How to Elevate Metabolic Health with Exercise Snacks? – Dr Arvind Bhateja

In the hustle and bustle of our daily lives, finding time for a full workout can be challenging. However, there’s good news for those who crave a healthier lifestyle without sacrificing precious time – the exercise snack. These bite-sized bursts of activity might be the secret ingredient to enhancing your metabolic health says Dr. Arvind Bhateja.

Why Vigorous Physical Activity Matters?

In the pursuit of good metabolic health, vigorous physical activity stands out as a powerful ally. The key lies in its ability to kick-start your metabolism, prompting the body to burn calories more efficiently. As we engage in these short, intense bursts of movement, our muscles demand increased energy, leading to a cascade of metabolic reactions that ultimately contribute to improved overall health.

The Art of the Exercise Snack

Unlike traditional workouts that demand dedicated time slots, exercise snacks are mini-sessions designed to seamlessly fit into your daily routine. Whether it’s a quick sprint up the stairs, a brisk walk around the block, or a series of jumping jacks during a work break, these micro-workouts can be tailored to your schedule.

The beauty of exercise snacks lies in their flexibility. No need for elaborate equipment or a gym membership – just a willingness to move. Incorporating these bite-sized sessions into your routine ensures that even the busiest individuals can prioritize their health without feeling overwhelmed.

Fueling Fat Oxidation and Mastering Glucose Control

One of the remarkable benefits of exercise snacks is their impact on fat oxidation and glucose control. The brief but intense nature of these bursts challenges the body to tap into its fat stores for energy, promoting fat metabolism. This, in turn, contributes to weight management and a leaner physique.

Moreover, regular bouts of vigorous activity enhance insulin sensitivity, helping regulate blood sugar levels. For those concerned about diabetes or simply aiming to maintain stable energy throughout the day, exercise snacks provide a natural and accessible solution.

Incorporating Exercise Snacks into Your Lifestyle

Now that the benefits are clear, the next step is to seamlessly integrate exercise snacks into your daily life. Consider taking the stairs instead of the elevator, opting for a brisk walk during lunch, or engaging in a quick set of bodyweight exercises at home. The key is to find opportunities throughout the day to move and elevate your heart rate.

Remember, consistency is key. Aim for at least three to five exercise snacks per day, ensuring that they become a natural part of your routine. Over time, these small efforts add up to significant improvements in metabolic health, leaving you feeling energized and revitalized.

The exercise snack is not just a fleeting trend but a practical and effective approach to achieving good metabolic health. By embracing these bite-sized bursts of activity, you can seamlessly infuse vitality into your daily routine, promoting fat oxidation, optimizing glucose control, and ultimately crafting a lifestyle that prioritizes your well-being.

So, lace up those sneakers and start snacking your way to a healthier, more vibrant you!

Disclaimer: The views expressed in this article are of the author and not of Medical Dialogues. The Editorial/Content team of Medical Dialogues has not contributed to the writing/editing/packaging of this article.

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South Korea Doctors’ Strike: President Says Won’t back down over medical reforms

Seoul: Amid the South Korean doctors’ protest against the government for over a month now, President Yoon Suk Yeol vowed on Monday not to back down in the face of vehement protests by doctors seeking to derail his plan to drastically increase medical school admissions, as he called their walkouts “an illegal collective action” that poses “a grave threat to our society.” 

About 12,000 medical interns and residents in South Korea have been on strike for six weeks, causing hundreds of cancelled surgeries and other treatments at university hospitals. In support of their action, many senior doctors at their teaching schools have also submitted resignations though they haven’t stopped treating patients.

According to the AP news agency, Public surveys show that a majority of ordinary South Koreans support the government plan. But observers say many people are increasingly fed up with the protracted confrontation between the government and doctors, threatening to deal a blow to governing party candidates ahead of next week’s parliamentary elections.

In a nationally televised address, President Yoon Suk Yeol said adding 2,000 medical students is the minimum increase needed to address a shortage of physicians in rural areas, the military and essential but low-paying professions like paediatrics and emergency departments. Yoon said South Korea’s doctor-to-patient ratio — 2.1 physicians per 1,000 people — is far below the average of 3.7 in the developed world.

“Increasing the number of doctors is a state project that we can’t further delay,” Yoon said.

Yoon urged the striking doctors to return to work, saying they have a responsibility to protect people’s lives in line with the local medical law. He also said the government remains open to talks if doctors come up with a unified proposal that adequately explains their calls for a much smaller increase in the medical school enrollment quota.

“I can’t tolerate an attempt to carry through their thoughts by force without due logic and grounds,” Yoon said. “The illegal collective action by some doctors has become a grave threat to our society.”

Yoon said the recruitment plan won’t lead to lower earnings for doctors, citing what he called expected increases in national income and demand for medical services in the fast-ageing society. He said the average income of South Korean doctors is the highest in the developed world.

Later Monday, the Korean Medical Association, which represents doctors in South Korea, criticized Yoon for repeating what his government has already argued to support the recruitment plan.

“It was an address that brought us greater disappointment because we had high hopes” for some changes in the government’s position, Kim Sung-geun, a spokesperson for KMA’s emergency committee, told reporters.

Yoon said the government is taking final administrative steps to suspend the licenses of the strikers but added he doesn’t want to punish the young doctors. This implies that his government is willing to soften punitive measures on the strikers if they return to work soon.

Yoon recently ordered officials to pursue “a flexible measure” to resolve the dispute and seek constructive consultations with doctors at the request of ruling party leader Han Dong-hoon.

It’s unclear if the government and doctors can find a breakthrough to settle their standoff anytime soon. Last week, KMA elected Lim Hyun-taek, a hardliner who has called for a decrease in the medical school admission cap, as its new chief.

After his election Tuesday, Lim said that doctors can sit down for talks with the government if Yoon apologizes and dismisses top health officials involved in the recruitment plan. Lim also threatened to launch an all-out fight if any doctors received punitive steps over their recent protests. 

Also read- Medical School Admission Seats: South Korea’s Medical Professors Announce To Join Protests

What could be the reason behind the doctors’ protest?

South Korea has a universal healthcare system funded by a public health insurance system though most doctors work in private practices and hospitals are usually privately owned.

As per the Jagran news report, the current working conditions in the medical field in South Korea are causing dissatisfaction among junior doctors. They feel that the compensation they receive does not adequately reflect the long hours they work, and they are urging the government to prioritize addressing these urgent concerns rather than focusing on increasing the number of doctors in the country.

The government plans to increase admissions to medical schools by 2,000 starting in 2025 from 3,000 now to fill what it projects to be a large shortfall of doctors by 2035.

Some medical professionals pointed out that the government’s plans will do little to fix the near-term situation as they lack proper measures to shore up essential services and rural areas grappling with a deepening shortage of doctors. It also takes around 10 years for a doctor to be fully trained.

According to a Reuters report, junior doctors or trainees typically work 80 to 100 hours, five days a week – meaning up to 20 hours a day. Protesting doctors said these working conditions need to be addressed by hiring more senior staff and not increasing the number of trainees or junior doctors.

The five biggest hospitals in Seoul — Seoul National University Hospital, Seoul Asan Medical Center, Samsung Medical Center, Severance Hospital and Seoul St. Mary’s Hospital — play a key role in providing medical care for patients in critical conditions.

Doctors counter that schools can’t handle such an abrupt increase in students and that it would eventually hurt the country’s medical services. But critics say, doctors, one of the best-paid professions in South Korea, are simply worried that the supply of more doctors would result in lower future incomes.

The striking junior doctors represent a fraction of the total doctors in South Korea — estimated at 115,000 by Yoon and 140,000 by a doctors’ association. But in some major hospitals, they account for about 30% to 40% of doctors, assisting qualified doctors and department chiefs during surgeries and other treatments while training.

Doctors say the government enrollment plan lacks measures to resolve key medical issues such as how to increase the number of physicians in some key but unpopular professions. They say newly recruited students would also try to work in the capital region and high-paying fields like plastic surgery and dermatology. They say the government plan would also likely result in doctors performing unnecessary treatments due to increased competition.

Also read- South Korea Doctors Strike: Health Ministry Notifies 2 Doctors Of License Suspension

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Faridabad optometrist crushed to death by speeding tractor

Gurgaon: In an unfortunate incident, a 24-year-old optometrist from Faridabad lost her life in an accident after a tractor collided with her scooter from behind and crushed her.

According to the police, the driver reportedly collided with the doctor’s scooter from the rear. Consequently, she was thrown off and the driver purportedly drove his truck over the deceased. 

In response to the accident, the police arrested the accused on Sunday based on a complaint filed by the deceased father who demanded stringent action against the accused. However, he has been released on bail after being produced in court the same day.

Also read- Tragic: 2 Second-Year MBBS Student Dies In Bike Accident In Coimbatore

In his complaint, the father said, “The tractor was being driven in a rash manner. Immediately after the accident, the driver fled from the spot. Please initiate stringent legal action against him.”

As per a TOI news report, the doctor aged 24 was on her way home from the hospital with her father who was riding a bike a few metres behind her when the incident occurred around 4 pm on Saturday in sector 55. 

Following the accident, the doctor’s father along with local police, rushed Saifi to a nearby hospital where she was declared dead on arrival by the doctors.

Later, an FIR was registered under sections 304A (causing death due to rash or negligent act) and 279 (rash driving on a public way) of the Indian Penal Code (IPC) at the Sector 58 police station.

ASI Anil Kumar from the Sector 58 police station told The Daily, “The accused confessed to have driven negligently. He fled the spot but passersby were able to note down the vehicle registration number and passed it on to the police.”

An investigation into the case is underway. 

Also read- Doctor, 2 Others Killed After Car Collides With Electric Pole In UP

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High blood pressure may begin in childhood, finds study

A new research to be presented at this year’s European Congress on Obesity, from 12-15 May, suggested that children and teenagers living with overweight or obesity are more likely to have high blood pressure as adults (aged 50-64 years), suggesting the processes behind the condition could begin as early as childhood.

Hypertension is a major global health concern, affecting 1.28 billion adults aged 30-79 years worldwide. It significantly increases the risk of cardiovascular diseases like heart attacks, strokes, and chronic kidney disease. Poor diet, lack of exercise, and obesity are modifiable risk factors. High BMI in adults is strongly linked to high blood pressure, but the impact of elevated BMI during childhood and puberty on midlife blood pressure remains unclear.
In the study, researchers examined 1,683 individuals from two population-based cohorts to investigate the relationship between BMI during development and blood pressure in midlife (50-64 years old). They utilized data from the BMI Epidemiology Study Gothenburg (BEST) cohort and the Swedish Cardio-Pulmonary bio-Image Study (SCAPIS). Developmental BMI was assessed using school health records and military enrolment examinations for young adults. Blood pressure measurements in midlife were obtained from SCAPIS participants not taking medication for high blood pressure. All analyses were adjusted for birth year.
The results revealed that in men, both childhood BMI and pubertal BMI change independently contributed to increased systolic and diastolic blood pressure in middle age. For each one unit increase in childhood BMI, there was a 1.30 mmHg increase in systolic blood pressure and a 0.75 mmHg increase in diastolic blood pressure. In women, only pubertal BMI change was significantly associated with increased blood pressure in midlife, with a 0.96 mmHg increase in systolic blood pressure and a 0.77 mmHg increase in diastolic blood pressure. Childhood BMI did not show a significant association with blood pressure in midlife for women.
“Although the differences in blood pressure are not very large, if blood pressure is slightly elevated over many years, it can damage blood vessels and lead to cardiovascular and kidney disease. Our findings indicate that high blood pressure may originate in early life. Excessive fat mass induces chronic low-grade inflammation and endothelial dysfunction [impaired functioning of the lining of the blood vessels] already in childhood. Higher amounts of visceral abdominal fat increase the risk of developing hypertension in adults. And we have previously shown that a large pubertal BMI change in men is associated with visceral obesity [fat around the internal organs] at a young adult age. So enlarged visceral fat mass might, in individuals with a high BMI increase during puberty, be a possible mechanism contributing to higher blood pressure.” explained co-author Dr Jenny Kindblom from Sahlgrenska University Hospital, Sweden.
Reference: Study suggests high blood pressure could begin in childhood; EUROPEAN ASSOCIATION FOR THE STUDY OF OBESITY; MEETING: European Congress on Obesity (ECO2024)

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How does meat consumption affect mortality risk among frail? Study finds out

A recent study published in The Journal of Nutrition, Health and Aging explored how meat consumption influences the risk of death in frail populations.

Frailty, a clinical syndrome affecting almost 10% of the elderly, undermines their ability to handle stress. Nutrition plays a key role in frailty development, with protein supplements often used to boost strength and physical function in frail older adults. Meat, as a food category, includes red meat, fish, and poultry. Rich in proteins and micronutrients, meat is important for building and maintaining muscle strength, enhancing physical strength, and minimizing the incidence of malnutrition in the elderly. Although meat is a rich protein source, its impact on the health of frail individuals remains under-researched.

In the study, around 20,000 participants, with a mean age of 58 years were enrolled. About 38% and 12% ate red meat and processed meat, respectively. Higher processed meat consumption, particularly more than 4 times a week, increased all-cause mortality by 20% and deaths from cardiovascular disease (CVD) by 25%. Red meat intake showed a U-shaped relationship with mortality, with lower death rates from all causes, cancer, and CVD observed among those consuming red meat up to 2 times a week. Compared to those consuming red meat less than once a week, the risk of all-cause deaths was 14% lower in this group. Additionally, for every additional 25 g of red meat consumed, there was a 7% increase in all-cause mortality and a 16% increase in deaths from CVD among the frail. Overall meat consumption did not show the same impact on mortality.

The findings suggested that a higher processed meat intake was associated with an increased risk of all-cause and cardiovascular mortality among frail individuals. Moderate intake of unprocessed red meat and higher intake of unprocessed substitutes such as poultry was associated with a decreased risk of all-cause, cancer, and cardiovascular mortality. Replacing processed meat or unprocessed red meat with fish or unprocessed poultry may be encouraged to reduce mortality and prolong life expectancy.

Reference: Jie Chen a, Weihao Xu, Lintao Dan, Junhan Tang b, Jirong Yue e, Emiel O. Hoogendijk f, and Chenkai Wu (2024). Associations between meat consumption and all-cause and cause-specific mortality in middle-aged and older adults with frailty. The Journal of Nutrition, Health and Aging. doi: http://dx.doi.org/10.1016/j.jnha.2024.100191.

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Combination of empagliflozin and citalopram effective against major depressive disorder: Study

Iran: Combination therapy of empagliflozin and citalopram is effective in reducing symptom severity in patients with major depressive disorder, a randomized double-blind, placebo-controlled clinical trial has shown.

Empagliflozin is a blood sugar-lowering drug that works as a highly selective and potent inhibitor of sodium-glucose co-transporter 2 (SGLT2).

“This average reduction in symptom severity was statistically significant over time compared to the reduction of symptoms seen in the placebo-citalopram group,” Atefeh Zandifar, Alborz University of Medical Sciences, Karaj, Iran, and colleagues wrote in their study published in BMC Psychiatry.

Considering the promising findings, the researchers recommend further study of empagliflozin as adjunctive therapy in MDD with longer follow-ups and larger sample sizes.

Major depressive disorder (MDD) is one of the most common psychiatric disorders associated with a high disease burden. MDD affects an estimated 300 million people worldwide every year, which accounts for the highest number of years of disability among psychiatric disorders.

Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant that is prescribed commonly as the first line of treatment for MDD. The prescribed SSRIs include fluoxetine, citalopram, paroxetine, and sertraline. However, the researchers note that the current treatment using antidepressants has limitations, so it will be helpful to use medication with anti-inflammatory and neuromodulation properties alongside them.

Against the above background, the researchers studied the effectiveness of empagliflozin as an adjunctive therapy to reduce the severity of depression symptoms.

The study included outpatients with moderate to severe depression (Hamilton Depression Rating Scale (HDRS) > = 17) who were not under related medication or had not taken medication for at least the last two months, with ages 18–60 years and had written informed consent to enter the study (N = 90). They were randomly divided into two groups receiving placebo or empagliflozin (10 mg daily) combined with citalopram (40 mg daily) in an 8-week randomized, double-blind, placebo-controlled clinical trial. They were evaluated using the HDRS in weeks 0, 4, and 8.

The researchers reported the following findings:

· HDRS scores were equal to 28.42, 20.20, and 13.42 in the placebo group during weeks 0, 4, and 8, respectively. These scores were 27.36, 13.76, and 7.00 for the group treated with empagliflozin.

· Compared to the control group, patients treated with empagliflozin using repeated-measures ANOVA showed a greater improvement in reducing the severity of depression symptoms over time.

In conclusion, the study found that empagliflozin is associated with psychiatric usefulness and a reduction in the severity of depression symptoms compared to the control group.

“Considering the multitude of possible mechanisms involved in the formation of this effect along with the vascular and metabolic benefits of this medication, it seems that evaluating empagliflozin’s effect as adjuvant treatment on MDD among different clinical groups in multicenter conditions and with a larger sample size with longer follow-ups may be accompanied by more accurate clinical judgment in this field,” the researchers wrote.

Reference:

Zandifar, A., Panahi, M., Badrfam, R. et al. Efficacy of empagliflozin as adjunctive therapy to citalopram in major depressive disorder: a randomized double-blind, placebo-controlled clinical trial. BMC Psychiatry 24, 163 (2024). https://doi.org/10.1186/s12888-024-05627-0

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Routine Use of albumin in ARDS as supplement to diuresis not required, recommends new Transfusion Medicine Guidelines

Routine Use of albumin in ARDS or as a supplement to diuresis is not advised, new Transfusion Medicine Guidelines suggest a new study published in the Chest.

Albumin is commonly employed across a wide range of clinical settings to improve hemodynamics, facilitate fluid removal, and manage complications of cirrhosis. The International Collaboration for Transfusion Medicine Guidelines developed guidelines for the use of albumin in patients requiring critical care, undergoing cardiovascular surgery, kidney replacement therapy, or experiencing complications of cirrhosis. Co-chairs oversaw the guideline development process and the panel included researchers, clinicians, methodologists, and a patient representative. The evidence informing this guideline arises from a systematic review of randomized clinical trials and systematic reviews, in which multiple databases were searched (inception to November 23, 2022). The panel reviewed the data and formulated the guideline recommendations using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The guideline was revised after public consultation.

Results: The panel made 14 recommendations on albumin use in adult critical care (3 recommendations), pediatric critical care (1 recommendation), neonatal critical care (2 recommendations), cardiovascular surgery (2 recommendations), kidney replacement therapy (1 recommendation), and complications of cirrhosis (5 recommendations). Of the 14 recommendations, 2 had moderate certainty of evidence, 5 had low certainty of evidence, and 7 had very low certainty of evidence. Two of the 14 recommendations suggested conditional use of albumin for patients with cirrhosis undergoing large volume paracentesis or with spontaneous bacterial peritonitis. Twelve of 14 recommendations did not suggest albumin use in a wide variety of clinical situations where albumin is commonly transfused. There are currently few evidence-based indications that support the routine use of albumin in clinical practice to improve patient outcomes. This guideline provides clinicians with actionable recommendations on the use of albumin.

Reference:

Callum J, Skubas NJ, Bathla A, Keshavarz H, Clark EG, Rochwerg B, Fergusson D, Arbous S, Bauer SR, China L, Fung M, Jug R, Neill M, Paine C, Pavenski K, Shah PS, Robinson S, Shan H, Szczepiorkowski ZM, Thevenot T, Wu B, Stanworth S, Shehata N; ICTMG Intravenous Albumin Guideline Group. Use of Intravenous Albumin: A Guideline from the International Collaboration for Transfusion Medicine Guidelines. Chest. 2024 Mar 4:S0012-3692(24)00285-X. doi: 10.1016/j.chest.2024.02.049. Epub ahead of print. PMID: 38447639.

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Miscarriages tied to increased risk of gestational diabetes and high BP-related disorders in later pregnancies: Study

Australia: A recent study published in eClinicalMedicine has revealed an association between prior spontaneous abortion and increased odds of gestational diabetes mellitus, but not pre-eclampsia. 

The study further revealed an increased risk of subsequent pre-eclampsia in women who experienced recurrent pregnancy loss. 

The new Curtin University research has revealed a link between miscarriage and the increased risk of developing complications of gestational diabetes and high blood pressure-related disorders in later pregnancies.

Researchers from the Curtin School of Population Health analyzed 52 studies involving more than 4 million pregnancies across 22 countries to investigate the health impacts of miscarriage, abortion, and recurrent pregnancy loss (more than two miscarriages in succession) on subsequent pregnancies.

The study found different health risks for each group.

People who had experienced a miscarriage were 44 percent more likely to develop gestational diabetes during later pregnancies but only 6 percent more likely to develop high blood pressure in subsequent pregnancies.

Conversely, people who had experienced recurrent pregnancy loss showed no increased risk of gestational diabetes but were 37 percent more likely to develop pre-eclampsia, a potentially dangerous complication characterized by high blood pressure, in later pregnancies.

There was no evidence linking abortion to diabetic or hypertensive-related issues, either during or outside of pregnancy.

Lead study author Dr Jennifer Dunne said establishing the links between pregnancy loss, diabetes, and high blood pressure could have a far-reaching impact.

“Miscarriages occur in 15-25 percent of all pregnancies-which is around 23 million per year, globally,” Dr Dunne said.

“Gestational diabetes and high blood pressure disorders in pregnancy can cause a variety of significant health problems; understanding the relationship between pregnancy loss and later pregnancy complications could reveal new ways to mitigate risks or possibly prevent these conditions from progressing.

“Further research into the biological links between pregnancy loss and later health issues might reveal new targets for developing treatments.”

Dr Dunne said the study added to what was already known about pregnancy complications and health later in life, even beyond pregnancy.

“Knowing miscarriage can lead to these pregnancy complications, later on, is important, as these conditions during pregnancy have previously been linked to a higher risk of people developing heart disease later in life,” Dr Dunne said.

“By shedding light on the long-term health effects of miscarriages and repeated pregnancy losses, this study paves the way for improved healthcare strategies, research, and support for those affected enhancing the outcomes for parents and babies in future pregnancies.”

Reference:

Jennifer Dunne, Damien Foo, Berihun A. Dachew, Bereket Duko, Amanuel T. Gebremedhin, Sylvester D. Nyadanu, Gavin Pereira, Gizachew A. Tessema. Diabetic and hypertensive disorders following early pregnancy loss: a systematic review and meta-analysis. eClinicalMedicine, 2024; 102560 DOI: 10.1016/j.eclinm.2024.102560.

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Immediate Weight-Bearing may Improve Clavicle Fracture Rehabilitation: Study

A recent study published in the Journal of Orthopaedic Trauma revealed that immediate upper extremity weight-bearing as tolerated (WBAT) after surgical fixation is safe and does not compromise healing in patients with clavicle fractures. This research was conducted across three Level 1 trauma centers that marks a potential shift in postoperative care and rehabilitation strategies.

Traditionally, patients who undergo open reduction internal fixation (ORIF) for mid-shaft clavicle fractures have been advised to limit the weight-bearing on their affected arm to prevent hardware failure and ensure proper healing of the fracture. However, the outcome of this new study suggests that patients with concomitant lower extremity trauma can safely engage in WBAT using assistive devices like walkers or crutches immediately after surgery.

The retrospective cohort study focused on patients over 18 years who underwent ORIF for mid-shaft clavicle fractures and compared the individuals who allowed immediate WBAT with a matched cohort that adhered to non-weight-bearing (NWB) restrictions. The primary outcomes were to assess the safety of WBAT in terms of hardware failure, infection rates and the overall healing process.

The key findings from this study underline the safety and effectiveness of the immediate WBAT protocol. Among the 39 patients in the WBAT group, there was no significant increase in the risk of acute hardware failure that require surgical intervention when compared to their NWB counterparts. Both groups expressed a 2.5% incidence of such complications, with overall hardware failure rates showing no significant difference. All the patients in this study achieved fracture union regardless of their weight-bearing status, even the individuals who required revision surgery for acute hardware failure.

These results found beneficial implications for the management of clavicle fractures. The study challenges existing postoperative restrictions and opens the door for earlier rehabilitation and potentially quicker recovery times by supporting the safety of immediate WBAT. This could significantly improve patient outcomes in the individuals with additional lower extremity injuries by enabling more efficient use of assistive devices and promoting earlier return to daily activities. Overall, this research represents a leap ahead in improving the existing understanding of bone healing and rehabilitation by encouraging further research that could potentially revise the guidelines to reflect these insights into safe and effective postoperative care.

Source:

Frane, N., Watzig, B., Vohra, A., Deeyor, S., Hui, C., McKee, M., & Dehghan, N. (2024). Immediate Weight-bearing Through Walker or Crutches After Surgical Fixation of Clavicle Fractures in Patients With Lower Extremity Fractures: A Retrospective Cohort Study. In Journal of Orthopaedic Trauma (Vol. 38, Issue 4, pp. 227–233). Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1097/bot.0000000000002773

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Dual Antiplatelet Therapy Prevents Neurological Deterioration in Stroke Patients: JAMA Study

A recent study published in the Journal of American Medical Association revealed compelling evidence supporting the efficacy of dual antiplatelet therapy over single antiplatelet treatment for patients suffering from mild to moderate ischemic strokes. 

The study was conducted across 66 hospitals in China from December 20, 2016 to August 9, 2022 and involved a total of 3000 patients with acute mild to moderate strokes that occur within 48 hours of symptom onset. This trial assess the comparative effectiveness of clopidogrel plus aspirin versus aspirin alone in preventing recurrent strokes and minimizing neurological deterioration.

The results unveiled a clear advantage for dual antiplatelet therapy, with patients receiving clopidogrel plus aspirin demonstrating significantly lower rates of early neurological deterioration at 7 days when compared to those treated with aspirin alone. Among the 2915 participants included in the analysis, only 4.8% of those on dual therapy experienced early neurological deterioration when compared to 6.7% in the aspirin-only group.

This study found no significant difference in bleeding events between the two treatment groups that ensures a comparable safety profile for both therapeutic approaches. These findings provide substantial evidence supporting the adoption of dual antiplatelet therapy as a superior option for managing acute ischemic strokes that are mild to moderate in severity.

This study marks a significant stride in stroke care by emphasizing the potential impact of the findings on clinical practice. Overall, these results underline the importance of dual antiplatelet therapy to prevent neurological deterioration and to improve outcomes for individuals with mild to moderate stroke. 

Reference:

Chen, H.-S., Cui, Y., Wang, X.-H., Ma, Y.-T., Han, J., Duan, Y.-J., Lu, J., Shen, L.-Y., Liang, Y., Wang, W.-Z., Wang, H., Zhao, Y., Zhang, J.-T., Song, Y.-L., He, X.-M., Li, R.-H., Tao, D.-B., Li, J., … Huang, S.-M. (2024). Clopidogrel Plus Aspirin vs Aspirin Alone in Patients With Acute Mild to Moderate Stroke. In JAMA Neurology. American Medical Association (AMA). https://doi.org/10.1001/jamaneurol.2024.0146

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