How to tackle the ‘profound and lasting impact’ of COVID-19 on cardiovascular health

Millions of people around the world are suffering from the serious cardiovascular effects of COVID infection and long COVID. A lack of clear guidance on how to reduce this suffering and prevent further harm means that patients are not receiving the care they need, and some are turning to unproven or unsafe treatments.

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A third of licensed GPs in England not working in NHS general practice

Despite rising patient demand and commitments to strengthen primary care, one in three GPs with a license to practice in England are not working in NHS general practice, finds a study published by The BMJ.

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Type 2 diabetes may accelerate development of multiple chronic diseases, study suggests

New research presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD), Vienna (15–19 Sept), reveals type 2 diabetes (T2D) as a critical factor in chronic disease accumulation, particularly during the early stages.

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Research shows GLP-1RA drugs dramatically reduce death and cardiovascular risk in psoriasis patients

Psoriasis patients treated with glucagon-like peptide-1 receptor agonists (GLP-1RAs) face a 78% lower risk of death and a 44% lower risk of major cardiovascular events compared to those taking other diabetes or weight-loss medications, new research has shown.

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Rising Burden of Asthma and COPD Among Older Indians Linked to Social and Household Factors, Finds Study

India: A new study published in the Archives of Public Health sheds light on the growing burden of chronic lung diseases—Asthma and Chronic Obstructive Pulmonary Disease (COPD)—among India’s middle-aged and elderly populations. Conducted by Aditi Chakraborty and colleagues from the Department of Biostatistics and Epidemiology, International Institute for Population Sciences, Mumbai, the study reveals how social, individual, and household factors influence the prevalence of these conditions and their association with age-related health complications.

Using data from the first wave of the Longitudinal Ageing Study in India (LASI), the research offers the first nationally representative estimates of Asthma and COPD among individuals aged 45 years and above. The findings indicate that 4.38% of the surveyed population reported Asthma, while 2.1% had COPD.

The study revealed the following findings:

  • The risk of developing Asthma and COPD increases with age, especially after 60 years.
  • Individuals from wealthier backgrounds show higher prevalence rates of these conditions.
  • People belonging to socially disadvantaged groups (SC, OBC, or non-classified) are more likely to be affected.
  • Women are at a lower risk compared to men.
  • Those who have discontinued smoking face a higher risk of developing both Asthma and COPD.
  • Living in homes without a separate kitchen increases vulnerability to these conditions.
  • The use of open fires for cooking is linked to a higher risk, particularly for COPD.
  • Exposure to passive smoking raises the likelihood of developing COPD.
  • Regional variations exist, with lower risk seen in the northeast and higher prevalence in the southern regions of India.
  • Both Asthma and COPD are strongly associated with limitations in Activities of Daily Living (ADL).
  • These conditions are also linked to difficulties in Instrumental Activities of Daily Living (IADL).
  • A higher risk of falls is observed among individuals with Asthma or COPD.
  • The findings suggest that chronic lung diseases contribute significantly to functional decline and dependency among older adults.

“The research highlights the dual burden of chronic respiratory diseases and functional impairments in India’s ageing population,” the authors note. They call for an integrated healthcare approach that addresses both respiratory health and age-related syndromes.

Despite its insights, the study acknowledges limitations, including its reliance on self-reported data and its cross-sectional nature, which limit causal inference. The authors recommend future studies using longitudinal data and clinical diagnostics to better understand these associations over time.

“The study emphasizes the urgent need for targeted public health strategies that combine respiratory care with geriatric support. Strengthening health education, improving access to age- and gender-sensitive healthcare, enhancing diagnostic services, and mitigating household risk factors like indoor pollution and tobacco exposure are vital steps toward promoting healthy ageing in India,” the authors concluded.

Reference:

Chakraborty, A., Yadav, S. & Kumar, A.H.S.A. Chronic lung diseases (Asthma and COPD) among middle-aged and older populations in India: social, individual, and household determinants and their associations with geriatric syndromes. Arch Public Health 83, 186 (2025). https://doi.org/10.1186/s13690-025-01675-4

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Cord Connection: Enhancing Infant Outcomes During Caesarean Deliveries, study suggests

Integrating extra-uterine placental transfusion (EUPT) and intact-cord stabilization (ICS) during cesarean sections (CS) poses significant advantages for both term and preterm infants, facilitating smoother physiological transitions to extra-uterine life. Recent Research identified a critical need for delayed cord clamping (DCC), as it has been linked to reductions in intraventricular hemorrhage, anemia, and neurodevelopmental deficits in various studies. However, the standard practice of cutting the umbilical cord immediately often complicates infant stabilization, particularly in emergency or preterm CS where equipment is not readily accessible at the operating table.

Protocol Development Challenges

The intervention aimed to develop a protocol for EUPT paired with ICS and physiology-based cord clamping (PBCC), rooted in a systematic literature review revealing a lack of robust existing evidence for the efficacy and feasibility of these methods in CS. Obstacles to implementing such practices typically revolve around maintaining sterility and preventing maternal blood loss while ensuring effective neonatal resuscitation.

Pilot Testing Logistics and Training

Pilot testing involved assessing logistics, workflow, and the clinical environment necessary to employ this new approach. A systematic training of involved personnel through simulation sessions helped identify key challenges— including maintaining sterile technique amidst the complexities of CS, managing infant temperature to avert hypothermia, and communication between the surgical team and neonatal staff. Notably, the application of a dry-electrode ECG device (NeoBeat™) allowed enhanced heart rate monitoring, though it raised concerns regarding sterility.

Data Collection and Outcomes

Data collected indicated that EUPT and ICS were successfully completed in 26 out of 29 cases, though time frames for placental delivery and cord clamping sometimes exceeded set criteria. Mean arterial blood volume transfer from placenta to infant varied, indicating that the timing for intervention measures can be significantly inconsistent during actual clinical circumstances, thus necessitating further adjustments.

Implications and Future Directions

The findings suggest that while the protocol is functionally feasible and does not compromise either maternal or infant safety significantly, there are numerous procedural refinements needed to optimize workflow. Staff feedback from pilot testing emphasized the importance of managing the surgical environment to maintain sterility while ensuring effective stabilization of the infant. The study underscores the potential of EUPT and ICS to enhance neonatal outcomes during CS, though larger scale studies are required for conclusive evidence, particularly concerning preterm infants.

Key Points

– EUPT and ICS integration during cesarean sections improves physiological transition for both term and preterm infants, while standard immediate cord clamping often complicates infant stabilization, particularly in emergency cases or when equipment is not readily available.

– Development of a protocol for EUPT and ICS, along with PBCC, faces challenges such as maintaining maternal sterility and preventing blood loss while ensuring effective neonatal resuscitation, reflecting a current gap in robust evidence regarding their feasibility in cesarean section contexts.

– Pilot testing revealed specific logistical challenges, necessitating a systematic approach to training personnel. Key issues identified included maintaining sterility amid surgical processes, preventing infant hypothermia, and ensuring effective communication between surgical and neonatal teams.

– Successful implementation of EUPT and ICS was recorded in 26 of 29 cases, but the variability in arterial blood volume transfer timing highlighted inconsistencies and the need for protocol adjustments to achieve targets in clinical environments.

– Feedback from trial participants indicated that while the protocol’s feasibility was evident and did not significantly compromise safety for mothers or infants, further refinements are essential to streamline workflow and maintain sterile conditions.

– The study points towards the significant potential of EUPT and ICS to improve neonatal outcomes during cesarean sections, underscoring the need for larger-scale research to validate findings, particularly in the context of preterm infants.

Reference –

Elisabeth Saether et al. (2025). Extra-Uterine Placental Transfusion And Intact-Cord Stabilisation Of Infants In Caesarean Sections: An Intervention Development And Pilot-Study (INTACT-1). *BMC Pregnancy And Childbirth*, 25. https://doi.org/10.1186/s12884-025-07641-w.

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PET/MRI Outperforms Standard Imaging in Rectal Cancer Staging, Study Shows

Poland: A recent prospective study published in the International Journal of Colorectal Disease has revealed that using PET/MRI instead of conventional imaging can substantially improve the diagnosis, treatment planning, and overall outcomes for patients with rectal cancer. The research shows that this hybrid imaging method provides superior accuracy in detecting lymph node involvement and tumor deposits, key factors in determining therapy.

Rectal cancer remains a significant global health concern, with rising incidence and mortality, especially among adults under 50. The authors noted that in the United States alone, roughly 154,000 new colorectal cancer cases and nearly 53,000 deaths are expected in 2025. Accurate staging is therefore crucial to guide preoperative strategies and improve survival rates.
The investigation, led by Dr. Rafał Maksim of the Maria Skłodowska-Curie Białystok Oncology Center in Poland, compared whole-body F-18 FDG PET/MRI with standard imaging techniques such as CT and MRI. Forty-two patients with histologically confirmed rectal cancer were enrolled. All participants first underwent conventional clinical staging and were scheduled for preoperative radiotherapy or radiochemotherapy. Before treatment began, they were restaged using PET/MRI to assess tumor size, lymph node status, and mesorectal tumor deposits.
The study led to the following findings:
  • PET/MRI showed the highest diagnostic accuracy for measuring tumor length, with an AUC of 0.73.
  • Combining the maximum standardized uptake value (SUVmax) of lymph nodes with carcinoembryonic antigen (CEA) blood test results increased diagnostic performance to an AUC of 0.921.
  • PET/MRI detected more lymph node involvement and mesorectal tumor deposits compared with conventional imaging.
  • The hybrid scan changed the clinical stage in 64% of patients, including 11 upstaged, 16 downstaged, and 15 with no change.
  • These findings led to modifications in treatment plans for about 26% of patients, affecting decisions such as surgical approach and the need for additional therapy.
Hybrid PET/MRI combines detailed anatomical imaging from multiparametric MRI with metabolic data from PET scanning, offering a more comprehensive picture than either modality alone. While the study cohort was relatively small, the prospective design and the significant impact on staging emphasize the promise of this technology.
The researchers emphasized the need for larger, multicenter prospective studies and long-term outcome tracking to confirm these findings and establish clear diagnostic thresholds.
“Our results suggest that incorporating F-18 FDG PET/MRI into standard clinical pathways could become an important step toward more individualized and effective treatment for rectal cancer,” the authors concluded.
Reference:
Maksim, R., Buczyńska, A., Sidorkiewicz, I. et al. Standard of practice imaging vs. PET/MR: a comparative prospective study in rectal cancer staging. Int J Colorectal Dis 40, 198 (2025). https://doi.org/10.1007/s00384-025-04998-4

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Awakening Awareness: Study assesses Impact of Communication on Pain Perception in Anesthetized ICU Patients

Recent study aimed to explore the impact of verbal communication on the consciousness level, pain, and agitation of anesthetized patients admitted to the intensive care unit (ICU). The researchers conducted a double-blind randomized controlled trial with 70 anesthetized patients in an ICU setting in Iran.

Methodology

The patients were randomly assigned to an intervention group that received verbal communication twice daily for 10 days, and a control group that received routine ICU care without verbal communication. The researchers used validated tools to measure the patients’ level of consciousness (Glasgow Coma Scale), pain (Behavioral Pain Scale), and agitation (Richmond Agitation-Sedation Scale) before and after the intervention.

Results

The results showed that the intervention group experienced a significant improvement in consciousness level, reduction in pain, and decrease in agitation compared to the control group over the 10-day period. Before the intervention, there were significant differences between the groups in consciousness level and agitation, but not in pain. After the intervention, the trends over time revealed that the verbal communication group had greater improvements in all three outcomes compared to the control group.

Conclusion and Implications

The researchers suggest that the simplicity and cost-effectiveness of the verbal communication intervention make it a valuable nursing practice to facilitate the recovery process and enhance the quality of care for anesthetized ICU patients. However, they acknowledge the need for larger studies to confirm these findings, given the small sample size and potential confounding variables inherent in the unique ICU patient population. Overall, the study provides evidence that structured verbal communication by nurses can positively impact the clinical status of sedated, critically ill patients.

Key Points

Here are the 6 key points from the research paper:

1. The study explored the impact of verbal communication on the consciousness level, pain, and agitation of anesthetized patients in the intensive care unit (ICU).

2. The study used a double-blind randomized controlled trial design with 70 anesthetized ICU patients in Iran, divided into an intervention group that received verbal communication twice daily for 10 days and a control group that received routine ICU care.

3. The researchers used validated tools to measure the patients’ level of consciousness, pain, and agitation before and after the intervention.

4. The results showed that the intervention group experienced significant improvements in consciousness level, reduction in pain, and decrease in agitation compared to the control group over the 10-day period.

5. The researchers suggest that the verbal communication intervention is a simple and cost-effective nursing practice that can facilitate the recovery process and enhance the quality of care for anesthetized ICU patients.

6. The researchers acknowledge the need for larger studies to confirm these findings, given the small sample size and potential confounding variables in the unique ICU patient population.

Reference –

Ali Talebi et al. (2025). Effect Of Nurse’S Verbal Communication On The Level Of Consciousness, Pain, And Agitation In Anesthetized Patients Admitted To The Intensive Care Unit: A Double-Blind Clinical Trial. *BMC Anesthesiology*, 25. https://doi.org/10.1186/s12871-025-03071-5.

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Fetal exposure to vape liquids linked to changes in skull shape, reveals study

In utero exposure to two liquid ingredients in e-cigarettes – minus the nicotine that drives addiction – can alter skull shape during fetal development, a new study in mice has found.

In a series of experiments, pregnant mice were exposed to a combination of two liquids used to create vaping’s throat hit and smoke plume. Compared to two other experimental conditions, the offspring of mothers exposed to a specific ratio of these compounds weighed less and were born with narrowed facial features and shortened skulls.

The finding was surprising to researchers not only because no nicotine was present, but because the ratio of chemicals that produced the skull defect was designed by the e-cigarette industry to be a safer available option than the proportions in earlier products.

“This had no nicotine, and it’s still having effects on the development of the skull in our model, which was not anything we expected,” said lead study author James Cray, professor of anatomy in The Ohio State University College of Medicine.

The research was published recently in the journal PLOS One.

Cray’s developmental biology lab has studied the effects of in utero exposure to nicotine on head and face development for years, reporting in 2020 that exposure to nicotine through breastmilk caused skull defects in mice. About 3% of babies are born annually with a birth defect, according to the Centers for Disease Control and Prevention, and alterations to the head and neck are among the most common – particularly cleft lip and/or cleft palate.

In this study, the team was developing a model to serve as an experimental control for comparison to animals exposed in utero to nicotine through vaping.

Pregnant mice were exposed to either filtered free air or two humectants – hydrating substances that function as carriers of other e-cigarette contents – at differing concentrations: 50% each of propylene glycol and glycerol (also called vegetable glycerin), or 30% propylene glycol and 70% glycerol (30/70 PG/VG).

Because propylene glycol in e-cigarettes has been linked to increasing uptake of nicotine, Cray said, “a lot of companies have moved toward getting away from a high percentage of propylene glycol toward more glycerol, trying to position this as a safer alternative.”

Female mice were exposed to these three different conditions at a rate of one puff per minute, four hours per day on five days each week during the roughly 20-day pregnancy.

The cranial width and height of mouse pup skulls were scanned two weeks after birth. The analysis showed statistically significant reduced measures in the offspring of pregnant mice exposed to the presumed safer 30/70 PG/VG mixture compared to mice exposed to free air and the 50/50 formula.

“What we see is a consistent narrowing of all of the facial features, and the same thing as we move back into the cranium as well. So globally they’re narrower and a little bit shorter-headed, which does mimic some observable changes that we see in children,” Cray said. “We also saw a bit of a reduction in weight. These animals were within the normal range of an animal that age, but they still weighed less.”

The findings were consistent across several litters of mice and in both biological sexes.

“The 50/50 mixture had no dramatic statistical changes – and that’s where we were looking for the difference. We thought heavier propylene glycol should be causing more effects, and it was the exact opposite,” Cray said.

The Food and Drug Administration began regulating electronic nicotine delivery systems in 2016, but has faced legal pushback from e-cigarette companies – which prevailed in a June 20 U.S. Supreme Court ruling that makes it easier to sue the FDA over efforts to block products from the market. In April, the court sided with the FDA’s crackdown on sweet-flavored products after a major increase in teen vaping.

Though researchers continue to study the health effects of multiple ingredients detected in e-cigarettes, many unknowns remain as the products grow in popularity.

“The majority of users are young adults and teenagers, so we are talking about people who are in peak reproductive years. And with development of the head happening very early in fetal development, people could be using these products and not even realize that they are pregnant, which is of great concern,” Cray said.

“This is a small study that speaks to the possibility that nicotine-free vaping is not safe. And it’s a sign that we probably should study the nicotine-free products as much as we study the nicotine-laden products.”

Reference:

Ethan Richlak,Logan Shope,Ethan Leonard,Leslie Sewell,Tyler Maykovich,Amr Mohi,Roy A. Miller,Matthew W. Gorr,Loren E. Wold, In utero exposure to electronic cigarette carriers alters craniofacial morphology, PLOS One, https://doi.org/10.1371/journal.pone.0327190

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Artificially Sweetened Drinks in Pregnancy Linked to Higher Gestational Diabetes Risk: Study

Australia: Researchers have found in a new study that frequent intake of artificially sweetened beverages during pregnancy was associated with an 88% increased risk of gestational diabetes.

The investigation, published in Diabetes Research and Clinical Practice, was led by Bereket Gebremichael of the School of Agriculture, Food and Wine at the University of Adelaide, Australia. Using data from the Australian Longitudinal Study on Women’s Health (ALSWH), the team explored whether consuming artificially sweetened beverages (ASBs) before conception or during pregnancy influences the risk of complications such as gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), and preterm birth (PTB).
Researchers analyzed health information from 3,653 women and applied a generalized linear mixed model, along with an augmented inverse probability weighting estimator, to evaluate both the relative risk and the average treatment effect. They defined frequent consumption as five or more ASB drinks per week.
The study led to the following findings:
  • Among women with preconception exposure to artificially sweetened beverages (ASBs), the incidence was 9.1% for gestational diabetes mellitus (GDM), 6.7% for hypertensive disorders of pregnancy (HDP), and 4.3% for preterm birth (PTB).
  • For women consuming ASBs during pregnancy, the incidence rates were 8.6% for GDM, 7.5% for HDP, and 4.0% for PTB.
  • Frequent ASB intake during pregnancy was associated with an adjusted relative risk of 1.88 for GDM.
  • The adjusted relative risk was 1.59 for HDP and 1.22 for PTB.
  • The average treatment effect of frequent ASB consumption compared with none was 0.06.
While the relationship between pregnancy, ASB intake, and GDM was clear, the connections to HDP and PTB remained uncertain. Similarly, exposure to these beverages before conception showed no definite association with any of the pregnancy outcomes studied.
The researchers highlighted a potential dose–response trend: the more artificially sweetened drinks consumed during pregnancy, the greater the risk of developing GDM. Importantly, this relationship appeared to be partly mediated by maternal body mass index (BMI). In other words, higher ASB consumption might contribute to weight gain during pregnancy, which in turn elevates the likelihood of gestational diabetes.
These findings carry significant public health implications. They suggest that reducing artificially sweetened beverage intake during pregnancy could help lower GDM risk, especially when combined with efforts to manage maternal weight gain. The authors emphasized that while their data reveal a strong link between ASB intake and GDM, more research—particularly prospective cohort studies and randomized clinical trials—is needed to confirm causality and to guide nutritional recommendations for expectant mothers.
“Frequent consumption of artificially sweetened beverages during pregnancy was strongly associated with an increased risk of gestational diabetes. In contrast, associations with hypertensive disorders of pregnancy and preterm birth remain inconclusive. The study highlights the importance of counseling women on beverage choices and weight management as part of comprehensive prenatal care,” the authors concluded.
Reference:
Gebremichael, B., Begum, M., Bianco-Miotto, T., Zhou, S. J., & Lassi, Z. S. (2025). Preconception and pregnancy artificially sweetened beverage consumption and its association with adverse pregnancy outcomes: Findings from the Australian longitudinal study on women’s health. Diabetes Research and Clinical Practice, 227, 112422. https://doi.org/10.1016/j.diabres.2025.112422

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