Seaweed supplementation improves glycemic control and diabetes management

A recent study published in the Journal of Nutrients found compelling evidence that support the potential of seaweed supplementation in the management of diabetes. Diabetes pose a pervasive health threat and the need for effective prevention and management strategies paramount, this study looked into the impact of seaweed consumption on various facets of blood glucose control.

Diabetes demands innovative approaches to prevention and management. To recognize the efficacy of dietary interventions like the Mediterranean diet and calorie restriction coupled with exercise-induced weight reduction, researchers turned their attention to the potential benefits of seaweed. With its rich content of polyphenols and fucoidan, seaweed has been associated with blood glucose regulation, improved intestinal health, and enhanced lipid profiles.

This exhaustive analysis conducted with the help of databases including PubMed, RISS, Google Scholar, ScienceDirect, and the Cochrane Library. 23 studies were included in this comprehensive meta-analysis.

The results of the study were;

Postprandial blood glucose, glycated hemoglobin (HbA1c), and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) levels demonstrated substantial improvements in the group supplemented with seaweed compared to the control group.

Fasting blood glucose and insulin levels did not exhibit significant associations with seaweed consumption.

Seaweed supplementation taken particularly at higher doses (1000 mg or more) proved more beneficial than lower doses. Specific seaweed varieties that include Laminaria digitata, Undaria pinnatifida, Acophyllum nodosum, and Fucus vesiculosus, were identified as particularly effective in improving blood glucose levels.

This research suggests that seaweed supplementation could be a promising strategy to reduce the postprandial blood glucose, HbA1c, and HOMA-IR levels and offers a tangible avenue for improved blood glucose management and a potential decrease in the risk of type 2 diabetes.

Source:

Kim, Y. R., Park, M. J., Park, S. Y., & Kim, J. Y. (2023). Brown Seaweed Consumption as a Promising Strategy for Blood Glucose Management: A Comprehensive Meta-Analysis. Nutrients, 15(23). https://doi.org/10.3390/nu15234987

Powered by WPeMatico

Increased risk of suicidal ideation and suicide around menstrual cycles, finds study

USA: In the first longitudinal study of how suicidal thoughts and related symptoms fluctuate across the menstrual cycle, University of Illinois Chicago (UIC) researchers identified when some female patients are at the highest risk, offering new guidance for clinicians about when to focus interventions with suicidal patients.

The study, published in the American Journal of Psychiatry, revealed that female patients with a history of suicidality experience an increased risk of suicidal ideation or suicidal planning in the days surrounding menstruation, according to a new study by researchers at the University of Illinois Chicago.

“As clinicians, we feel responsible for keeping our patients safe from a suicide attempt, but we often don’t have much information about when we need to be most concerned about their safety,” said Tory Eisenlohr-Moul, associate professor of psychiatry at UIC and senior author of the paper. “This study establishes that the menstrual cycle can affect many people who have suicidal thoughts, which makes it one of the only predictable recurring risk factors that has been identified for detecting when a suicide attempt might occur.”

The American Journal of Psychiatry study, which is co-led by postdoctoral researcher Jaclyn Ross and MD/PhD student Jordan Barone, followed 119 patients who completed a daily survey to track suicidal thoughts and other mental health symptoms over at least one menstrual cycle. The design allowed the researchers to collect detailed data on changes in patients’ mental health over the course of their cycle. Previous research did not have this sort of tracking and only worked to estimate the timing of a person’s menstrual cycle status with a single timepoint after a suicide attempt.

Those past studies observed a pattern where suicide attempts increased in the days just before or after the onset of menses-the “perimenstrual” phase. The new UIC study replicated this pattern, finding that suicidal ideation was more severe and suicidal planning was more likely to occur during this point in the cycle compared to other phases.

The daily data also allowed the researchers to delve deeper into differences between individuals in how the cycle affects symptoms and suicidality.

“Previously, there haven’t been good predictors for why or when Person A is likely to make a suicide attempt versus when Person B is going to make an attempt,” Barone said. “Not everyone is hormone sensitive to the cycle in the same way, and we were able to statistically show the value of including individual differences in our models.”

Most patients in the study reported significant elevation of psychiatric symptoms such as depression, anxiety and hopelessness in the premenstrual and early menstrual phases, while others reported emotional changes at different times of their cycle. Individuals also varied in the specific psychiatric symptoms that appeared alongside suicidal thoughts.

“People differed in which emotional symptoms were most correlated with suicidality for them,” Eisenlohr-Moul said. “Just because the cycle makes somebody irritable or have mood swings or feel anxious, it doesn’t necessarily mean that that’s going to have the same effect on creating suicidality for each person.”

That observation fits with the broader research focus of Eisenlohr-Moul’s group, the CLEAR lab. The laboratory also studies premenstrual dysphoric disorder, a condition associated with an increased risk of suicidal thoughts and behaviors. Observational studies and clinical trials led by Eisenlohr-Moul have found that PMDD may result from some people’s heightened sensitivity to the reproductive hormones estrogen and progesterone — and stabilizing those hormones may lessen symptoms.

Similar dynamics of hormone sensitivity may be at play in the influence of the menstrual cycle upon suicidal thoughts in people without PMDD, the authors said. But more research is needed to determine how these factors affect each other in individual patients, and how that information could best be used clinically to prevent suicide attempts.

One idea is for patients to keep track of their mental health symptoms over the course of their cycle — as subjects did in the current study — to enable their clinicians to make personalized recommendations about their care.

“We’re excited to use the best methods out there to try to create individual prediction models for each person, so that we’re not putting people into a box,” Eisenlohr-Moul said. “We want to really figure out: does the cycle matter for this person, and then exactly how does it matter and how we can best intervene based on that information.”

Reference:

Jaclyn M. Ross, Jordan C. Barone, Hafsah Tauseef, Katja M. Schmalenberger, Anisha Nagpal, Natania A. Crane, Tory A. Eisenlohr-Moul, Predicting Acute Changes in Suicidal Ideation and Planning: A Longitudinal Study of Symptom Mediators and the Role of the Menstrual Cycle in Female Psychiatric Outpatients With Suicidality, https://doi.org/10.1176/appi.ajp.20230303.

Powered by WPeMatico

Serial amnioinfusions improve survival in neonates without kidneys; long-term management remains a concern: JAMA

USA: In neonates with bilateral renal agenesis, prenatal serial amnioinfusions can mitigate neonatal lethal pulmonary hypoplasia, but infants face substantial morbidity independent of lung function, according to the RAFT trial.

In the nonrandomized clinical trial, published in the Journal of the American Medical Association (JAMA), 82% of live-born infants survived to 14 days of life or longer and placement of dialysis access, but there was a reduction in longer-term neonatal survival. Serial amnioinfusions were not associated with severe maternal complications.

A higher number of amnioinfusions, higher birth weight, and gestational age greater than 32 weeks were all factors associated with survival to 14 days. There was no occurrence of serious maternal complications, although delivery before 37 weeks gestation was universal and 61% had preterm prelabour rupture of membranes.

Bilateral renal agenesis is the most severe congenital anomaly of the fetal urinary tract. Fetal anuria leads to a lack of amniotic fluid, which depressurizes the airways, impairing pulmonary development and resulting in lethal pulmonary hypoplasia. Restoring amniotic fluid via serial amnioinfusions may promote lung development, enabling survival. Therefore, Jena L. Miller, Johns Hopkins University, Baltimore, Maryland, and colleagues aimed to assess neonatal outcomes of serial amnioinfusions initiated before 26 weeks gestation to mitigate lethal pulmonary hypoplasia.

The nonrandomized trial was conducted from 2018 to 2022 at 9 US fetal therapy centres. Centres had to have a maternal-fetal medicine doctor who had performed amnioinfusion procedures for anhydramnios or oligohydramnios at least 15 times before.

Outcomes are reported for 21 pairs of mother-fetus with confirmed anhydramnios due to isolated fetal bilateral renal agenesis without other identified congenital anomalies.

The intervention involved ultrasound-guided percutaneous amnioinfusions of isotonic fluid before 26 weeks gestation to maintain normal amniotic fluid levels. An additional three mothers elected against the infusions and entered an expectant management group providing observational data before and after delivery. All of the expectant management fetuses died.

The primary endpoint was postnatal infant survival to 14 days of life or longer with dialysis access placement.

The researchers reported the following findings:

  • The trial was stopped early based on an interim analysis of 18 maternal-fetal pairs given concern about neonatal mortality and morbidity beyond the primary endpoint despite the demonstration of the efficacy of the intervention.
  • There were 17 live births (94%), with a median gestational age at delivery of 32 weeks, 4 days.
  • All participants were delivered before 37 weeks’ gestation. The primary outcome was achieved in 14 of 17 live-born infants.
  • Factors associated with survival to the primary outcome included a higher number of amnioinfusions, higher birth weight, and gestational age greater than 32 weeks.
  • Only 6 (35%) of the 17 neonates born alive survived hospital discharge while receiving peritoneal dialysis at a median age of 24 weeks of life.

“The findings indicate that serial amnioinfusions mitigated lethal pulmonary hypoplasia but were linked with preterm delivery,” the researchers wrote. “The lower survival to discharge rate underscores the additional mortality burden independent of lung function.”

“There is a need for additional long-term data to fully characterize the outcomes in surviving neonates and assess the mortality and morbidity burden,” they concluded.

Reference:

Miller JL, Baschat AA, Rosner M, et al. Neonatal Survival After Serial Amnioinfusions for Bilateral Renal Agenesis: The Renal Anhydramnios Fetal Therapy Trial. JAMA. 2023;330(21):2096–2105.

doi:10.1001/jama.2023.21153

Powered by WPeMatico

Delay in treatment of cancer patient leading to death: GTB hospital, doctors held negligent, slapped Rs 5 lakh compensation

Noting that the apathetic approach of the hospital and its doctors towards the gravity of the ailment raises a presumption as regards to the failure of treating doctors in clinical judgment and choosing the right course of action in time, the Delhi State Consumer Disputes Redressal Commission has upheld the District Forum’s order that found GTB Hospital and its two doctors guilty of negligence and delay in treating a cancer patient who eventually succumbed to the disease.

The District Commission had directed the facility and the doctors to jointly pay a lump sum compensation of Rs 5 lakhs to the heirs (complainants) of the deceased patient.

For more details, check out the link given below:

Delay In Treatment Of Cancer Patient Leading To Death: GTB Hospital, Doctors Held Negligent, Slapped Rs 5 Lakh Compensation

Powered by WPeMatico

Nashik Municipal Corporation alerts hospitals after person tests Zika virus positive

The Nashik Municipal Corporation (NMC) has issued a cautionary alert to all hospitals under its jurisdiction following a positive Zika virus case approximately one month ago. The infected individual, a 22-year-old, received successful treatment in a private hospital, with blood and urine samples subsequently sent to the National Institute of Virology (NIV) Pune for further analysis, confirming the Zika virus infection.

Conducting an extensive survey in the Bharat Nagar slum area of Nashik, where the patient resides, the NMC has proactively sent samples from all 91 women in the locality to the NIV for testing. Given the significance of protecting pregnant women from Zika, these women have been advised to sleep under mosquito nets. Authorities assured the public that there is no cause for panic, asserting control over the situation.

For more news & updates, check out the link given below:

https://medicaldialogues.in/

Powered by WPeMatico

FDA approves travoprost implant for treatment of ocular hypertension and glaucoma

The US Food and Drug Administration has approved travoprost intracameral implant for treatment of ocular hypertension and glaucoma.

The implant iDose TR developed by Glaukos is designed to provide long-duration treatment for the full range of glaucoma disease severity.

iDose TR is a first-of-its-kind, long-duration, intracameral procedural pharmaceutical therapy designed to continuously deliver 24/7 therapeutic levels of a proprietary formulation of travoprost inside the eye for extended periods of time. iDose TR is intended to improve the standard of care by addressing the ubiquitous patient non-compliance issues and chronic side effects associated with topical glaucoma medications.

“The FDA approval of iDose TR represents a significant milestone for Glaukos following an extensive pioneering journey since the inception of the original idea nearly 15 years ago. Today’s approval ushers in a new era of interventional glaucoma therapy by enabling a more proactive and reliable approach for patients in need,” said Thomas Burns, Glaukos chairman and chief executive officer. “We believe iDose TR can be a transformative, novel technology able to fundamentally improve the treatment paradigm for patients with open-angle glaucoma or ocular hypertension. We are grateful to the clinical investigators and study participants in the clinical trials for their instrumental roles in helping us reach this important advancement for glaucoma patient care. At Glaukos, we are relentlessly focused on delivering novel therapies for chronic eye diseases and now iDoseTR has the potential to redefine the standard of care for patients in the U.S. affected by open-angle glaucoma and ocular hypertension.”

“With the next generation of procedural pharmaceutical solutions for glaucoma such as iDose TR, we now have a new tool that will confront the standard legacy practice of relying on topical drops, which are known to cause uncomfortable side effects and present a myriad of challenges such as treatment adherence, complex dosing regimens, and difficulty with self-administration,” said John Berdahl, MD, clinician and researcher at Vance Thompson Vision. “The clinical data suggest that iDoseTR is not only effective with a favorable safety profile, but it has potential to relieve patients from the burdens of prescription eye drops for an extended period of time. I look forward to adding this novel therapy into my treatment toolbox for the benefit of my patients.”

The FDA approval is based on results from two prospective, randomized, multicenter, double-masked, Phase 3 pivotal trials (GC-010 and GC-012) designed to compare the safety and efficacy of a single administration of one of two iDose TR models with different travoprost release rates (referred to as the fast- and slow-release iDose TR models, respectively) to topical timolol ophthalmic solution, 0.5% BID (twice a day), in reducing IOP in subjects with open-angle glaucoma or ocular hypertension. In total, the Phase 3 trials randomized 1,150 subjects across 89 clinical sites. The FDA approval and Phase 3 data referenced below is for the slow-release iDose TR model, consistent with the company’s NDA submission and commercialization plans.

Both Phase 3 trials successfully achieved the pre-specified primary efficacy endpoints through 3 months and demonstrated a favorable tolerability and safety profile through 12 months. IOP reductions from baseline over the first 3 months were 6.6-8.4 mmHg in the iDose TR arm, versus 6.5-7.7 mmHg in the timolol control arm (mmHg range represents IOP reduction means across the six U.S. FDA pre-specified timepoints of 8 a.m. and 10 a.m. at Day 10, Week 6 and Month 3). Based on these outcomes, the FDA concluded in the prescribing information that iDose TR demonstrated non-inferiority to timolol ophthalmic solution in IOP reduction during the first 3 months. The FDA also noted that subsequently iDose TR did not demonstrate non-inferiority over the next 9 months.

At 12 months, 81% of iDose TR subjects were completely free of IOP-lowering topical medications across both trials. In both trials, iDose TR demonstrated excellent tolerability and subject retention with 98% of iDose TR subjects continuing in the trial at 12 months, versus 95% of timolol control subjects. In controlled studies, the most common ocular adverse reactions reported in 2% to 6% of iDose TR patients were increases in intraocular pressure, iritis, dry eye, and visual field defects, most of which were mild and transient in nature.

iDose TR is also supported by positive results from a Phase 2b clinical trial, which were recently highlighted in a peer-reviewed publication in Drugs ). The study authors concluded, “The travoprost intraocular implant demonstrated robust IOP-lowering and substantially reduced topical IOP-lowering medication burden for up to 36 months following a single administration, while maintaining a favorable safety profile.”

Glaukos intends to commence initial commercial launch activities for iDose TR in the latter part of the first quarter of 2024. Glaukos has established a wholesale acquisition cost for iDose TR of $13,950, per dose (or implant).

Alongside the iDose TR approval announcement, Glaukos is proud to introduce the iDose Your Dose Initiative. For every iDoseTR sold, Glaukos pledges to make available an equal number of iDoseTR units for qualifying charitable donation requests in the U.S. and around the globe for recipients that satisfy independent eligibility requirements.

Powered by WPeMatico

Treat e-cigarettes same as tobacco: WHO urges Govts

The World Health Organization (WHO) on Thursday urged governments to treat e-cigarettes similarly to tobacco and ban all flavours, threatening cigarette companies’ bets on smoking alternatives.

Some researchers, campaigners and governments see e-cigarettes, or vapes, as a key tool in reducing the death and disease caused by smoking. But the U.N. agency said “urgent measures” were needed to control them.

For more details, check out the link given below:

WHO Calls For Ban On Flavoured Vapes, Treating E-Cigarettes The Same As Tobacco

Powered by WPeMatico

Health Bulletin 15/December/2023

Here are the top health stories for the day:

WHO calls for ban on flavored vapes

The World Health Organization (WHO) on Thursday urged governments to treat e-cigarettes similarly to tobacco and ban all flavours, threatening cigarette companies’ bets on smoking alternatives.

Some researchers, campaigners and governments see e-cigarettes, or vapes, as a key tool in reducing the death and disease caused by smoking. But the U.N. agency said “urgent measures” were needed to control them.

For more details, check out the link given below:

WHO Calls For Ban On Flavoured Vapes, Treating E-Cigarettes The Same As Tobacco

NMC hosps alerted after man tests positive for Zika virus

The Nashik Municipal Corporation (NMC) has issued a cautionary alert to all hospitals under its jurisdiction following a positive Zika virus case approximately one month ago. The infected individual, a 22-year-old, received successful treatment in a private hospital, with blood and urine samples subsequently sent to the National Institute of Virology (NIV) Pune for further analysis, confirming the Zika virus infection.

Conducting an extensive survey in the Bharat Nagar slum area of Nashik, where the patient resides, the Nashik Municipal Corporation has proactively sent samples from all 91 women in the locality to the NIV for testing. Given the significance of protecting pregnant women from Zika, these women have been advised to sleep under mosquito nets. Authorities assured the public that there is no cause for panic, asserting control over the situation.

Delay in treatment of cancer patient leading to death: GTB hospital, doctors held negligent, slapped Rs 5 lakh compensation

Noting that the apathetic approach of the hospital and its doctors towards the gravity of the ailment raises a presumption as regards to the failure of treating doctors in clinical judgment and choosing the right course of action in time, the Delhi State Consumer Disputes Redressal Commission has upheld the District Forum’s order that found GTB Hospital and its two doctors guilty of negligence and delay in treating a cancer patient who eventually succumbed to the disease.

The District Commission had directed the facility and the doctors to jointly pay a lump sum compensation of Rs 5 lakhs to the heirs (complainants) of the deceased patient.

For more details, check out the link given below:

Delay In Treatment Of Cancer Patient Leading To Death: GTB Hospital, Doctors Held Negligent, Slapped Rs 5 Lakh Compensation

Powered by WPeMatico

COPD treatment: CDSCO nod to AstraZeneca India to market triple drug combination inhalation aerosol

Bangalore: Biopharmaceutical company AstraZeneca India has announced that it has received Central Drugs Standard Control Organisation (CDSCO) approval to market its inhalation aerosol, a triple combination of budesonide (160 mcg), glycopyrrolate (9 mcg), and formoterol fumarate (4.8 mcg). The pressurized metered dose inhaler is recommended for the treatment and maintenance of patients with chronic obstructive pulmonary disease (COPD).

COPD is the second leading cause of death in India, accounting for more than 50% of chronic respiratory diseases. It is the third leading cause of death worldwide. Coughing, difficulty breathing, wheezing, and fatigue are the symptoms of the disease. Smoking or using tobacco in any form, sedentary lifestyle choices, and air pollution are all risk factors for COPD.
The damage from exacerbations due to COPD extends beyond the lungs. The risk of a cardiovascular event rises dramatically during a severe hospitalised exacerbation.

“In comparison to currently available dual therapies, this triple combination therapy is proven to considerably lower the rate of moderate to severe exacerbations, mortality rates, and increase lung function. The inhalation aerosol is highly recommended for all patients with a history of multiple exacerbations,” the Company stated.

Dr. Anil Kukreja, Vice-President, Medical Affairs and Regulatory, AstraZeneca India added, “Preventing exacerbations is central to the management of chronic obstructive pulmonary disease. The triple combination therapy has clinically demonstrated a significant reduction in the rate of moderate or severe exacerbations as compared with other available dual therapies. The indication improves lung function, helps with COPD symptoms and prevents flare-ups. We are also looking at the possibility of extending benefit towards the complete spectrum of respiratory disorders like chronic bronchitis, emphysema, or both.”

Dr. Sanjeev Panchal, Country President & Manging Director, AstraZeneca India, said, “COPD is probably an underprioritized disease around the world. In India, government has already demonstrated its intent to manage COPD better by including it in National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases and Stroke (NPCDCS). With this approval, we are bringing science based novel therapy to India and bridging access to better therapies that can transform outcomes for COPD patients. This approval is also a strong example of innovative drug delivery technique that can target a common therapeutic challenge thereby reducing mortality as well as overall COPD disease burden.”

Read also: AstraZeneca gets CDSCO panel Nod to study anti-cancer drug Volrustomig in women with cervical cancer

Powered by WPeMatico

Standards of Care in Diabetes 2024: ADA updates recommendations on hypoglycemia prevention and management

USA: The American Diabetes Association (ADA) has released an updated “Standards of Care in Diabetes 2024,” which is available online and is published as a supplement to the January 2024 issue of Diabetes Care.

The ADA’s Standards of Care for 2024 include new recommendations to screen for heart failure, type 1 diabetes risk, and peripheral arterial disease (PAD), along with new obesity management guidance. It also includes new recommendations related to bone health and liver disease. The Standards of Care are essentially the global guidelines for the care of individuals with diabetes and those at risk.

This article will focus mainly on updated recommendations on hypoglycemia prevention and management. Recommendations are described below:

Hypoglycemia Assessment, Prevention, and Treatment

  • History of hypoglycemia should be reviewed at every clinical encounter for all individuals at risk for hypoglycemia and evaluated as indicated.
  • Clinicians should screen all individuals at risk for hypoglycemia for impaired hypoglycemia awareness.
  • Clinicians should consider an individual’s risk for hypoglycemia when selecting diabetes medications and glycemic goals.
  • The use of CGM (continuous glucose monitoring) is beneficial and recommended for individuals at high risk for hypoglycemia.
  • Glucose is the preferred treatment for the conscious individual with glucose <70 mg/dL (<3.9 mmol/L), although any form of carbohydrate that contains glucose may be used. Fifteen minutes after initial treatment, repeat the treatment if hypoglycemia persists.
  • Glucagon should be prescribed for all individuals taking insulin or at high risk for hypoglycemia. Family, caregivers, school personnel, and others providing support to these individuals should know its location and be educated on how to administer it. Glucagon preparations that do not have to be reconstituted are preferred.
  • All individuals taking insulin A or at risk for hypoglycemia C should receive structured education for hypoglycemia prevention and treatment, with ongoing education for those who experience hypoglycemic events.
  • One or more episodes of level 2 or 3 hypoglycemia should prompt reevaluation of the treatment plan, including deintensifying or switching diabetes medications if appropriate.
  • Refer individuals with impaired hypoglycemia awareness to a trained healthcare professional to receive evidence-based intervention to help reestablish awareness of symptoms of hypoglycemia.
  • Ongoing assessment of cognitive function is suggested with increased vigilance for hypoglycemia by the clinician, patient, and caregivers if impaired or declining cognition is found.

Reference:

American Diabetes Association Professional Practice Committee; 6. Glycemic Goals and Hypoglycemia: Standards of Care in Diabetes—2024. Diabetes Care 1 January 2024; 47 (Supplement_1): S111–S125. https://doi.org/10.2337/dc24-S006

Powered by WPeMatico