0.037). The rate of intrauterine pregnancy was also significantly higher in the barbed suture group (p = 0.041). The intervals between surgery and pregnancy did not differ significantly between the two groups.

The use of barbed sutures in laparoscopic tubal anastomosis can result in shorter operation times and better reproductive outcomes than the use of conventional sutures.

Reference:

Karadag, C., Karadag, B. Comparison of reproductive outcomes after laparoscopic tubal anastomosis using conventional (non-barbed) sutures and barbed sutures. BMC Surg 25, 301 (2025). https://doi.org/10.1186/s12893-025-03043-z

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Early and Consistent Physical Therapy Reduces Need for Knee Injections in Osteoarthritis Patients, Study Finds

USA: A new study published in Arthritis and Rheumatology has highlighted the significant role of physical therapy (PT) in reducing the need for intra-articular injections among individuals with newly diagnosed knee osteoarthritis (OA). The research, led by Deepak Kumar and colleagues from Boston University, Boston, Massachusetts, examined how the timing, frequency, and type of PT sessions influence the likelihood of requiring future intra-articular therapies, such as corticosteroid or hyaluronic acid injections.

The investigation utilized data from the Optum Labs Data Warehouse, a large deidentified claims database in the United States. It included 67,245 adults diagnosed with knee OA who were referred for physical therapy within the first year of their diagnosis. Participants were grouped based on whether they had previously undergone intra-articular treatments. The study then evaluated the relationship between PT initiation time, the number of sessions attended, and the type of PT (active versus passive) with subsequent use of intra-articular therapies over the following year.

The study revealed the following findings:

  • Patients who started physical therapy earlier had a lower risk of needing additional intra-articular interventions.
  • Among those with prior intra-articular therapy, initiating PT between 9 and 12 months after diagnosis was associated with a 44% higher risk of future injections compared to starting within the first month.
  • Similar benefits of early PT initiation were observed in patients without prior intra-articular treatments.
  • Attending 13 or more PT sessions was linked to a reduced risk of future intra-articular therapy—10% lower in patients with prior injections and 12% lower in those without—compared to attending only 1 to 5 sessions.
  • A higher number of PT sessions appeared to provide a protective effect against the need for invasive joint procedures.
  • The study found no significant difference in outcomes between predominantly active and passive PT approaches.
  • Timing and session frequency of PT were more influential in reducing future intra-articular treatments than the specific PT modality used.

The researchers concluded that integrating PT early in the management of knee OA and ensuring adequate session frequency could help reduce reliance on intra-articular corticosteroid or hyaluronic acid injections. Such strategies not only promote better long-term joint health but may also lower treatment costs and decrease the risks associated with repeated intra-articular procedures.

With knee osteoarthritis being a leading cause of disability worldwide, these findings offer valuable guidance for clinicians and patients. Emphasizing timely and consistent physical therapy as part of an initial treatment plan may serve as a proactive step to manage symptoms effectively while minimizing the need for more invasive interventions later on.

Reference:

Neogi, T., Dubreuil, M., Peloquin, C., Marinko, L., Camarinos, J., Felson, D. T., & Kumar, D. (2025). Association of Physical Therapy Care With Use of Intra-Articular Injections in People With Knee Osteoarthritis: A Real-World Cohort Study. Arthritis & Rheumatology, 77(8), 1006-1014. https://doi.org/10.1002/art.43155

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Strong Leg Muscles Linked to Lower Metabolic Syndrome Risk in Obese Youth: Study

Italy: A small study published in the European Journal of Pediatrics has revealed that children and adolescents with obesity who have stronger leg muscles are at a lower risk of developing metabolic syndrome (MetS). Researchers emphasized the importance of promoting physical activity from an early age to support muscle integrity and long-term metabolic health.

The cross-sectional study, conducted by Alessandro Gatti and colleagues from the Laboratory of Adapted Motor Activity (LAMA) at the University of Pavia, examined the association between physical fitness and metabolic syndrome severity in children with obesity. Metabolic syndrome, characterized by a cluster of cardiometabolic risk factors including high blood pressure, abnormal lipid levels, and increased waist circumference, is increasingly observed in the pediatric population, particularly in those with obesity.

The researchers assessed 62 children and adolescents aged 7–17 years with a BMI z-score greater than two standard deviations. Physical fitness was evaluated across three domains: cardiorespiratory fitness, muscular strength, and speed-agility. The severity of metabolic syndrome was determined using a MetS risk score derived from BMI z-score, HDL cholesterol, systolic blood pressure, triglycerides, and fasting glucose.

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

  • Lower limb muscular strength, assessed through the standing broad jump test, was significantly linked to reduced odds of metabolic syndrome.
  • A 1 standard deviation (24 cm) increase in jump distance was associated with a 53% lower risk (OR: 0.47).
  • Cardiorespiratory fitness and speed-agility did not show significant associations with metabolic syndrome or other cardiometabolic outcomes in this group.
  • Muscular strength demonstrated inverse relationships with BMI z-score, systolic blood pressure, and waist-to-height ratio.

These results emphasize the role of maintaining muscle integrity in supporting metabolic health during childhood and adolescence.

The authors noted that while the sample size was relatively small, the study maintained sufficient statistical power and followed strict ethical and methodological guidelines, including the STROBE recommendations. They acknowledged that the cross-sectional design limits causal interpretation, but the findings provide valuable insights into the linear relationship between physical fitness components and metabolic syndrome risk in children with obesity.

Importantly, this is the first study to explore these associations in Italian children and adolescents with obesity using a comprehensive battery of physical fitness tests. The findings emphasize the need to integrate muscle-strengthening activities into early-life physical activity programs to promote balanced growth, skeletal muscle health, and long-term prevention of metabolic diseases.

“Educating children about the importance of daily physical activity from a young age is crucial for fostering lifelong healthy habits,” the authors stated, adding that public health initiatives should prioritize strategies to enhance muscular strength among pediatric populations at risk.

The authors concluded, “By encouraging regular physical activity and incorporating targeted strength exercises, healthcare providers and caregivers can play a vital role in reducing metabolic risks and supporting overall health in children struggling with obesity.”

Reference:

Vandoni, M., Gatti, A., Carnevale Pellino, V. et al. Exploring the link between metabolic syndrome risk and physical fitness in children with obesity: a cross-sectional study. Eur J Pediatr 184, 497 (2025). https://doi.org/10.1007/s00431-025-06339-7

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Global rise in many Early-Onset GI cancers with colorectal cancer leading the trend, reveal two Dana-Farber reviews

Early-onset gastrointestinal (GI) cancers are rising at alarming rates worldwide and, in the U.S., are increasing faster than any other type of early-onset cancer, including breast cancer, according to two recent literature reviews from Dana-Farber Cancer Institute.

“Early-Onset Gastrointestinal Cancers: A Review,” published today in JAMA, provides a comprehensive analysis of the incidence, risk factors, and treatment approaches for early-onset GI cancers. Authors note the rising rate goes beyond colorectal cancer to include gastric, esophageal, and pancreatic cancers, among other less common GI malignancies. Early-onset GI cancer is typically defined as GI cancer diagnosed in adults younger than 50 years.

“Colorectal cancer is the most common early-onset GI cancer worldwide, accounting for more than half of the cases, but it is not the only GI cancer that is rising in younger adults. Unfortunately, pancreatic, gastric, and esophageal cancers are also increasing in young people,” said Dr. Kimmie Ng, senior author of the review and director of the Young-Onset Colorectal Cancer Center at Dana-Farber. “The rising incidence of early-onset GI cancers is alarming and underscores the need for enhanced prevention strategies and early detection methods.”

Of the GI cancers highlighted in the review, colorectal cancer is the only one currently with recommended screening guidelines for average-risk individuals in the U.S. Still, Dr. Ng says despite recommendations to begin colorectal cancer screening at age 45 for average-risk individuals, fewer than 1 in 5 (19.7%) U.S. adults aged 45 to 49 were screened in 2021, indicating a significant gap in early detection efforts.

“Screening adherence is absolutely critical,” says co-author Dr. Thejus Jayakrishnan, also of Dana-Farber. “We have strong evidence that colorectal cancer screening saves lives by reducing both the number of people who develop colorectal cancer and the number of people who die from it. Each missed screening is a lost opportunity to detect cancer early when it is more treatable, or to prevent cancer altogether by identifying and removing precancerous polyps.”

Steepest rise seen in youngest age groups: British Journal of Surgery review

The number of newly diagnosed cases of early-onset GI cancers rose by 14.8 percent between 2010 and 2019, noted a similar review published earlier this month in the British Journal of Surgery. The review notes the rise in early-onset cases disproportionately affects people who are Black, Hispanic, of Indigenous ancestry, and women.

Dr. Ng is senior author of that review. Dr. Sara Char, of Dana-Farber, and Catharine O’Connor, a medical student at Harvard Medical School, are co-first authors.

The count of early-onset GI cases is highest in the oldest group – people aged 40 to 49 – but the rise in rates is progressively steeper in younger groups. For example, people born in 1990 are twice as likely to develop colon cancer and four times as likely to develop rectal cancer compared to those born in 1950, according to the authors.

The authors also note that recent data from the Centers for Disease Control and Prevention (CDC) indicated a more than tripling of the incidence of colorectal cancer in people aged 15 to 19 and a near doubling in people aged 20-24.

Reviews offer comprehensive look at risk factors, treatment, and prognosis

Together, these two review papers observe several common risk factors associated with early-onset GI cancers. Modifiable lifestyle factors listed as significant contributors to the development of these cancers include obesity, poor diet, sedentary lifestyle, smoking, and alcohol consumption.

Nonmodifiable factors include family history and hereditary syndromes like Lynch syndrome. The JAMA review found 15% to 30% of these cancers have pathogenic germline variants, indicating a hereditary predisposition to developing cancer. Both reviews emphasize the importance of genetic testing for all patients with early onset GI cancers to assess familial risk of cancer and to guide treatment.

Treatment approaches for early-onset GI cancers are similar to those for later-onset cases, and may involve chemotherapy, surgery, and radiation, depending on the stage of the cancer. However, both papers found that patients with early-onset cancers often receive more aggressive treatment but may have similar or shorter survival rates compared to older patients.

The authors advocate for the establishment of specialized centers with multidisciplinary teams to support patients with early-onset GI cancers, addressing unique challenges such as fertility preservation, parenting, and psychosocial distress.

“Taken together, these two reviews are a call to action for further research on why rates of GI cancers are increasing in younger adults,” said Ng. “There is currently limited data available, especially in pancreatic, gastric, and esophageal cancers. This comprehensive look at what data exist can help raise education and awareness which is important because as a collective group, digestive system cancers account for a significant proportion of cancer-related deaths in younger adults in the U.S. and around the world.”

Reference:

Jayakrishnan T, Ng K. Early-Onset Gastrointestinal Cancers: A Review. JAMA. Published online July 17, 2025. doi:10.1001/jama.2025.10218

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