Study Evaluates Effectiveness of Virtual Telehealth for Prenatal Care

Recent study investigates the implementation of virtual telehealth visits (VV) for prenatal checkups in Japan during the COVID-19 pandemic, analyzing the extent of their utilization, challenges faced, and the feasibility for future incorporation. Japan maintains low maternal and neonatal mortality rates facilitated by standard perinatal check-ups as per the Maternal and Child Health Act. With the pandemic prompting a shift towards telemedicine for prenatal care, despite previous studies indicating that telehealth does not adversely impact perinatal outcomes, Japan’s adoption of VV remains notably low. A nationwide survey was conducted, targeting all delivery facilities registered with the Japanese Association of Obstetricians and Gynecologists. Of the 2,214 facilities surveyed, 49.5% responded, revealing that only 1.6% had adopted VV, with 2.6% planning to. Usual barriers identified included limited human resources, costs, and a perceived lack of demand from patients. Conversely, pregnant women’s responses indicated a significant need for VV; 60.2% expressed anxiety about in-person visits, and 36.6% preferred VV even outside pandemic constraints.

Self-Assessment Viability

The research also included assessments of self-measured health parameters by pregnant women and healthcare provider measurements to evaluate feasibility. Concordance was observed for various metrics, including blood pressure and fundal height, demonstrating the potential viability of self-measurements. However, significant discrepancies were noted in fetal heart rate evaluations, suggesting a need for improved methodologies in this area.

Challenges in Self-Monitoring

Additionally, the study explored challenges in self-monitoring, with a considerable percentage of participants expressing difficulty, particularly in measuring fetal heart rate and fundal height. Despite these perceptions, many self-assessments aligned closely with professional measurements, highlighting discrepancies between perceived and actual assessment accuracy.

Disconnect Between Providers and Patients

The research emphasizes a glaring disconnect between healthcare providers’ acknowledgment of patient demand for VV and the women’s actual preferences for prenatal care delivery, recommending enhanced dialogue among stakeholders. It identifies the essentiality of establishing clear guidelines and robust support mechanisms to facilitate VV’s integration into Japan’s prenatal care landscape.

Future Directions for Telehealth

Overall, while the potential for telehealth in prenatal care is validated, substantial hurdles remain, necessitating targeted efforts to optimize these services moving forward. Given the findings, the study stresses the urgency for constructive engagement between policymakers and healthcare professionals to improve the adoption of VV in prenatal check-ups, accommodating the evident demand among pregnant women.

Key Points

– -Utilization of Virtual Telehealth Visits (VV):- The implementation of virtual prenatal check-ups during the COVID-19 pandemic in Japan was minimal, with only 1.6% of surveyed delivery facilities adopting VV, despite 60.2% of pregnant women showing anxiety about in-person visits and 36.6% preferring VV outside the pandemic.

– -Survey Findings:- A nationwide survey targeting 2,214 delivery facilities yielded a response rate of 49.5%. The main barriers to VV adoption identified by healthcare providers included limited human resources, costs, and a perceived low demand from patients, contrasting with the actual expressed need from pregnant women.

– -Self-Assessment of Health Parameters:- The study evaluated the feasibility of self-measured health parameters among pregnant women, finding concordance with healthcare provider measurements for blood pressure and fundal height, but significant discrepancies in fetal heart rate evaluations, indicating a need for better measurement methods.

– -Challenges in Self-Monitoring:- Participants encountered difficulties in self-monitoring, particularly in measuring fetal heart rate and fundal height. Despite these challenges, many self-assessments closely aligned with professional measurements, showcasing a gap between perceived and actual accuracy in self-monitoring.

– -Provider-Patient Disconnect:- The research highlights a disconnect between healthcare providers’ recognition of patient demand for VV and the actual preferences of pregnant women for prenatal care delivery, calling for improved communication and understanding between healthcare stakeholders.

– -Future Directions for Telehealth:- The findings underscore the potential of telehealth for prenatal care while also recognizing substantial challenges that must be addressed. Urgent engagement between policymakers and healthcare professionals is necessary to enhance VV adoption and meet the evident demand among pregnant women for alternative care options.

Reference –

Mariya Kobayashi et al. (2025). Virtual Telehealth Visits For Prenatal Checkups During The COVID- 19 Pandemic In Japan: A Nationwide Survey And Feasibility Study. *BMC Pregnancy And Childbirth*, 25. https://doi.org/10.1186/s12884-025-07598-w.

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Chitosan Nanoparticles Show Promise in Preventing Enamel Erosion, suggests study

Researchers have found in a new study that Chitosan suspension significantly reduced enamel loss in an in vitro erosive challenge, indicating its potential as an effective material for enamel erosion prevention.

Chitosan nanoparticles suspension (ChNPs) showed antimicrobial effects in the oral cavity, but its effects on enamel erosion prevention remain little explored. This study synthesized ChNPs and evaluated their effect on enamel after erosive challenge. ChNPs were synthesized by ionic gelation and characterized using scanning electron microscopy (SEM), infrared spectrophotometry (FTIR), dynamic light scattering methods (DLS) and zeta potential (ZP). In total, 56 human enamel blocks were divided into four groups (n=14/group): (i) ChNPs suspension (4.4mg/mL); (ii) 0.05% sodium fluoride solution (NaF); (iii) chitosan solution (5.0 mg/mL); and (iv) distilled water. After incubation in freshly collected human saliva (3h), the samples were exposed to erosive challenge in 1% citric acid (90s) and remineralizing solution (2h) performed four times a day. After the 1st and 4th acid exposures, solutions were applied for 2 min. After 7 days, % Vickers surface hardness change (% SMH) was obtained using 300 g load applied for 15s. Enamel surface loss was evaluated using optical profilometer by subtracting the final profile values from baseline ones. Data were analyzed by ANOVA and post-hoc T tests (α=0.05). Surface topography was obtained by optical profilometer. Results: SEM revealed the formation of spherical nanoparticles. DLS showed nanoparticles with 85.7±10.5 nm diameter and ZP value of +45.5±5.4mV. Enamel surface loss was significantly lower in ChNPs and NaF groups, exhibiting a less rough surface in the treated areas. ChNPs, NaF and chitosan groups showed lower % SMH values. ChNPs suspension minimized enamel loss after in vitro erosive challenge and appears to be a promising material for enamel erosion prevention.

Reference:

França RCS, Dias RTA, Reis RM, Sousa FB, Carlo HL, Santos RLD, Carvalho FG. Chitosan nanoparticles suspension can minimize enamel loss after in vitro erosive challenge. J Appl Oral Sci. 2025 Apr 18;33:e20240445. doi: 10.1590/1678-7757-2024-0445. PMID: 40266045; PMCID: PMC12014109.

Keywords:

Chitosan, Nanoparticles, Show, Promise, Preventing, Enamel, Erosion, suggests, study,França RCS, Dias RTA, Reis RM, Sousa FB, Carlo HL, Santos RLD, Carvalho FG. Chitosan

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S.T.O.N.E. Score Effective in Predicting Stone-Free Outcomes After Ureteral Lithotripsy: Study Shows

Yemen: A new study published in Research and Reports in Urology has demonstrated the clinical relevance of the S.T.O.N.E. score as a reliable tool for predicting stone-free rates (SFR) in patients undergoing semirigid pneumatic ureteral lithotripsy (ULT), offering a valuable preoperative guide for urologists.

“The S.T.O.N.E. score proves to be a valuable predictor of stone-free rates following ureteral lithotripsy, facilitating better preoperative planning and aiding in identifying patients at higher risk of treatment failure,” the researchers wrote.

Ureteral lithotripsy is a widely used treatment for ureteral stones, yet predicting its success remains a clinical challenge. In response, Faisal Ahmed, Department of Urology, School of Medicine, Ibb University, Ibb, Yemen, and colleagues evaluated the S.T.O.N.E. score—a composite measure that incorporates five key factors: stone Size, Topography (location), degree of Obstruction, Number of stones, and Hounsfield units (HU) from CT imaging—to assess its ability to forecast treatment outcomes.

The study retrospectively analyzed data from 266 patients who underwent ULT at IBB University Hospitals between April 2021 and September 2023. The patient population had a mean age of 47.7 years, and the majority (72.2%) were male. Preoperative CT scans were used to calculate the S.T.O.N.E. score for each participant, and a predictive model was developed to assess the likelihood of residual stones post-procedure.

The study revealed the following findings:

  • The average S.T.O.N.E. score among the patients was 7.8.
  • A total of 85.3% of patients achieved stone-free status following ureteral lithotripsy (ULT), while 14.7% had residual stone fragments.
  • Key predictors of treatment failure included higher Hounsfield units, larger stone size, proximal stone location, and moderate to severe hydronephrosis.
  • Patients with a S.T.O.N.E. score greater than eight were found to have a higher likelihood of treatment failure.
  • The predictive model demonstrated an overall accuracy of 85.0%, with a sensitivity of 72.0% and specificity of 81.0%.
  • The area under the ROC curve confirmed the strong ability of the model to distinguish between outcomes.
  • Calibration analysis showed a close match between predicted and actual results.
  • Decision curve analysis indicated the model’s clinical utility by effectively stratifying patients into high- and low-risk categories.

“The S.T.O.N.E. score offers a practical and efficient method for preoperatively estimating the likelihood of residual stones,” the authors noted. “It allows clinicians to tailor surgical plans and counsel patients more effectively based on individualized risk.”

The study concludes that integrating the S.T.O.N.E. score into routine urological assessment may optimize surgical planning and resource utilization. However, the authors emphasize the importance of further validation across broader and more diverse populations before universal adoption. Future multicenter trials are encouraged to assess its applicability in varied clinical environments and to support the score’s incorporation into standard care protocols.

Reference:

Ahmed F, Al-Kohlany K, Al-Naggar K, Alnadhari I, Altam AY, Badheeb M. Assessing the Predictive Accuracy of the S.T.O.N.E. Score for Stone-Free Rates in Semirigid Pneumatic Ureteral Lithotripsy: Implications for Validation. Res Rep Urol. 2025;17:139-152

https://doi.org/10.2147/RRU.S515846

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Timing of RSV Immunization Matters for Infant Protection suggests study

The seasonal timing of when infants receive the new respiratory syncytial virus (RSV) immunization is crucial for ensuring its effectiveness, according to Yale research published in JAMA Network Open.

Nirsevimab is a seasonal immunization that targets RSV in infants. As a monoclonal antibody-a protein that can bind to a specific target-nirsevimab binds to a particular area of the virus and blocks RSV from entering human cells.

In a new study testing the effectiveness of the monoclonal antibody in a real-world setting, researchers at Yale School of Medicine (YSM) found that immunization was up to 85% effective at preventing serious illness in children under one year of age. However, timing its administration to coincide with seasonal outbreaks is important because the monoclonal antibody’s effectiveness waned three months after receiving the shot.

Children with severe RSV “are essentially drowning in their own mucus,” says Carlos Oliveira, MD, PhD, assistant professor of pediatrics (infectious diseases) at YSM and senior author of the study. So having immunizations that can prevent this and keep vulnerable infants from ending up in the hospital “is huge,” he says.

A dangerous disease

RSV is incredibly common. Almost every child will contract the virus before the age of two. Some people who get RSV only develop a runny nose and fever. But for infants and elderly patients, the virus can be deadly.

“Any parents of a baby with severe RSV will see how their child is constantly struggling to breathe,” says Oliveira, who is also an assistant professor of biostatistics at Yale School of Public Health. Excessive mucus produced to fight off the virus can clog the small airways of children under the age of six months. Globally, around 1.4 million children under the age of six months end up hospitalized due to RSV every year, mostly during the fall and winter. Of those, approximately 27,000 will die.

There is no targeted treatment for RSV. But in July 2023, the U.S. Food and Drug Administration (FDA) licensed nirsevimab as the first single-dose, long-acting monoclonal antibody for the prevention of RSV in infants. Previously, palivizumab was the only preventative option and required monthly injections to sustain its protective effect.

Clinical trials found nirsevimab to be safe and effective for infants. This study is an important continuation of that research. Vaccines and medications are still studied after FDA approval to track their effectiveness in the general population-outside of the clinical trial setting-and further inform optimal use. These types of studies are considered phase IV trials.

RSV immunization prevents severe illness

Oliveira and his colleagues collected data on approximately 3,000 infants who received care in the Yale New Haven Health System for respiratory illnesses between October 2023 and May 2024. This was the first RSV season in which nirsevimab was available, and only 10% of infants in the study had received the immunization before seeking medical help.

Of the 3,000 infants, the researchers tracked who had tested positive for RSV, who had been immunized, and how they fared across the study period. About 680 infants tested positive for RSV, and 166 infants-97% of whom had not been vaccinated with nirsevimab-ended up hospitalized.

The data showed that the monoclonal antibody didn’t provide total protection against RSV; nirsevimab was around 68% effective at preventing RSV infection in infants. However, the researchers found that immunization was 85% effective at preventing infants from being hospitalized.

So, while nirsevimab didn’t prevent all RSV infections, “the key takeaway is that the monoclonal antibody was very good at preventing severe disease,” says Oliveira. Immunization was the difference between an infant with a runny nose and one that ended up in the ICU.

Oliveira and his colleagues’ research also shows that nirsevimab becomes less effective after about 14 weeks. The U.S. Centers for Disease Control and Prevention recommends that infants who are eight months old or younger receive the shot at the very start of the RSV season, which runs between October and March.

Information from Oliveira’s study will help policymakers decide when to roll out nirsevimab during the RSV season.

Reference:

Xu H, Aparicio C, Wats A, et al. Estimated Effectiveness of Nirsevimab Against Respiratory Syncytial Virus. JAMA Netw Open. 2025;8(3):e250380. doi:10.1001/jamanetworkopen.2025.0380

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Brensocatib Significantly Reduces Exacerbations in Bronchiectasis, confirms study

Researchers have discovered in a new study that treating airway inflammation with the experimental drug brensocatib lowers the rate of pulmonary exacerbations in patients with bronchiectasis. The phase III ASPEN trial showed that the DPP-1 (dipeptidyl peptidase 1) inhibitor brensocatib reduced the annualized rate of exacerbations by about 20% versus placebo. This result indicates that brensocatib may be a viable option for patients intolerant of long-term antibiotics or exposed to antimicrobial resistance. Insmed’s drug has the potential to be the first FDA-approved medicine specifically for bronchiectasis as well as the first approved DPP-1 inhibitor for clinical use. This study was published in The New England Journal of Medicine by Chalmers and colleagues.

The ASPEN trial was a global, double-blind, randomized, controlled trial with 1,721 patients with bronchiectasis across 391 sites in 35 countries. Carried out from November 2020 to March 2023, the study enrolled 1,680 adults and 41 adolescents. Adults were randomly assigned in a 1:1:1 ratio to receive once-daily oral brensocatib at doses of 10 mg or 25 mg or placebo for 52 weeks.

Participants were stratified by geographic region, sputum presence of Pseudomonas aeruginosa, and number of exacerbations during the year before screening. The trial population was roughly two-thirds female, close to 75% white, and roughly one-third P. aeruginosa-positive sputum. Approximately 30% had three or more exacerbations in the prior year, 15.2% a history of COPD, and 18.7% a history of asthma.

Key findings

  • Brensocatib lowered the annualized rate of pulmonary exacerbations to 1.02 for the 10 mg group and 1.04 for the 25 mg group, as compared with 1.29 in the placebo group. This translates to rate ratios of 0.79 and 0.81 for the 10 mg and 25 mg doses, respectively (adjusted P=0.004 and P=0.005).

  • Furthermore, time to first exacerbation was prolonged in the treatment groups (HR 0.81 for 10 mg, P=0.02; HR 0.83 for 25 mg, P=0.04). At 52 weeks, 48.5% of the patients on brensocatib were free from exacerbations as compared to 40.3% receiving placebo, which was a reduction by a nearly 20% relative advantage.

  • The decrease in lung function according to forced expiratory volume in 1 second (FEV1) was also smaller in the patients treated with brensocatib. There was a fall of 62 mL in the placebo group by week 52, while decreases were less pronounced in the 10 mg and 25 mg brensocatib arms at 50 mL and 24 mL (P=0.04 compared 25 mg with placebo).

  • The frequency of total and severe adverse events was comparable between treatment and placebo groups. Hyperkeratosis, however, was more common in the brensocatib groups: 3.0% in the 25 mg group, 1.4% in the 10 mg group, and 0.7% in the placebo group.

Brensocatib decreased pulmonary exacerbations and mitigated lung function decline in patients with bronchiectasis and had an adequate safety profile. These results strengthen its utility as a first-in-class drug focusing on neutrophilic inflammation in bronchiectasis, particularly for subjects who cannot take long-term antibiotics.

Reference:

Chalmers JD, et al “Phase 3 trial of the DPP-1 inhibitor brensocatib in bronchiectasis” N Engl J Med 2025; DOI: 10.1056/NEJMoa2411664.

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Risk of poststroke epilepsy low among young adults, reveals JAMA study

A new study published in the Journal of American Medical Association showed that young individuals had a comparatively low risk of poststroke epilepsy (PSE), and the parameters for the current risk scores can be applied to identify young patients at high risk.

Poststroke epilepsy patients frequently require long-term antiepileptic medication, which might have negative side effects, including depression, lethargy, lightheadedness, and behavioral abnormalities. Esmée Verburgt and her team therefore carried out this study to confirm existing PSE risk scores among a cohort of young individuals and to look into the risk of and risk factors for PSE at an early age.

Data from the ODYSSEY (Observational Dutch Young Symptomatic Stroke Study), a prospective cohort study that was carried out across 17 Dutch hospitals from May 27, 2013, to March 3, 2021, with follow-up until February 28, 2024, were used in this investigation. The primary exposure was the first ischemic stroke, or ICH, to be confirmed by neuroimaging.

Nearly, 1388 consecutive patients, between ages 18 to 49, who had no history of epilepsy and had an ischemic stroke or intracerebral hemorrhage (ICH) confirmed by neuroimaging were included in the study and 57 (4.1%) of them experienced PSE.

Following an ischemic stroke, the 5-year cumulative risk of PSE was 3.7%, and following an ICH, it was 7.6%. Following an ischemic stroke, PSE was linked to cortical involvement and an abrupt symptomatic seizure (less than seven days). Only cortical engagement was linked to PSE following ICH. Both scores had satisfactory calibration, with the C statistic for the SeLECT 2.0 risk score being 0.78 and the CAVE risk score being 0.83.

Overall, this research found that young persons with ischemic stroke or ICH had a comparatively low incidence of PSE, which peaked in the first year following the stroke. Existing risk scores can be utilized to accurately tell young patients about their risk of PSE and may be applied to patients who have had a stroke at an early age. For high-risk individuals, future clinical studies should examine the best main and secondary prophylactic measures.

Source:

Verburgt, E., Fellah, L., Ekker, M. S., Schellekens, M. M. I., Boot, E. M., Immens, M. H. M., van Alebeek, M. E., Brouwers, P. J. A. M., Arntz, R. M., van Dijk, G. W., Gons, R. A. R., van Uden, I. W. M., den Heijer, T., van Tuijl, J. H., de Laat, K. F., van Norden, A. G. W., Vermeer, S. E., van Zagten, M. S. G., van Oostenbrugge, R. J., … de Leeuw, F.-E. (2025). Risk of poststroke epilepsy among young adults with ischemic stroke or intracerebral hemorrhage. JAMA Neurology. https://doi.org/10.1001/jamaneurol.2025.0465

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Study finds pinworm medication has potential to treat aggressive skin cancer

A common pinworm medication may stop and reverse cancer growth in Merkel cell carcinoma, an aggressive form of skin cancer, according to research led by University of Arizona Cancer Center researchers and published in the Journal of Clinical Investigation.

Merkel cell carcinoma is a rare but fast-growing neuroendocrine cancer that is three to five times more likely than melanoma to be deadly. Response rates to current therapies – surgery, radiation and immunotherapy – are limited, resulting in a need for effective and broadly applicable therapeutics.

“Merkel cell carcinoma is increasing in incidence,” said senior author Megha Padi, PhD, a U of A Cancer Center member and an assistant professor in the U of A College of Science. “Even though it’s a rare cancer type, it mimics a lot of properties that other cancers have.”

Pyrvinium pamoate, a medication approved by the Food and Drug Administration in 1955 to treat pinworms, has been shown to have antitumor potential in several different cancers, including breast, colorectal, pancreatic and bladder cancers. This is the first time it has been studied in models of Merkel cell carcinoma.

Padi and the research team found that in laboratory models of Merkel cell carcinoma, pyrvinium pamoate inhibited cancer cell growth and reversed the cancer’s neuroendocrine features. In mouse models of Merkel cell carcinoma, pyrvinium pamoate reduced tumor growth.

“This is a hypothesis, but some people think the reason an antiparasitic agent could be effective against cancers is because tumors are a little bit like parasites in our body,” Padi said. “Parasites and tumors must develop ways to use scarce resources in their host to feed themselves and allow for unlimited multiplication. If the pathways that they have hijacked to feed themselves are the same, then you get lucky, and you have a tumor type that could be amenable to killing by these antiparasitic drugs.”

Padi and the research team chose to test pyrvinium pamoate after identifying the Wnt signaling pathway as one of the molecular mechanisms that drives the transition of normal cells into Merkel cell carcinoma. Pyrvinium pamoate is a known Wnt pathway inhibitor.

Further research is needed to optimize treatment protocols for the development of pyrvinium pamoate as a clinically useful medication for Merkel cell carcinoma.

Reference:

Jiawen Yang, James T. Lim, Paul Victor Santiago Raj, Marcelo G. Corona, Integrative analysis reveals therapeutic potential of pyrvinium pamoate in Merkel cell carcinoma, Journal of Clinical Investigation, DOI:10.1172/JCI177724.

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Study marks rise in psychotherapy outpatient visits and declines in medication use for mental health care

Psychotherapy assumed a larger role in outpatient mental health care while psychiatric medication without psychotherapy became less common, according to a new study at Columbia University Mailman School of Public Health and Columbia University Irving Medical Center. The findings are published in the American Journal of Psychiatry.

“After years of American mental health care moving towards greater use of psychiatric medications, the pendulum has started swinging back towards psychotherapy,” said Mark Olfson, MD, MPH, Columbia Mailman School professor of Epidemiology and Psychiatry.

Among adults receiving outpatient mental health care between 2018 and 2021, an increase occurred in use of only psychotherapy, from 11.5 percent in 2018 to 15.4 percent in 2021, respectively; while taking medication only declined from 68 percent to 62 percent. Increases also occurred in psychotherapy visits and total national psychotherapy expenditures ($31 billion to $51 billion) with a decrease in patients

receiving psychotherapy from psychiatrists from 41 percent to 34 percent. Psychiatric medications included antidepressants – the most common class of medications — antipsychotics, stimulants or other ADHD medications, anxiolytics or hypnotics, and mood stabilizers obtained from pharmacies during the survey year.

Much of the change occurred between 2018 and 2019, which indicates that factors other than the COVID pandemic and the rise of telemental health care contributed to the shift in outpatient mental health treatment, according to Olfson. During the study period, a significant increase in the average number of visits occurred for patients with mild or moderate distress but not for patients with serious disturbances.

To investigate recent national trends in outpatient mental health care, the researchers analyzed data from four representative surveys of the U.S. household population, the 2018–2021 Medical Expenditure Panel Survey, focusing on adults with outpatient mental health visits (17,821)

including psychotherapy visits (6,415). They further presented data trends on mental health patients receiving psychotherapy only, those receiving medications, or a combination of the two.

“Psychiatrists provided psychotherapy to a decreasing percentage of all psychotherapy patients, which may have increased the need for psychiatrists to refer patients to and collaborate with non-physician psychotherapists,” observed Olfson. “At the same time, social workers and counselors, but not psychologists, assumed a larger role in providing psychotherapy and there was an increase in the average number psychotherapy visits per patient. A decrease in the fraction of patients with just one or two psychotherapy visits further suggests there was a decline in early drop out. Americans are becoming more willing to seek out and stick with psychotherapy.”

According to Olfson, psychotherapy by mental health counselors may increase further following a recent change in Medicare reimbursement policy that allows mental health counselors and licensed marital and family therapists to bill for psychotherapy.

Reference:

Mark Olfson, M.D., M.P.H. mo49@cumc.columbia.edu, Chandler McClellan, Ph.D., Samuel H. Zuvekas, Ph.D., Melanie Wall, Ph.D. https://orcid.org/0000-0001-6673-3467, and Carlos Blanco, Psychotherapy Trends in the United States, American Journal of Psychiatry, https://doi.org/10.1176/appi.ajp.20240492

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What is role of gamma knife radiosurgery in management of grade 2 meningioma?

The role of radiosurgery in the treatment of grade 2 meningioma remains unclear. This study aimed to evaluate the long-term outcomes of gamma knife radiosurgery (GKRS) in patients with grade 2 meningiomas and to identify factors influencing tumor control and survival.

In this retrospective study, seventy patients underwent GKRS for grade 2 meningioma between 2007 and 2016. Tumor recurrence was categorized as local, marginal, or distant. Survival curves were estimated using the Kaplan-Meier method, while the log-rank test and Cox proportional hazards model were employed to analyze potential risk factors.

The median follow-up period was 48 months (range: 8 to 132 months). The one-year, three-year, and five-year local control rates were 92%, 73%, and 65%, respectively. The one-, three-, and three-year progression-free survival rates were 87%, 51%, and 44%, respectively. Multiple lesions and multiple prior recurrences were identified as negative predictors of marginal control and progression-free survival. Similarly, multiple lesions and marginal doses ≤13 Gy were associated with poor local control. Serious complications related to gamma knife use occurred in 4% of patients.

Our results support the use of GKRS as a reasonable treatment option in the management of grade 2 meningiomas. A higher margin dose should be considered to achieve better local control. Outfield progression (marginal and/or distant recurrence) was common, particularly in patients with multiple prior recurrences and/or multiple lesions. More aggressive treatment strategies should be explored for patients with these risk factors.

Reference:

Bao E, Wang K, Gao D, Luo B, Liu A, Sun S. The Role of Gamma Knife Radiosurgery in the Management of Grade 2 Meningioma. Neurosurgical Subspecialties. 2025;1(1):11-19. doi: 10.14218/NSSS.2024.00002.

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High Dietary Acid Load Linked to Increased Risk of Knee Osteoarthritis, Study Finds

Iran: A new case-control study published in Scientific Reports has shed light on a potential dietary risk factor for knee osteoarthritis (KOA), suggesting that a higher dietary acid load (DAL) may significantly increase the odds of developing the condition. The study was conducted among adults aged 40 years and above in Zabol County, Iran, and adds to growing evidence that dietary habits could influence joint health through mechanisms such as systemic inflammation.

Knee osteoarthritis is a prevalent degenerative joint disorder that causes chronic pain and reduced mobility, especially in older adults. In recent years, researchers have increasingly focused on modifiable lifestyle factors—particularly diet—to better understand and potentially prevent KOA. Emerging evidence points to dietary acid load as a contributing factor, with its role in promoting systemic inflammation linked to the development of the condition.

Against the above background, Farshad Amirkhizi, Department of Nutrition, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran, and colleagues conducted a case-control study to examine the association between dietary acid load and the risk of knee osteoarthritis in adults aged 40 years and older.

For this purpose, the researchers recruited 150 newly diagnosed knee osteoarthritis patients and 300 matched controls based on age, sex, and BMI from Zabol County, Iran. They evaluated dietary intake using a validated food frequency questionnaire and calculated dietary acid load based on nutrient composition. To assess the association between DAL and KOA risk, logistic regression analysis was performed, adjusting for potential confounding variables including physical activity, smoking habits, and supplement use.

Key Findings:

  • Individuals in the highest dietary acid load (DAL) quartile had significantly greater odds of developing knee osteoarthritis (KOA) compared to those in the lowest quartile (OR: 2.48), even after adjusting for confounders.
  • The likelihood of KOA increased progressively across DAL quartiles in both men (OR: 2.52) and women (OR: 2.55), following adjustment for potential confounding variables.

The study showed a significant link between high dietary acid load and increased odds of developing knee osteoarthritis, particularly among the Iranian population.

“These findings highlight the potential of dietary interventions focused on lowering dietary acid load as an effective strategy for preventing or managing knee osteoarthritis, particularly in aging populations,” the authors noted. They further emphasized that with the growing prevalence of KOA, identifying and understanding modifiable dietary risk factors is becoming increasingly crucial.

Concluding their study, the researchers stressed the importance of conducting further longitudinal investigations to confirm these associations and explore causal relationships. Such efforts, they stated, could inform clinical practices and public health strategies aimed at enhancing joint health and alleviating the overall burden of osteoarthritis.

Reference:

Moludi, J., Fateh, H. L., & Amirkhizi, F. (2025). Dietary acid load and the odds of knee osteoarthritis: A case–control study. Scientific Reports, 15(1), 1-7. https://doi.org/10.1038/s41598-025-98307-2

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