Hospitalisation in COPD Patients Linked to Sharp Rise in Cardiovascular Events and Mortality: Study

UK: A recent study published in the International Journal of Chronic Obstructive Pulmonary Disease highlights a concerning link between hospitalisation in individuals with chronic obstructive pulmonary disease (COPD) and a significantly heightened risk of major adverse cardiovascular events (MACE) and mortality within the year following discharge.

Conducted by Anne E. Ioannides and her colleagues at the School of Public Health, Imperial College London, the prospective cohort study utilised electronic health records from across England between 2010 and 2019. Researchers analysed data from the Clinical Practice Research Datalink Aurum, which was linked with hospital and mortality records, to assess outcomes in COPD patients who experienced at least one hospitalisation compared to those who did not.

The study focused on two primary outcomes: non-fatal MACE—including acute coronary syndrome, arrhythmia, heart failure, or ischemic stroke—and cause-specific mortality over one year post-hospitalisation. Participants were stratified based on whether the hospitalisation was elective or emergency, and by the cause of admission (cardiovascular, respiratory, or other causes).

The following were the key findings of the study:

  • Cardiovascular risk significantly increased in COPD patients following hospitalisation.
  • Emergency hospitalisation was associated with an eight-fold higher risk of major cardiovascular events within one year (adjusted hazard ratio [aHR] 8.85).
  • Elective hospitalisations were linked to a seven-fold increase in cardiovascular event risk (aHR 7.04) compared to those who were not hospitalised.
  • All-cause mortality was notably higher after hospitalisation, especially for emergency admissions (aHR 2.49).
  • Elective cardiovascular hospitalisations did not show a significant rise in mortality risk.
  • The cause and type of hospitalisation influenced cause-specific mortality outcomes.
  • Respiratory-related hospitalisations were more likely to lead to respiratory-related deaths, highlighting a connection between the reason for admission and the eventual cause of death.

The researchers acknowledged several limitations, including potential misclassification of disease causes and lack of data on in-hospital treatments or medication use. Nonetheless, the study leveraged a robust dataset representative of the UK population and employed validated methodological approaches, including sensitivity analyses and propensity score adjustments.

From a clinical and public health standpoint, the study emphasizes the need for proactive cardiovascular screening and management in all COPD patients following hospitalisation, regardless of the reason for admission. Given that cardiovascular disease often remains underdiagnosed and undertreated in COPD patients, hospitalisation presents a key opportunity to initiate preventive strategies aimed at reducing MACE and mortality.

The study concludes that every hospital encounter for individuals with COPD should be viewed as a critical juncture to assess and manage cardiovascular risks. By doing so, healthcare systems may help mitigate the often-overlooked burden of cardiovascular complications and improve long-term outcomes in this high-risk population.

Reference:

Ioannides AE, Whittaker HR, Quint JK. Major Adverse Cardiovascular Events and Cause-Specific Mortality After Hospitalisation in COPD. Int J Chron Obstruct Pulmon Dis. 2025;20:2549-2560

https://doi.org/10.2147/COPD.S529171

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Cardiometabolic Diseases Significantly Accelerate Onset and Worsening of Neuropsychiatric Disorders: Study Finds

China: Individuals with cardiometabolic diseases (CMDs) such as type 2 diabetes, hypertension, ischemic heart disease, and stroke are at a significantly elevated risk of developing neurological and psychiatric disorders—and of progressing to more severe neuropsychiatric conditions and death—according to a large-scale longitudinal study published in Diabetes, Obesity and Metabolism.

The research, conducted by Jiang Li, MPH, from the Institute and Department of Endocrinology and Metabolism at Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, and colleagues, examined the long-term impact of CMDs on mental and neurological health. The team analyzed data from over 400,000 individuals enrolled in the UK Biobank, following them for a median period of 14.1 years.

The study focused on the progression from being neurologically and psychiatrically healthy to developing a first neuropsychiatric disorder (FNPD), progressing to neuropsychiatric multimorbidity (NPM)—defined as the coexistence of at least two conditions such as dementia, Parkinson’s disease, depression, anxiety, or sleep disorders—and finally to death.

The key findings of the study were as follows:

  • There was a strong association between cardiometabolic diseases (CMDs) and all stages of neuropsychiatric disorder progression.
  • Each additional CMD increased the risk of developing a first neuropsychiatric disorder by 28%.
  • The presence of more CMDs raised the likelihood of progressing from a single neuropsychiatric condition to neuropsychiatric multimorbidity by 7%.
  • The risk of death from any stage of neuropsychiatric disorder progression increased by up to 38% with each added CMD.

When researchers broke down the transitions by specific neuropsychiatric conditions, they observed that the relationship between CMDs and neuropsychiatric outcomes varied depending on the type and combination of CMDs present. This highlights the complexity and interplay between physical and mental health conditions.

“Cardiometabolic diseases appear to play a key role at nearly every stage of neuropsychiatric deterioration,” the authors noted. “Their impact is not limited to the initial onset of disorders but extends to the worsening of neuropsychiatric burden and increased mortality.”

The study’s results were further supported by analyses from a separate Chinese population cohort in the China Health and Retirement Longitudinal Study (CHARLS), reinforcing the generalizability of these findings across populations.

These insights have significant implications for public health and clinical care. The researchers emphasized the urgent need for integrated approaches to managing CMDs, not only to reduce cardiovascular risk but also to prevent the onset and worsening of neuropsychiatric illnesses.

The study highlights the importance of early detection and comprehensive management of cardiometabolic health as a potential strategy to curb the rising burden of mental and neurological disorders, particularly in aging populations.

Reference:

Li J, Xu X, Sun Y, Yu Y, Fu Y, Tan X, He L, Wang N, Lu Y, Wang B. Cardiometabolic diseases and dynamic transitions of neuropsychiatric disorders: A longitudinal trajectory analysis. Diabetes Obes Metab. 2025 Jul 16. doi: 10.1111/dom.16614. Epub ahead of print. PMID: 40667714.

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Regular opioid use may increase dementia risk, reveals research

In a study published in Alzheimer’s & Dementia, a team led by Dr. SHA Feng from the Shenzhen Institute of Advanced Technology of the Chinese Academy of Sciences, collaborating with Dr. Jed A. Barash from the Massachusetts Veterans Home at Chelsea and Prof. W. Andrew Kofke from the University of Pennsylvania, found that regular opioid use is associated with an increased risk of dementia, particularly vascular dementia.

Chronic non-cancer pain (CNCP) is defined as any painful condition that persists for more than three months and is unrelated to malignancy. Opioid use for CNCP became widespread in the mid-1990s. Inappropriate prescribing, dependence, and misuse of high-potency opioids have raised public health concerns.

Previous studies have suggested that opioid use may affect the endogenous opioid system and potentially impair the hippocampus and other central nervous system regions, increasing the risk of cognitive decline and dementia.

In this study, the researchers conducted a prospective cohort study involving 197,673 individuals with CNCP aged 37 to 73 from the UK Biobank, with a mean follow-up of 13.8 years. They applied multiple Cox, linear, and logistic regression models, which control for potential confounding factors, to explore the associations between regular opioid use and incident dementia, neuroimaging outcomes, and cognitive measures.

The researchers found that regular opioid use was associated with a 20% higher risk of all-cause dementia compared with taking analgesics. Participants who regularly used strong opioids had a over 70% increased risk of dementia, and those taking non-opioid analgesics showed a risk level similar to the non-users. Besides, a significant association between opioid use and vascular dementia (VD) was observed.

Through neuroimaging analyses, the researchers found that regular use of strong opioids was linked to reduced total brain volume (TBV), white matter volume (WMV), and hippocampal volume (HV). They also found that opioid use was associated with lower fluid intelligence, but not significantly associated with prospective memory decline.

This study underscores the importance of considering both opioid potency and cumulative exposure when evaluating the associations between opioid use and the risk of dementia or other adverse outcomes. This study provides valuable insights into the strategies for addressing the complex interplay between chronic pain, analgesic use, and cognitive impairment.

Reference:

Tengfei Lin, Jed A. Barash, Shiyu Wang, Fuxiao Li, Zhirong Yang, W. Andrew Kofke, Feng Sha, Jinling Tang, Regular use of opioids and dementia, cognitive measures, and neuroimaging outcomes among UK Biobank participants with chronic non-cancer pain, Alzheimer’s & Dementia, https://doi.org/10.1002/alz.70177.

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Ketamine use in chronic pain unsupported by evidence, review finds

The off-label use of ketamine to treat chronic pain is not supported by scientific evidence, a new Cochrane review has found.

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COVID infection ages blood vessels, especially in women, research reveals

A COVID infection, particularly in women, may lead to blood vessels aging around five years, according to research published in the European Heart Journal.

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A stroke stole her ability to speak—18 years later, scientists used AI to bring it back

Ann Johnson became paralyzed after a brainstem stroke at age 30. As a participant in a clinical trial led by researchers at UC Berkeley and UC San Francisco, she finally heard her voice again.

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Why is research into women’s mental health decades behind?

A global mental health crisis is evolving. And at the forefront of the surging rates of mental health disorders globally are women, who are disproportionately affected when compared to men.

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A rare ‘brain-eating amoeba’ has been detected in Queensland water. Is tap water safe?

One of the world’s most dangerous water-borne microorganisms, commonly called a “brain-eating amoeba,” has recently been detected in two drinking water supplies in southwest Queensland.

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Breaking News: Study evaluates Impact of Down Syndrome Diagnoses on Maternal Well-Being

Recent study focused on mothers’ experiences receiving a Down syndrome diagnosis, aiming to discern its impact on their emotional well-being and child care. Analyzing data from 40 mothers—42.5% receiving a prenatal diagnosis, 17.5% during labor/delivery, and 40% postnatally—the investigation employed reflexive thematic analysis to derive four pivotal themes: the identity of the person delivering the news, the timing of the diagnosis, the setting in which it was communicated, and unexpectedly positive experiences that arose even in this largely distressing context.

Communication Inadequacies

The findings illuminated crucial inadequacies in how healthcare professionals communicate such sensitive information. Many mothers noted a lack of empathy and training among medical practitioners, often reporting that the delivery of the diagnosis was cold and devoid of supportive guidance. Miscommunication was prevalent, with some mothers receiving inaccurate information, like fatalistic predictions regarding their child’s future. This suggests a pressing need for enhanced training focused on both medical knowledge and empathetic communication skills among healthcare providers. Timing proved significant in shaping maternal experiences. While responses varied, mothers who received prenatal diagnoses generally felt more prepared and less distressed than those informed during labor or shortly after birth, who frequently reported feelings of shock and grief. For some, prenatal awareness facilitated emotional preparedness, allowing them to seek information and adjust expectations regarding their child’s arrival.

Contextual Influences

The contextual setting of the diagnosis delivery also played a crucial role. Many mothers reported inappropriate settings—like operating rooms or hospital corridors—where privacy was lacking. This contributed to a negative emotional impact during an already stress-laden period. In contrast, a minority of experiences characterized as positive were characterized by compassionate delivery and provision of resources and support information.

Need for Systematic Reforms

The findings underscore the overarching necessity for systematic reforms in how healthcare professionals communicate diagnoses of Down syndrome. Establishing standardized protocols that emphasize empathy and accuracy is essential. Training should not only inform healthcare professionals about Down syndrome but enhance their sensitivity to the emotional landscape mothers navigate upon receiving such news.

Conclusion and Future Directions

In conclusion, addressing these communication challenges is vital for fostering supportive environments that enable families to cope with and thrive following a Down syndrome diagnosis. Future studies should further explore how demographic variables and context influence these experiences, aiming to enhance the emotional support offered within healthcare settings.

Key Points

– -Emotional Impact of Diagnosis-: Analysis of experiences from 40 mothers revealed significant emotional ramifications dependent on the timing and setting of the Down syndrome diagnosis. Mothers receiving prenatal diagnoses reported feeling more prepared, whereas those informed during labor or postnatally often experienced shock and grief.

– -Communication Deficiencies-: Many healthcare professionals demonstrated inadequate communication skills, with mothers citing a lack of empathy, cold delivery, and misinformation concerning their child’s prognosis. The prevalence of miscommunication indicates a critical need for improved compassion and accuracy among practitioners.

– -Contextual Effects-: The environment in which the diagnosis was communicated significantly affected mothers’ emotional responses. Many described inappropriate settings lacking privacy, such as operating theatres or hallway discussions, exacerbating their distress.

– -Calls for Systematic Reform-: Findings emphasize the urgent necessity for healthcare reforms, advocating for standardized protocols that prioritize both empathetic communication and accurate information provision specific to Down syndrome.

– -Training Highlights-: Future training initiatives should not only educate healthcare providers on the medical aspects of Down syndrome but must also cultivate skills related to empathetic engagement and emotional support for families during this challenging time.

– -Future Research Directions-: Recommendations for future studies include investigating the impact of demographic factors and contextual variables on maternal experiences, with a goal of enhancing emotional support mechanisms within healthcare environments post-diagnosis.

Reference –

Marcela Tenorio D et al. (2025). Your Baby Has Down Syndrome: A Reflexive Thematic Analysis Of Breaking The News To Parents. *BMC Pregnancy And Childbirth*, 25. https://doi.org/10.1186/s12884-025-07665-2.

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University of Cincinnati study finds vision loss fear may keep some from having cataract surgery

Fear of vision loss may deter some patients from undergoing necessary cataract surgery, according to a newly published study. Cataracts are the leading cause of reversible blindness, and surgery remains the only effective treatment.

The study, recently published in The Journal of Clinical Ophthalmology, highlights the trust patients place in their physicians and the critical role of doctor-patient communication in making medical decisions.

The research was led by Lisa Kelly, MD, a Taylor Asbury-endowed professor-educator and director of medical student education in the Department of Ophthalmology at the University of Cincinnati College of Medicine. Kelly also serves as medical director of UC eye clinics. The study’s corresponding author was Samantha Hu, a fourth-year medical student. Stephanie Wey, MD, a former UC resident, and Rainier Yono, a third-year medical student, also contributed.

The research team surveyed 42 patients at Hoxworth Eye Clinic, the training site for UC’s ophthalmology residents located near UC Medical Center. The study explored a possible link between health literacy and fear surrounding cataract surgery.

“We hypothesized that patients with lower health literacy would fear surgery more, especially the risk of vision loss,” said Hu. “But our findings didn’t support that.”

Cataracts develop when proteins in the eye’s natural lens break down and clump together, leading to blurry or dimmed vision. Because the condition is most commonly age-related, those surveyed were all 50 and older. Sixty percent reported a yearly income below $50,000.

Study findings

Among those surveyed, 36% reported fear of cataract surgery, and more than half of those specifically feared it would lead to vision loss. However, researchers found no correlation between this fear and a patient’s health literacy level.

“We found patients who would benefit from surgery reasonably understood the procedure after we educated them,” Kelly said. “But even with clear explanations, sometimes their fear persisted.”

Hu noted that simply providing more information wasn’t always helpful. “Overloading patients with data doesn’t necessarily ease their concerns,” she said.

Instead, the study pointed to the importance of open communication.

“Yes, patient education matters, but it’s not always sufficient,” said Kelly. “What’s equally important is building relationships and trust to help patients overcome fear.”

Hu said the findings emphasize how much patients rely on their physicians to guide them to medical decisions based on their individual needs.

“It underscores the trust patients place in their doctors — and the need for physicians to truly understand their patient population,” said Hu.

Kelly added, “It’s a reminder that our patients are people with real fears. Our role is to partner with them in their health care.”

Moving forward, researchers are likely to delve deeper into patients’ fear around cataract surgery and how physicians can further strengthen doctor-patient relationships.

Path to residency

Hu is part of the UC College of Medicine’s Class of 2025. She is originally from Greenwood Village, Colorado, a suburb of Denver.

As Hu became more focused on pursuing the ophthalmology specialty, she said she reached out to Kelly about taking part in research and joined the study in her second year of medical school for the data gathering process.

Hu said she was intrigued by this study because of her interest in the social determinants of health, the economic and social conditions that influence differences in people’s health. “Sam and I spent a lot of one-on-one time together as she worked on this research project,” said Kelly. “I got to know her well.”

The results of the study were first presented at a medical conference last year and likely helped Hu stand out in the competitive residency matching process.

“Engaging with a scholarly question in research like this better positions medical students to take a critical look at the literature,” Kelly said.

Reference:

 Hu S, Fear of Cataract Surgery and Vision Loss: The Effects of Health Literacy and Patient Comprehension at an Academic Hospital-Based Eye Clinic, Journal of Clinical Ophthalmology, DOI https://doi.org/10.2147/OPTH.S490630

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