Bubbly idea: Ultrafine bubble showers suppress atopic dermatitis

Bubble baths might be soothing soaks, but bubble showers could be the next thing in keeping the skin clean.

An Osaka Metropolitan University-led medical research team found that ultrafine bubble showers might help prevent atopic dermatitis.

Graduate School of Medicine student Ayaki Matsumoto and Associate Professor Hisayoshi Imanishi led the study into using ultrafine bubbles, often used to clean medical equipment, on mice with atopic dermatitis.

The scientists found that in mice with atopic dermatitis due to external factors, inflammation was markedly suppressed when the affected skin was showered with ultrafine bubbles, while normal showers also showed some positive results. Additionally, the ultrafine bubble showers improved the levels of proteins in the skin that act as a protective barrier. For mice with atopic dermatitis caused by genetic factors, however, there were no significant differences even compared to mice who were not showered.

“The results of this study suggest that ultrafine bubble shower treatment might be a new treatment for allergen-induced atopic dermatitis for humans, but this study was conducted on mice and the shower treatment period was short, only a week or two,” stated graduate student Matsumoto.

“From now on,” Professor Imanishi added, “it will be necessary to conduct ultrafine bubble shower therapy for several months on human patients to examine the effects.”

Reference:

Ayaki Matsumoto, Beneficial effects of ultrafine bubble shower on a mouse model of atopic dermatitis, Frontiers in Immunology, https://doi.org/10.3389/fimmu.2024.1483000.

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Subarachnoid spinal anesthesia Safe and Effective Anesthesia Option for High-Risk Obstetric Cases: Study

Recent study discusses the challenges of managing parturients with cardiovascular disease (CVD) during anesthesia, highlighting the increased perioperative morbidity and mortality due to the heightened demands of pregnancy. The preference for regional anesthesia in obstetrics is established, with general anesthesia (GA) and conventional spinal posing risks of hemodynamic instability in CVD patients. The introduction of segmental spinal anesthesia (SSA) has shown promise in providing better hemodynamic stability by confining anesthesia to specific dermatomes, enhancing safety for high-risk patients.

Case Studies of Parturients with Pre-Existing Cardiovascular Disease

The research presented five cases of parturients with significant pre-existing CVD (severe mitral stenosis, aortic stenosis, hypertrophic obstructive cardiomyopathy, and peripartum cardiomyopathy) who successfully underwent cesarean section under SSA at a particular institute from September 2023 to January 2024. The implementation of thorough preoperative evaluation and optimization was emphasized, with a multidisciplinary approach for planning combined epidural and SSA, invasive monitoring, and postoperative intensive care unit (ICU) management. Informed consent and meticulous monitoring were highlighted throughout the procedures.

Anesthetic Technique Employed for Parturients with CVD

The anesthetic technique employed included segmental spinal administration at specific vertebra levels using a combination of bupivacaine and fentanyl to achieve effective blockade and hemodynamic stability. Close monitoring and prompt management of hypotensive episodes with phenylephrine boluses were reported. Postoperative care included ongoing vigilance, epidural analgesia, cardiac function reassessment, and uneventful recovery for all cases.

Discussion on Anesthesia Options for CVD Patients

Different options for anesthesia were discussed, including graded epidural, combined spinal-epidural, and continuous spinal anesthesia, with a preference for SSA due to its muscle relaxation, reduced anesthetic requirement, and stable hemodynamics. The study emphasized the potential risks of GA in CVD patients, suggesting carefully managed GA might be necessary in specific scenarios to ensure patient safety. The findings advocate for SSA as an effective, safe, and viable alternative anesthesia technique for high-risk obstetric cases involving parturients with underlying CVD. The research exhibited successful outcomes, underlining the importance of individualized approaches and meticulous perioperative management to enhance safety and optimize recovery in such complex clinical scenarios.

Key Points

– Regional anesthesia, especially segmental spinal anesthesia (SSA), is preferred over general anesthesia (GA) in managing parturients with cardiovascular disease (CVD) due to the risks of hemodynamic instability associated with GA and conventional spinal anesthesia.

– Five cases of parturients with significant pre-existing CVD successfully underwent cesarean section under SSA, emphasizing the importance of thorough preoperative evaluation, multidisciplinary planning, invasive monitoring, and postoperative intensive care unit (ICU) management to ensure patient safety.

– The anesthetic technique employed involved segmental spinal administration at specific vertebra levels using a combination of medications to achieve effective blockade and stable hemodynamics, with close monitoring and prompt management of hypotensive episodes.

– Different anesthesia options, including graded epidural, combined spinal-epidural, and continuous spinal anesthesia, were discussed, with a preference for SSA due to its muscle relaxation, reduced anesthetic requirement, and stable hemodynamics, highlighting the potential risks of GA in CVD patients.

– The study advocates for SSA as an effective, safe, and viable alternative anesthesia technique for high-risk obstetric cases involving parturients with underlying CVD, stressing the importance of individualized approaches and meticulous perioperative management to enhance safety and optimize recovery in complex clinical scenarios.

– Successful outcomes were achieved with the use of SSA, underscoring the significance of personalized care and detailed perioperative management in improving safety and recovery for parturients with CVD undergoing anesthesia for cesarean sections.

Reference –

Ajit Kumar et al. (2025). Enhancing Recovery In Cervical Spine Surgery With Erector Spinae Plane (ESP) Block- A Case Series. *Indian Journal Of Anaesthesia*. https://doi.org/10.4103/ija.ija_690_24.

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Osteoporosis cases on the rise but risk differs across demographics, reveals study

While increased average life expectancy is a testament to modern medicine and public health efforts, an aging population comes with an increased presence of chronic diseases such as osteoporosis. Research published in Osteoporosis International by Hong Xue  and graduate students Christopher Naso, Ge Song, and Kenny Lin supplies evidence that some groups are at greater risk for osteoporosis and less likely to receive an official diagnosis:

• From 2005 to 2018, there has been a significant increase in the overall number of individuals who have osteoporosis in the U.S.

• Osteoporosis has increased across all age groups, except those 80 years and older.

• Non-Hispanic White women were shown to have the highest prevalence of diagnosed osteoporosis.

• Nearly 70% of individuals with osteoporosis have gone undiagnosed, primarily men, Mexican Americans, and individuals aged 50-59.

This study is the first to assess undiagnosed osteoporosis trends over time across by gender, ethnicity/race, age group, and both gender and ethnicity/race. Findings indicate there is greater need for proactive care for bone health.

Reference:

Naso, C.M., Lin, SY., Song, G. et al. Time trend analysis of osteoporosis prevalence among adults 50 years of age and older in the USA, 2005–2018. Osteoporos Int 36, 547–554 (2025). https://doi.org/10.1007/s00198-025-07395-3

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Weight training protects older people’s brains against dementia, study suggests

The benefits of weight training are many: it promotes gains in strength and muscle mass, reduces body fat, and contributes to well-being and mental health. And now a study carried out at the State University of Campinas (UNICAMP), in the state of São Paulo, Brazil, has demonstrated another important effect: it protects the brains of older people against dementia. The results were published in the journal GeroScience.

The study involved 44 people with mild cognitive impairment – an intermediate clinical condition between normal aging and Alzheimer’s disease in which cognitive decline is greater than expected for age, indicating a higher risk of dementia. The results showed that strength training not only improved memory performance but also altered brain anatomy.

After six months of twice-weekly weight training, the participants showed protection against atrophy in the hippocampus and precuneus – brain areas associated with Alzheimer’s disease-as well as improvements in parameters that reflect the health of neurons (white matter integrity).

“We already knew that there would be physical improvement. Cognitive improvement was also imagined, but we wanted to see the effect of weight training on the brains of older people with mild cognitive impairment. The study showed that, fortunately, weight training is a strong ally against dementia, even for people who are already at high risk of developing it,” says Isadora Ribeiro, a FAPESP doctoral fellowship recipient at UNICAMP’s School of Medical Sciences (FCM) and first author of the article.

The work was carried out within the framework of the Brazilian Institute for Neuroscience and Neurotechnology (BRAINN) – a FAPESP Research, Innovation and Dissemination Center (RIDC)-and is the first to demonstrate what happens to the integrity of the white matter of individuals with mild cognitive impairment after weight training.

“As well as neuropsychological tests, we also performed MRI scans at the beginning and end of the study. These results are very important because they indicate the need to include more physical educators in the public health system at the primary health care level since increased muscle strength is associated with a reduced risk of dementia. It’s a less complex and cheaper treatment that can protect people from serious diseases,” comments Marcio Balthazar, BRAINN researcher and study supervisor.

“For example, the new anti-amyloid drugs approved in the United States indicated for the treatment of dementia and for people with mild cognitive impairment, cost around USD 30,000 a year. That’s a very high cost. These non-pharmacological measures, as we’ve shown is the case with weight training, are effective, not only in preventing dementia but also in improving mild cognitive impairment,” the researcher adds.

Protocol

The research participants were divided into two groups: half underwent a resistance exercise program with weight training sessions twice a week, at moderate to high intensity and with progressive loads; the other half did not exercise during the study period and were part of the so-called control group.

In the analyses carried out at the end of the intervention, the volunteers who practiced weight training had better performance in verbal episodic memory, improved integrity of neurons and areas related to Alzheimer’s disease protected from atrophy, while the control group showed a worsening of brain parameters.

“A characteristic of people with mild cognitive impairment is that they have volume loss in some brain regions associated with the development of Alzheimer’s. But in the group that did strength training, the right side of the hippocampus and precuneus were protected from atrophy. This result justifies the importance of regular weight training, especially for older people,” Ribeiro highlights.

The researcher believes that a longer period of training could lead to even more positive results than those reported in the study. “All the individuals in the bodybuilding group showed improvements in memory and brain anatomy. However, five of them reached the end of the study without a clinical diagnosis of mild cognitive impairment, such was their improvement. This leads us to imagine that longer training sessions, lasting three years, for example, could reverse this diagnosis or delay any kind of dementia progression. It’s certainly something to be hopeful about and something that needs to be studied in the future,” Ribeiro argues.

According to the researchers, weight training can protect the brain against dementia on two fronts: by stimulating the production of neural growth factor (an important protein for the growth, maintenance and survival of neurons) and by promoting global disinflammation in the body.

“Any physical exercise, whether weight training or aerobic activity, is known to increase levels of a chemical involved in brain cell growth. It can also mobilize anti-inflammatory T-cells. This is key. After all, the more pro-inflammatory protein that is released in the body, the greater the chance of developing dementia, accelerating the neurodegenerative process and forming dysfunctional proteins that eventually kill neurons,” Balthazar explains.

To assess these issues, the volunteers’ levels of irisin and BDNF (brain-derived neurotrophic factor) – substances whose synthesis is stimulated by muscle contraction and which are associated with neural protection and synaptic plasticity-were measured. The results are currently being analyzed.

“It’s a continuation of this study in which we’ll try to better understand how these factors are related to changes in brain anatomy. We believe that it’s a set of anti-inflammatory and neuroprotective factors that lead to these changes,” Ribeiro predicts.

Reference:

Ribeiro, I.C., Teixeira, C.V.L., de Resende, T.J.R. et al. Resistance training protects the hippocampus and precuneus against atrophy and benefits white matter integrity in older adults with mild cognitive impairment. GeroScience (2025). https://doi.org/10.1007/s11357-024-01483-8

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Pretreatment with chlorhexidine and benzalkonium chloride fails to impact Long-Term Bonding in immediate dentin sealing: Study

Researchers have found in a new study that pretreatment with chlorhexidine and benzalkonium chloride does not improve long-term bonding in immediate dentin sealing when using a universal adhesive. However, All Bond Universal adhesive applied in the etch-and-rinse mode demonstrated better long-term bonding performance compared to its self-etch mode when antibacterial agents were used. Effective and durable bonding in immediate dentin sealing is a crucial factor in the success of adhesive-bonded restorations. This study aimed to examine the effects of chlorhexidine and benzalkonium chloride pretreatments on the initial and long-term bond strength of a universal adhesive applied in two different etching modes. The research involved preparing flat dentin surfaces from extracted molars, which were divided into six groups based on pretreatment type and etching mode. The adhesive was used in either etch-and-rinse or self-etch mode, followed by the application of a hydrophobic resin layer. After the provisional stage and final cementation with resin, bond strength was evaluated both immediately after application and again after one year of storage.The results indicated that pretreatment with chlorhexidine did not have a significant effect on bond strength, while pretreatment with benzalkonium chloride led to weaker immediate bonding performance when used in self-etch mode. However, in the etch-and-rinse mode, there were no substantial differences in bond strength among the pretreatment groups immediately after bonding or after one year. Over time, the bond strength in the self-etch mode declined across all groups, with the chlorhexidine group showing the weakest long-term bonding. In contrast, the etch-and-rinse mode showed stable or slightly improved bond strength over time, with the benzalkonium chloride group achieving the highest values after one year. Overall, neither chlorhexidine nor benzalkonium chloride pretreatment provided additional benefits in improving long-term bonding performance in immediate dentin sealing when using the universal adhesive in this study. However, when incorporating antibacterial agents, the etch-and-rinse mode of All Bond Universal adhesive demonstrated superior long-term bonding compared to its self-etch mode. These findings suggest that the choice of etching mode plays a critical role in maintaining durable adhesive restorations.

Reference:

Shafiei, F., Jowkar, Z., Eslamipanah, S. et al. Comparative evaluation of chlorhexidine and benzalkonium chloride pretreatments on bond strength durability of immediate dentin sealing with universal adhesive: an in vitro study. BMC Oral Health 25, 390 (2025). https://doi.org/10.1186/s12903-025-05745-5

Keywords:

Pretreatment, chlorhexidine, benzalkonium, chloride, fails, impact, Long-Term Bonding, immediate dentin sealing, Study, Shafiei, F., Jowkar, Z., Eslamipanah, S

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Norepinephrine as initial vasoactive agent has lower mortality rates in Pediatric Septic Shock compared to Epinephrine: JAMA

Researchers have found in a new study that Children without known cardiac dysfunction who were treated with norepinephrine as the initial vasoactive agent for septic shock showed lower mortality rates compared to those treated with epinephrine, though both groups had similar rates of major adverse kidney events within 30 days (MAKE30). Further prospective studies are required to confirm whether norepinephrine should be the preferred first-line agent in such cases.

There is no consensus and wide practice variation in the choice of initial vasoactive agent in children with septic shock. A study was done to determine whether receipt of epinephrine compared with norepinephrine as the first vasoactive medication administered is associated with improved outcomes among children with septic shock without known cardiac dysfunction. This single-center, retrospective cohort study used propensity score matching to examine encounters in which a patient was diagnosed with septic shock and required a vasoactive infusion within 24 hours of ED arrival at a freestanding quaternary care children’s hospital. Participants included patients aged 1 month to 18 years who presented to the ED and were diagnosed with septic shock without known cardiac dysfunction and began an epinephrine or norepinephrine infusion within 24 hours of ED arrival between June 1, 2017, and December 31, 2023. Data were analyzed from March 1 to December 31, 2024. The primary outcome was major adverse kidney events by 30 days (MAKE30). Secondary outcomes were 30-day in-hospital mortality, 3-day mortality, need for kidney replacement therapy or persistent kidney dysfunction, endotracheal intubation, mechanical ventilation days, extracorporeal membrane oxygenation, and hospital and intensive care unit length of stay. Primary and secondary outcomes were assessed with the χ2 test of proportions for binary variables and Wilcoxon rank sum test for continuous variables. Results Among 231 included encounters, the median (IQR) age was 11.4 (5.6-15.4) years, 126 were female (54.6%), and 142 had a medical history that predisposed them to sepsis (61.5%). Most (147 [63.6%]) initially received an epinephrine infusion and 84 (36.4%) received norepinephrine. In the epinephrine group, 9 of 147 (6.1%) met the outcome of MAKE30 and 6 of 147 (4.1%) died within 30 days. In the norepinephrine group, 3 of 84 (3.6%) met MAKE30 and there were no deaths. After inverse probability of treatment weighting, there were no significant differences in the primary outcome, MAKE30. With 2:1 propensity matching, epinephrine was associated with greater 30-day mortality compared with norepinephrine (3.7% vs 0%; risk difference: 3.7%; 95% CI, 0.2%-7.2%). In this study, those receiving epinephrine had greater 30-day mortality but no difference in MAKE30. Prospective, confirmatory studies are needed to determine if norepinephrine should be the first-line vasoactive agent in pediatric septic shock.

Reference:

Eisenberg MA, Georgette N, Baker AH, Priebe GP, Monuteaux MC. Epinephrine vs Norepinephrine as Initial Treatment in Children With Septic Shock. JAMA Netw Open. 2025;8(4):e254720. doi:10.1001/jamanetworkopen.2025.4720

Keywords:

Norepinephrine, initial, vasoactive, agent, lower , mortality rates, Pediatric, Septic Shock, compared, Epinephrine, JAMA , Eisenberg MA, Georgette N, Baker AH, Priebe GP, Monuteaux MC. Epinephrine

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Self-Harm in India: Study Links Suicide Attempts and NSSI to Mental Health Disorders

India: A recent secondary analysis examining cases of non-suicidal self-injury (NSSI) and suicide attempts has shed light on the patterns and clinical characteristics of individuals presenting with self-harm at a tertiary care hospital. The Indian study, published in the Cureus Journal, identified distinct differences between suicide attempts and NSSI.     

The researchers reported that suicide attempts were most prevalent among individuals aged 31–40 years, with depressive disorder identified in 68.7% of cases. In contrast, non-suicidal self-injury (NSSI) was more common in the 18–30 age group and was frequently linked to substance use disorder (67.1%). They further noted that self-poisoning was the most commonly used method, possibly due to insufficient pesticide regulations.

The researchers note that self-harm encompasses both suicide attempts and non-suicidal self-injury (NSSI), each associated with psychiatric disorders and psychosocial stressors. While suicide attempts reflect an intent to end one’s life, NSSI often functions as a maladaptive coping strategy. In India, the stigma surrounding mental health and limited access to psychiatric care pose significant barriers to early intervention.

Against the above background, Kashyap Shah, Psychiatry, Mahatma Gandhi Memorial Medical College, Indore, IND, and colleagues examined the patterns of self-harm, underlying psychiatric comorbidities, and key risk factors among patients seeking care at a tertiary hospital, highlighting the need for targeted prevention strategies.

For this purpose, the researchers conducted a retrospective review of medical records from 165 patients who presented with suicide attempts or non-suicidal self-injury between January and June 2024. They analyzed data on demographics, psychiatric diagnoses, self-harm methods, and substance use using both descriptive and inferential statistical approaches.

Based on the study, the researchers reported the following findings:

  • Among the 165 cases, 69 involved suicide attempts, while 96 were cases of non-suicidal self-injury (NSSI).
  • Suicide attempts were more prevalent in individuals aged 31–40 years, whereas NSSI was more common in the 18–30 age group.
  • Depressive disorder was the most frequent diagnosis among those who attempted suicide, affecting 55 individuals (68.7%).
  • Substance use disorder was more commonly associated with NSSI, reported in 51 individuals (67.1%).
  • Self-poisoning was the most frequently used method, possibly due to weak pesticide regulations in India.
  • A significant association was observed between suicide intent and a history of past suicide attempts.

This study emphasizes the link between non-suicidal self-injury, suicide attempts, and shared risk factors. Early intervention is key to managing self-harm and preventing suicide. Immediate priorities include medical stabilization and a thorough suicide risk assessment.

The authors stressed that addressing psychosocial risks, administering appropriate pharmacotherapy for co-existing mental illnesses, and implementing structured post-discharge care are crucial in reducing self-harm and suicide risk.

They concluded that targeted interventions, including early screening and restricting access to harmful substances, could significantly improve mental health outcomes and alleviate the burden of self-harm.

Reference:

Shah K, Mathur R, Mishra S, et al. (March 17, 2025) Non-suicidal Self-Injury and Suicide Attempts: A Secondary Analysis Describing the Patterns and Clinical Characteristics of Patients Presenting With Self-Harm to a Tertiary Care Hospital. Cureus 17(3): e80715. DOI 10.7759/cureus.80715

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Stroke Patients with Artery Dissection Face Greater Risks with IV Thrombolysis: Study Finds

Japan: A recent study has highlighted the potential risks and outcomes associated with intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS) who have underlying intracranial artery dissection (IAD). The nationwide study found that patients with AIS and IAD face a threefold higher risk of intracranial hemorrhage following intravenous thrombolysis.

“While IAD did not increase in-hospital mortality, we observed a significant reduction in the chances of achieving functional independence at discharge. These findings highlight the importance of thorough risk assessment before administering IVT to patients with IAD, ensuring a more informed and cautious approach to treatment,” the researchers wrote in the International Journal of Stroke.

IVT is a widely used AIS treatment aiming to restore blood flow and minimize neurological damage. However, its safety in patients with underlying intracranial artery dissection remains uncertain due to the structural fragility of the dissected artery. This raises concerns about potential complications, including intramural hematoma exacerbation and arterial rupture, making it crucial to carefully evaluate the risks before administering IVT in such cases.

Given these potential risks, Yuichi Imanaka, Department of Health Security System, Center for Health Security, Graduate School of Medicine, Kyoto University, Kyoto, Japan, and colleagues aimed to determine whether IAD is associated with an increased likelihood of intracranial hemorrhage (ICH) following IVT and to assess its impact on functional outcomes.

For this purpose, the researchers conducted a retrospective matched-pair cohort study using a nationwide inpatient database in Japan, including AIS patients treated with IVT from 2010 to 2024. They excluded cases with carotid or vertebral artery dissections, missing mRS data, or prior intra-arterial thrombolysis. Patients with IAD were matched 1:4 with non-IAD controls based on key clinical factors. Outcomes, including ICH, functional independence at discharge (mRS 0–2), and in-hospital mortality, were analyzed using multivariable logistic regression, adjusting for demographic, clinical, and hospital-related variables.

The key findings of the study were as follows:

  • Among 83,139 AIS patients treated with IVT, 242 (0.3%) had underlying IAD (median age: 54 years; 34% women). These patients were matched with 968 non-IAD controls.
  • IAD was linked to a higher risk of ICH (OR = 3.18).
  • Patients with IAD had a lower likelihood of functional independence at discharge (OR = 0.51).
  • IAD was not associated with increased in-hospital mortality (OR = 1.09).

“The findings suggest that patients with underlying intracranial artery dissection have a higher risk of intracranial hemorrhage and a lower likelihood of functional recovery after intravenous thrombolysis compared to those without IAD,” the researchers concluded.

Reference:

Egashira, S., Kunisawa, S., Koga, M., Ihara, M., Tsuruta, W., Uesaka, Y., Fushimi, K., Toda, T., & Imanaka, Y. (2025). Safety and outcomes of intravenous thrombolysis in acute ischemic stroke with intracranial artery dissection. International Journal of Stroke. https://doi.org/10.1177/17474930251317326

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Women are overtaking men in the most extreme sports events, study shows

Much of the work devoted to exploring potential sex-specific differences in exercise or sports performance has been derived from laboratory-based studies. While these studies are typically well-controlled and guide an understanding of physiological mechanisms, they may lack pragmatic or practical relevance to the “real world.”

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Heart disease deaths worldwide linked to chemical widely used in plastics

Daily exposure to certain chemicals used to make plastic household items could be linked to more than 365,000 global deaths from heart disease in 2018 alone, a new analysis of population surveys shows.

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