Study highlights risks of cesarean births to future pregnancies

Women who have cesarean births at an advanced stage of labor are about eight times more likely to develop scars in the womb which are known to increase the likelihood of premature births in future pregnancies, UCL researchers have found.

Powered by WPeMatico

Calorie labeling linked to 2% average reduction in energy content of menu items

Calorie labeling, which became law in April 2022 in England, is associated with only a small (2%) average reduction in the energy content of food that is available away from home, finds research published in the open access journal BMJ Public Health.

Powered by WPeMatico

Whole genome sequencing could match more breast cancer patients to tailored therapies and trials

Whole genome sequencing offered to breast cancer patients is likely to identify unique genetic features that could either guide immediate treatment or help match patients to clinical trials, say scientists at the University of Cambridge. Their research is published in The Lancet Oncology.

Powered by WPeMatico

Night shift workers undergo increased risk of kidney stone events: Study

A new study published in the journal of Mayo Clinic Proceedings showed that kidney stones are 15% to 22% more common in shift workers, with night shift workers having the highest risk.

A developing employment trend in contemporary culture, shift work interferes with circadian rhythms and modifies a number of physiological and behavioral processes. According to new research, these disturbances may raise the risk of kidney stones by causing metabolic and renal dysfunctions. This connection may be mediated by lifestyle characteristics that frequently accompany shift employment, like erratic sleep patterns, dehydration, nutritional imbalances, and decreased physical activity.

Developing focused preventative interventions requires an understanding of how these variables affect kidney stone etiology in shift workers. Using data from the UK Biobank, this study thoroughly examined the relationships between shift work, its kind, frequency, and length, as well as the mediating role that lifestyle plays in the relationship between shift work and kidney stone incidence.

This study included 226,459 UK Biobank individuals who were recruited between December 19, 2006, and October 1, 2010, and who were followed up with until May 1, 2023. The employment status of participants, including shift work, shift type, shift frequency, and years of shift work, were inquired about during the baseline study. Lifestyle factors included body mass index, hydration consumption, sleep duration, sedentary time, dietary features, physical activity, and smoking status. The relationship between shift employment and kidney stone occurrences was examined using Cox proportional hazards regression models, and the mediating effects of lifestyle choices were investigated using mediation analyses.

In 2893 patients, a kidney stone formed after a median follow-up of 13.7 years. Shift workers were more likely to experience kidney stone occurrences in the fully adjusted models (hazard ratio, 1.15; 95% CI, 1.04 to 1.26).

Younger individuals (less than 50 years old) and employees who never or infrequently performed hard manual labor showed stronger connections. Potential mediators were found to include body mass index, hydration consumption, smoking, sleep length, and sedentary time.

Overall, the risk of kidney stone occurrences was positively correlated with shift employment in this study, and the correlations were partially mediated by lifestyle choices. These results highlight the importance of encouraging healthy lifestyles among shift workers and imply that working shifts should be regarded as a risk factor for kidney stones.

Source:

He, M., Dou, X., Su, Y., Zhang, Z., Lin, H., & Yang, Y. (2025). Lifestyle factors in the association of shift work with kidney stone events. Mayo Clinic Proceedings. Mayo Clinic, 100(10), 1731–1744. https://doi.org/10.1016/j.mayocp.2025.03.032

Powered by WPeMatico

Dupilumab Outperforms Omalizumab in First Head-to-Head Trial for Severe CRSwNP with Asthma: Study

The EVEREST trial directly compared biologics in severe chronic rhinosinusitis with nasal polyps (CRSwNP) and coexisting asthma, and found that dupilumab (Dupixent) was superior to omalizumab (Xolair). At week 24, dupilumab achieved better results across all primary and secondary efficacy endpoints. The findings were published in the recent issue Lancet Respiratory Medicine.

CRSwNP is a chronic inflammatory condition primarily driven by type 2 inflammation, often leading to nasal obstruction, loss of smell, and significant impairment of quality of life. Biologics like dupilumab, which targets interleukin (IL)-4 and IL-13 signaling, and omalizumab, which targets immunoglobulin E (IgE), have each been shown to reduce symptoms. Until now, however, no trial had directly compared their performance.

This phase 4 trial enrolled 360 participants across 17 countries between 2021 and 2024. The patients included were adults with severe, uncontrolled CRSwNP (nasal polyp score ≥5, with congestion and smell loss lasting at least 8 weeks) and physician-diagnosed asthma. They were randomly assigned to receive either dupilumab (300 mg every two weeks) or omalizumab (dose adjusted by weight and IgE levels) for 24 weeks, along with standard mometasone furoate nasal spray.

The main goals of this study were improvement in nasal polyp size, measured endoscopically, and improvement in smell, tested using the University of Pennsylvania Smell Identification Test (UPSIT). Out of 819 screened patients, 360 were enrolled, where 181 received dupilumab and 179 received omalizumab. The participants were predominantly middle-aged (mean age 52 years), with 55% male and 45% female representation.

At 24 weeks, dupilumab outperformed omalizumab across all primary and secondary measures. Patients on dupilumab saw a greater reduction in nasal polyp size, with an average decrease of –1.6 points when compared with omalizumab. Smell recovery was also significantly better, with UPSIT scores improving by an average of 8 points in the dupilumab group versus the omalizumab group. Both results were statistically highly significant (p<0.0001).

When safety was assessed, 64% of dupilumab recipients and 67% of omalizumab recipients reported events. The most frequent were nasopharyngitis, accidental overdose, headache, upper respiratory infections, and cough. No deaths were reported during the trial. Overall, the findings establish dupilumab as a more effective option for patients struggling with severe nasal polyps and asthma, which reinfored its role as a first-choice biologic in type 2 inflammatory respiratory disease.

Source:

De Corso, E., Canonica, G. W., Heffler, E., Springer, M., Grzegorzek, T., Viana, M., Horváth, Z., Mullol, J., Gevaert, P., Michel, J., Peters, A. T., Wagenmann, M., Zaghloul, S., Zhang, M., Corbett, M., Nash, S., Angello, J. T., Radwan, A., Deniz, Y., … Hellings, P. W. (2025). Dupilumab versus omalizumab in patients with chronic rhinosinusitis with nasal polyps and coexisting asthma (EVEREST): a multicentre, randomised, double-blind, head-to-head phase 4 trial. The Lancet. Respiratory Medicine. https://doi.org/10.1016/s2213-2600(25)00287-5

Powered by WPeMatico

Patients with Allergies Face Elevated Risk of Developing Optic Neuritis: Study Shows

South Korea: A new large-scale population-based study published in Scientific Reports has identified a noteworthy link between allergic diseases and an increased risk of developing optic neuritis (ON). The research highlights the need for heightened clinical vigilance and further exploration into the shared inflammatory mechanisms connecting allergic and autoimmune diseases.

Drawing data from the Korean National Health Insurance Service (NHIS) database, Jaeryung Kim from the Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea, and colleagues analyzed health records of over 4 million adults aged 20 years and older who underwent health screenings in 2009.
The participants were followed for nearly a decade—up to December 2018 or until they developed ON. Using Cox proportional hazards models, the researchers assessed the risk of ON while accounting for various confounding factors such as age, sex, and comorbidities.
The study revealed the following findings:
  • During a median follow-up of 8.2 years, 3,640 individuals (0.09%) were diagnosed with optic neuritis (ON).
  • Individuals with any allergic disease had a 32% higher risk of developing ON compared to those without allergies (adjusted hazard ratio [aHR] 1.31).
  • Among the allergic conditions studied, allergic rhinitis (AR) showed the strongest association with ON (aHR 1.33).
  • Asthma and atopic dermatitis were not significantly associated with ON risk after adjusting for confounding factors.
The study’s findings point toward possible shared immunopathogenic mechanisms between allergic inflammation and optic nerve inflammation. The researchers propose that chronic allergic inflammation, immune dysregulation, or cytokine-mediated pathways could potentially predispose individuals to autoimmune responses that affect the optic nerve.
Clinically, these findings emphasize the importance of early screening and monitoring for optic neuritis symptoms—such as vision loss, eye pain, or color vision changes—in patients suffering from allergic rhinitis. Prompt detection and intervention may help mitigate vision-related complications in such high-risk populations.
The authors further highlighted that while effective control of allergic symptoms and inflammation may potentially reduce ON risk, more evidence is needed to establish causality. They call for future longitudinal and mechanistic studies to explore inflammatory biomarkers, immune cell dynamics, and genetic predispositions that may underlie this association.
Additionally, the researchers suggest that upcoming investigations should include diverse populations across different regions and ethnicities, as well as examine how allergy treatments influence ON risk and outcomes. Extending research into potential links between allergic disorders and other neurological conditions could also deepen the understanding of overlapping disease mechanisms.
“The large cohort study highlights a significant connection between allergic diseases—especially allergic rhinitis—and an elevated risk of optic neuritis, reinforcing the importance of integrating ophthalmic vigilance into the management of allergic conditions. These insights open new avenues for preventive care and research at the intersection of allergy, immunity, and neuro-ophthalmology,” the authors concluded.
Reference:
Kim, J., Han, K., Jung, J., Oh, S. Y., Park, K., & Min, J. (2025). Analysis of optic neuritis risk in patients with allergic diseases. Scientific Reports, 15(1), 1-9. https://doi.org/10.1038/s41598-025-18088-6

Powered by WPeMatico

Prolonged Vaginal Progesterone Use Linked to Higher Gestational Diabetes Risk: Study Shows

Turkey: Researchers have found in a new study that the use of vaginal progesterone may increase the risk of gestational diabetes, especially with longer duration and early initiation in pregnancy, suggesting the need for repeat glucose tolerance testing beyond 24–28 weeks.

The research, published in the Revista da Associação Médica Brasileira, explored whether progesterone prescribed to prevent spontaneous preterm birth could influence the development of gestational diabetes mellitus (GDM). Led by Dr. Ayşe Rabia Kanbak of Bakırçay University’s Gynecology and Obstetrics Clinic in İzmir, Turkey, the team conducted a large cross-sectional analysis to clarify this potential association.
The investigators reviewed data from 3,066 pregnant women aged 18–39 years who underwent a standard 2-hour, 75-gram oral glucose tolerance test (OGTT) between 24 and 28 weeks of gestation. Of these participants, 418 were diagnosed with GDM based on at least one abnormal plasma glucose reading, while 2,648 women with normal glucose levels served as the control group. The two groups were evaluated for factors such as maternal age, parity, pre-pregnancy body mass index, smoking status, gestational age, and use of vaginal progesterone.
The key findings of the study were as follows:
  • Vaginal progesterone use was more frequent in the gestational diabetes group than in the control group (22% vs. 16%).
  • Women who developed gestational diabetes received progesterone for a longer period, averaging nearly 60 days compared with about 52 days in those without the condition.
  • The duration of treatment ranged from 28 to 90 days.
  • Earlier initiation of progesterone appeared to increase further the risk of developing gestational diabetes.
According to the authors, these findings highlight the need for additional vigilance in women prescribed prolonged vaginal progesterone therapy. They recommend that clinicians consider repeating the OGTT after the routine 24–28 week window for patients who begin progesterone early in pregnancy or require extended treatment.
The study’s retrospective design and limited follow-up introduce some caution. Because many patients were ultimately transferred to other hospitals, obtaining complete outcome data was challenging, and the authors note that larger, randomized controlled trials are necessary to confirm their observations and inform clinical protocols.
Despite these limitations, the results point toward a clinically significant relationship between vaginal progesterone and gestational diabetes. As progesterone supplementation remains an important tool for preventing spontaneous preterm birth, the researchers stress that careful glucose monitoring—especially with longer treatment courses—could help reduce potential complications for both mother and baby.
“The study indicates that vaginal progesterone use may raise the risk of gestational diabetes, with longer and earlier treatment further increasing this risk. Patients on prolonged therapy may benefit from an additional oral glucose tolerance test after the routine 24–28-week screening,” the authors concluded.
Reference: https://doi.org/10.1590/1806-9282.20250444

Powered by WPeMatico

HPV Infection Linked to Higher Risk of Depression and Bipolar Disorder, Study Finds

Taiwan: A large population-based cohort study has revealed that adults diagnosed with human papillomavirus (HPV) face a significantly higher risk of developing certain psychiatric disorders, particularly major depressive disorder (MDD) and bipolar disorder (BD).

The study, published in the Journal of Medical Virology by Hui-Chin Chang and colleagues from the Evidence-based Medicine Center, Chung Shan Medical University Hospital, Taichung, Taiwan, highlights a critical but often overlooked connection between viral infections and mental health outcomes.
The researchers used data from the TriNetX research network, a large global health database, to assess this relationship. Adults diagnosed with HPV were 1:1 propensity score–matched with non-HPV individuals based on factors such as age, sex, comorbidities, and socioeconomic status.
The study tracked new diagnoses of major depressive disorder, bipolar disorder, and schizophrenia using ICD-10-CM codes. Cox proportional hazard models were employed to estimate hazard ratios, while Kaplan–Meier analyses were conducted to determine cumulative incidence rates over time.
The analysis led to the following findings:
  • Adults aged 18 years and older with an HPV diagnosis had a 28% higher risk of developing major depressive disorder (HR 1.28) compared with those without HPV.
  • The risk of developing bipolar disorder was 31% higher in individuals with HPV (HR 1.31).
  • No significant association was observed between HPV infection and the onset of schizophrenia (HR 1.07).
  • Women, younger adults, and individuals with sleep disorders were more susceptible to developing psychiatric conditions following an HPV diagnosis.
  • These vulnerable subgroups showed stronger associations, indicating that biological, hormonal, or psychosocial factors may contribute to the increased psychiatric risk.
The authors emphasized that while HPV is primarily recognized for its role in causing cervical and other anogenital cancers, the potential neuropsychiatric implications of HPV infection are gaining increasing attention. The exact mechanisms underlying this association remain unclear but could involve immune dysregulation, inflammatory pathways, or stress responses triggered by chronic infection or the psychological burden of diagnosis.
Importantly, the study highlights the need for routine mental health screening and early intervention among individuals diagnosed with HPV, particularly women and those with preexisting vulnerabilities such as sleep disorders. The authors suggest that integrating psychological assessment into HPV care could improve overall health outcomes and quality of life for affected patients.
However, the researchers also noted certain limitations. Being a retrospective study, it could not establish causality, and potential confounding factors such as lifestyle, medication use, or undiagnosed psychiatric conditions could not be entirely ruled out. Despite these constraints, the study’s large sample size and robust analytical methods lend considerable strength to the findings.
The study provides compelling evidence that HPV infection may increase susceptibility to major depressive and bipolar disorders, reinforcing the importance of holistic care that addresses both physical and mental health aspects in individuals living with HPV.
“Further longitudinal and mechanistic studies are warranted to confirm these findings and explore the biological pathways linking HPV to mental health disorders,” the authors concluded.
Reference:
Chang, C., Chu, J., Chang, C., Hsu, T., Hung, H., Su, J., Chen, J., & Gau, Y. (2025). New-Onset Major Depressive Disorder, Schizophrenia and Bipolar Disorder in People With Human Papillomavirus Diagnosis: A Population-Based Cohort Study. Journal of Medical Virology, 97(10), e70618. https://doi.org/10.1002/jmv.70618

Powered by WPeMatico

Synthol Injections Identified as Rare Cause of Hypercalcemia: Case report

Poland: A new case report highlights that intramuscular injections of synthol—a site-enhancement oil popular among some bodybuilders—can trigger severe and long-lasting hypercalcemia. The report highlights that routine medical treatments may only provide temporary relief, and surgical removal of the injected material appears to be the only definitive therapy to normalize calcium levels.  

The study, published in BMC Nephrology, was led by Dr. Magdalena Markowska and colleagues from the Department of Internal Diseases, Nephrology and Dialysis at the Military Institute of Medicine—National Research Institute in Warsaw, Poland. They describe a 60-year-old man who developed persistent high calcium levels decades after receiving synthol injections. Despite extensive testing to rule out more common causes of hypercalcemia, such as parathyroid disorders, malignancy, or sarcoidosis, the investigative team traced the source of excess calcium to the old injection sites. Muscle biopsy revealed calcified tissue filled with a silicone-like substance, confirming the long-term impact of synthol on calcium metabolism.
According to the authors, the patient initially presented with weakness, significant weight loss, and acute kidney injury. Laboratory results showed markedly elevated serum calcium and impaired kidney function. Standard interventions—including intravenous fluids, diuretics, steroids, and bisphosphonates—brought only temporary reductions in calcium levels. Imaging studies revealed calcifications in multiple organs, and high-resolution chest scans showed unusual changes in the pectoral muscles. A detailed medical history uncovered that the patient had received intramuscular injections, likely containing synthol, more than thirty years earlier to enhance muscle appearance.
Synthol is composed of approximately 85 percent oil, 7.5 percent lidocaine, and 7.5 percent alcohol. While it is known to cause local complications such as pain, muscle deformities, chronic wounds, and fibrosis soon after injection, delayed systemic effects like hypercalcemia have rarely been documented. Only a handful of similar cases have been reported worldwide. The researchers note that the mechanism is thought to resemble the body’s reaction to free silicone or paraffin oil, in which chronic inflammation and granuloma formation lead to dysregulated vitamin D metabolism and excess calcium release into the bloodstream.
The team emphasized that the patient’s hypercalcemia persisted despite aggressive medical management and recurred after initial improvement. This clinical course supports the conclusion that surgical excision of the affected muscle tissue is the most effective treatment when hypercalcemia arises from synthol deposits.
Dr. Markowska and her colleagues caution that hypercalcemia, if left untreated, can damage multiple organ systems and become life-threatening. They advise clinicians to consider a history of cosmetic or bodybuilding injections when faced with unexplained high calcium levels, even if the injections occurred many years earlier. Prompt recognition of this unusual cause is essential to avoid delays in appropriate treatment and to prevent serious complications.
The authors call for greater awareness of the long-term risks of synthol use, noting that what might initially appear to be a cosmetic procedure can have serious and lasting consequences for metabolic and kidney health.
Reference:
Markowska, M., Romejko, K., Moszyńska, Z. et al. Intramuscular synthol injections cause hypercalcemia in long-term observation: a case report study. BMC Nephrol 26, 476 (2025). https://doi.org/10.1186/s12882-025-04397-5

Powered by WPeMatico

MS does not worsen menopause symptoms: study

The largest study of its kind has found menopause is not associated with an increased risk of disability in women with multiple sclerosis (MS).

Until now, the impact of reduced sex hormones on women with MS had only been the subject of small studies, some with conflicting results.

Published in JAMA Neurology, the Monash University-led project assessed whether menopause modified the risk of disability progression for women with relapse-onset MS. It did not.

MS is a chronic autoimmune and neurodegenerative condition, which impacts the immune and nervous systems. It affects three times more women than men and impacts 1 in 800 Australians.

Senior author Associate Professor Vilija Jokubaitis, who is Deputy Head of Monash University’s School of Translational Medicine Department of Neuroscience, said until now, the impact of menopause on MS disease trajectory remained unclear.

“MS disability typically gets worse in both men and women as people age, with a noticeable shift at about the age of 50, which is also around the age of menopause for most women,” Associate Professor Jokubaitis said.

“During perimenopause, the amount of estrogen and progesterone in women fluctuates a lot, before levels of these hormones fall significantly at menopause. In this study we asked whether the loss of sex hormones at menopause could be the reason for MS worsening in women at midlife.

“Previous studies have also looked at this question but have reported conflicting results. These studies have been quite small, reporting on between 74-148 post-menopausal women studied over long periods of time.

“Ours is therefore the largest study of its kind. Our research found that menopause is not associated with an increased risk of disability accumulation in women with MS. Therefore, the increases in disability we see around the age of 50 are not directly due to menopause, but are likely due to other aging processes that affect all people irrespective of sex or gender.”

The study used data from the MSBase Registry, the world’s largest MS clinical outcomes register that follows over 120,000 people with MS around the world and is headquartered in Monash University’s Department of Neuroscience.

It also observed 987 Australian women with MS recruited from eight Australian neuroimmunology-specialist centres, of which 404 (40 per cent) had undergone menopause. They were followed on average for just over 14 years.

“Whilst reproductive ageing may be additive to the effects of somatic ageing, our study does not support menopause as the leading factor for disability progression in older women with MS,” the study found.

First author Dr Francesca Bridge, a neurologist who treats MS patients at Alfred Health, said the results should reassure women with MS undergoing menopause, and their doctors, that it wouldn’t make their MS worse.

“The menopausal transition can be challenging for many women,” Dr Bridge said. “This study gives women with MS one less thing to be concerned about. This study will guide the health/clinical management of women with MS through the menopausal transition.

“The study findings are particularly important for doctors including neurologists, who will now be able to give reassuring advice to their patients that menopause won’t make their MS disability worsen faster.”

Dr Bridge said the menopausal transition was challenging regardless, with symptoms including hot flushes, memory issues, mood disturbance and urinary dysfunction, which could overlap with pre-existing MS-related symptoms.

She said the results would guide clinical conversations around the management of menopause and its symptoms, including lifestyle modifications, and the use of menopausal hormonal therapies (MHT) and non-hormonal therapies to improve quality of life.

“Women with MS will benefit from the holistic management of menopausal symptoms with lifestyle measures such as exercise and maintaining a healthy diet, as well as pharmacological measures such as menopausal hormone therapy (MHT) and non-hormone-based medications to improve their symptoms and quality of life,” she said.

Reference:

Bridge F, Sanfilippo PG, Zhu C, et al. Menopause Impact on Multiple Sclerosis Disability Progression. JAMA Neurol. Published online September 29, 2025. doi:10.1001/jamaneurol.2025.3538

Powered by WPeMatico