Liver transplantation utilizing grafts donated after euthanasia is feasible, study suggests

Organ donation following medical assistance in dying (MAiD), also known as euthanasia, is a relatively new practice both in North America and worldwide. A first comparison of liver transplantation using organs donated after MAiD in Canada has shown good patient survival with outcomes similar to standard donation after circulatory death.

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Is Canada failing the rising numbers of youth who use opioids?

Youth opioid use is increasing in Canada, as are related emergency department visits and deaths, yet governments are not providing adequate support to address this public health crisis, argue the authors of a CMAJ (Canadian Medical Association Journal) editorial.

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Efforts to promote safer opioid prescribing in Canada appear to be having an effect

Efforts to promote safer opioid prescribing in Canada appear to be having an effect, as new research in the Canadian Medical Association Journal shows a decrease in opioid dispensing between 2018 and 2022.

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Can inpatient care help address overdose crisis?

Is expanding hospital inpatient, or bed-based, care a way to help address the overdose crisis? An analysis article in the Canadian Medical Association Journal describes the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance), which can help provinces determine whether bed-based care is effective.

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NZ may be on the cusp of another measles outbreak—what happened in 2019 should be a warning

The recent confirmation of new measles cases unconnected to international travel suggests the highly contagious disease has likely started spreading through communities, according to Health New Zealand.

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President Murmu inaugurates Yashoda Medicity, stresses expansion of quality healthcare

Ghaziabad: The President of India, Smt. Droupadi Murmu inaugurated Yashoda Medicity at Indirapuram, Ghaziabad, Uttar Pradesh, on October 26, 2025.  

Speaking on the occasion, the President said that healthcare is an integral part of nation-building. Protecting people from disease and improving their health is a priority for the government. For this purpose, health and medical infrastructure, institutions, and services are being continuously expanded across the country. She stated that all such efforts will certainly contribute to building a healthy and developed India. Apart from the government, all other stakeholders will also play a crucial role in these efforts. Therefore, it is the responsibility of all stakeholders to expand healthcare services and ensure that quality services are available in all areas of the country and that no citizen is deprived of effective healthcare. Good private sector healthcare institutions can make an invaluable contribution to achieving this goal. She expressed confidence that Yashoda Medicity will bring about transformative work in the healthcare sector.

Also Read:Yashoda Medicity opens Robotic Surgery Training Centre in Ghaziabad

The President was happy to note that during the global pandemic of COVID-19, the Yashoda Hospital treated a large number of people, and that it has diligently embraced national priorities such as the National TB Elimination Program. She urged the institution to contribute its utmost to national campaigns related to sickle cell anemia. She also advised the stakeholders of the hospital to undertake research and collaborate with other institutions for the treatment of cancer, the PIB stated.

The President said that fulfilling social responsibility, along with medical responsibility, should be a priority for healthcare institutions. She was confident that Yashoda Medicity would realize its mission of ‘Affordable World Class Healthcare Services to All.’ She stated that with the support of excellent healthcare institutions in both the private and government sectors, India will gain more recognition as a global healthcare destination.

Also Read:Dr JB Sharma takes over as Head of Obstetrics and Gynaecology at Yashoda Medicity

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Punjab to set up Aam Aadmi Clinics in all central jails

Chandigarh: Amid overcrowding and rising health concerns in Punjab’s prisons, the state government is now planning to establish Aam Aadmi Clinics (AACs) in all ten central jails to provide inmates with better medical care. 

The state health department has reportedly begun identifying suitable spaces within the jails to implement the initiative.

Also Read:SC approves 300-bed Hospital on Sanganer Jail land

Confirming the development, a senior health official said, “Yes, there is a proposal to set up AACs in central jails across Punjab. The proposal is under consideration, and we are examining the modalities for implementation.” The official added that though the initial plan is to establish AACs in central jails only, the project could later be extended to other jails as well, reports the Hindustan Times.

Punjab already has 24/7 medical officers deployed in all jails; however, the AAC model is expected to significantly expand access to medical care. The government recently floated tenders to establish 236 new AACs, which will bring the total number of functional clinics in the state to around 1,117.

A senior health department official mentioned that AACs offer 107 types of free medicines and 47 types of free diagnostic tests, which will significantly improve medical treatment for jail inmates.

According to the news reports, Punjab’s prison system has long faced challenges due to overcrowding, with inmates suffering from serious illnesses, including HIV, hepatitis C, and tuberculosis. In August, the principal secretary (jails) had written to the principal secretary (health) highlighting the strain on prison healthcare services. The letter noted inadequate medical infrastructure, vacant healthcare posts, and limited preventive care facilities.

Also Read:Delhi Government tightens leave policy for Mohalla Clinic doctors

Some health officials have raised concerns over the legal implications of deploying contract-based medical officers under the AAC model. Speaking to Hindustan Times, a former medical officer at Patiala Central Jail warned, “Any inmate could make multiple visits to AACs, which may appear pretentious. Later, they might use medical records to seek bail on the grounds of inadequate treatment. The government should carefully consider the legal ramifications of this project.”

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Automated Insulin Delivery Benefits Adults with Type 2 Diabetes Regardless of C-Peptide Levels: Study Finds

USA: A new study published in Diabetes Care revealed that automated insulin delivery (AID) systems lowered A1C levels and increased time in the glucose range for adults with type 2 diabetes, regardless of their C-peptide levels. Researchers concluded that having a low C-peptide level should not be a prerequisite for AID therapy.        

The study addresses a key policy issue: the Centers for Medicare & Medicaid Services (CMS) currently requires a low C-peptide level for insulin pump coverage unless the individual is β-cell autoantibody positive. This requirement limits access to automated insulin delivery systems for many adults with type 2 diabetes, even when they could benefit from the technology.
Researchers performed a secondary analysis of the Randomized Trial Evaluating the Efficacy and Safety of Control-IQ+ Technology in Adults With Type 2 Diabetes Using Basal-Bolus Insulin Therapy. The trial assessed the t:slim X2 insulin pump with Control-IQ+ technology in adults with insulin-treated type 2 diabetes.
Participants were grouped based on C-peptide levels according to CMS criteria: 195 patients had high C-peptide levels, while 59 were classified as having low C-peptide levels. All participants had blood glucose ≤225 mg/dL at the time of C-peptide measurement and were negative for antiglutamic acid decarboxylase antibodies.
Key Findings:
  • Over the 13-week study, adults using AID systems experienced significant improvements in glycemic control.
  • Mean A1C levels in the AID group decreased by 0.8% from baseline, a significantly greater reduction than in the control group for both high and low C-peptide subgroups.
  • Patients using AID spent more time in the target glucose range (70–180 mg/dL) than those in the control group, with significant improvements in both high and low C-peptide categories.
  • Among adults aged 65 years or older, AID therapy led to larger A1C reductions for those with high C-peptide levels compared with the control group.
  • Although reductions for older patients with low C-peptide levels were not statistically significant, overall glycemic improvements were observed across all C-peptide groups.
The study highlights that the benefits of automated insulin delivery are not limited to patients with low C-peptide levels. “A benefit of AID is present with high C-peptide levels and low C-peptide levels. Thus, requiring a low C-peptide level as a prerequisite for AID therapy is not warranted,” the authors wrote.
The study was led by Dr. Irl B. Hirsch of the University of Washington School of Medicine in Seattle. The researchers noted certain limitations, including the small number of participants in the low C-peptide subgroup, the 13-week duration of the trial, and the fact that C-peptide measurements were not always taken in fasting conditions.
Overall, the findings suggest that automated insulin delivery systems can improve glycemic outcomes for adults with type 2 diabetes regardless of residual insulin production, supporting broader access to AID technology and challenging current CMS coverage requirements.
Reference:
Irl B. Hirsch, Yogish C. Kudva, David T. Ahn, Thomas Blevins, Michael R. Rickels, Dan Raghinaru, John W. Lum, Craig Kollman, Jordan E. Pinsker, Roy W. Beck, 2IQP Study Group; Adults With Type 2 Diabetes Benefit From Automated Insulin Delivery Irrespective of C-Peptide Level. Diabetes Care 2025; dc251125. https://doi.org/10.2337/dc25-1125

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Acetaminophen Linked to Lower Risk of ICU Delirium in Critically ill Patients: Study Shows

USA: A new retrospective cohort study published in the Annals of the American Thoracic Society suggests that acetaminophen may play a significant role in preventing delirium among critically ill patients in the Intensive Care Unit (ICU).

The research, led by Dr. Somnath Bose from the Department of Anesthesia, Critical Care, and Pain Medicine at Beth Israel Deaconess Medical Center and Harvard Medical School, highlights the potential of this widely used analgesic to improve outcomes in the ICU beyond its traditional role in pain management.
Delirium is a common and serious complication in ICU patients, associated with increased morbidity, longer hospital stays, and higher mortality. Pain and systemic inflammation are recognized contributors to delirium, but strategies to prevent it outside of the postoperative setting remain limited. The study aimed to investigate whether acetaminophen administration could reduce the incidence of ICU delirium in a broad critically ill population.
The researchers conducted a retrospective analysis of 17,818 adult patients admitted to any ICU in a tertiary hospital for 48 hours or longer between 2015 and 2024. Patients who received at least 2 grams of acetaminophen per day during their ICU stay were considered exposed to the medication. Delirium was assessed using the Confusion Assessment Method for the ICU (CAM-ICU), which was performed every 12 hours as part of routine clinical care. Multivariate logistic regression models and fractional polynomial analyses were used to explore the relationship between acetaminophen exposure and delirium incidence.
The study led to the following notable findings:
  • Among the cohort, 5,332 patients (29.9%) received acetaminophen during their ICU stay.
  • 5,438 patients (30.5%) developed delirium during their ICU stay.
  • Acetaminophen use was associated with a significant reduction in delirium incidence, with an adjusted odds ratio of 0.66.
  • The absolute risk difference for delirium with acetaminophen use was -6.0%.
  • A dose-dependent relationship was observed: patients with a higher proportion of ICU stay under the effect of acetaminophen experienced less delirium.
  • The protective effect plateaued at approximately 40% coverage of the ICU stay, indicating that sustained exposure may be important for reducing delirium risk.
“These findings suggest that acetaminophen could serve as a safe, readily available intervention to decrease delirium among critically ill patients,” Dr. Bose wrote. The study emphasizes that these results are hypothesis-generating and highlight the need for prospective randomized controlled trials to confirm the efficacy of acetaminophen for delirium prevention in the ICU.
The study provides compelling evidence that acetaminophen is linked to a clinically meaningful reduction in ICU delirium among unselected critically ill patients. The inverse association between the proportion of time patients were under acetaminophen’s effect and the time they experienced delirium indicates a potential strategy for ICU clinicians to mitigate this common and detrimental complication.
“If confirmed in future trials, acetaminophen could become a simple, low-risk approach to improving outcomes for critically ill patients,” the authors concluded.
Reference:
Bose S, Paschold BS, Shamsi T, Kaiser L, Pensier J, Chen G, Nguyen V, Janga SR, Behera A, Talmor D, Subramaniam B, Schaefer MS. Role of Acetaminophen in Intensive Care Unit Delirium Prevention: A Retrospective Cohort Study. Ann Am Thorac Soc. 2025 Aug 4. doi: 10.1513/AnnalsATS.202506-683OC. Epub ahead of print. PMID: 40758474.

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Early-Life Sugar Restriction Linked to Lower Adult Heart Disease Risk: BMJ

UK: A study examining World War II-era sugar rationing in the United Kingdom found that individuals exposed to limited sugar intake from conception through early childhood had significantly lower cardiovascular risks later in life. Those who spent their first 1,000 days under sugar rationing showed a 20% lower risk of cardiovascular disease and a 25% lower risk of heart attack after age 40.   

The research, published in the BMJ, analyzed data from 63,433 participants in the UK Biobank born between October 1951 and March 1956. Participants were free from cardiovascular disease at baseline, and the study excluded multiple births, adoption cases, and individuals born outside the UK. Exposure to sugar rationing was determined by birth date relative to the end of rationing in 1953, creating a natural quasi-experiment. External validation was performed using the Health and Retirement Study and the English Longitudinal Study of Ageing.
Jiazhen Zheng, a doctoral student at the Hong Kong University of Science and Technology, and colleagues investigated a range of cardiovascular outcomes, including incident cardiovascular disease, myocardial infarction, heart failure, atrial fibrillation, stroke, and cardiovascular mortality. 
They applied Cox and parametric hazard models, adjusting for demographic, socioeconomic, lifestyle, parental health, genetic factors, and geographic location. A subset of participants underwent cardiac magnetic resonance imaging to assess cardiac structure and function.
Key Findings:
  • Longer exposure to sugar rationing in early life was associated with lower cardiovascular risk in adulthood.
  • Participants exposed in utero and during their first one to two years had a hazard ratio of 0.80 for cardiovascular disease.
  • Hazard ratio for myocardial infarction in the same group was 0.75.
  • Hazard ratio for heart failure was 0.74.
  • The hazard ratio for atrial fibrillation was 0.76.
  • Hazard ratio for stroke was 0.69.
  • Hazard ratio for cardiovascular mortality was 0.73.
  • Diabetes and hypertension mediated approximately 31% of the association between early sugar restriction and cardiovascular risk.
  • Birth weight contributed only 2% to the observed association.
  • Cardiac imaging revealed modest improvements, including higher left ventricular stroke volume index and ejection fraction among those exposed to early sugar restriction.
“Our results indicate that limited sugar exposure during the critical first 1,000 days of life confers lasting cardiovascular benefits,” the researchers noted. They emphasized that the protective effects were more pronounced with longer durations of sugar restriction, highlighting the importance of early-life nutrition in shaping lifelong heart health.
The study emphasizes the potential of population-level interventions during early development, such as dietary guidelines and sugar reduction policies, to reduce long-term cardiovascular risk. The authors recommend further research to explore individual-level dietary exposures, the interaction of genetic and environmental factors, and the mechanisms through which early sugar restriction influences cardiometabolic outcomes.
This research contributes to growing evidence that early nutrition plays a critical role in lifelong heart health. By showing that early-life sugar limitation can reduce the risk of heart disease and improve cardiac function decades later, the study provides compelling support for policies and interventions targeting nutrition in pregnancy and early childhood.
“Overall, these findings offer important insights for public health strategies, suggesting that careful management of sugar intake during the first 1,000 days after conception could be a practical approach to preventing cardiovascular disease in later life,” the authors concluded.
Reference: BMJ 2025;391:e083890

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