Leafy greens could be good for the heart, suggests study

A cup and a half of leafy green vegetables could go a long way to addressing atherosclerotic vascular diseases (ASVD’s), new research from Edith Cowan University (ECU), the University of Western Australia and the Danish Cancer Institute has found.

ASVDs are a subgroup of cardiovascular disease, which are current leading causes of death world-wide, primarily due to heart attacks and strokes. ECU PhD student Ms Montana Dupuy noted that in Australia, cardiovascular diseases claim the life of one person every 12 minutes.

Research led by Ms Dupuy has found that the higher dietary intake of Vitamin K1 could reduce the risk of ASVD.

“Leafy green and cruciferous vegetables, like spinach, kale and broccoli, contain Vitamin K1 which may assist in preventing vascular calcification processes that characterise cardiovascular disease. The great news is that these vegetables can be easily incorporated into your daily meals” she said.

In addition to its’ potential role in vascular calcification inhibition, Vitamin K may also be beneficial for musculoskeletal health, through its impact on bone strength.

ECU Senior Research Fellow Dr Marc Sim noted that a cup and a half of such vegetables is an easy way to increase our daily vitamin K intake and may lower our risk for cardiovascular disease”.

“This research found women who consumed approximately 30% higher intakes of Vitamin K1 than currently recommended in the Australian Dietary Guidelines had lower long-term risk of ASVD,” he said.

“Of importance, when we examined the blood vessels in the neck, those with a higher Vitamin K1 intake also had less thickening of these blood vessels, a marker of atherosclerosis.”

The work led by Ms Dupuy and Dr Sim on the impact of Vitamin K to vascular health, as well as musculoskeletal health, will now help to inform future research at ECU’s Future Foods and Digital Gastronomy Lab and to deliver specialised meals as part of clinical trials to improve population health.

“This research has provided key evidence to support our future studies. We are now creating new foods which pack more leafy greens that are rich in Vitamin K1. These novel foods can be used in communities with special nutritional and dietary requirements, such as aged care residents,” said ECU Post Doctoral Research Fellow Dr Liezhou Zhong.

“We are consolidating all our epidemiological data and converting that into a tangible product that would benefit the community,” he added.

Reference:

Dupuy, M., Zhong, L., Radavelli-Bagatini, S. et al. Higher vitamin K1 intakes are associated with lower subclinical atherosclerosis and lower risk for atherosclerotic vascular disease-related outcomes in older women. Eur J Nutr 64, 171 (2025). https://doi.org/10.1007/s00394-025-03686-x.

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Hyperbaric Oxygen Therapy Shows Lasting Relief for Radiation-Induced Cystitis: 5-Year RICH-ART Trial Results

Sweden: Researchers have revealed that hyperbaric oxygen therapy (HBO2) can offer sustained relief from symptoms of chronic radiation-induced cystitis for up to five years, according to a long-term follow-up of the RICH-ART trial published in eClinicalMedicine. The study, led by Dr. Nicklas Oscarsson from the University of Gothenburg, adds important new insights into the durability of the therapeutic effects of HBO₂.

Radiation-induced cystitis is a distressing complication that affects about 5–10% of patients who undergo pelvic radiotherapy for cancers such as prostate, bladder, or cervical cancer. Common symptoms include blood in the urine, urgency, frequency, and painful urination—all of which can severely impact a patient’s quality of life. While HBO₂ has been known to improve symptoms in the short term, evidence regarding its long-term efficacy has been limited.

The RICH-ART trial was a multicentre, open-label phase 2–3 study carried out across five Nordic hospitals in Sweden, Norway, Denmark, and Finland. It included patients aged between 18 and 80 years who had completed pelvic radiotherapy at least six months prior and had persistent bladder symptoms. Participants were randomly assigned to receive either HBO₂ therapy—30 to 40 daily sessions of 100% oxygen at high pressure—or standard care. Patients in the control group were later offered HBO₂.

The study led to the following findings:

  • The five-year follow-up included 70 patients who had received hyperbaric oxygen therapy (HBO₂).
  • Average urinary symptom scores improved by 18 points at six months post-treatment.
  • At five years, the improvement remained stable, with a 19.1-point increase from baseline.
  • Approximately 69% of patients (48 out of 70) experienced significant and sustained improvement, showing a mean increase of 22.9 points.
  • The remaining 31% (22 patients) showed little to no symptom improvement even after five years.
  • Only 12.8% of patients required repeat HBO₂ therapy due to the recurrence of symptoms.
  • Adverse events were documented only during the HBO₂ treatment period.
  • There were no new safety concerns during the long-term follow-up.

The findings not only reinforce the long-term efficacy of HBO₂ in managing chronic radiation cystitis but also underline the need for further research. “This is the first study to report five-year outcomes, offering vital data on the lasting impact of this therapy,” the authors stated. They suggest that HBO₂ could become a more widely adopted component of standard care, though further studies are needed to refine treatment protocols, assess economic viability, and identify predictors of treatment response.

The authors concluded, “The RICH-ART trial provides compelling evidence that HBO₂ can deliver durable symptom relief for patients suffering from radiation-induced bladder complications. As researchers continue to investigate optimal dosing and patient selection strategies, HBO₂ stands out as a promising and effective treatment option for improving long-term quality of life in this population.”

Reference: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(25)00146-4/fulltext

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15 Drugs Including Pomol-650, Glimiz-2 Banned in Karnataka, Check Full List

Bengaluru: In a move to protect public health, the Karnataka Government’s Drug Testing Laboratory has declared 15 drugs manufactured by 14 companies as “Not of Standard Quality”.

Authorities have issued an urgent directive to chemists, wholesalers, doctors, hospitals, and nursing homes, instructing them not to stock, sell, or use the listed drugs. Those already in possession of these products are required to intimate the concerned area Drugs Inspector or Assistant Drugs Controller. The public has also been strongly advised not to use these medicines.

Some of the notable substandard drugs include Compound Sodium Lactate Injection IP (Ringer-Lactate solution for injection) manufactured by Ultra Laboratories, Otsuka Pharmaceuticals India and Tam Bran Pharmaceuticals, Pomol-650 (Paracetamol Tablets IP 650 mg) by Aban Pharmaceuticals, and MITO Q7 Syrup by Bion Therapeutics India.

The list also includes Glimiz-2 (Glimepiride tablets IP 2mg) manufactured by Knm Pharma, Iron Sucrose Injection USP 100 mg (Irogain) manufactured by Regain Labs.

 

 

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Akums Gets CDSCO Panel Nod for BE Study of Rizatriptan-Meloxicam FDC, Told to Revise Phase III Protocol

New Delhi: In response to the proposal presented by the Akums Drugs & Pharmaceuticals along with BE and Phase III clinical trial protocol of the fixed dose combination (FDC) Rizatriptan Benzoate plus Meloxicam IP 20mg uncoated orally disintegrating Tablet, the Subject Expert Committee (SEC) functional under the Central Drug Standard Control Organisation (CDSCO) has recommended for grant of permission to conduct the BE study of the proposed drug.

In addition, the committee opined that placebo should not be used as a comparator and patient with frequency of migraine attack more than 2 in a month should be included in inclusion criteria and above mentioned criteria for 6 months prior to starting study and patients on Prophylaxis medication should not be included in the study and same may be mentioned in the exclusion criteria.

Also, the committee recommended the firm to submit BE study report along with revised Phase III clinical trial protocol to CDSCO for further review by the committee.

This came after the firm presented the proposal along with BE & Phase III clinical trial protocol before the committee.

Meloxicam and rizatriptan combination is used to treat acute migraine headaches with or without aura. It is not used to prevent migraine headaches and is not used for cluster headaches. Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID).

Rizatriptan is used to treat migraine headaches (severe, throbbing headaches that sometimes cause nausea and sensitivity to sound and light). Rizatriptan is in a class of medications called selective serotonin receptor agonists.

Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve the symptoms of arthritis (juvenile rheumatoid arthritis, osteoarthritis, and rheumatoid arthritis), such as inflammation, swelling, stiffness, and joint pain.

At the recent SEC meeting for Neurology and Psychiatry held on 18th June 2025, the expert panel reviewed the proposal along with BE & Phase III clinical trial protocol before the committee.

After detailed deliberation, the committee recommended for grant of permission to conduct the BE study.

As regard to Phase III clinical trial protocol, the committee opined that:

1. Placebo should not be used as a comparator.

2. Patient with frequency of migraine attack more than 2 in a month should be included in inclusion criteria and above mentioned criteria for 6 months prior to starting study.

3. Patients on Prophylaxis medication should not be included in the study and same may be mentioned in the exclusion criteria.

“Accordingly, the firm should submit BE study report along with revised Phase III clinical trial protocol to CDSCO for further review by the committee,” the panel noted.

Also Read: Biocon Gets CDSCO Panel Nod to Market Trastuzumab PGS in India

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CDSCO Asks Serum Institute to Revise Protocol for Trivalent Flu-COVID Vaccine Trial

New Delhi: The Subject Expert Committee (SEC) under the COVID-19 division of the Central Drugs Standard Control Organization (CDSCO) has reviewed a proposal submitted by Serum Institute of India Pvt. Ltd. (SIIPL) for a Phase II/III clinical trial of its Trivalent Nanoparticle Influenza Vaccine (NIV) and COVID-Influenza Combination (CIC) Vaccine, and has asked the firm to submit a revised study protocol incorporating additional design, safety, and statistical considerations.

The protocol, reviewed during the SEC meeting held on June 4, 2025, was titled:

“Phase II/III, multicentre, observer-blind, randomized, active-controlled study to evaluate immunogenicity and safety of a Trivalent Nanoparticle Influenza Vaccine and Covid-Influenza combination vaccine compared with Licensed Influenza and Covid-19 Vaccines in adults.”

The committee observed that the CIC vaccine leverages the baculovirus-insect cell platform also used in Novavax’s COVOVAX, which SIIPL had manufactured and distributed globally in over 200 million doses during the pandemic.

“Currently proposed Trivalent Influenza Nanoparticle Vaccine (tNIV) and Covid Influenza Vaccine Combination (CIC) are based on the same platform. CIC vaccine formulation contains both the SARS-CoV-2 and Influenza antigens,” the SEC noted.

In support of the proposal, the firm cited multiple international studies:

Over 4,300 participants took part in clinical trials for nanoparticle influenza vaccines (tNIV/qNIV), including adults aged >60 years in the U.S.

More than 2,100 participants were enrolled in Australia for the CIC vaccine trials combining COVID and influenza antigens.

“These trials demonstrated that CIC is safe and immunogenic… all doses were found safe,” the panel noted.

The investigational products used in all these trials were manufactured by SIIPL, further aligning the proposed Indian study with globally validated formulations.

However, the SEC has directed key changes before granting final approval to proceed:

“The study should be designed as four arm study with Covid Trivalent Influenza Combination (CIC) Vaccine, Trivalent Influenza Nanoparticle Vaccine, SARS-CoV-2 rs (JN.1 variant) and Fluquad.”

“Sample size of participants should be increased as per statistical calculation in proposed four arms with age stratification so that high-risk population (more than 55 years of age group) is appropriately considered for safety and immunogenicity analysis.”

“Cross-neutralization against VoCs for Covovax JN.1 alone and in CIC, immunogenicity persistence studies, efficacy end-points for hospitalization or severe COVID-19 cases should be part of exploratory objectives.”

Accordingly, the firm has been advised to submit a revised protocol incorporating all recommended modifications for further deliberation by the committee.

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Coaxial SIL Drains Less Painful Yet Equally Effective as PVC Drains after video-assisted thoracoscopic surgery lung resections: Study

A new study has confirmed that coaxial silicone (SIL) drains, due to their softer material, result in less patient discomfort while providing drainage efficacy comparable to that of traditional PVC drains after video-assisted thoracoscopic surgery (VATS) lung resections.

Chest drains are routinely used after video-assisted thoracoscopic surgery (VATS) lung resections to evacuate fluid and air from the pleural space. We compared the impact of coaxial silicone (SIL) drains vs. standard polyvinyl chloride (PVC) drains on postoperative pain, drainage efficacy, and short-term treatment outcome following VATS lobectomy.

The prospective randomized study included 80 patients who underwent VATS lobectomy for lung cancer between September 2020 and June 2023. Patients were randomized into two groups based on the type of chest drain used postoperatively: 40 in the experimental group (coaxial SIL drain Fr 24) and 40 in the control group (standard PVC drain Fr 24). The researchers collecting the data and the caregivers were not blinded to the group allocation. The primary objective was to evaluate pain over the initial 2 postoperative days by assessing analgesic consumption, respiratory muscle strength [measured as maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP)], and pain intensity using the visual analog scale (VAS). MIP, MEP, and VAS were measured both at rest and during physical activity.

 Sixty-nine patients were included in the final analysis: 35 in the experimental group and 34 in the control group. The groups were comparable in terms of drainage efficacy and short-term treatment outcome, but pain was significantly lower in the experimental group (coaxial SIL drain). Diclofenac consumption was significantly lower in the experimental group (P=0.004), with a trend toward lower consumption of other analgesics. All respiratory muscle strength measurements were higher in the experimental group, with significant differences in static MIP on the second postoperative day (P=0.046), both static (P=0.02) and dynamic (P=0.050) MEP on the first postoperative day, and static MEP on the second postoperative day (P=0.02). Static VAS (S-VAS) on the first postoperative day was statistically significantly lower in the experimental group (P=0.003). Dynamic VAS (D-VAS) was comparable between the groups.

This study confirmed the hypothesis that coaxial SIL drains, owing to their softer material, cause less pain while maintaining efficacy comparable to standard PVC drains.

Reference:

Boris Greif, Janez Žgajnar, Tomaž Štupnik,  Impact of chest tube type on pain, drainage efficacy, and short-term treatment outcome following video-assisted thoracoscopic surgery lobectomy: a randomized controlled trial comparing coaxial silicone drains and standard polyvinyl chloride drains, Journal of Thoracic Disease, DOI:10.21037/jtd-24-1489 

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Cognitive tests in infancy can offer insight into intelligence at age 30 and beyond: Study

Watching a baby babble, play and interact with others can provide useful insight into what their cognitive ability might be like decades later, according to new University of Colorado Boulder research published in the journal PNAS.

The study of more than 1,000 twins found that tests as early as 7 months of age can help predict performance on cognitive measures at age 30. It also found that an infant’s environment plays a more significant role in shaping life-long cognition than scientists realized. It could even influence risk of dementia later in life, the authors said.

“Our findings highlight the enduring consequences of the very early childhood environment on cognitive ability and suggest that early life is a critical developmental period that we should be paying attention to,” said lead author Daniel Gustavson, assistant research professor at the Institute for Behavioral Genetics (IBG).

What twins can teach us

Similar to “IQ,” general cognitive ability (GCA) is a single, composite measure of a person’s capacity to learn, reason, understand and problem-solve.

Prior research has shown that much of our GCA is established by childhood. Give an 8-year-old a battery of tests to determine their GCA and their score will look remarkably similar at age 30. Measures of intelligence at age 20 are highly correlated with those at age 62, and IQ doesn’t change much between age 11 and 90.

But few scientists have looked back further to see what-if anything-signals in infancy can tell us about cognition in adulthood and old age.

Gustavson and senior author Chandra Reynolds, a professor of psychology and neuroscience, looked at data from 1,098 participants in the Colorado Longitudinal Twin Study. IBG launched the study in 1985, enrolling baby twins from Colorado’s Front Range to assess the role that genes vs. environment play in various aspects of development.

Researchers have since collected reams of data, via periodic laboratory samples, home visits, surveys, interviews and behavioral tests.

“We have co-authors on this paper who have been involved since the start and watched these twins grow up,” said Gustavson.

As early as 7 months old, researchers assessed seven measures of cognition, including vocalization, ability to stay on task, and “novelty preference”-whether the infants preferred to play with new toys over ones they were familiar with.

Age-appropriate cognitive assessments have been done at five points, so far.

The team found that looking at cognitive tests in infancy could predict about 13% of the variance in scores at age 30. Two measures-novelty preference and task orientation-were the strongest predictors. This early life “signal” is not huge, the authors note.

“We certainly do not want to imply that cognition is somehow fixed by seven months old,” Gustavson said. “But the idea that a very simple test in infancy can help predict the results of a very complicated cognitive test taken 30 years later is exciting.”

Nature, nurture or both?

To explore what role genetics vs. environment plays, the study compared GCA score differences between identical twins, who share 100% of their genes, and fraternal twins, who only share half of their genes. In general, if there is greater similarity among identical twins than fraternal twins, this suggests that genes play a strong role in that trait.

They also analyzed the twins’ DNA collected via blood or saliva.

As expected, genes played a big role in influencing general cognitive ability, with genetic influences measured by age 7 accounting for about half of the variation in scores at age 30.

But environment also had a significant and lasting impact.

“One of the most exciting findings was that 10% of the variability in adult cognitive ability was explained by environmental influences before year one or two,” said Gustavson.

The older the children got, the more influence genes had and the less environment had.

“This suggests that even the pre-preschool environment matters,” Gustavson said.

Reynolds, who studies age-related diseases including Alzheimer’s and dementia, says the findings could have implications not only for how youth do in school or how adults perform at work but also how prone they may be to age-related cognitive decline.

“Cognitive aging is a life-long process, not just something that begins in mid-life,” she said. “It could be that certain interventions, like strong educational foundations in early life could help maximize what people are capable of and help them keep that cognitive gas in the tank for as long as possible.”

A polygenic score for intelligence

The study also confirms that “polygenic scores” can be a useful tool.

Polygenic scores are single numbers that aggregate a person’s genetic variants to estimate predisposition to a trait, like intelligence.

“There are thousands of genes that influence intelligence, so you are never going to find an ‘intelligence gene’, but we have found many with tiny effects that when put together can have an impact,” Gustavson said.

For the study, the researchers used genetic data from nearly 1 million individuals gathered via large datasets like 23 and Me to give each of the adult twins a polygenic score based on their own DNA, for cognitive ability.

Remarkably, the twins’ scores closely matched what would be expected based on their tests when they were babies.

“Studies like ours show us that both family-based and genomic-based datasets are valuable in answering questions about how genetic and environmental influences change across the lifespan,” said Gustavson. 

Reference:

D.E. Gustavson,G.A. Borriello,M.A. Karhadkar,S.H. Rhee,R.P. Corley,S. Rhea,L.F. DiLalla,S.J. Wadsworth,N.P. Friedman,& C.A. Reynolds, Stability of general cognitive ability from infancy to adulthood: A combined twin and genomic investigation, Proc. Natl. Acad. Sci. U.S.A. 122 (21) e2426531122, https://doi.org/10.1073/pnas.2426531122 (2025).

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High Uric Acid Levels Tied to Elevated Risk of Skin Cancer, Study Finds

China: A new study published in Clinical, Cosmetic and Investigational Dermatology has uncovered a significant association between elevated serum uric acid (SUA) levels and an increased risk of both malignant melanoma (MM) and non-melanoma skin cancer (NMSC). Conducted by Dr. Yihao Niu and colleagues from the Faculty of Chinese Medicine, Macau University of Science and Technology, the research utilized large-scale data from the National Health and Nutrition Examination Survey (NHANES). It employed Mendelian randomization techniques to evaluate causality.

Serum uric acid, a metabolic byproduct of purine breakdown, has previously been linked to various health conditions, including cardiovascular disease and metabolic syndrome. However, its role in skin cancer development has not been established. This study aimed to fill that gap by analyzing SUA levels with skin cancer incidence among 1,219 individuals—336 diagnosed with melanoma (MM) and 883 with non-melanoma skin cancer (NMSC)—from the NHANES dataset spanning 1999 to 2020.

Multivariable regression models were used to adjust for potential confounding factors, including age, sex, race, lifestyle habits, and existing comorbidities.

The following were the key findings of the study:

  • Each 1 mg/dL increase in serum uric acid (SUA) was linked to a 19% higher risk of malignant melanoma.
  • A similar rise in SUA was associated with a 13% higher risk of non-melanoma skin cancer.
  • These associations were more evident among women and individuals of Mexican American ethnicity.
  • Despite the observed associations, Mendelian randomization analysis did not confirm a causal relationship between SUA levels and skin cancer.
  • Causality was assessed using methods like inverse variance weighting (IVW), MR-Egger, and the weighted median approach based on genome-wide association study (GWAS) data.
  • The findings suggest that SUA may act as a risk marker rather than a direct cause of skin cancer.
  • Restricted cubic spline (RCS) models revealed a non-linear relationship, with skin cancer risk increasing more sharply beyond certain SUA thresholds.
  • Elevated SUA levels were more strongly linked to malignant melanoma risk in older adults (aged 60 and above).
  • In contrast, non-melanoma skin cancer was found to be more prevalent in younger individuals with higher SUA levels.

The study’s authors emphasized the importance of interpreting SUA levels as part of a broader clinical picture, noting that systemic inflammation, oxidative stress, and immune dysregulation—all of which can be influenced by uric acid—may contribute to carcinogenesis.

The researchers note that while elevated SUA does not appear to be a direct cause of skin cancer, its strong association with MM and NMSC highlights its potential utility as a biomarker for identifying individuals at increased risk. They call for further investigations that integrate basic science, longitudinal data, and refined genetic tools to clarify the mechanisms at play and to explore whether lowering SUA might offer protective benefits.

Reference:

Niu Y, Shi S, Chen Y, Yang S, Yan P, Kou J. Association Between Serum Uric Acid Levels and Skin Cancer: Results from NHANES Data and Mendelian Randomization Analysis. Clin Cosmet Investig Dermatol. 2025;18:1437-1452

https://doi.org/10.2147/CCID.S517389

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IL-17 Inhibitors Increase Risk of Candida and Fungal Infections in Psoriasis Patients: Study

Researchers have found in a recent analysis reveals IL-17 inhibitors significantly increase the risk of Candida infections and other superficial fungal infections in patients with moderate-to-severe psoriasis, compared to placebo and other biologics.

Biologic agents have become a key treatment option for moderate-to-severe plaque psoriasis; however, the associated risk of superficial fungal infections, such as Candida and dermatophytes infections, remains unclear. This study aims to systematically assess the impact of different biologic agents on these infection risks and to compare the differences between them. Research questions and keywords were developed based on the Population, Intervention, Control and Outcome (PICO) framework. A systematic search of PubMed, EMBASE, the Cochrane Library and Web of Science was conducted for randomised controlled trials (RCTs) published up to December 2024, using the keywords ‘psoriasis’, ‘biologics’, ‘anti-IL-17’, ‘anti-IL-12/23’, ‘anti-TNF’, ‘superficial fungal infections’, ‘dermatophyte infections’, ‘Candida’ and ‘onychomycosis’. Meta-analyses were performed using RevMan 5.4 and STATA 16.0 software. Results: A total of 644 records were identified, with 29 articles included in the final analysis. Meta-analysis indicated that compared with placebo, interleukin-17 (IL-17) inhibitors notably raised the risk of Candida infections (OR = 2.39, 95% CI = 1.84–3.11, p < 0.00001), whereas tumour necrosis factor-alpha (TNF-α) inhibitors (OR = 1.75, 95% CI = 0.53–5.82, p = 0.36) and interleukin-12/23 (IL-12/23) inhibitors (OR = 1.11, 95% CI = 0.27–4.63, p = 0.88) showed no significant differences. Cross-comparison demonstrated that IL-17 inhibitors had a higher risk of Candida infection compared to TNF-α inhibitors (OR = 2.23, 95% CI = 1.08–4.57, p = 0.03) and IL-12/23 inhibitors (OR = 4.21, 95% CI = 2.71–6.55, p < 0.00001). For dermatophyte infections, the overall risk associated with biologic agents was increased (OR = 1.89, 95% CI = 1.19–3.01, p = 0.007), IL-17 inhibitors showed a higher risk compared to IL-12/23 inhibitors (OR = 2.70 95% CI = 1.29–5.63, p = 0.008). Overall, biologic agents significantly increased the risk of superficial fungal infections compared to placebo (OR = 2.10, 95% CI = 1.73–2.55, p < 0.00001). Biologic agents, particularly IL-17 inhibitors, notably increase the risk of superficial fungal infections in psoriasis patients. In clinical practice, targeted monitoring protocols should be established, including regular follow-up to promptly detect superficial fungal infections and initiate antifungal treatment as necessary.

Reference:

H. Liu, L. Zhou, Z. Song, R. Zhang, and Y. Kang, “ Biologic Therapy and Superficial Fungal Infection Risk in Moderate-to-Severe Psoriasis: A Meta-Analysis,” Mycoses 68, no. 6 (2025): e70081, https://doi.org/10.1111/myc.70081.

Keywords:

IL-17, Inhibitors, Increase, Risk, Candida, Fungal Infections, Psoriasis Patients, Study, H. Liu, L. Zhou, Z. Song, R. Zhang, and Y. Kang, Mycoses

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Antioxidants Preserve Bleached Enamel Color but Acidic Gels May Pose Enamel Risk: Study

Researchers have found in a new study that antioxidant agents maintained color stability after tooth bleaching and showed high antioxidant activity. However, QUI and QC gels had acidic pH, which may risk enamel damage. Therefore clinically, these antioxidants can aid bond strength recovery without compromising esthetic outcomes, but acidic formulations should be used cautiously.

This study evaluated the color stability of enamel submitted to 10% hydrogen peroxide (HP) followed by antioxidants agents, and the pH and antioxidant activity (AA%) of these agents. Bovine enamel-dentin blocks were randomly distributed into groups (n=10/group): GNC (negative control: no treatment); GPC (positive control: bleaching only); TOC_10% (HP+10% α-tocopherol); GT_10% (HP+10% green tea extract); GS_5% (HP+5% grape seed extract); SA_10% (HP+10% sodium ascorbate); QUI_10% (HP+10% quinoa extract); and QC_1% (HP+1% quercetin). Color (ΔE00) and whiteness index (ΔWID) changes were analyzed using a digital spectrophotometer. The pH and AA% were determined using a pH meter and the DPPH method, respectively. Data were analyzed by ANOVA/Tukey’s and Dunnett’s tests (α=0.05). Results At 14 days post-bleaching, GNC promoted the lowest ΔWID and ΔE00 (p<0.05), and no differences were found between GPC and the remaining groups submitted to the antioxidant agents (p>0.05). QC_1% and QUI_10% exhibited acidic pH levels (3.64 and 4.75, respectively), whereas TOC_10% and GS_5% exhibited alkaline pH (7.07 and 7.64, respectively). No differences in AA% were found between the agents (p>0.05), ranging from 92.6 to 97.6%. The antioxidant agents did not interfere in bleached enamel color stability, showing satisfactory antioxidant activity. However, QUI and QC gels displayed acidic pH. Clinical significance: The antioxidants evaluated showed high AA% and no impact on post-bleaching color stability, suggesting that their capacity to recover bond strength demonstrated elsewhere would not compromise the esthetic efficacy of tooth bleaching. However, those with acidic pH should be used with caution due to potential enamel damage.

Reference:

Alves RO, Nunes GP, Martins TP, Alves de Toledo PT, Ragghianti MHF, Delbem ACB. Effect of Quercetin-Doped Hydrogen Peroxide Gels on Enamel Properties: An In Vitro Study. Gels. 2025 Apr 27;11(5):325. doi: 10.3390/gels11050325. PMID: 40422345; PMCID: PMC12111415.

Keywords:

Antioxidants, Preserve, Bleached, Enamel, Color, Acidic, Gels, May, Pose, Enamel Risk, Study , Journal of Applied Oral Science, Antioxidants; Tooth bleaching; Color; Hydrogen peroxide, Alves RO, Nunes GP, Martins TP, Alves de Toledo PT, Ragghianti MHF, Delbem ACB

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