GLP-1 Drugs May Increase Rejection Risk in Lung Transplant Recipients, Study Suggests

A recent study presented at the 2025 International Society for Heart and Lung Transplantation (ISHLT) annual meeting suggests that glucagon-like peptide-1 receptor agonists (GLP-1 RAs)—a class of drugs widely used to treat type 2 diabetes and obesity-may elevate the risk of organ rejection in lung transplant recipients.

Researchers, led by Dr. Zainab Dhanani and colleagues, investigated the outcomes of lung transplant patients who had been prescribed GLP-1 RAs such as semaglutide or liraglutide. The analysis compared these patients to matched controls who were not taking GLP-1 agents.
Findings indicated a statistically significant increase in episodes of acute rejection and possibly chronic lung allograft dysfunction (CLAD) in those receiving GLP-1 RAs. GLP-1 RAs have been celebrated for their cardiometabolic benefits and their role in weight reduction, especially in transplant populations where obesity is a risk factor. However, their influence on immune modulation may unintentionally provoke immune responses against transplanted lungs. The underlying mechanism remains unclear but may involve increased immune activation or altered pharmacokinetics of immunosuppressants.
The researchers caution against immediate changes in clinical practice, emphasizing the need for further large-scale studies to validate these findings. However, they recommend careful monitoring of lung transplant patients who are prescribed GLP-1 agents and a multidisciplinary approach when considering their use in this population. As GLP-1 RAs gain popularity for metabolic disease management, this study highlights the importance of evaluating potential immunological consequences in vulnerable populations, such as transplant recipients.

Reference:

International Society for Heart and Lung Transplantation. Source Reference: Dhanani Z, et al “The impact of glucagon-like peptide-1 receptor agonists on lung transplant outcomes” ISHLT 2025.

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SGLT2 inhibitors significantly reduced Cholesterol Levels in CKD Patients: Study

A new study published in the Metabolites journal found that SGLT2 inhibitors (SGLT2i) significantly reduced total cholesterol levels in all chronic kidney disease (CKD) patients over a 24-month period, irrespective of their diabetes mellitus (DM) status. However, no notable changes were observed in triglycerides (Tg), LDL cholesterol (LDLc), or HDL cholesterol (HDLc) levels.

The study analyzed the medical records of 75 patients diagnosed with CKD who had been on SGLT2i therapy. Key biochemical markers, kidney function indicators, and blood pressure readings were compared between baseline values and those taken two years into the treatment.

The study found a statistically significant reduction in total cholesterol (Chol) levels across all participants, regardless of whether they had diabetes mellitus. While triglycerides (Tg) and low-density lipoprotein cholesterol (LDLc) also trended downward, these changes were not statistically significant. High-density lipoprotein cholesterol (HDLc) levels showed a slight increase, though again, this was not significant enough to draw strong conclusions.

Despite expectations, creatinine clearance (Ccr), a marker of kidney filtration ability, showed a significant decrease over the 24-month period, suggesting some progression of kidney function impairment. Serum urea (Sur), another marker of declining renal performance, significantly increased. However, levels of proteinuria (Prt), a key indicator of kidney damage, remained stable, suggesting that SGLT2i may have a protective effect on kidney structure even as filtration metrics fluctuate.

Blood pressure outcomes revealed a significant reduction in diastolic blood pressure (DBP), which could contribute to cardiovascular risk reduction in this patient population. This adds to the growing body of evidence supporting the cardiovascular benefits of SGLT2 inhibitors.

The study concluded that SGLT2 inhibitors appear to contribute to better cholesterol control and some cardiovascular benefits in CKD patients, with a complex but manageable impact on renal function. These findings reinforce the role of SGLT2i in holistic CKD management and may prompt further prospective studies to explore their long-term outcomes and mechanisms of action.

Overall, this study highlights the growing interest in SGLT2i therapies not just for their glucose-lowering abilities in diabetic patients, but also for their broader implications in CKD management, particularly in improving lipid profiles and offering mild blood pressure benefits.

Source:

Gajić, S., Janković, S., Stojadinović, M., Filić, K., Bontić, A., Pavlović, J., Mrđa, I., Petrović, K., Hadži-Tanović, L., Žunić, J., Kostić, M., Kezić, A., & Baralić, M. (2025). The effects of SGLT2 inhibitors on lipid profile and kidney function in patients with chronic kidney disease regardless of diabetes and hypertension status. Metabolites, 15(4). https://doi.org/10.3390/metabo15040271

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Cryotherapy Effectively Reduces Postoperative Pain After Root Canal Treatment, suggests study

Researchers have found in a new study that Cryotherapy may significantly reduce postoperative pain in single-visit root canal treatments of molars with pulp necrosis and symptomatic apical periodontitis (SAP). This offers a biocompatible, cost-effective, and simple pain management option.

The present study aimed to assess the effects of intracanal cryotherapy on pain following single-visit non-surgical root canal treatment (NSRCT) of molar teeth with pulpal necrosis and symptomatic apical periodontitis (SAP).

This parallel-two arm, single-blind, randomized superiority clinical trial was registered at www.clincaltrials.gov (NCT05611736). Patients referred for NSRCT meeting the inclusion criteria were included. Preoperative radiographs, pulp sensibility tests, and pain scores on the visual analog scale (VAS) were recorded. Following shaping and cleaning, 302 patients were randomly allocated to the two groups (n = 151). In the experimental group, final irrigation was done using 0.9% physiologic saline solution at 2.5 °C, whereas in the control group, final irrigation was done using the same solution at room temperature.

All treatments were performed in a single visit. Analgesics intake and presence, duration, and intensity of pain using the VAS at 6, 24, 72 h, and 1 week were recorded. Any adverse events were recorded. Data was analyzed using the Mann–Whitney U test and the Student’s t test (P < 5%). Results: Patients in the cryotherapy group had significantly less postoperative pain at 6, 24, and 72 h (P < 0.05). There was no difference in postoperative pain at 1 week (P > 0.05). No adverse event was recorded in either group during or immediately after root canal treatment. Cryotherapy significantly reduces postoperative pain in single-visit root canal treatment of molars with pulp necrosis and SAP.

It can be considered a biocompatible, economical, and straightforward method for managing postoperative pain.

Reference:

Ahmad MZ. Effects of intracanal cryotherapy on postoperative pain in necrotic teeth with symptomatic apical periodontitis: a randomized controlled clinical trial. Front Dent Med. 2025;6. doi:10.3389/fdmed.2025.1543383.

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Pre-Pregnancy BMI and Weight Gain Linked to Higher Cesarean Delivery Risk, suggests study

Recent study focused on investigating the impact of pre-pregnancy BMI and changes in gestational weight gain (GWG) trajectories on cesarean section rates in women with gestational diabetes mellitus (GDM). The research was conducted in Taiwan with 947 participants diagnosed with GDM. The study classified GWG patterns into non-rapid excessive weight gain and rapid excessive weight gain groups, with the latter contributing significantly to cesarean section rates. Pre-pregnancy BMI played a crucial role, with normal and overweight/obese women having higher odds of cesarean sections. Multiparous women and those with rapid excessive weight gain trajectories were more likely to undergo cesarean delivery.

Importance of Educating Women on Weight Management

The findings emphasized the importance of educating women on weight management from pre-pregnancy through pregnancy to reduce cesarean section incidences. Specifically, women with GDM showing rapid excessive weight gain should receive particular attention to minimize the cesarean delivery risk. Gestational weight gain in the first trimester is associated with maternal fat, while weight gain in the second and third trimesters affects fetal growth. It was highlighted that excessive GWG poses a threat to birth outcomes, and that maintaining appropriate weight gain is crucial for avoiding adverse childbirth outcomes.

GWG Trajectories and Relationship with Cesarean Incidences

The study utilized group-based trajectory modeling to identify different GWG trajectories and their relationship with cesarean section incidences. The results indicated that excessive and rapid GWG was a high-risk factor for cesarean section, especially in underweight women before pregnancy. Additionally, the study discussed the physiological mechanisms linking excessive GWG, hyperglycemia, fetal hyperinsulinemia, and adverse birth outcomes. Recommendations included emphasizing pre-pregnancy weight management and gestational weight changes to reduce cesarean section rates in women with GDM.

Addressing Pre-pregnancy BMI and Monitoring GWG Trajectories

Overall, the study highlighted the importance of addressing pre-pregnancy BMI, monitoring GWG trajectories, and providing targeted interventions to prevent rapid and excessive weight gain during pregnancy, particularly in women with GDM. The findings contribute to understanding the relationship between GWG patterns and cesarean sections, emphasizing the need for tailored interventions to improve maternal and infant health outcomes.

Key Points

– The study aimed to assess the influence of pre-pregnancy BMI and variations in gestational weight gain (GWG) patterns on cesarean section rates in women diagnosed with gestational diabetes mellitus (GDM) in Taiwan, involving 947 participants.

– Two GWG trajectory groups were identified: non-rapid excessive weight gain and rapid excessive weight gain, with the latter demonstrating a significant association with increased cesarean section rates.

– Women with normal and overweight/obese pre-pregnancy BMIs were found to have higher chances of undergoing cesarean deliveries, especially if they were multiparous and had rapid excessive weight gain trajectories during pregnancy.

– Educating women on weight management is crucial throughout pre-pregnancy and pregnancy to mitigate the risk of cesarean sections, particularly for those with GDM exhibiting rapid excessive weight gain to reduce adverse birth outcomes.

– Excessive and rapid GWG, particularly in underweight women before pregnancy, was identified as a major risk factor for cesarean deliveries, with physiological mechanisms connecting excessive GWG, hyperglycemia, fetal hyperinsulinemia, and negative birth outcomes.

– The study emphasizes the significance of addressing pre-pregnancy BMI, tracking GWG trajectories, and offering tailored interventions to prevent excessive weight gain during pregnancy, with a specific focus on women with GDM to enhance maternal and infant health outcomes.

Reference –

Tzu-Ling Chen et al. (2025). Gestational Weight Gain Patterns As Predictors Of Cesarean Deliveries In Women Diagnosed With Gestational Diabetes Mellitus. *BMC Pregnancy And Childbirth*, 25. https://doi.org/10.1186/s12884-025-07222-x.

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Hyperbaric oxygen Safe with Limited Efficacy in Reducing severity of radiation-induced dermatitis: Study

Researchers have found in a pilot study that hyperbaric oxygen therapy (HBOT) did not significantly reduce the severity of radiation-induced dermatitis (RID). However, it was safe, well tolerated, and showed potential benefits in enhancing patient comfort and quality of life. Further large-scale trials with optimised protocols are necessary to determine its effectiveness in RID management.

Radiation-induced dermatitis (RID) is a common adverse effect of adjuvant radiotherapy in patients with breast cancer, often leading to discomfort and reduced quality of life. Hyperbaric oxygen therapy (HBOT) has been proposed as a potential intervention to mitigate RID, but its efficacy remains uncertain. This pilot study aimed to assess the feasibility, safety, and preliminary efficacy of HBOT in reducing RID severity. This single-institution, randomized, controlled pilot study included 30 patients undergoing adjuvant radiotherapy for breast cancer. Participants were assigned to either HBOT (100% oxygen at 1.5 atmospheres absolute, 30 min per session, three times per week, for 7 weeks) or standard care. The primary outcome was to determine whether HBOT reduces the incidence of grade 2 or higher RID, based on Radiation Therapy Oncology Group criteria. Secondary outcomes included the Skindex-29, Catterall Skin Scoring Profile, Numeric Rating Scale (NRS), and EORTC QLQ Core Questionnaire-C30 scores. Results: Twenty-five patients completed the study. The incidence of grade 2 or higher RID was 73.3% in both the HBOT and control groups, with no significant difference (p = 0.700). No statistically significant differences were observed in primary or secondary endpoints. Trends toward lower skin-related discomfort and improved patient-reported outcomes in the HBOT group were noted but did not reach statistical significance. HBOT was well tolerated, with no serious adverse events reported.This pilot study did not demonstrate a significant reduction in RID severity with HBOT. However, the therapy was safe and well tolerated, with potential benefits in patient comfort and quality of life. Larger trials with optimized HBOT protocols are needed to clarify its role in RID management. Trial Registration Number and the date of registration: NCT06158347 (28/11/2023) and KCT0009847 (15/10/2024).

Reference:

Lee JY, Hyun MH, Yang G, Lee S. Efficacy and safety of hyperbaric oxygen therapy for radiation-induced dermatitis in patients with breast cancer: a randomized pilot study. Support Care Cancer. 2025 Apr 21;33(5):399. doi: 10.1007/s00520-025-09463-0. PMID: 40259026.

Keywords:

Hyperbaric, oxygen, Safe, Limited, Efficacy, Reducing, severity, radiation-induced, dermatitis, study, Lee JY, Hyun MH, Yang G, Lee S, Breast cancer; Hyperbaric oxygen therapy; Radiation-induced dermatitis; Skin toxicity.

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Increased Residential Greenness improves Maternal Vitamin D Deficiency in Areas with air pollution: Study

A recent study published in Environmental Pollution investigated the relationship between residential greenness and maternal vitamin D deficiency (VDD) during pregnancy. The findings indicate that higher levels of surrounding greenness are associated with a reduced risk of Vitamin D Deficiency in expectant mothers. This inverse relationship is particularly significant in areas with elevated concentrations of fine particulate matter (PM₂.₅). The study also suggests that the beneficial impact of greenness on vitamin D status may be partially mediated by a reduction in PM₂.₅ exposure.

Adequate vitamin D is essential for the health of both the mother and foetus, and it can be influenced by environmental factors. However, research on the associations between greenness exposure and vitamin D concentrations during pregnancy is limited. This retrospective birth cohort study, conducted from 2014 to 2018, assessed the greenness of residences using the satellite-derived normalised difference vegetation index (NDVI). Serum 25-hydroxyvitamin D [25(OH)D] concentrations were categorised as non-deficient (≥50 nmol/L) or deficient (<50 nmol/L). Multiple log-binomial regression models were used to estimate the association of NDVI with serum 25(OH)D concentrations and vitamin D deficiency (VDD). Subgroup and mediation analyses were conducted to estimate the association of ambient particulate matter (PM) on the association between NDVI and VDD. A total of 64,663 pregnant women with a mean maternal age of 30.6 (standard deviation: 3.86) years were included. 250-m NDVI was negatively associated with the risk of VDD (per 0.1-unit increase, relative risk [RR]: 0.98, 95% CI: 0.97–0.99). With the highest quartile of NDVI exposure as the reference group, the upper-middle quartile (RR: 1.02, 95% CI: 1.00–1.03), and lowest quartile (RR: 1.03, 95% CI: 1.01–1.06) had an increased risk of VDD. At higher PM2.5 exposure concentrations, 250-m NDVI exposure was negatively associated with the risk of VDD (RR: 0.98, 95%CI: 0.97–0.99, per 0.1-unit increase), but not at lower PM2.5 exposure concentrations. Among pregnant women with higher PM2.5, the mediation of PM2.5 exposure on the association between 250-m NDVI and VDD was 44.70% (P = 0.0116). Among pregnant women with higher PM10 exposure, the mediation of PM10 exposure on the association between 250-m NDVI and VDD was 17.98% (P = 0.002). These findings suggest that higher residential greenery significantly reduces the risk of VDD in pregnant women, particularly in those exposed to increased PM concentrations.

Reference:

Dongjian Yang, Yanling Shen, Qun Wang, Xin Sun, Mengxiang Li, Jinjing Shi, Lei Chen, Jun Zhang, Xinhua Ji. Association of greenness exposure with serum vitamin D status and effects of ambient particulate matter among pregnant women in early pregnancy,

Environmental Pollution, 2025, 126067, ISSN 0269-7491, https://doi.org/10.1016/j.envpol.2025.126067.

(https://www.sciencedirect.com/science/article/pii/S0269749125004403)

Keywords:

Dongjian Yang, Yanling Shen, Qun Wang, Xin Sun, Mengxiang Li, Jinjing Shi, Lei Chen, Jun Zhang, Xinhua Ji. Association, greenness, exposure, serum, vitamin D, status, effects, ambient, particulate, matter, among, pregnant, women, early, pregnancy

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How to Enhance Paediatric Anaesthesia Training, Bridge Skill Gap through Targeted Curriculum and Supervision?

Recent study investigates the training gaps in pediatric anesthesia education among postgraduate trainees and educators. Given the specialized nature of pediatric anesthesia, effective management is crucial yet often not met by current training programs. A cross-sectional survey was conducted with a sample of 567 individuals, comprising anesthesia trainees, consultants, and educators, receiving a 25.3% response rate from 144 participants. The aim was to assess exposure to pediatric anesthesia, teaching methodologies, and perceived competency in performing essential clinical tasks. The methodology relied on a self-administered Google questionnaire, validated by experts in the field, which included 29 questions focusing on various aspects of pediatric anesthesia education. The survey sought to gather insights on clinical exposure, supervising methodologies, and assessment strategies. The results revealed that the median score for exposure to pediatric anesthesia was rated as ‘good’ on a scale of 1 to 5 but highlighted a concerning reliance on direct proactive supervision, as 47% of trainees primarily assisted rather than independently performed procedures.

Trainee Exposure

Among the responding trainees, only 19% reported exposure to children under one year, with elective placements in pediatric operating theaters noted by 25% of participants in the first six months of training, increasing to 36.81% by the second year. However, the overall performance of critical functions such as intravenous line insertion, mask ventilation, laryngeal mask airway insertion, tracheal intubation, and caudal block was evaluated as moderate, indicating insufficient opportunities for hands-on practice.

Skill Correlation

Notably, a significant positive correlation (r = 0.714) was identified between mask ventilation and tracheal intubation skills, suggesting that increased practice in mask ventilation may enhance capabilities in intubation – an essential competency in pediatric anesthesia. Teaching methods were primarily traditional, emphasizing interactive lectures for knowledge acquisition, while hands-on practice and mentoring were recognized for skill development and attitude formation. Concerns were raised regarding the limited formative assessments implemented in the training programs, with only 36% of respondents indicating their use, primarily through Objective Structured Clinical Examination (OSCE). Reflective practice was encouraged among 76% of students, yet only 69.9% maintained personal logbooks, demonstrating low engagement with formative assessments essential for professional growth.

Study Limitations

Various limitations of the study were identified, particularly the geographical imbalance in participant responses and a skewed representation between students and educators. This highlights the necessity for a standardized national approach to pediatric anesthesia training that ensures adequate exposure and skill competencies across institutions, particularly those facing resource limitations. In conclusion, the findings suggest that a shift to a competency-based medical education framework is paramount, integrating formative assessments and experiential learning opportunities to bolster proficiency in pediatric anesthesia. There is a clear need for curriculum enhancement that focuses on skill development and fostering independent practice, which could be achieved through a well-structured framework involving competency committees and systematic evaluations of trainee performance. The emphasis on establishing clear entrustment goals and implementing simulation-based learning could substantially bridge the gaps identified in the training process, ultimately improving patient safety and care in pediatric anesthesia.

Key Points

-Training Gaps Identified:- The study highlights significant gaps in pediatric anesthesia education for postgraduate trainees, emphasizing that current training programs often fail to provide adequate management techniques necessary for this specialized field.

– -Trainee Experience and Exposure Levels:- Only 19% of surveyed trainees had experience with pediatric patients under one year old, and while elective exposure increased from 25% in the first six months to 36.81% in the second year, hands-on practice for critical procedures like intravenous line insertion and tracheal intubation was deemed insufficient.

– -Correlation between Skills:- A strong positive relationship (r = 0.714) between mask ventilation and tracheal intubation skills was found, indicating that improving skills in mask ventilation could enhance intubation performance, which is crucial in pediatric anesthesia settings.

– -Teaching Methodologies and Assessment Practices:- Traditional teaching methods dominated, focusing on interactive lectures for knowledge acquisition rather than on hands-on practice. Furthermore, formative assessments were underutilized, with only 36% of respondents reporting their implementation, primarily via Objective Structured Clinical Examination (OSCE).

– -Engagement with Reflective Practice:- While a majority (76%) of trainees were encouraged to engage in reflective practices, only 69.9% maintained personal logbooks. This low level of engagement highlights the need for better integration of formative assessments which are vital for professional development.

– -Recommendations for Curriculum Improvement:- The findings advocate for a shift toward a competency-based medical education framework, incorporating formative assessments, experiential learning, and simulation-based training to enhance skills and encourage independent practice, ultimately aimed at improving patient safety and care outcomes in pediatric anesthesia.

Reference –

Vasudha Devi et al. (2025). Perceived Learning Gaps In Paediatric Anaesthesia Training: A Cross -Sectional Survey. *Indian Journal Of Anaesthesia*. https://doi.org/10.4103/ija.ija_807_24.

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Evidence Suggests Causal Link Between Shingles Vaccination and Reduced Dementia Risk

Utilizing a quasi-experiment, a new study published in the Journal of American Medical Association offers proof of a herpes zoster vaccination’s positive impact on avoiding or postponing dementia, which is more likely to be causative than the correlational data now available.

The herpes zoster (HZ) vaccine appears to prevent or postpone dementia, according to recent data from a quasi-experiment conducted in Wales. This study examined the impact of HZ immunization on dementia incidence in a different demographic and health system environment by taking use of a comparable quasi-experiment conducted in Australia. Thus, to ascertain the impact of the HZ vaccine on the likelihood of obtaining a new dementia diagnosis, Michael Pomirchy and team carried out this investigation.

Primary care doctors in Australia began providing the live attenuated HZ vaccination to anyone aged 70–79 for free on November 1, 2016. As a result, there was a natural cutoff: those who turned 80 right before the start date were not eligible, while others who turned 80 right after were. Minimal age differences that are unlikely to be associated with health behavior are used in this quasi-experiment. With vaccination eligibility determined by birthdate, this study examined new dementia cases documented in electronic health records using regression discontinuity and birth-week data from 65 general practices.

As of November 1, 2016, the mean age of the 101,219 patients in this sample was 62.6 years, with 52.7% of them being female. People who were born just before or shortly after the date-of-birth eligibility barrier (November 2, 1936) for the HZ immunization had a well balanced history of chronic illness diagnoses and use of preventive health services.

Patients born soon before compared to shortly after the date-of-birth eligibility criterion had a sudden 16.4 percentage point increase in the likelihood of ever getting the HZ immunization. Thus, the HZ vaccination program’s eligibility requirements produced comparison groups that were born close on either side of the qualifying criterion for date of birth and were probably identical to one another, with the exception of a significant variation in their likelihood of getting the intervention of interest.

This study showed that eligibility for HZ immunization reduced the likelihood of acquiring a new dementia diagnosis by 1.8 percentage points over 7.4 years. Being eligible for HZ immunization had no effect on the likelihood of seeking other preventive health care or acquiring a diagnosis of common chronic illnesses other than dementia.

Overall, compared to the current associational data, this study and the analysis conducted in Wales offer evidence that is more resilient to confounding issues (such as healthy vaccine bias).

Source:

Pomirchy, M., Bommer, C., Pradella, F., Michalik, F., Peters, R., & Geldsetzer, P. (2025). Herpes zoster vaccination and dementia occurrence. JAMA: The Journal of the American Medical Association. https://doi.org/10.1001/jama.2025.5013

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Copper and iron levels may influence development of fibromyalgia, reports research

A recent study which employed Mendelian randomization (MR) analysis identified copper (Cu) and iron (Fe) as potential contributors to fibromyalgia (FM) risk, shedding new light on the role of trace elements in the chronic pain condition. While FM’s exact cause remains elusive, the findings published in the recent issue of Nature Scientific Reports suspect that abnormalities in trace element metabolism may influence its development.

Using data from genome-wide association studies (GWAS), the study investigated 15 major trace elements to determine their causal relationships with FM. Single nucleotide polymorphisms (SNPs), or genetic variations linked to these elements, were analyzed through multiple MR methods, including inverse-variance weighting (IVW), MR Egger, weighted median, weighted mode, and simple mode approaches.

The two-sample MR analysis revealed a significant link between Cu and an increased risk of FM. According to the IVW method, higher Cu levels were associated with a 9.5% greater risk of developing FM (OR = 1.095, 95% CI: 1.015 to 1.181, P = 0.018). Also, Fe was found to have a protective effect, reducing the FM risk by 56% (OR = 0.440, 95% CI: 0.233 to 0.834, P = 0.011).

To ensure these relationships were not influenced by other factors, this study conducted a multivariable analysis controlling for selenium, a potential confounder. The findings remained consistent which confirmed the independent effects of Cu and Fe on FM risk. No significant associations were observed for other trace elements such as zinc and selenium.

These results highlight the potential importance of Cu and Fe in FM pathophysiology and suggest that monitoring and regulating these elements could be valuable in managing the condition. While Cu appears to elevate FM risk, Fe may offer protective benefits, opening new avenues for dietary and therapeutic strategies.

However, the study calls for further research to validate these findings and to explore the precise biological mechanisms through which Cu and Fe influence FM risk. Future investigations may provide deeper insights into whether dietary modifications or supplementation strategies could reduce FM symptoms or prevent its onset. With FM affecting millions globally and often leading to chronic pain, fatigue, and cognitive issues, identifying modifiable risk factors such as trace elements could be a major step in improving patient outcomes.

Reference:

Zeng, W., Hu, M., Ma, L., Huang, F., & Jiang, Z. (2025). Copper and iron as unique trace elements linked to fibromyalgia risk. Scientific Reports, 15(1). https://doi.org/10.1038/s41598-025-86447-4

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Hysteroscopic diagnostic criteria precise in detecting chronic endometritis: Study

A new study published in the American Journal of Obstetrics and Gynecology found the hysteroscopic diagnostic criteria to be highly sensitive and reliable for identifying chronic endometritis.

Chronic endometritis (CE) is characterized by ongoing inflammation of the uterine mucosa. The microscopic detection of plasma cells in the endometrial stroma is a characteristic of this disease. Although few cases of abacterial CE have been reported, several bacteria, mostly gram-negative and intracellular (including Enterococcus faecalis, Escherichia coli, urea-plasma, Mycoplasma, Chlamydia, and Streptococcus spp.), have been linked to the development of CE.

The gold standard method for diagnosing and treating endocervical and intracavitary lesions is hysteroscopy. Thus, to evaluate the diagnostic accuracy of current hysteroscopic criteria in comparison to histological examination (with or without supplementary immunohistochemistry) for the diagnosis of chronic endometritis, Gaetano Riemma and colleagues carried out this study.

The diagnostic accuracy of hysteroscopy for chronic endometritis was assessed by comparing hysteroscopic criteria with histological (with or without immunohistochemistry) diagnosis. Studies were chosen based on whether they were prospective, retrospective, or randomized. The diagnostic odds ratio, sensitivity, specificity, and area under the summary receiver operating characteristic curve were the main results. Secondary outcomes included both positive and negative probability ratios.

In accordance with the Synthesizing Evidence from Diagnostic Accuracy Tests methodological standards and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations, a diagnostic accuracy meta-analysis was carried out. The Quality Evaluation Tool for Diagnostic Accuracy Studies−2 (QUADAS-2) was used to perform the quality evaluation. Using the Deeks funnel plot asymmetry test, publication bias was assessed.

A total of 13 investigations compared the histological examination of endometrial samples with the existing hysteroscopic criteria. The diagnostic odds ratio, after combining all the investigations, was 40. With a very good diagnostic accuracy, the assessed area under the summary receiver operating characteristic curve was 0.93. The corresponding sensitivity and specificity were 84% and 89%. Also, the probability ratios for good and negative outcomes were 7.4 and 0.19, respectively.

Overall, hysteroscopic diagnostic criteria are very sensitive and accurate for the detection of chronic endometritis. If there is no hysteroscopic suspicion, the illness may be ruled out. However, because hysteroscopy alone carries a risk of false positives, endometrial biopsy is advised to confirm the diagnosis in situations where hysteroscopic diagnostic signs of chronic endometritis are present.

Reference:

Riemma, G., Parry, J. P., De Franciscis, P., Carugno, J., Lettieri, D., Cobellis, L., Vitagliano, A., Etrusco, A., Lin, L.-T., Angioni, S., & Vitale, S. G. (2025). Hysteroscopic criteria for the diagnosis of chronic endometritis: A systematic review and diagnostic test accuracy meta-analysis. American Journal of Obstetrics and Gynecology. https://doi.org/10.1016/j.ajog.2025.03.005

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