Fasting-mimicking diet found effective against chronic kidney disease, suggests study

A new study published in the journal of Science Translation Medicine showed that a fasting-mimicking diet (FMD) improved kidney function in a mouse model by lowering proteinuria and improved endothelial function and encouraged renal protection in chronic kidney disease (CKD). The cycles of a fasting-mimicking diet encourage regeneration and lessen damage in the pancreas, blood, stomach, and neurological system of the mice. While many organs benefit from fasting-mimicking diets, it is unclear how FMDs directly impact podocyte function and chronic kidney disease. Further, rats have not been used to test for an FMD. Thus, Villani and colleagues examined the effects of a low-salt FMD on chronic renal disease in a rat.

This study induced and fed CKD animal models a low-salt FMD that is comparable to what stage-III CKD patients in humans should consume each day. For 5 days a month for 3 months, the 13 clinical study participants consumed a plant-based meal that included unique vegetable-based soup, energy bar, energy drink, chip snack, tea, and important fatty acid and mineral-rich supplement formulations. Body composition, oxidative stress and inflammation markers, serum level of insulin-like growth factor 1 (IGF-1), cardiovascular and endothelial risk factors, renal function markers, regenerative markers (circulating stem cells), and psychocognitive evaluation were among the physiological markers that this research assessed before, during, and, for some parameters, a year after the end of the intervention. The metabolic parameters of the animals were assessed.

The deterioration of kidney structures and function in rodents was slowed by 6 cycles of the proprietary low-salt FMD. This resulted in a significant decrease in glomerular and tubular injury, as well as a significant decrease in the albumin-to-creatine ratio and blood urea nitrogen at 4 and 6 weeks following the diet cycles. The FMD improved proteinuria, decreased inflammation, and alleviated renal impairment in the clinical study. 

When combined, these early findings provide credence to the viability of FMD and the necessity of conducting extensive randomized studies to determine whether the disease-reversing and regenerative benefits of the diet would also apply to people. Overall, the findings of this pilot clinical trial demonstrated that the FMD is well tolerated and preserves lean muscle mass in individuals with stage-III CKD. 

Reference:

Villani, V., Frank, C. N., Cravedi, P., Hou, X., Bin, S., Kamitakahara, A., Barbati, C., Buono, R., Da Sacco, S., Lemley, K. V., De Filippo, R. E., Lai, S., Laviano, A., Longo, V. D., & Perin, L. (2024). A kidney-specific fasting-mimicking diet induces podocyte reprogramming and restores renal function in glomerulopathy. In Science Translational Medicine (Vol. 16, Issue 771). American Association for the Advancement of Science (AAAS). https://doi.org/10.1126/scitranslmed.adl5514

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Early Antihypertensive Treatment may increase Death risk among Stroke Patients with PAD: CATIS-2 Trial Analysis

China: A recent secondary analysis of the CATIS-2 randomized clinical trial has revealed that early initiation of antihypertensive treatment in patients with acute single subcortical infarction (SSI) and coexisting parent artery disease (PAD) stenosis could potentially elevate the risk of functional dependency or death within 90 days.

The findings published in JAMA Network Open underscore the need for a cautious approach to blood pressure (BP) management in these patients.

The China Antihypertensive Trial in Acute Ischemic Stroke II (CATIS-2) indicates that early antihypertensive treatment does not reduce the risk of dependency or death in acute ischemic stroke (AIS) compared to delayed treatment. Given that single subcortical infarction is a significant subtype of stroke, the impact of the timing of antihypertensive therapy on clinical outcomes in these cases remains uncertain.

Against the above background, Yufei Wei, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China, and colleagues examine the relationship between early versus delayed antihypertensive treatment and clinical outcomes in patients with SSI, with a focus on whether the presence of PAD stenosis influences these outcomes.

This secondary analysis of the CATIS-2 randomized clinical trial involved 106 hospitals across China from June 2018 to July 2022. The trial included patients with AIS who presented within 24 to 48 hours of symptom onset and had elevated systolic blood pressure. For the current post hoc subgroup analysis, participants with SSI detected via diffusion-weighted imaging were examined. Patients were categorized into two groups: those with SSI and PAD stenosis, and those with SSI but without PAD stenosis. Statistical analysis for this study was conducted between July 2023 and May 2024.

The exposures of interest were early antihypertensive therapy (initiated immediately) versus delayed therapy (starting on day 8). The primary outcome measure was the combination of functional dependency or death, assessed by a modified Rankin Scale score of ≥3 at 90 days.

The study led to the following findings:

  • Among 997 patients with SSI in CATIS-2 (mean age, 62.4 years; 61.4% men), 11.6% had SSI with PAD, and 88.4% had SSI without PAD.
  • There was no significant difference in the primary outcome between early and delayed antihypertensive treatment groups among all patients with SSI (8.8% versus 7.1%; OR, 125).
  • Among patients with SSI with PAD, early antihypertensive treatment was associated with increased risk of the primary outcome compared with delayed treatment (23.4% versus 7.7%; OR, 3.67); this finding was not observed in patients with SSI without PAD (6.6% versus 7.1%; OR, 0.93).
  • Significant interaction with treatment and PAD stenosis presence was detected for the primary outcome.

The findings showed no overall association between early versus delayed antihypertensive treatment and clinical outcomes within three months for patients with acute single subcortical infarction. However, a significant interaction between treatment timing and the presence of parent artery disease stenosis was observed. Early antihypertensive treatment was linked to a higher risk of death or functional dependency at 90 days among patients with SSI who also had PAD stenosis, a relationship not seen in those without PAD stenosis.

“Further research is needed to investigate the mechanisms behind these findings and to develop more individualized blood pressure management strategies for patients with SSI,” the researchers concluded.

Reference:

Wei Y, Xie X, Pan Y, et al. Early vs Delayed Antihypertensive Treatment in Acute Single Subcortical Infarction: A Secondary Analysis of the CATIS-2 Randomized Clinical Trial. JAMA Netw Open. 2024;7(8):e2430820. doi:10.1001/jamanetworkopen.2024.30820

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Cannabis use can cause chromosomal damage, increasing cancer risk and harming offspring: Study

Cannabis use causes cellular damage that increases the risk of highly cancerous tumours, according to a new paper published in the scientific journal Addiction Biology. The paper describes cannabis as a “genotoxic” substance because it damages a cell’s genetic information, which can lead to DNA mutations, accelerated aging, and cancer. To make matters worse, this genotoxicity may be transmitted via damaged egg and sperm to the cannabis user’s offspring, making the risk of cannabis use trans-generational.

In a recent publication in Addiction Biology researchers from The University of Western Australia have made a link between established knowledge that cannabis use damages cellular energy production by inhibiting mitochondria and new cancer research published in Science showing that mitochondrial dysfunction drives chromosomal damage, which shows up as increased rates of cancer, accelerated aging, and birth defects.

The Science studies were not conducted in the context of cannabis use; however, they provide mechanistic insights into some observations about cannabis use that were not previously well understood, such as that cannabis causes both mitochondrial and genetic damage. Taken together, the article in Addiction Biology put older historical research about cannabis into context and suggests that cannabis-related genotoxic damage may be all around us-even if we largely don’t see it.

Co-author Dr. Stuart Reece comments: “The link we’ve described between cannabis use and genotoxicity has far-reaching consequences. This new research shows how genetic damage from cannabis use can be passed down the generations. This should reframe the discussion surrounding cannabis legalization from a personal choice to one that potentially involves multiple subsequent generations.”

Reference:

Albert Stuart Reece, Gary Kenneth Hulse, Key insights into cannabis-cancer pathobiology and genotoxicity, Addiction Biology, https://doi.org/10.1111/adb.70003

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Platelet-rich plasma improves healing of acute patellar tendon defect if injected early after injury: Study

Platelet-rich plasma improves healing of acute patellar tendon defect if injected early after injury suggests a study published in the BMC Musculoskeletal Disorders.

There is no consensus on the frequency and timing of platelet-rich plasma (PRP) injection in tendon healing. We aimed to evaluate the effectiveness of single versus multiple PRP injections in the healing of patellar tendon defects in the experimental model, through histological and biomechanical investigation. Forty-four male skeletally mature Dutch rabbits were randomly divided into the five study groups ( A, B,C, D,E). After creating a longitudinal acute patellar tendon defect on both knees (One-third the width of the patella tendon), the right legs of the rabbits were used as the intervention group and the left legs as the control groups. Animals in groups A, B, and C were euthanized on days 7, 14, and 28, respectively, after the first PRP injection. Animals in group D received the second PRP injection on day 10 and was euthanized on day 14. Animals in group D received the second and third PRP injections on days 10 and 20, respectively, and were euthanized on day 28. The outcomes were evaluated histologically (modification of Movin’s Grading) and biomechanically. Results

The inflammatory condition was exaggerated in groups D and E. Load at failure was higher in the non-injected side of groups D and E, while there was no significant difference between the right and left legs of the three groups A, B and C. In other word, groups with a single PRP injection were more resistant to the increasing load compared to the groups with multiple PRP injections. PRP improves tendon healing if injected early after injury, while its injection after the initial phase of injury hampers tendon healing. In addition, a single PRP injection seems to be more effective than multiple PRP injection. Therefore, in cases where PRP injection is indicated for tendon repair, such as acute tendon injury, we recommend using a single PRP injection during tendon repair surgery.

Reference:

Ghaderi, M.T., Momenzadeh, O.R., Jaberi, F.M. et al. Effect of a single versus serial platelet-rich plasma injection on acute patellar tendon defect healing: an experimental study. BMC Musculoskelet Disord 25, 684 (2024). https://doi.org/10.1186/s12891-024-07804-4

Keywords:

Platelet-rich, plasma, improves, healing, acute, patellar, tendon, defect, injected, early, after, injury, study, Ghaderi, M.T., Momenzadeh, O.R., Jaberi, F.M, Platelet-rich plasma, Tendon defect, Patellar tendon, Rabbit model, Knee, BMC Musculoskeletal Disorders

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NMC vs Pacific Medical College: HC stays ruling on additional MBBS seats, students in Limbo

MBBS Students, who were admitted to Pacific Medical College, Bhilo ka Bedla this year, are facing uncertainty regarding their future as a Division bench of the Rajasthan High Court has now overturned an earlier order of the High Court allowing an increase of MBBS seats at the institute.

However, the HC bench comprising Justices Shree Chandrashekhar and Rekha Borana clarified that the students who have already deposited the fee with the Counselling Board, shall be at liberty to pray for a refund of the same and if any such prayer is made, the appellants/Counselling Board shall be under an obligation to refund the same with immediate effect.

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Study reveals student preferences: NExT exam vs Final prof exams

While there is still no clarity regarding when the National Exit Test (NExT), the proposed licentiate and entrance test, might be held, a recent study revealed that only 31% of the students across the country are aware of the entire pattern of the NExT exam.

The study also revealed that the majority of medical students prefer NExT to serve as an exam for post-graduate entrance competition but not the third professional part 2 (final year) theory exam. Medical students participating in the study preferred NExT Step 1 to be conducted every 6 months as a 1-day exam of 3-hour duration. “Most students want no attempt limits. Majority further prefer at least three mock tests to be conducted annually. Students prefer 100% MCQ-based examination for theoretical university professional exams for better alignment with the entrance exam pattern. They also opine that NExT Step 2 should be conducted by NMC after completion of the Internship,” the study results stated.

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Without immediate action, nearly 260 million people in the US predicted to be overweight or obese by 2050

Over the past three decades, there has been a startling increase in the prevalence of obesity across the U.S., at least doubling in adult men and women (aged 25 and older) and older female and male adolescents (aged 15–24 years) since 1990, with the number of people living with overweight and obesity reaching over 208 million in 2021—a trend set to continue in the coming decades without significant reform, according to a major new analysis from the Global Burden of Disease Study Collaborator Network, published in The Lancet.

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GLP-1 RA use tied to lower rate of venous thromboembolism in diabetes

For patients with type 2 diabetes mellitus (T2DM), glucagon-like peptide 1 receptor agonist (GLP-1 RA) use is associated with a lower risk for venous thromboembolism (VTE), according to a study scheduled for presentation at the annual meeting of the American Society of Hematology, to be held from Dec. 7 to 10 in San Diego.

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AI tool predicts cancer gene activity from biopsy images

To determine the type and severity of a cancer, pathologists typically analyze thin slices of a tumor biopsy under a microscope. But to figure out what genomic changes are driving the tumor’s growth—information that can guide how it is treated—scientists must perform genetic sequencing of the RNA isolated from the tumor, a process that can take weeks and costs thousands of dollars.

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Photoacoustic imaging technique reduces skin tone bias in breast cancer detection

Breast cancer is a major health concern worldwide, and early detection is crucial for effective treatment. Traditional imaging methods, such as mammography, have limitations, especially for women with dense breast tissue. Photoacoustic imaging, which combines light and sound to create detailed images of breast tissue, offers a promising alternative. However, recent research has highlighted a significant challenge: skin tone bias.

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