C-reactive Protein–Triglyceride Glucose Index Independently Predicts Stroke Risk in Cardiovascular-Kidney-Metabolic Syndrome: Study

Researchers have identified in a new study that the C-reactive protein–triglyceride glucose index (CTI) is linearly and positively correlated with stroke risk among subjects with cardiovascular-kidney-metabolic (CKM) syndrome. The study concluded that CTI not only better predicts stroke risk compared to the well-established triglyceride–glucose index (TyG), but also represents a useful risk marker among patients with CKM stage 2 and 3, where the risk of stroke events is notably high. The study was published in BMC Cardiovascular Disorders by Yinsong Xu and fellow researchers.

The data from 5767 subjects with stages 0–3 CKM syndrome participating in the China Health and Retirement Longitudinal Study (CHARLS) were examined in this study. The participants were tracked from 2011 to 2020 to examine the development of incident stroke, as diagnosed by self-reported questionnaires.

The CTI was derived from the formula:

CTI = 0.412 × ln[hs-CRP (mg/L)] + ln[(triglyceride (mg/dL) × fasting glucose (mg/dL)) / 2]

More advanced statistical techniques such as Cox proportional hazards models, restricted cubic spline (RCS) analysis, and subgroup analyses were utilized to compare associations of CTI with risk of stroke. Predictive accuracy was compared with TyG and metabolic score for insulin resistance (METS-IR) using time-dependent ROC analysis. Multiple testing correction was achieved through the false discovery rate approach to provide robustness.

Results

  • After controlling for possible confounders, higher levels of CTI were significantly linked to increased risk of stroke (Hazard Ratio [HR] 1.33, 95% CI 1.18–1.51).

  • RCS analysis revealed a linear relationship, without any suggestion of nonlinearity (P for nonlinearity = 0.182).

Subgroup analysis showed stage-specific effects:

  • CKM Stage 2: HR 1.27, 95% CI 1.04–1.56 (P = 0.019; adjusted P = 0.023)

  • CKM Stage 3: HR 1.25, 95% CI 1.04–1.50 (P = 0.022; adjusted P = 0.025)

  • CKM Stages 0–1: No significant association seen

  • Predictive performance analysis also revealed that CTI outperformed TyG at both year 5 and year 7 in stroke prediction consistently, with DeLong’s test adjusted P = 0.028 for both contrasts.

The present nationwide cohort study supplies strong evidence that the CTI is independently and linearly related to stroke risk in CKM syndrome patients, especially at stages 2 and 3. In addition, CTI always presents higher predictive accuracy than TyG and thus has the potential to serve as an excellent clinical tool for risk stratification and early intervention in high-risk individuals.

Reference:

Xu Y, Chen S, Zhu J, et al. C-reactive protein-triglyceride glucose index and stroke risk in early cardiovascular-kidney-metabolic syndrome: a National cohort study. BMC Cardiovasc Disord. 2025;25(1):634. Published 2025 Aug 26. doi:10.1186/s12872-025-05143-3

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Single-Dose Clesrovimab Safely Lowers RSV Infections and Hospitalizations in Infants: NEJM

Researchers have found in a new clinical trial that a single dose of clesrovimab, a long-acting investigational monoclonal antibody targeting site IV of the respiratory syncytial virus (RSV) fusion protein, significantly reduced the risk of RSV-associated illness in healthy infants. The study, published in The New England Journal of Medicine, evaluated the safety and efficacy of clesrovimab in both preterm and full-term infants during their first RSV season, a period marked by heightened vulnerability to severe lower respiratory tract infections. Infants were randomly assigned to receive either one intramuscular injection of clesrovimab or placebo, and outcomes were monitored for 150 days following administration. Findings showed that clesrovimab markedly lowered the incidence of medically attended lower respiratory tract infections due to RSV compared with placebo, and also substantially reduced RSV-related hospitalizations, underscoring its potential as a preventive strategy for this common and sometimes life-threatening infection. Importantly, the safety profile of clesrovimab was comparable to placebo, with no signal of increased adverse events, further supporting its potential suitability for widespread use. RSV is a leading cause of infant hospitalization worldwide, and while supportive care remains the mainstay of treatment, there is a recognized need for effective preventive measures beyond maternal vaccination and existing monoclonal antibodies. The results of this large, randomized, placebo-controlled trial suggest that clesrovimab could fill an important gap in infant RSV prevention strategies by providing durable protection with a single dose, potentially easing the burden on healthcare systems and reducing parental anxiety during RSV season. The authors noted that longer follow-up and real-world studies will be essential to confirm durability of protection, cost-effectiveness, and feasibility of integration into national immunization programs, but the current evidence positions clesrovimab as a promising candidate for future inclusion in RSV prevention protocols for infants.

Keywords: Clesrovimab, RSV, monoclonal antibody, infants, prevention, respiratory infection, hospitalization, immunization

Reference: Zar HJ, Simões EAF, Madhi SA, Ramilo O, Senders SD, Shepard JS, Laoprasopwattana K, et al; CLEVER (MK-1654-004) Study Group. Clesrovimab for Prevention of RSV Disease in Healthy Infants. N Engl J Med. 2025; DOI: 10.1056/NEJMoa2502984.

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Crisaborole Boosts Effectiveness of Amorolfine in Keratinized Tinea Foot: Study

Researchers have found in a new study that adding two percent crisaborole ointment to amorolfine hydrochloride cream significantly enhances therapeutic outcomes in the management of keratinized tinea foot. Tinea foot, a common superficial fungal infection caused by dermatophytes, often presents in a chronic keratinized form where thickened skin and scaling limit the penetration and efficacy of topical antifungal treatments. Amorolfine hydrochloride, a well-established antifungal agent, is effective against dermatophytes but faces challenges in achieving optimal results in heavily keratinized lesions due to poor drug penetration. The study explored whether the phosphodiesterase-4 (PDE4) inhibitor crisaborole, known for its anti-inflammatory and skin barrier–modulating properties, could improve outcomes when combined with amorolfine. The combination therapy demonstrated superior antifungal activity, greater improvement in lesion clearance, and better patient-reported symptom relief compared with amorolfine monotherapy. The enhanced effectiveness is thought to stem from crisaborole’s ability to reduce inflammation, soften hyperkeratotic tissue, and improve drug absorption, thereby allowing amorolfine to penetrate more effectively into the infected areas. Importantly, the combination was well tolerated, with no significant increase in adverse effects, supporting its safety for clinical use. These findings suggest that dual therapy with crisaborole and amorolfine may provide a more effective option for patients with keratinized tinea foot, a condition that is often resistant to standard topical treatments and requires prolonged therapy. The results also open avenues for exploring similar combination approaches in other keratinized fungal infections where topical antifungal penetration is limited. Clinicians may consider the combined regimen as part of personalized treatment strategies, particularly for patients with chronic or recurrent infections. However, the researchers emphasized the need for larger randomized controlled trials to validate these results, assess long-term efficacy, and determine whether the combination can reduce recurrence rates.

Keywords: Crisaborole, amorolfine, keratinized tinea foot, dermatophyte infection, topical antifungal therapy, combination treatment, PDE4 inhibitor, skin barrier, hyperkeratosis, clinical effectiveness

Reference:
Li, X., Zhang, Y., Chen, L., et al. Combination of crisaborole ointment with amorolfine cream improves therapeutic efficacy in keratinized tinea pedis. Mycoses. 2025. https://doi.org/10.1111/myc.78945

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Albuminuria, Not Kidney Function, Predicts Future Cancer Risk, reveals study

Researchers have determined in a new study that albuminuria, and not diminished kidney function, is independently associated with a greater risk of cancer development. The research, involving more than 1.3 million participants in 54 global cohorts, showed albuminuria levels to be associated consistently with site-specific and overall cancer risk, while eGFR had no apparent correlation with the majority of cancers. The study was published in the British Journal of Cancer by Yejin M. and colleagues.

Chronic kidney disease (CKD) is prevalent all over the world and generally evaluated with two significant markers: eGFR, which is a measure of kidney function, and albuminuria, which is a measure of kidney damage. Because both CKD and cancer have common risk factors of age, hypertension, diabetes, and inflammation, it is necessary to determine if markers of CKD independently are predictive of cancer.

This participant-level data meta-analysis involved 54 cohorts with full data on albuminuria (defined as urine albumin-to-creatinine ratio [ACR]) and eGFR and on cancer incidence. A total of 1,319,308 participants were included, all aged 18 years or more, with no history of cancer or end-stage kidney disease at baseline. Both overall and site-specific cancer outcomes were examined after adjustment for established cancer risk factors.

Statistical analyses included adjusted hazard ratios (HRs) for cancer incidence related to ACR and eGFR changes, in addition to 1-year landmark analysis to control for early detection bias.

Results

  • Incidence of overall cancer during follow-up was 17.3 per 1000 person-years.

  • Albuminuria: Increased ACR was significantly associated with increased cancer risk. Namely, with each 8-fold rise in ACR, the HR for cancer adjusted was 1.08 (95% CI 1.06–1.10). This correlation remained across various cancers.

  • eGFR: There was no significant correlation between decreased eGFR and cancer risk overall. Reduced eGFR was associated, however, with urological cancers and multiple myeloma increased risk.

  • Site-specific associations: Increased ACR correlated with increased risk for various cancers, such as kidney, head and neck, colorectal, liver, pancreas, bile duct, stomach, larynx, lung, hemolymphatic cancers, leukemia, and multiple myeloma.

  • Robustness check: Results were replicated in 1-year landmark analysis, reducing the risk of reverse causality.

Patients with increased urine albumin had a higher risk of developing a broad variety of cancers, highlighting albuminuria as an essential biomarker for cancer prediction. These results necessitate further studies into pathways between albuminuria and cancer and indicate that monitoring albuminuria routinely can have implications greater than kidney disease control.

Reference:

Mok, Y., Surapaneni, A., Sang, Y. et al. Chronic kidney disease and incident cancer risk: an individual participant data meta-analysis. Br J Cancer (2025). https://doi.org/10.1038/s41416-025-03140-z

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Midlife Hypertension Increased Vascular Dementia Risk: Study

A new study published in the journal of Alzheimer’s & Dementia found that high blood pressure during midlife is strongly associated with an increased risk of dementia later in life, particularly vascular dementia, while hypertension during pregnancy appears to have little impact on long-term cognitive health.

This study examined health data from 1,363,457 women with a mean age of 57 and tracked them over an average of 21 years to investigate the relationship between hypertension and subsequent dementia. The participants were asked about current treatment for high blood pressure and any history of pregnancy-related hypertension. Dementia cases were identified via hospital records, and sophisticated statistical models adjusted for socioeconomic status, lifestyle factors, and metabolic health to isolate the effects of hypertension.

Over the course of the study, a total of 84,729 women developed dementia. The results showed that women with midlife hypertension had a 17% higher risk of developing dementia of any type compared to the individuals without high blood pressure (hazard ratio [HR] 1.17, 95% confidence interval [CI] 1.15 to 1.19). The link was even stronger for vascular dementia, with affected women showing a 50% increased risk (HR 1.50, 95% CI 1.45 to 1.56), whereas the risk for Alzheimer’s disease appeared minimal (HR 1.01, 95% CI 0.98 to 1.04).

These findings highlight midlife hypertension as a modifiable risk factor for dementia, particularly vascular dementia, reinforcing the importance of early detection and management of high blood pressure.

Also, hypertension during pregnancy did not demonstrate a significant effect on dementia risk later in life. Women who experienced high blood pressure while pregnant had only a very slight increase in risk (HR 1.04, 95% CI 1.01 to 1.06), suggesting that the long-term cognitive impact of pregnancy-related hypertension is minimal.

While Alzheimer’s disease was largely unaffected by midlife blood pressure, vascular dementia was strongly linked to earlier hypertension. This distinction highlights the complex relationship between cardiovascular health and cognitive decline.

These results could have major public health implications, emphasizing that midlife hypertension is not only a concern for heart disease and stroke but also for long-term brain health. Controlling blood pressure through lifestyle changes and medical management in midlife could help reduce the incidence of vascular dementia in aging populations.

Overall, these findings reinforces that keeping blood pressure in check during midlife is an useful strategy for protecting the brain, while pregnancy-related hypertension appears to play a negligible role in later-life dementia risk.

Source:

Floud, S., Hermon, C., Whiteley, W., Fitzpatrick, K. E., & Reeves, G. K. (2025). Hypertension in pregnancy and in midlife and the risk of dementia: prospective study of 1.3 million UK women. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 21(9), e70595. https://doi.org/10.1002/alz.70595

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Hormone Therapy for VMS: Safe in Women 50–59, Risky in Those 70+, Finds JAMA Study

USA: A secondary analysis of two randomized clinical trials found that conjugated equine estrogens (CEE) alone and CEE plus medroxyprogesterone acetate (MPA) reduced vasomotor symptoms (VMS) without raising ASCVD risk in postmenopausal women aged 50–59. However, in women aged 70 and older with VMS, ASCVD risks increased. Findings support HT use in women 50–59, caution for ages 60–69, and avoidance in those 70+.

Published in JAMA Internal Medicine, the investigation revisited data from the landmark Women’s Health Initiative (WHI) hormone therapy trials. Jacques E. Rossouw, MD, of the National Heart, Lung, and Blood Institute, and colleagues examined outcomes in 27,347 postmenopausal participants, aiming to clarify which women with moderate to severe VMS might safely benefit from hormone therapy (HT).
The analysis included women aged 50 to 79 years from 40 U.S. clinical centers who were followed for up to eight years. Participants received either daily conjugated equine estrogens (CEE) 0.625 mg alone, CEE combined with medroxyprogesterone acetate (MPA) 2.5 mg, or placebo. The primary focus was the incidence of atherosclerotic cardiovascular disease (ASCVD), encompassing nonfatal heart attack, angina requiring hospitalization, coronary revascularization, ischemic stroke, peripheral arterial disease, carotid artery disease, or cardiovascular death.
The following were the key findings of the study:
  • Hormone therapy significantly relieved moderate or severe vasomotor symptoms (VMS) in women enrolled at baseline.
  • CEE alone reduced VMS by about 41% across all age groups.
  • The combination of CEE plus MPA showed the greatest benefit in younger women, with effectiveness declining with age.
  • Relative risk reductions for VMS were 59% in women aged 50–59, 28% in women aged 60–69, and showed virtually no benefit in those aged 70–79.
  • Cardiovascular outcomes demonstrated a clear age-related pattern.
  • Women aged 50–59 with bothersome VMS had no significant change in atherosclerotic cardiovascular disease (ASCVD) risk with CEE alone (HR 0.85) or CEE plus MPA (HR 0.84).
  • Women aged 60–69 showed a slight, non-significant increase in ASCVD risk with CEE alone (HR 1.31), while combination therapy remained neutral.
  • Women aged 70 and older experienced marked risk increases: CEE alone nearly doubled ASCVD events (HR 1.95) and CEE plus MPA more than tripled them (HR 3.22), adding hundreds of cases per 10,000 person-years.
These findings reinforce current guidance that favors menopausal hormone therapy for healthy, recently postmenopausal women suffering moderate to severe hot flashes or night sweats, while advising caution after age 60 and recommending against initiation after age 70. The authors note that only oral CEE and MPA were tested, and some subgroups were small, but emphasize that new large trials in this population are unlikely.
“Overall, the WHI secondary analysis provides reassurance that hormone therapy can be a safe and effective option for symptom relief in younger postmenopausal women when carefully selected, while highlighting significant cardiovascular dangers in older women with ongoing vasomotor complaints,” the authors concluded.
Reference:
Rossouw JE, Aragaki AK, Manson JE, et al. Menopausal Hormone Therapy and Cardiovascular Diseases in Women With Vasomotor Symptoms: A Secondary Analysis of the Women’s Health Initiative Randomized Clinical Trials. JAMA Intern Med. Published online September 15, 2025. doi:10.1001/jamainternmed.2025.4510

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On-duty doctor removed after rat bites passenger at Indore Airport

Indore: Following an incident where a passenger was bitten by a rat while waiting for his flight to Bengaluru at Indore airport, authorities have removed an on-duty doctor for his alleged insensitive behaviour, officials said.  

A man travelling from Indore to Bengaluru was bitten by a rat on Tuesday in the departure area of the airport. The passenger alleged the rodent suddenly got into his trousers and bit his leg, they said.  

According to the PTI report, the passenger protested loudly following the incident and demanded that he be administered a rabies injection, on the advice of his personal doctor, but the vaccine was apparently unavailable in the airport’s health facility.

Also Read:Rat bites at Jabalpur Hospital: Rs 50,000 fine slapped on cleaning firm

After his protest, the airport doctor administered him a tetanus injection, dressed the wound and gave him antibiotic tablets.  

Airport director Vipinkant Seth told PTI that the doctor was attached to a private hospital which provides medical facilities at the airport.  

“We learnt that the doctor behaved insensitively with the injured passenger, although his attitude was not rude. We have asked the hospital to replace him with another doctor at the airport,” Seth said, reports PTI.  

An initial fine of Rs 500 has been imposed on the pest control agency under the tender conditions, and the housekeeping contractor has been issued a show-cause notice, he added.  

Medical Dialogues had earlier reported that taking cognisance of the deaths of two newborns allegedly bitten by rats at Indore’s government-run Maharaja Yeshwantrao (MY) Hospital, the National Human Rights Commission (NHRC) has issued notices to the Principal Secretary, Public Health and Medical Education Department, Madhya Pradesh government, and Indore District Collector, seeking an action taken report within 10 days.  

Also Read:HoD Paediatric Surgery removed, doctor suspended amid MY Hospital rat bite controversy

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Cancer deaths expected to rise to over 18 million in 2050, nearly 75% more than in 2024

There has been a rapid increase in the global number of cancer cases and deaths between 1990 and 2023, despite advances in cancer treatment and efforts to tackle cancer risk factors over that same time period.

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Cancer deaths expected to rise to over 18 million in 2050, nearly 75% more than in 2024

There has been a rapid increase in the global number of cancer cases and deaths between 1990 and 2023, despite advances in cancer treatment and efforts to tackle cancer risk factors over that same time period.

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Women who miss their first mammogram face higher risk of breast cancer death, study finds

Women who miss their first mammogram run a higher risk of being diagnosed with advanced breast cancer and dying from the disease. This is shown in a new study from Karolinska Institutet published in BMJ.

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