Treating Heart Failure with Anti-Obesity Medication: Dual Benefits for Clinical Outcomes and Climate Impact

New research has found that the use of GLP-1 receptor agonists*, a class of medications commonly prescribed for patients with obesity and diabetes, reduces the environmental footprint of healthcare and clinical outcomes when used to treat heart failure.

Treatment of heart failure patients with these therapies led to fewer hospitalizations and lower calorie intake, which together translated into decreased greenhouse gas emissions, less medical waste, and reduced water usage.

The study is one of the first to quantify the environmental co-benefits of pharmacologic treatment. The findings are being presented today at the 2025 European Society of Cardiology Congress in Madrid, Spain.

The healthcare sector is responsible for nearly 5% of greenhouse gas emissions globally (1), highlighting the need for interventions to reduce the environmental footprint of clinical care.

Patient level meta-analysis of four randomised controlled trials, SELECT, FLOW, STEP HFpEF, and STEPHFpEF DM, was conducted. All the trials involved patients with a type of heart failure, called heart failure with preserved ejection fraction, who had been treated with GLP-1 receptor agonists or a placebo. Estimates of mean inpatient days, ICU admissions, emergency department and ambulatory visits per event of heart failure, and related greenhouse gas emissions were obtained from previously published literature.

A total of 54 worsening heart failure events were reported among 1,914 patients receiving GLP1-receptor antagonist treatment, compared to 86 events among 1,829 patients receiving placebo.

Those receiving the treatment were estimated to have 9.45 kg CO₂-equivalent emissions per patient per year, compared to 9.70 kg CO₂-equivalent emissions per patient per year among placebo users. The differences were predominantly driven by emissions arising from inpatient stays and outpatient visits due to worsening heart failure events.

The study was led by Dr.Sarju Ganatra, Director of Sustainability and Vice Chair of Research at Lahey Hospital & Medical Center in the US and the President of Sustain Health Solutions, a non-profit organization that helps healthcare organizations integrate sustainability in care delivery. He explained, “The magnitude of the potential environmental emission savings found in our analysis was striking.”

“0.25 kg of CO2-equivalent per person saved annually from reduced hospitalizations might sound small. However, when this figure is scaled up to the millions of patients eligible for these therapies, it adds up to over 2 billion kilograms of CO2-equivalent saved. Similar-scale reductions were observed in waste generation and water use. This research highlights how even modest incremental individual gains can result in significant collective impact,” Dr Ganatra continued.

2 billion kg of CO2 is approximately equivalent to 20,000 full capacity Boeing 747 long-haul flights, or city-wide emissions from Brussels over 3 months. Around 30 million trees grown over 10 years would be needed to offset 2 billion kg of CO2.

The analysis also showed that those taking the GLP1-receptor antagonist treatment had approximately 695.33 kg CO2-equivalent lower emissions per patient per year due to a reduction in daily calorie consumption compared to placebo.

“By combining clinical trial data with environmental life cycle assessment metrics, we offer a new lens to evaluate the full impact of prescribing decisions. We also show that it is possible for medical treatments to deliver dual benefits-better health for patients and a healthier planet,” Dr Ganatra added. “We hope that in the future, policymakers will integrate sustainability metrics into health technology assessments, drug coverage decisions, and procurement frameworks.”

Each worsening heart failure event was assumed to involve one inpatient admission and a round trip to the hospital. Greenhouse gas emissions associated with the production and use of a GLP1 receptor agonist were obtained from a leading pharmaceutical drug manufacturer.

The study used modelling data from prior trials and established environmental life cycle assessment emissions data sets, rather than direct measurements. It could not take into account patient-level variability such as behavioural differences, and the research used mean values for hospital-related emissions.

“The next step for this research is to validate our modelling with real-world emissions data and clinical outcomes. In the future, we hope that environmental impact will be integrated into clinical trial designs, drug regulatory processes, and formulary decisions to ensure health systems align with planetary health goals,” Dr Ganatra concluded.

The findings from this study also support previous research that found that treatment of patients with GLP-1 receptor agonists reduced hospital visits for patients with heart failure with preserved ejection fraction.

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HCQ Plus Prednisolone Improves Outcomes in Inflammatory Cardiomyopathy: Study

Inflammatory cardiomyopathy, often following fulminant myocarditis, is characterized by myocardial inflammation, impaired cardiac function, and increased risk of heart failure. Effective management of this condition is essential to prevent long-term complications and improve patient survival. Traditional treatment approaches often focus on supportive care, but recent research has explored immunomodulatory therapies to directly target inflammation and preserve cardiac function.

A new study investigated the efficacy of a 12-month combination therapy with hydroxychloroquine (HCQ) and prednisolone in patients diagnosed with inflammatory cardiomyopathy. The study included patients who had experienced fulminant myocarditis and demonstrated reduced left ventricular function, elevated inflammatory markers, and clinical symptoms of heart failure. The intervention group received HCQ alongside a tapering regimen of prednisolone, while outcomes were monitored through cardiac imaging, laboratory markers, and patient-reported functional status.

Results showed that combination therapy significantly improved cardiac function, as measured by increased left ventricular ejection fraction and reduced ventricular dilation. Inflammatory markers, including C-reactive protein and cytokine levels, were markedly reduced, indicating effective suppression of myocardial inflammation. Patients also reported improved exercise tolerance and reduced fatigue, suggesting enhanced quality of life. Importantly, the treatment was well tolerated, with no serious adverse events reported, highlighting the potential safety of long-term HCQ and prednisolone therapy in this population.

The authors note that while these findings are promising, larger multicenter studies with longer follow-up are needed to confirm efficacy, optimize dosing, and fully evaluate long-term safety. Nevertheless, the study provides strong preliminary evidence that combining HCQ with prednisolone can be an effective strategy to manage inflammatory cardiomyopathy following fulminant myocarditis, addressing both inflammation and cardiac function.

Reference: He, W., Cui, G., Chen, J. et al. The efficacy and safety of hydroxychloroquine in patients with chronic inflammatory cardiomyopathy: a multicenter randomized study (HYPIC trial). BMC Med 23, 467 (2025). https://doi.org/10.1186/s12916-025-04301-w

Keywords: hydroxychloroquine, prednisolone, inflammatory cardiomyopathy, fulminant myocarditis, heart function, cardiac inflammation, immunomodulatory therapy, left ventricular ejection fraction, heart failure, Journal of Cardiac Failure, He, W., Cui, G., Chen, J

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Toripalimab-Based Cisplatin-Free Strategy Efficacious, safe in Advanced NPC: JAMA

Researchers have found in a phase 3 trial that toripalimab combination therapy without cisplatin proved feasible, offering high failure-free survival and low toxicity in locoregionally advanced nasopharyngeal carcinoma (NPC). This study was published in JAMA by The DIAMOND Study Group.

NPC is a cancerous tumor that originates from the nasopharynx and has a high incidence in East and Southeast Asia. Concurrent cisplatin-radiotherapy has long been standard treatment, but the toxicity of cisplatin, especially nausea, vomiting, and renal damage, usually constrains tolerability and impairs patients’ quality of life. This new phase 3 trial offers solid evidence that a cisplatin-sparing strategy can be as effective and safer.

This multicenter, open-label, randomized phase 3 clinical trial was carried out in 13 Chinese hospitals from August 2021 to July 2022.

  • Participants: 532 T4N1M0 or T1-4N2-3M0 NPC patients

  • Median age: 47 years (IQR, 39–54 years)

  • Women: 25.2%

Randomization:

  • Standard therapy group (n=266): toripalimab + gemcitabine-cisplatin induction chemotherapy + concurrent cisplatin-radiotherapy

  • Cisplatin-sparing group (n=266): same regimen without concurrent cisplatin

  • Toripalimab (240 mg) was administered every 3 weeks for a total of 17 cycles (3 induction, 3 concurrent with radiotherapy, and 11 adjuvant).

The coprimary outcomes were failure-free survival (noninferiority margin: 8%) and all-grade incidence of vomiting. Secondary outcomes were overall survival, recurrence-free survival, distant metastasis–free survival, safety, tumor response, quality of life, and tolerability.

Key Findings

With a median follow-up of 37 months (range, 4–50 months):

Failure-free survival (3-year rate):

  • Cisplatin-sparing group: 88.3%

  • Standard therapy group: 87.6%

  • Difference: 0.7% (1-sided 95% CI lower limit, −3.9%)

  • P = .002 for noninferiority (HR, 0.92; 95% CI, 0.66–1.79; log-rank P = 0.73)

Incidence of all-grade vomiting:

  • Cisplatin-sparing group: 26.2% (68/260)

  • Standard therapy group: 59.8% (156/261)

  • Difference: 33.6% (P < .001)

Quality of life:

  • Improved in cisplatin-sparing group, particularly in gastrointestinal symptoms, global health status, and functional scores

  • Patient-reported participation rates: 87.5% (QoL) and 94.7% (tolerability)

  • Overall survival and recurrence-free outcomes: Similar between groups

In this large phase 3 trial, toripalimab combined with induction chemotherapy and radiotherapy was found to be noninferior on survival outcomes and superior on safety and quality of life for advanced NPC. These results indicate that a cisplatin-sparing regimen could be a new standard of care, minimizing treatment burden without loss of efficacy.

Reference:

The DIAMOND Study Group. Toripalimab Combination Therapy Without Concurrent Cisplatin for Nasopharyngeal Carcinoma: The DIAMOND Randomized Clinical Trial. JAMA. Published online August 21, 2025. doi:10.1001/jama.2025.13205

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Symptoms Predict Exacerbation Risk in Bronchiectasis, Suggesting Expanded Role for Macrolide Therapy: Study Finds

Spain: A large international study led by Dr. Oriol Sibila and colleagues at the Hospital Clinic, University of Barcelona, has shown that the daily symptom burden in bronchiectasis patients is a strong independent predictor of future exacerbations.

The findings, published in The Lancet Respiratory Medicine, also suggest that long-term macrolide treatment could benefit patients with high symptom levels—even if they have not yet experienced frequent exacerbations.
Bronchiectasis, a chronic lung condition marked by abnormal airway widening and recurrent infections, is currently managed with long-term macrolide antibiotics only in patients who suffer three or more exacerbations per year, according to international guidelines. However, this new research indicates that focusing solely on past exacerbations may overlook a group of patients who remain at high risk due to their symptom profile.
The investigators drew on data from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) registry, which included nearly 9,500 patients with available quality-of-life data at baseline and at least one year of follow-up. Using the Quality of Life-Bronchiectasis Respiratory Symptoms Score (QoL-B-RSS), they tracked how symptom severity related to outcomes.
Based on the study, the researchers reported the following findings:
  • Every 10-point reduction in QoL-B-RSS scores increased the likelihood of a future exacerbation by 10%.
  • Patients with few or no prior exacerbations but high symptom burden had a one-year exacerbation rate (1.55) nearly identical to those with frequent exacerbations and moderate symptoms (1.58).
  • Symptom burden emerged as a strong marker of active disease and future risk.
  • A pooled analysis of the BLESS, BAT, and EMBRACE trials (341 participants) showed that macrolide therapy reduced exacerbations in both frequent-exacerbator and highly symptomatic but low-exacerbation groups.
  • The number needed to treat (NNT) was nearly identical in both groups—1.45 in frequent exacerbators versus 1.43 in highly symptomatic patients—indicating comparable benefit.
These findings challenge current treatment recommendations, which do not account for symptom severity when prescribing long-term macrolide therapy. According to the authors, integrating symptom assessment into treatment decisions could allow for earlier intervention, potentially preventing progression to the frequent-exacerbator stage. The approach mirrors strategies used in other airway diseases like asthma and COPD, where preventing exacerbations early is a key goal of care.
The study does carry limitations, including reliance on self-reported quality-of-life questionnaires, missing data within the registry, and the post-hoc nature of the macrolide trial analysis. Nevertheless, with participants drawn from 27 countries, the results appear broadly applicable and consistent across regions.
“Overall, the research highlights the need to reconsider treatment algorithms for bronchiectasis. Rather than focusing solely on past exacerbation frequency, clinicians may need to pay closer attention to patients with a heavy daily symptom burden, who appear to face equally high risks and derive significant benefit from preventative macrolide therapy,” the authors concluded.
Reference:
Symptoms, risk of future exacerbations, and response to long-term macrolide treatment in bronchiectasis: an observational study. Sibila, Oriol et al. https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(25)00160-2/fulltext

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Cardiac Arrest in Space: Automatic Chest Compressions Superior in Microgravity CPR, reveals research

New research has found a more effective way to conduct cardiopulmonary resuscitation (CPR) in microgravity,* which causes the weightlessness astronauts experience in space.

The study found that a type of automatic chest compression, carried out by a standard mechanical piston device, reached the depth needed to be effective, while the current CPR methods recommended for space travel are undereffective regarding this depth criteria.

Treating cardiac arrest during spaceflight is challenging because both the rescuer and the patient are floating due to microgravity. The current NASA emergency protocol for the International Space Station recommends the hand-stand method of CPR, where the rescuer performs a handstand on the patient’s chest with their legs pressing on the side of the spaceship to create the pressure needed for chest compressions.

“We tested different ways of giving chest compressions aboard a ‘flying laboratory’ which recreated the microgravity conditions that astronauts experience in space. Use of a particular type of automatic chest compression device was the only method that gave the depth that is recommended by international resuscitation guidelines to keep blood flowing to the brain in a real life cardiac arrest. We hope that our findings will be incorporated into the next guidelines (1) for treating cardiac arrest in space,” Explained Nathan Reynette from the Cardiology Department at Université de Lorraine – CHRU de Nancy.

The research was conducted in a ‘flying laboratory’ onboard a modified civil aircraft, the only one of its kind in Europe, called the A310 Air Zero G at the Centre National d’Etudes Spatiales, the French space agency. Freefalling phases of parabolic flight were used to accurately recreate microgravity for 22 seconds during each parabola, with around 30 parabolas per single fight. The experiments were conducted over three flights. Chest compression depths and rates were monitored by a high fidelity CPR training manikin.

Earth-based chest compressions during CPR are based on the rescuer’s weight, which does not exist in microgravity. As a result, over the last 30 years, researchers have searched for alternative methods, such as the Handstand method, Reverse Bear Hug method and the Evetts Russomano method. Until now, despite numerous trials, none of the proposed methods were shown to reach the depth standards needed for effective chest compressions.

Three types of automatic chest compression devices were tested. Automatic chest compression devices are routinely used on Earth by doctors in restricted environments such as emergency helicopter, or where prolonged CPR needs to be carried out over a longer period of time, such as refractory cardiac arrest which can last for more than 40 minutes. This type of CPR is not considered to be superior to manual CPR in normal conditions but has been proven to be effective when chest compressions are challenging.

Three types of automatic chest compression devices were tested; a standard mechanical piston device, a compression band device, and a small-sized piston device. Best practice guidance, such as advice given by the European Resuscitation Council (2), suggests that to be effective chest compressions must reach a depth of between 50 to 60mm.

Of the three automatic chest compression devices tested, the standard mechanical piston device had the highest median compression depth. The median compression depth of the standard mechanical piston device was 53.0mm, which was considerably more than the other two automatic chest compression devices, that both had median depths of 29mm, and the manual handstand method of CPR which achieved a depth of 34.5mm.

Reflecting on whether future space missions will take automatic chest compression devices in their emergency medical kit, Mr Reynette said, “It will be up to every space agency whether they want to include automatic chest compression devices in their emergency medical kit. We know they have other considerations beyond effectiveness, such as weight and space constraints.

“While cardiac arrest is a high danger event, that could even terminate a space mission, it is a relatively low risk for now. Most astronauts are young, healthy and physically fit individuals who have intensive medical monitoring, including scanning for chronic heart disease, before going into space. Nevertheless, longer lasting space missions in future and space tourism could increase the risks of a medical emergency occurring.” He continued.

The research project was a collaboration between clinicians from the CHU de Nancy, medical researchers from University of Lorraine and University of Paris, engineers from the Laboratoire Georges Charpak of the Ecole Nationale des Arts et Metiers Paris Tech and from the Centre National d’Etudes Spatiales, the French space agency and Novespace.

“This research highlights once again the usefulness of automated chest compression devices to perform CPR in challenging environments. Space medicine often provides transferable lessons for emergency procedures in isolated environments on Earth, where space and clinical experience are also limited. Further research could explore whether automated chest compression devices could prove useful to carry out CPR in environments such as submarines and artic bases.” Mr Reynette concluded. 

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Study looks for markers that predict risk of severe chlamydia infection

A new study has identified markers that may predict whether a chlamydia infection is likely to ascend into the uterus and endometrium. The work could lead to new diagnostics that can predict a woman’s risk of severe infection.

Chlamydia trachomatis (CT) is a sexually transmitted bacterium that can lead to pelvic inflammatory disease, infertility and other reproductive problems in women when it ascends to the upper genital tract.

“Chlamydia infection cannot be definitively diagnosed as ascending beyond the cervix into the endometrium without performing an endometrial biopsy,” says Dr. Toni Darville, professor of pediatrics, microbiology and immunology at the University of North Carolina at Chapel Hill’s School of Medicine and director of the UNC-Chlamydia Vaccine Initiative, which initiated the research project.

“We wanted to see if we could identify biomarkers that would allow us to predict which women were at risk of severe disease without having to perform an invasive procedure,” says Xinxia Peng, professor of infectious disease and member of the Bioinformatics Research Center at North Carolina State University. Peng is the corresponding author of the study.

Peng and colleagues from NC State and UNC School of Medicine performed 16S ribosomal RNA (rRNA) gene based high-throughput amplicon sequencing analysis of mucosal samples from the cervicovaginal microbiome (CVM) of 246 women who were part of a cohort at high risk for CT. 16S rRNA genes are used to tag and identify bacteria so that amounts can be quantified.

The women were divided into three groups: CT negative, CT positive and CT ascended. The researchers then compared CVM composition between the three groups to see if there were any features that indicated a higher risk for ascended CT.

The sequencing analysis revealed that the amounts of certain microbial species, such as Hemophilus haemolyticus, Sutterella stercoricanis or Actinobaculum massiliense, were predictive of ascended chlamydial infection and they were also correlated with the levels of seven cytokines, or proteins secreted by the immune system, previously reported to be associated with CT ascension.

“The most striking point is that it’s the amount of chlamydia that correlates most strongly with ascension,” Peng says. “Which is both surprising and not – of course a high level of CT would drive spread, but prior to this work it was difficult to quantify CT levels accurately.”

“The part we don’t know yet is how these microbes may be interacting with the immune system to control pathogen burden and ascension,” says Catherine O’Connell, professor of pediatrics at UNC School of Medicine and co-project leader.

“We knew that some bacterial species make a woman more susceptible to CT infection, while ‘good’ bacteria such as lactobacillus seem to make it harder to become infected,” O’Connell says. “This work shows that other bacteria present may be keeping host immunity alert and responsive, making it harder for infecting chlamydia to grow abundantly. It shows that there is potential for developing biomarkers to identify women at high risk for ascended CT.”

Reference:

Sangmi Jeong ht, Tammy Tollison , Hayden Brochu, Cervicovaginal microbial features predict Chlamydia trachomatis spread to the upper genital tract of infected women, Infection and Immunity, https://doi.org/10.1128/iai.00057-25

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Total-body PET imaging takes a look at long COVID: Study

Using total-body PET imaging to get a better understanding of long COVID disease is the goal of a new project at the University of California, Davis, in collaboration with UC San Francisco. The project is funded by a grant of $3.2 million over four years from the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health.

About 1 in 10 COVID-19 survivors develop a range of long COVID symptoms that can last from months to years. How and why these symptoms develop isn’t completely known, but they have been linked to activated immune T cells getting into organs and tissues. Researchers also have linked long COVID to damage to the inner lining of blood vessels. These events can be related, because blood vessels become leaky when T cells are activated nearby, but may also be coincidental because leaky blood vessels allow more immune cells to leave the blood and enter tissues.

Negar Omidvari, assistant project scientist at the UC Davis Department of Biomedical Engineering and principal investigator on the grant, will use total-body positron emission tomography (PET) technology, originally developed by Professors Simon Cherry and Ramsey Badawi at UC Davis, and kinetic modeling to look at both processes simultaneously in patients with long COVID.

Imaging the entire body

PET imaging usually uses short-lived radioactive tracers to measure metabolic activity inside the body. Conventional PET can only look at a single organ or a section of the body at a time. The uEXPLORER PET scanner developed at UC Davis can image the entire body at the same time, giving a much more detailed picture of what is going on in the body.

Omidvari will collaborate with CellSight Technologies Inc. of San Francisco to use a tracer called 18F-AraG, which specifically tags activated T cells. Using dynamic total-body PET imaging and sophisticated modeling, she aims to see how activated T cells collect in different organs at different times, where blood vessel damage is occurring, and whether these processes are related to each other.

“If we can separate the vascular damage from the presence of activated T cells in tissue, we should be able to get a much better picture of what’s going on,” Omidvari said.

The team will also check blood samples for markers for inflammation and immune activation that correlate with PET imaging data.

The study will work with patients from UCSF’s long COVID program (LIINC – Long-term Impact of Infection with Novel Coronavirus) who will be scanned at baseline, four and eight months. People who have fully recovered from COVID-19 and have no remaining symptoms will be scanned as controls.

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The Silent Relief: Study Unveils Efficacy of Intraperitoneal Local Anesthetics in Postoperative Pain Management

Recent scientific study looked into the use of local anesthetic medications administered directly into the abdominal cavity to manage pain after abdominal surgery. While this method is commonly used, its effectiveness and safety have been unclear. The researchers conducted a systematic review and meta-analysis of various studies to evaluate how well these medications work for postoperative pain control. The study found that intraperitoneal local anesthetics (IPLA) were associated with a small reduction in postoperative pain intensity up to 48 hours after surgery. Patients who received IPLA also tended to use less opioid pain medication at 24 hours post-surgery, experienced less nausea and vomiting, and had a quicker recovery of gastrointestinal transit. However, there was no significant impact on the length of hospital stay or the overall quality of recovery. It is important to note that the level of evidence supporting the use of IPLA was considered to be low to very low. This means that while there were some positive effects observed, there was insufficient data on potential side effects and long-term outcomes. The researchers recommended further studies to better understand the risks and benefits of using IPLA as a routine pain management strategy after abdominal surgery. Overall, the study suggested that using local anesthetics directly into the abdominal cavity could provide some relief for postoperative pain, but due to the limited evidence available, it is not yet recommended as a standard practice. More research is needed to fully assess the safety and long-term effects of this approach before it can be widely adopted in clinical settings.

Key Points –

– -Effectiveness of Intraperitoneal Local Anesthetics (IPLA):- The systematic review and meta-analysis found that IPLA is associated with a statistically significant reduction in postoperative abdominal pain intensity when compared to control groups at multiple time points (6, 12, 24, and 48 hours post-surgery), suggesting it may provide a small short-term analgesic effect. However, the clinical significance remains unclear due to the low certainty of the evidence.

– -Reduction in Opioid Consumption:- IPLA was linked to a significant decrease in opioid use at 24 hours after surgery, with an average reduction of approximately 10.4 mg of oral morphine equivalent. However, no substantial reduction in opioid use was observed at the 48-hour mark, indicating that the benefit may be short-lived.

– -Impact on Nausea and Vomiting:- The administration of IPLA led to a notable reduction in the incidence of postoperative nausea and vomiting, with a 21% lower risk (relative risk of 0.79). This effect was consistent across various types of surgeries, suggesting a beneficial outcome of IPLA in managing these common postoperative complications.

– -Gastrointestinal Recovery:- There was a reported decrease in time to gastrointestinal transit recovery associated with IPLA, with an average reduced time of approximately 3.8 hours. However, the certainty of this evidence is low, given the limited number of studies contributing to this finding.

– -No Effect on Hospital Stay and Quality of Recovery:- The analysis showed no significant differences in hospital length of stay and quality of recovery between groups receiving IPLA and control groups. This suggests that while IPLA may alleviate pain and nausea, it does not appear to influence overall recovery metrics or hospitalization duration.

– -Low Certainty of Evidence and Need for Further Research:- Despite some promising outcomes related to pain management and nausea reduction, the evidence supporting the use of IPLA is considered low to very low quality. The study calls for more rigorous randomized controlled trials to better evaluate adverse effects and long-term outcomes related to IPLA to definitively determine its role in standard postoperative care after intra-abdominal surgeries.

Reference –

M. Boulianne et al. (2025). Intraperitoneal Local Anesthetics For Postoperative Pain Management Following Intra-Abdominal Surgery: A Systematic Review And Meta-Analysis. *BMC Anesthesiology*, 25. https://doi.org/10.1186/s12871-025-03105-y.

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Sharp Weight Loss from Childhood to Adulthood May Raise Glaucoma Risk: Study Shows

China: A large-scale retrospective cohort study published in the American Journal of Ophthalmology has revealed that individuals with low body size in adulthood face a significantly higher risk of developing primary open-angle glaucoma (POAG), a leading cause of irreversible blindness worldwide.

The research, led by Jianqi Chen and colleagues from the State Key Laboratory of Ophthalmology at Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, analysed data from 467,768 participants in the UK Biobank to explore how body size changes from childhood to adulthood influence glaucoma risk. 

In the study, childhood body size was categorised as low, average, or high based on self-reported comparisons with peers, while adult body size was determined using BMI-adjusted models. Nine distinct growth patterns from early life to adulthood were identified, and their relationship with POAG incidence was examined using Cox proportional hazards models.

The following were the notable findings of the study:

  • Individuals with low adult body size, regardless of childhood size, had a higher likelihood of developing POAG than those with an average body size throughout life.
  • Persistently low body size or a shift from average to low body size was associated with a 35% greater risk of POAG.
  • Transitioning from high to low body size was linked to a 49% increased risk compared to those with average size in both stages.
  • High adult body size was associated with a 14% lower risk of POAG compared to average adult body size.
  • High childhood body size was slightly linked to an increased risk of POAG.
  • Among individuals with low childhood body size, gaining weight to reach an average adult size was associated with a 21% reduction in POAG risk.
  • Among individuals with low childhood body size, gaining weight to reach a high adult size reduced POAG risk by 42%.
  • Participants with high childhood body size who lost substantial weight to reach a low adult size had a 66% higher risk of POAG.
  • Moderate weight loss from high childhood size did not significantly affect POAG risk.

The authors emphasised that low adult body size consistently emerged as a risk factor for POAG, highlighting the importance of avoiding drastic and sustained weight loss, particularly from childhood to adulthood. They pointed out that while weight management is crucial for overall health, the potential impact of body size changes on eye health should not be overlooked.

Since POAG often progresses silently until advanced stages, identifying modifiable risk factors is vital for prevention. The findings suggest that maintaining a stable and healthy body size over the life course could be an important factor in reducing glaucoma risk. By recognising that early-life growth patterns may shape future disease susceptibility, healthcare providers could develop targeted interventions aimed at preserving both systemic and ocular health.

Reference:

Chen, J., Ling, Y., Zhu, Y., Li, Z., Ge, D., Cai, R., Deng, F., Huang, S., Zhuo, Y., & Lei, L. (2025). Early Life Body Size Trajectory and the Risk of Primary Open-angle Glaucoma: A Retrospective Cohort Study. American Journal of Ophthalmology. https://doi.org/10.1016/j.ajo.2025.07.039

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Positive results revealed from first prospective trial in heart failure due to Chagas disease

In patients with heart failure (HF) caused by Chagas disease, sacubitril/valsartan was superior to enalapril for the composite primary endpoint, predominantly driven by a significant reduction in N-terminal pro-B-type natriuretic peptide (NT-proBNP), according to late-breaking research presented in a Hot Line session today at ESC Congress 2025.

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