Reflux recurrence risk after laparoscopic fundoplication similar in Both Erosive and Nonerosive GERD: JAMA

A new study published in the Journal of American Medical Association showed that reflux recurrence risk after laparoscopic fundoplication was similar in patients with nonerosive and erosive gastroesophageal reflux disease (GERD), challenging the notion that nonerosive GERD is less suitable for surgery. The findings suggest that absence of erosive disease on endoscopy should not preclude antireflux surgery.

With a more benign history of the disease and less sensitivity to antireflux drugs, nonerosive GERD is increasingly being seen as a distinct entity from erosive GERD. It is unknown if antireflux surgery works better for erosive GERD than nonerosive GERD. And so, to determine if individuals with nonerosive GERD experience greater reflux symptoms following antireflux surgery than those with erosive GERD, this study was carried out.

All patients in Finland and Sweden who had primary laparoscopic fundoplication for GERD between January 1, 1996, and December 31, 2019 were included in this population-based cohort analysis. Between March and April of 2024, statistical analysis was carried out. The primary exposure was comparing individuals with erosive GERD (i.e., erosive esophagitis found during preoperative endoscopy) with those with nonerosive GERD (i.e., no erosive esophagitis or Barrett esophagus found during preoperative endoscopy).

Reflux recurrence was the primary outcome, which was defined as secondary antireflux surgery or postoperative antireflux medication for at least 6 months. After controlling for age, sex, comorbidity, hospital volume of antireflux surgery, calendar year, and country, Poisson regression yielded hazard ratios (HRs) with 95% confidence intervals.

Of the 6,194 patients who had primary fundoplication, 2700 (43.6%) were diagnosed with nonerosive GERD and 3494 (56.4%) with erosive GERD (median age, 53 years [IQR, 42-62 years]; 3310 women [53.4%]).

In patients with nonerosive GERD (17.1% [461 of 2700]) and those with erosive GERD (17.1% [596 of 3494]), the frequency of reflux recurrence was comparable across a follow-up period of up to 23 years (range, 0-23 years; median, 8.8 person-years [IQR, 4.3-13.5 person-years]).

When examining recurrence by antireflux medication (HR, 1.04; 95% CI, 0.90-1.21) and secondary antireflux surgery (HR, 0.91; 95% CI, 0.75-1.10) separately, patients with nonerosive GERD had a similar overall risk of reflux recurrence as patients with erosive GERD (adjusted HR, 0.98; 95% CI, 0.87-1.11).

The HRs of the different follow-up groups following fundoplication and analyses stratified by the six factors in the multivariable model did not differ from one another. Overall, evidence suggesting nonerosive GERD is less responsive to antireflux drugs contradicts this conclusion. Therefore, the lack of erosive GERD seen during an upper endoscopy cannot be used as justification for skipping antireflux surgery.

Source:

Holmberg, D., Bielik, J., Santoni, G., Ness-Jensen, E., von Euler-Chelpin, M., Kauppila, J. H., & Lagergren, J. (2025). Reflux recurrence after laparoscopic fundoplication for nonerosive gastroesophageal reflux disease. JAMA Network Open, 8(6), e2517754. https://doi.org/10.1001/jamanetworkopen.2025.17754

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Instant Coffee and Genetics May Raise Risk of Dry Age-Related Macular Degeneration: Study

Approximately 200 million people globally live with age-related macular degeneration (AMD), with the majority affected by its dry form. While known risk factors include both genetics and lifestyle, a new study suggests that the combination of genetic predisposition and consumption of instant coffee may further increase the risk of developing dry age-related macular degeneration.

Coffee is a popular beverage, and previous cohort studies suggest it may reduce the risk of age-related macular degeneration (AMD). However, confounding factors in these studies necessitate further exploration of causal relationships using advanced methods. We obtained data on coffee consumption from genome-wide association studies (GWAS) and the latest age-related macular degeneration-related GWAS summary data from the Finngen consortium R11. We assessed their genetic correlation using linkage disequilibrium score regression (LDSC), explored causal associations using Mendelian randomization (MR), and identified shared genetic loci via colocalization. The results revealed a genetic correlation between instant coffee consumption and dry age-related macular degeneration, with each standard deviation (SD) increase in instant coffee intake associated with a corresponding odds ratio (OR) of approximately 6.92 for dry age-related macular degeneration, indicating a 6.92-fold increased risk. However, colocalization analysis did not show shared genetic variants between instant coffee consumption and age-related macular degeneration. Instant coffee may increase the risk of age-related macular degeneration, and reducing its intake could help prevent dry age-related macular degeneration. People at high-risk for age-related macular degeneration should avoid instant coffee. This study aids clinicians in identifying dietary factors, particularly instant coffee consumption, as potential risks for age-related macular degeneration. By providing genetically based causal evidence, our findings support the development of personalized age-related macular degeneration prevention strategies. Clinicians can advise patients to reduce instant coffee intake based on genetic risk profiles, offering a precision approach to reduce dry age-related macular degeneration risk. These interventions may significantly contribute to age-related macular degeneration prevention and treatment.

Reference:

Jia, Q., Z. Zha, S. Li, Y. Zhang, L. Ke, and S. Liu. 2025. “ Genetic Correlation and Mendelian Randomization Analyses Support Causal Relationships Between Instant Coffee and Age-Related Macular Degeneration.” Food Science & Nutrition 13, no. 6: e70439. https://doi.org/10.1002/fsn3..

Keywords:

Instant Coffee, Genetics, May, Raise, Risk, Dry, Age-Related, Macular, Degeneration, Study, Jia, Q., Z. Zha, S. Li, Y. Zhang, L. Ke, and S. Liu.

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Icariin Shows Kidney-Protective Effects Against Contrast-Induced Injury: Study

Researchers have discovered in a new research that oral administration of icariin at a dose of 100 mg/kg demonstrated significant renoprotective effects by mitigating contrast-induced renal injury. The protective mechanisms included anti-inflammatory, anti-apoptotic, and antioxidant actions.

Currently, the use of contrast agents in interventional procedures and imaging has been increasing. Icariin, an active component of Epimedium, offers beneficial biological activities such as antioxidation and anti-inflammation. Therefore, our study aimed to investigate the protective role of icariin and its underlying mechanisms against contrast-induced nephropathy (CIN). They divided twenty-four rats into four groups (n = 6 each): control group icariin-only treated group, contrast-induced nephropathy (CIN) group, and CIN+Icariin group, with six rats in each group. We performed renal function tests (serum creatinine and blood urea nitrogen (BUN) and histological evaluations. Additionally, we measured malondialdehyde (MDA) and superoxide dismutase (SOD) levels in renal supernatant and used ELISA to quantify caspase-8, caspase-9, cytochrome c, Bcl-2 associated protein x (Bax), and B cell lymphoma/leukemia 2 protein (Bcl-2) levels. We assessed nuclear factor kappa beta (NF-κB) and interleukin-1 beta (IL-1β) gene expression and evaluated immunoexpression of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), CD68, and caspase-3. Results: Icariin showed nephroprotective effects against CIN, demonstrated by reduced creatinine and BUN; decreased MDA, IL-6, NF-κB, TNF-α, IL-1β, CD68, caspase-8, caspase-9, Bax, and cytochrome c; and increased SOD and Bcl-2 levels. Renal histology improved in the CIN+Icariin group compared to CIN group. Oral administration of 100 mg/kg icariin exhibited renoprotective effects against contrast-induced renal injury through anti-inflammatory, anti-apoptotic, and antioxidant mechanisms.

Reference:

Hanan A. Elgendy, Amira Osman, Amira E. Farage, Medhat Taha, Sara Abubakr, Alaa.M. Badawy, Mohie Mahmoud Ibrahim, Ahmed Nabawy Ahmed Nasr, Hala Mahfouz, Tourki A.S. Baokbah, Ahmed shaban Abdelmonsef, Mohamed Ezzat Mahmoud, Ahmed Abdel-monem Elmetwally, Abdulrahman I. AbuAqil, Nora Elshehawy Helal, Icariin mitigates experimental contrast-induced nephropathy: Mechanistic insights, Tissue and Cell, Volume 96, 2025,

103020, ISSN 0040-8166, https://doi.org/10.1016/j.tice.2025.103020.

(https://www.sciencedirect.com/science/article/pii/S0040816625003003)

Keywords:

Icariin, Shows, Kidney-Protective, Effects, Against, Contrast-Induced, Injury, Study, Hanan A. Elgendy, Amira Osman, Amira E. Farage, Medhat Taha, Sara Abubakr, Alaa.M. Badawy, Mohie Mahmoud Ibrahim, Ahmed Nabawy Ahmed Nasr, Hala Mahfouz, Tourki A.S. Baokbah, Ahmed shaban Abdelmonsef, Mohamed Ezzat Mahmoud, Ahmed Abdel-monem Elmetwally, Abdulrahman I. AbuAqil, Nora Elshehawy Helal

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COPD Patients Face Earlier Mortality and Higher Comorbidity Burden: Study

Researchers have found in a real-world observational retrospective cohort study that patients with COPD died at a younger age and experienced more comorbidities compared to matched controls without COPD.

Patients with COPD suffer from various comorbidities, seemingly leading to a collective increase in morbidity and mortality. However, comorbidities with COPD have been largely unreported. Using healthcare claims data, only the deceased among around 250,000 COPD patients diagnosed in 2011– 2018 were evaluated by cause of death (cumulative incidence without competing risk) across a period of up to eight years. Results were compared with 1:1 propensity score-matched controls. Additionally, the prevalence of comorbidities in deceased patients was compared. Results: On average, deceased COPD patients and matched controls lived to be 75.7 and 78.0 years, respectively, and COPD patients had more comorbidities prior to death (mean 4.53 and 3.65). Both respiratory and cardiovascular-related deaths were more likely in COPD patients than in their matched controls (3.3 and 1.6 percentage points higher after eight years), and this was more extreme (9.8 and 3.4 percentage points higher, respectively) in the COPD subgroup with multiple/severe exacerbations; cumulative incidence of death increased with increasing COPD severity. Comorbidity prevalence, especially cardiovascular-related, was higher in COPD patients than in matched controls; COPD patients had a 42% higher risk of heart failure (RR 1.42; 1.38– 1.47), 30% higher risk of ischemic heart disease (RR 1.30; 1.25– 1.35), and 27% increased risk of atrial fibrillation (RR 1.27; 1.21– 1.32).

Conclusion: In this real-world observational retrospective cohort study, we found patients with COPD died at a younger age, and developed more comorbidities, than matched controls.

Reference:

Vogelmeier CF, Friedrich FW, Timpel P, Kossack N, Diesing J, Pignot M, Abram M, Gediga M, Halbach M. Comorbidities and Cause of Death in COPD Patients Compared to Non-COPD Controls: An 8-year Observational Retrospective Healthcare Claims Database Cohort Study. Int J Chron Obstruct Pulmon Dis. 2025;20:2117-2130

https://doi.org/10.2147/COPD.S488701

Keywords:

COPD, Patients, Face, Earlier, Mortality, Higher, Comorbidity, Burden, Study, exacerbations, mortality, cardiovascular disease, respiratory death, cardiovascular death, multimorbidity, Vogelmeier CF, Friedrich FW, Timpel P, Kossack N, Diesing J, Pignot M, Abram M, Gediga M, Halbach M. Comorbidities

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Roflumilast Foam as a Promising Topical Treatment for Scalp and Body Psoriasis: Phase 3 ARRECTOR Trial

Canada: In a major development for topical psoriasis therapy, researchers have found that roflumilast foam, 0.3%, applied once daily, significantly improves symptoms in patients with scalp and body psoriasis. The findings from the ARRECTOR Phase 3 randomized clinical trial, published in JAMA Dermatology, highlight both the efficacy and safety of the formulation in adolescents and adults.

The ARRECTOR trial, a double-blind, vehicle-controlled study, enrolled 432 participants aged 12 years and older. The participants presented with plaque psoriasis affecting up to 25% of the body, including a minimum of 10% scalp involvement. Conducted across 49 sites in the United States and Canada, the trial ran from August 2021 to June 2022.

Participants were randomly assigned to receive either roflumilast foam or a placebo (vehicle) once daily for eight weeks. The trial’s co-primary endpoints were based on the Scalp Investigator Global Assessment (S-IGA) and Body IGA (B-IGA), which measured the percentage of patients who achieved either a “clear” or “almost clear” status along with a minimum two-grade improvement from baseline.

Key findings were as follows:

  • By week 8, 66.4% of patients treated with roflumilast foam achieved Scalp Investigator Global Assessment (S-IGA) success, compared to 27.8% in the vehicle group.
  • Body Investigator Global Assessment (B-IGA) success was achieved by 45.5% of the roflumilast group versus 20.1% in the placebo group.
  • These results were statistically significant, indicating the strong efficacy of roflumilast foam.
  • Itch relief was measured using the Scalp Itch Numeric Rating Scale (SI-NRS) and Worst Itch NRS (WI-NRS).
  • There were significant improvements in itch as early as 24 hours after the first application of roflumilast foam.
  • The improvements in itch persisted through weeks 2, 4, and 8, with the roflumilast group consistently showing better outcomes than the control group.
  • Both groups experienced low rates of adverse events, and roflumilast was well tolerated.
  • There were no new safety concerns, highlighting the favorable safety profile of roflumilast foam.
  • The findings are significant, especially since existing topical treatments for scalp psoriasis often have limitations concerning tolerability, formulation, and long-term use.

The researchers note that roflumilast is a phosphodiesterase-4 (PDE-4) inhibitor, which targets inflammatory pathways central to psoriasis pathogenesis. Its foam formulation allows for easier application on hairy areas like the scalp, addressing one of the common barriers to patient adherence in topical treatment regimens.

“Overall, the findings support roflumilast foam, 0.3%, as a viable and convenient monotherapy for managing mild to moderate psoriasis involving both the scalp and body. With its promising efficacy, rapid symptom relief, and favorable safety profile, this treatment could represent a significant step forward in dermatologic care,” they concluded.

Reference:

Gooderham MJ, Alonso-Llamazares J, Bagel J, et al. Roflumilast Foam, 0.3%, for Psoriasis of the Scalp and Body: The ARRECTOR Phase 3 Randomized Clinical Trial. JAMA Dermatol. Published online May 07, 2025. doi:10.1001/jamadermatol.2025.1136

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High-Alcohol Medicinal Preparations to Come Under Schedule H1: Govt Panel Approves Rule Change

New Delhi: The Drugs Consultative Committee (DCC) has agreed to amend the Drugs Rules, 1945 to regulate the alcohol content in tinctures and other alcoholic preparations in view of concerns regarding their illegal sale through pharmacies.

During its 66th meeting held on June 17, 2025, the agenda was taken up for discussion as part of ongoing efforts to curb the misuse of high-alcohol-content medicinal products that are being diverted for non-medical purposes.

As per the official meeting minutes, “DCC was apprised that the proposal was deliberated in 92nd DTAB meeting wherein the DTAB agreed that the rules may be amended and exemption provided for alcoholic preparations containing the alcohol content 30ml or above in Schedule K may be removed and such preparations may be included in Schedule H1.”

This recommendation from the Drugs Technical Advisory Board (DTAB) was aimed at bringing tighter regulatory control over such preparations by removing the exemption under Schedule K and instead placing them under Schedule H1. To mention, Schedule H1 is a category under the Drugs and Cosmetics Rules, 1945 that includes prescription drugs which require strict monitoring, including mandatory maintenance of sale records and prescription retention by pharmacies. It is intended to prevent misuse of certain antibiotics, psychiatric drugs, and other high-risk medicines.

Also Read: Govt To Amen Schedule K of Drugs Rules 1945 To Exempt Antiseptics From Sale License

The committee was further informed that “a draft notification was prepared in the matter. However, it was decided to discuss the matter in the DCC afresh.”

Following a detailed review of the draft notification, the DCC endorsed the proposal. As per the minutes, “DCC discussed the draft notification prepared for the purpose and after detailed deliberation agreed with the proposal to appropriately amend the Drugs Rules, 1945.”

The proposed amendment is expected to enhance control over the availability and dispensing of high-alcohol medicinal preparations, addressing rising concerns over their potential misuse, especially in vulnerable populations.

The move also aligns with the broader objective of strengthening the drug regulatory framework to ensure that pharmaceutical products are used strictly for therapeutic purposes.

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Fire breaks out near AIIMS Trauma Centre after transformer blast

New Delhi: A fire broke out near the Trauma Centre of the All India Institute of Medical Sciences (AIIMS) in New Delhi on Thursday afternoon following a blast in an electric transformer, a Delhi Fire Services (DFS) official said.  

He added that no one was injured in the incident. 

“We received a call regarding a blast and a fire in an electric transformer at the AIIMS Trauma Centre at 3:34 pm. We rushed eight fire tenders to the spot. The fire was doused by 3:55 pm. No one was injured,” DFS chief Atul Garg said in a statement, according to news agency PTI.

Also Read:4 dead after smoke engulfs Kozhikode Medical College hospital, probe ordered

A fire officer told PTI that when their teams reached the spot, the staff of the AIIMS fire unit was already trying to bring the blaze under control.

“We immediately deployed the eight fire tenders and it took 30 to 40 minutes to douse the flames completely,” the officer said.

In a statement, the All India Institute of Medical Sciences (AIIMS) said, “We would like to inform that there was no fire at JPNATC, AIIMS Delhi. A fire incident occurred at an NDMC transformer located within the JPNATC complex, which was brought under control.”

“We are pleased to report that there were no injuries, no material loss and no disruption to the institute’s operations. All functions at the centre are operating normally,” the statement read.  

Medical Dialogues had earlier reported that a fire broke out in the burns ward of the government-run Victoria Hospital in Bengaluru, prompting the evacuation of 26 inpatients by the hospital staff. According to the preliminary investigation by the police, the fire broke out at around 3 a.m. in the burns ward due to a short circuit in the switchboard. A bed, register book, and other equipment were gutted in the incident. 

Also Read:Massive fire at Lucknow Hospital, 200 patients evacuated

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Physician associates provide safe care for diagnosed patients when directly supervised by a doctor

Physician associates provide safe and effective care when they work under the direct supervision of doctors and care for patients who have already been diagnosed, or when they undertake procedures for which they have been highly trained, finds a rapid review published in The BMJ.

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Large oncosomes in the blood may enable cancer diagnosis and monitoring

Cedars-Sinai investigators have discovered that large oncosomes—fluid-filled sacs released into the bloodstream by aggressive cancer cells—contain a consistent set of molecules across cancer types. Their findings, published in Cell Reports Medicine, highlight large oncosomes in the blood as a possible method of diagnosing and monitoring malignancies.

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Measles outbreak in Kentucky confirmed

There has been nationwide total of 1,267 confirmed cases of measles this year, with Kentucky being the latest state to announce an outbreak, the U.S. Centers for Disease Control and Prevention reported Wednesday.

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