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A recent analysis of U.S. population-based cohorts has revealed that early-onset chronic obstructive pulmonary disease (COPD) — diagnosed in individuals aged 18 to 49 — affects at least 4.5% of this age group and is tied to significantly higher long-term health risks. These include increased hospitalization rates, elevated risk of chronic lower respiratory disease mortality, a greater likelihood of developing heart failure, and higher all-cause mortality before age 75 (Lange et al., 2024).
The study, published in NEJM Evidence, highlights a growing concern: COPD is not just a disease of older adults. While traditionally associated with long-term smoking in older populations, early-onset COPD may result from multiple exposures — including secondhand smoke, environmental pollutants, vaping, and early-life respiratory infections — and often goes underdiagnosed in younger adults. Researchers suggest that defining and recognizing “early COPD” as a distinct clinical category could help identify at-risk individuals sooner and offer a critical window for intervention. Despite their younger age, patients with early COPD experience significant declines in lung function and quality of life and are more likely to develop comorbid conditions like cardiovascular disease. vThe findings point toward a need for earlier screening strategies, especially in young adults with chronic respiratory symptoms or known risk factors. Proactive management — including smoking cessation, pulmonary rehab, and timely pharmacotherapy — could potentially alter the trajectory of the disease.
Keywords: early-onset COPD, chronic respiratory disease, COPD in young adults, lung health, premature mortality, all-cause mortality, heart failure risk, respiratory hospitalization, U.S. cohorts, COPD risk factors, Lange, P., Barr, R. G., Hansel, N. N
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Researchers have found in a new study that minimally invasive tissue-selecting therapy (TST) is effective in managing severe hemorrhoids, significantly enhances anorectal motility, and demonstrates a low rate of postoperative complications, indicating a high level of safety.
Severe hemorrhoids have a serious impact on patients’ quality of life. At present, the main method for treating severe hemorrhoids is surgery, but surgical treatment causes greater trauma to patients and has a high degree of complications. There is an urgent need to find new surgical methods to solve these problems. To assess the ability of tissue-selective therapy stapler (TST) minimally invasive surgery to treat severe hemorrhoids by studying the clinical efficacy, postoperative complications, and anal dynamics of selective supramedullary hemorrhoid stomy. In the hospital, between March 2015 and February 2018, 141 patients with severe hemorrhoids were included into three groups according to the block randomization method: the TST group, the pieces per hour the PPH group, and the eastern rubber band ligation and coincident of dislocation for prolapse and hemorrhoid (EPH)group. There were 47 patients in each group. The clinical efficacy of the three groups of patients, changes in hospital stay time, operation time, intraoperative blood loss, postoperative complications, and anal dynamic indicators (rectal resting pressure, anal resting pressure, anorectal pressure difference, rectal tolerance, rectal perception threshold and length of the anal high-pressure zone) were observed and compared. Results: The total effective rate in the TST group was 93.62%, which was higher than the 74.47% and 72.34% in the PPH and EPH groups, respectively, after treatment. Hospitalization time, operation time, and intraoperative blood loss were lower in the TST group than in the EPH and PPH groups. Three months after surgery, the rectal resting pressure, rectal tolerance, and rectal sensing thresholds of patients in the TST group were lower than those in the PPH and EPH groups, and the anal canal resting pressure, the anorectal pressure difference and the length of the anal high-pressure zone were greater than those in the PPH and EPH groups. After surgery, the complication rate in the TST group was 10.64%, which was lower than the 27.66% and 31.91% reported in the PPH and EPH groups, respectively. Minimally invasive TST is effective in treating severe hemorrhoids, can significantly improve anorectal motility, has a low incidence of postoperative complications and is highly safe.
Reference:
Huang, R., Fan, M., Lin, H. et al. Tissue selecting therapy stapler minimally invasive surgery to treat severe hemorrhoids. BMC Surg 25, 293 (2025). https://doi.org/10.1186/s12893-025-02918-5
Keywords:
1500X 600 Minimally, Invasive, tissue-selecting, therapy, Effective, Safe, Severe, Hemorrhoids, reveals, research, Huang, R., Fan, M., Lin, H, Selective suprahemorrhoidal, mucosa anastomosis, Severe hemorrhoids, Clinical efficacy, Complications, Anal dynamics
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A new study published in the Journal of American Medical Association showed that when compared to standard therapy, remote, scalable cognitive behavioral therapy skills training programs for chronic pain (CBT-CP) therapies (either through telehealth or self-completed online courses) produced moderate reductions in pain and associated functional/quality-of-life outcomes in people with high-impact chronic pain.
Although they are not generally available, cognitive behavioral therapy (CBT) skills training programs are advised as the initial nonpharmacologic treatment for chronic pain. Thus, this study was set to evaluate the efficacy of telehealth and self-completed online remote, scalable CBT-CP therapies with standard care for those with high-impact chronic pain.
From January 2021 to February 2023, 2331 eligible individuals with high-impact chronic musculoskeletal pain from four geographically disparate US health care systems participated in this comparative efficacy, 3-group, phase 3 randomized clinical research. The period of follow-up ended in April 2024.
The participants were randomly assigned 1:1:1 to one of two remote, 8-session CBT-based skills training treatments: normal care with a resource guide (n = 777) or a health coach-led program via videoconference or phone (health coach; n = 778) or an online self-completed program (painTRAINER; n = 776).
Achieving or surpassing the minimum clinically meaningful difference (MCID) in pain intensity score (≥30% drop; score range, 0-10) on the 11-item Brief Pain Inventory–Short Form between baseline and 3 months was the main goal. Pain severity, pain-related interference, PROMIS (Patient-Reported Outcomes Measurement Information System) social role and physical functioning, and the patient’s overall perception of change were secondary outcomes at 3, 6, and 12 months.
A total of 2,210 (94.8%) of the 2,331 eligible randomized participants finished the trial. The adjusted proportion of individuals who experienced a 30% or more reduction in their pain severity score at 3 months was 26.6 (95% CI, 23.4-30.2) in the painTRAINER group, 20.8 (95% CI, 18.0-24.0) in the usual care group, and 32.0 (95% CI, 29.3-35.0) in the health coach group.
The relative risk [RR] for both intervention groups was 1.54 [95% CI, 1.30-1.82] when compared to the control group. The RR for painTRAINER versus usual care was 1.28 [95% CI, 1.06-1.55]; and the RR for the health coach program was 1.20 [95% CI, 1.03-1.40] when compared to the online self-completed painTRAINER program.
At 6 and 12 months following randomization, both intervention groups showed statistically significant improvements in pain severity outcomes as well as various secondary pain and functional outcomes as compared to conventional treatment. Overall, the results indicate that centralizing the delivery of CBT-CP-based programs using online interventions and telephone/videoconferencing is successful.
Reference:
DeBar, L. L., Mayhew, M., Wellman, R. D., Balderson, B. H., Dickerson, J. F., Elder, C. R., Justice, M., Keefe, F. J., McMullen, C. K., Owen-Smith, A. A., Rini, C., Von Korff, M., Waring, S., Yarava, A., Shen, Z., Thompson, R. E., Clark, A. E., Casper, T. C., & Cook, A. J. (2025). Telehealth and online cognitive behavioral therapy-based treatments for high-impact chronic pain: A randomized clinical trial: A randomized clinical trial. JAMA: The Journal of the American Medical Association. https://doi.org/10.1001/jama.2025.11178
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Researchers have discovered in a new study that rizatriptan was ineffective at relieving vestibular migraine attacks within 1 hour and showed only limited symptom improvement at 24 hours. These results do not support the use of rizatriptan for treatment of vestibular migraines. The study was published in JAMA Network by Jeffrey P. and colleagues.
This double-blind, placebo-controlled randomized clinical trial was conducted in two tertiary neurotologic centers. 222 patients (mean age 42.3 years; 70.7% female) were originally enrolled. After prospective observation to establish diagnosis and illness activity over a period, 134 patients (60.4%) with active disease were randomized in a 2:1 ratio to receive either rizatriptan 10 mg or placebo. Each patient was asked to treat up to three discrete attacks of vestibular migraine.
The major results were whether rizatriptan was able to decrease vertigo and unsteadiness/dizziness from moderate or severe to absent or mild at 1 hour after taking medication. Secondary outcomes were total resolution of the symptoms, decrease in headache and related symptoms, rescue medication use, 24-hour symptom status, treatment satisfaction, and quality of life at 48 hours.
Key Findings
The last efficacy analysis comprised 240 attacks with vestibular symptoms rated moderate or severe at treatment.
At 1 hour, rizatriptan and placebo had no statistically significant differences in relief of symptoms:
Vertigo relief: 48.3% (73/151 attacks) with rizatriptan vs. 56.8% (50/88 attacks) with placebo (Odds Ratio [OR], 0.71; 95% CI, 0.42–1.21)
Relief of unsteadiness/dizziness: 19.2% (29/151) on rizatriptan vs. 12.4% (11/89) on placebo (OR, 1.69; 95% CI, 0.80–3.57)
Use of rescue medication at 1 hour: Same for both groups at 26.4%
Total relief of symptoms at 1 hour: Not different
At 24 hours, rizatriptan had modest advantages:
Unsteadiness/dizziness: OR 2.65 favoring rizatriptan
Motion sensitivity: OR 3.58 favoring rizatriptan
Medium effects on headache, photophobia, and phonophobia were found by post hoc analysis
But treatment satisfaction and overall quality of life measures were inconsistent, and there were no severe adverse effects or side effect discontinuations.
The usage of rizatriptan is not recommended for the management of vestibular migraine attack, particularly when immediate control of the symptoms is warranted. These results highlight the urgent necessity of the discovery of targeted vestibular migraine therapies since the disease still has no standardized treatment.
Reference:
Staab JP, Eggers SDZ, Jen JC, et al. Rizatriptan vs Placebo for Attacks of Vestibular Migraine: A Randomized Clinical Trial. JAMA Neurol. 2025;82(7):676–686. doi:10.1001/jamaneurol.2025.1006
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A new technology that uses clinical MRI machines to image metabolic activity in the brain could give researchers and clinicians unique insight into brain function and disease, researchers at the University of Illinois Urbana-Champaign report. The non-invasive, high-resolution metabolic imaging of the whole brain revealed differences in metabolic activity and neurotransmitter levels among brain regions; found metabolic alterations in brain tumors; and mapped and characterized multiple sclerosis lesions — with patients only spending minutes in an MRI scanner.
Led by Zhi-Pei Liang, a professor of electrical and computer engineering and a member of the Beckman Institute for Advanced Science and Technology at the U. of I., the team reported its findings in the journal Nature Biomedical Engineering.
“Understanding the brain, how it works and what goes wrong when it is injured or diseased is considered one of the most exciting and challenging scientific endeavors of our time,” Liang said. “MRI has played major roles in unlocking the mysteries of the brain over the past four decades. Our new technology adds another dimension to MRI’s capability for brain imaging: visualization of brain metabolism and detection of metabolic alterations associated with brain diseases.”
Conventional MRI provides high-resolution, detailed imaging of brain structures. Functional MRI maps brain activity by detecting changes in blood flow and blood oxygenation level, which are closely linked to neural activity. However, they cannot provide information on the metabolic activity in the brain, which is important for understanding function and disease, said postdoctoral researcher Yibo Zhao, the first author of the paper.
“Metabolic and physiological changes often occur before structural and functional abnormalities are visible on conventional MRI and fMRI images,” Zhao said. “Metabolic imaging, therefore, can lead to early diagnosis and intervention of brain diseases.”
Both MRI and fMRI techniques are based on magnetic resonance signals from water molecules. The new technology measures signals from brain metabolites and neurotransmitters as well as water molecules, a technique known as magnetic resonance spectroscopic imaging. These MRSI images can provide significant new insights into brain function and disease processes, and could improve sensitivity and specificity for the detection and diagnosis of brain diseases, Zhao said.
Other attempts at MRSI have been bogged down by the lengthy times required to capture the images and high levels of noise obscuring the signals from neurotransmitters. The new technique addresses both challenges.
“Our technology overcomes several long-standing technical barriers to fast high-resolution metabolic imaging by synergistically integrating ultrafast data acquisition with physics-based machine learning methods for data processing,” Liang said. With the new MRSI technology, the Illinois team cut the time required for a whole brain scan to 12 and a half minutes.
The researchers tested their MRSI technique on several populations. In healthy subjects, the researchers found and mapped varying metabolic and neurotransmitter activity across different brain regions, indicating that such activity is not universal. In patients with brain tumors, the researchers found metabolic alterations, such as elevated choline and lactate, in tumors of different grades — even when the tumors appeared identical on clinical MRI images. In subjects with multiple sclerosis, the technique detected molecular changes associated with neuroinflammatory response and reduced neuronal activity up to 70 days before changes become visible on clinical MRI images, the researchers report.
The researchers foresee potential for broad clinical use of their technique: By tracking metabolic changes over time, clinicians can assess the effectiveness of treatments for neurological conditions, Liang said. Metabolic information also can be used to tailor treatments to individual patients based on their unique metabolic profiles.
“High-resolution whole-brain metabolic imaging has significant clinical potential,” said Liang, who began his career in the lab of the late Illinois professor Paul Lauterbur, recipient of the Nobel Prize for developing MRI technology. “Paul envisioned this exciting possibility and the general approach, but it has been very difficult to achieve his dream of fast high-resolution metabolic imaging in the clinical setting.
“As healthcare is moving towards personalized, predictive and precision medicine, this high-speed, high-resolution technology can provide a timely and effective tool to address an urgent unmet need for noninvasive metabolic imaging in clinical applications.”
Reference:
Zhao, Y., Li, Y., Jin, W. et al. Ultrafast J-resolved magnetic resonance spectroscopic imaging for high-resolution metabolic brain imaging. Nat. Biomed. Eng (2025). https://doi.org/10.1038/s41551-025-01418-4
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People with dementia are diagnosed an average of 3.5 years after symptoms are first noticed, or even longer (4.1 years) for those with early-onset dementia, finds a new study led by UCL researchers.
The study, published in the International Journal of Geriatric Psychiatry, is the first systematic review and meta-analysis of global evidence examining time to diagnosis in dementia.
The researchers reviewed data from 13 previously published studies which took place in Europe, US, Australia and China, reporting data on 30,257 participants.
The research team was investigating the average interval between symptom onset (rated by patients or family carers using interviews or medical records) to the final diagnosis of dementia.
Lead author Dr Vasiliki Orgeta (UCL Division of Psychiatry) said: “Timely diagnosis of dementia remains a major global challenge, shaped by a complex set of factors, and specific healthcare strategies are urgently needed to improve it. Other studies estimate that only 50-65% of cases are ever diagnosed in high-income countries, with many countries having even lower diagnostic rates.
“Timely diagnosis can improve access to treatments and for some people prolong the time living with mild dementia before symptoms worsen.”
In a pooled meta-analysis of 10 of the included studies, the researchers found that it typically takes 3.5 years from the first alert of symptoms to a patient receiving a diagnosis of dementia, or 4.1 years for those with early-onset dementia, with some groups more likely to experience longer delays.
They found that younger age at onset and having frontotemporal dementia were both linked to longer time to diagnosis. While data on racial disparities was limited, one of the studies reviewed found that black patients tended to experience a longer delay before diagnosis.
Dr Orgeta said: “Our work highlights the need for a clear conceptual framework on time to diagnosis in dementia, developed in collaboration with people with dementia, their carers, and supporters.”
Dr Phuong Leung (UCL Division of Psychiatry) said: “Symptoms of dementia are often mistaken for normal ageing, while fear, stigma, and low public awareness can discourage people from seeking help.”
Professor Rafael Del-Pino-Casado, of the University of Jaén, Spain, said: “Within healthcare systems, inconsistent referral pathways, limited access to specialists, and under-resourced memory clinics can create further delays. For some, language differences or a lack of culturally appropriate assessment tools can make access to timely diagnosis even harder.”
Dr Orgeta added: “To speed up dementia diagnosis, we need action on multiple fronts. Public awareness campaigns can help improve understanding of early symptoms and reduce stigma, encouraging people to seek help sooner. Clinician training is critical to improve early recognition and referral, along with access to early intervention and individualised support so that people with dementia and their families can get the help they need.”
Reference:
Olubunmi Kusoro, Moïse Roche, Time to Diagnosis in Dementia: A Systematic Review With Meta-Analysis, International Journal of Geriatric Psychiatry, https://doi.org/10.1002/gps.70129
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