Increased mortality and complication rates observed in women following TAVR, suggests study

A new study published in the International Journal of Cardiology showed that regardless of sex, there are still prominent differences in Transcatheter Aortic Valve Implantation (TAVI) outcomes. TAVR offers helpful therapeutic choices to individuals who would not have been considered for valve replacement, despite the fact that it is not risk-free. In terms of recuperation, the experience of a person with a TAVR operation can resemble that of a coronary angiography. The treatment of severe aortic stenosis (AS) has been transformed by transcatheter aortic valve implantation, yet, it is still unknown how sex difference affects TAVI results. Thereby, Manoj Kumar and his colleagues looked at how post-procedural outcomes of TAVI, such as readmission rates and healthcare burden, differed for men and women.

To find hospitalizations for TAVI, the Nationwide Readmissions Database (2016–2020) was utilized. Males and females were matched using a propensity score matching (PSM) algorithm. Pearson’s chi-squared test was employed to analyze the results. A total of 1,42,054 (44.3%) of the 3,20,324 TAVI hospitalizations involved surgical procedures on the female patients.

In-hospital mortality, stroke, post-procedural hemorrhage, vascular complications, acute respiratory failure (ARF), pericardial complications, transfusion requirement, vasopressor need, and major adverse cardiac and cerebrovascular events (MACCE) were all greater among women after propensity matching.

Acute kidney damage (AKI), sudden cardiac arrest (SCA), cardiogenic shock, and the need for mechanical circulatory support (MCS) were all considerably less common in women. At 30 and 90 days, readmission rates were greater for males than for women. Following TAVI, there was no discernible difference in the 180-day readmission rates for men and women. Also, procedure-related mortality declined for both sexes and hospitalization expenses and recuperation durations fell between 2016 and 2020.

Overall, men experienced greater rates of readmission, cardiogenic shock, AKI, and the requirement for mechanical circulatory support, whereas women saw higher rates of death and post-procedural complications. Despite improvements in procedure-related mortality and TAVI resource utilization from 2016 to 2020, regardless of sex, the results of this show notable differences in TAVI outcomes.

Reference:

Kumar, M., Hu, J.-R., Ali, S., Khlidj, Y., Upreti, P., Ati, L., Kumar, S., Shaka, H., Zheng, S., Bae, J. Y., Alraies, M. C., Mba, B., Yadav, N., Vora, A. N., & Davila, C. D. (2025). Sex disparities in outcomes of transcatheter aortic valve implantation- a multi-year propensity-matched nationwide study. In International Journal of Cardiology (Vol. 418, p. 132619). Elsevier BV. https://doi.org/10.1016/j.ijcard.2024.132619

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Melatonin Supplementation Improves Glycemic Control in Type 2 Diabetes, Research Finds

Iran: A recent systematic review and meta-analysis have highlighted the potential benefits of melatonin supplementation for individuals with Type 2 diabetes, revealing that it may improve glycemic control.

The findings, published in Current Pharmaceutical Design, indicate that patients with Type 2 diabetes who were supplemented with melatonin experienced significant improvements in their glycemic control. Notably, supplementing with melatonin at doses exceeding 6 mg daily for over 12 weeks appears to be more effective than other forms of intervention.

Melatonin, a hormone primarily produced by the pineal gland, is known for regulating sleep-wake cycles. However, it also has antioxidant properties and influences insulin sensitivity, making it a topic of interest in diabetes research.

Several previous studies have suggested that melatonin supplementation may positively affect glycemic control in patients with diabetes. However, the research regarding the effects of melatonin on glycemic parameters remains inconclusive. Therefore, Reza Nejad Shahrokh Abadi, Mashhad University of Medical Sciences, Mashhad, Iran, and colleagues sought to evaluate the effects of melatonin supplementation on glycemic parameters in individuals with Type 2 diabetes through a meta-analysis.

For this purpose, the researchers conducted a comprehensive search of PubMed/Medline, Scopus, and Web of Science until July 2024 to identify eligible randomized clinical trials (RCTs). They estimated overall effect sizes using a random-effects model, presenting the results as weighted mean differences (WMD). Additionally, the heterogeneity among the included trials was evaluated using the Cochran Q test, with interpretations based on the I² statistic.

The research revealed the following findings:

  • Out of 1,361 papers reviewed, eight eligible RCTs were included in this meta-analysis.
  • The results revealed that melatonin supplementation significantly reduced fasting blood glucose (WMD = -12.65 mg/dl), insulin levels (WMD = -2.30 μU/ml), hemoglobin A1c (WMD = -0.79%), and HOMA-IR (WMD = -0.83).

This systematic review and meta-analysis indicate that melatonin supplementation may provide significant benefits for glycemic control in individuals with Type 2 diabetes, especially at higher doses and over longer durations.

“As awareness of personalized treatment strategies in diabetes care increases, melatonin could become a valuable adjunct therapy. However, further research involving larger sample sizes is essential to establish definitive conclusions,” the researchers concluded.

Reference:

Abadi, Reza Nejad Shahrokh, et al. “Impact of Melatonin Supplementation On Glycemic Parameters in Patients With Type 2 Diabetes: a Systematic Review and Meta-analysis.” Current Pharmaceutical Design, 2024.

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High-sensitivity troponin shows promise in diagnosing acute coronary syndrome in primary care settings: Study

Chest pain is a common but challenging symptom for general practitioners to evaluate, as it can be caused by both serious conditions and more benign issues. This study assessed the effectiveness of various risk stratification tools, including clinical decision rules and troponin tests, in helping general practitioners rule out acute coronary syndrome in patients with chest pain.

Study Approach: Researchers conducted a systematic review of studies involving adult patients presenting with chest pain in primary care settings. The review included studies that examined the diagnostic accuracy of different clinical decision rules and troponin point-of-care tests, both conventional and high-sensitivity, in identifying acute coronary syndrome, which includes heart attacks. The study compared these tools to the unaided clinical judgment of general practitioners.

Main Findings: 14 studies were included in the final review.

• Some of the clinical decision rules without troponin improved safety. However, none consistently outperformed unaided general practitioner judgment in ruling out acute coronary syndrome.

• Conventional troponin as a standalone test did not meet the desired diagnostic accuracy, making the tests less reliable in primary care settings.

• High-sensitivity troponin tests demonstrated the highest diagnostic accuracy. However, this finding requires further prospective validation in primary care before it can be recommended for widespread use.

Why It Matters: Although high-sensitivity troponin tests hold promise, they are not yet ready to replace clinical judgment or be used independently in primary care settings without further validation.

Reference:

Simone van den Bulk, Amy Manten, Tobias N. Bonten and Ralf E. Harskamp, Chest Pain in Primary Care: A Systematic Review of Risk Stratification Tools to Rule Out Acute Coronary Syndrome, The Annals of Family Medicine September 2024, 22 (5) 426-436; DOI: https://doi.org/10.1370/afm.3141.

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Methotrexate Treatment may jeopardize immune responses of COVID-19 vaccination in Rheumatoid Arthritis Patients: Study

Researchers have discovered that methotrexate (MTX) therapy may substantially diminish vaccine-induced CD4 T cell activation resulting in decreased antibody responses in rheumatoid arthritis (RA) patients. A recent study was published in the journal RMD Open conducted by Kummer and colleagues.

MTX is widely accepted as the “gold standard” treatment for RA and commonly used to treat other IMIDs, including psoriatic arthritis (PsA) and spondyloarthritis (SpA). MTX inhibits purine and pyrimidine synthesis, which is required for cell division and, therefore, represents one of the most important anticancer drugs. Its anti-inflammatory effect in the treatment of IMID is poorly understood but may include blockade of NF-κB signaling, increased adenosine release, and T cell apoptosis.

Led by Laura YL Kummer, the study included 59 participants: 18 RA patients and 2 PsA patients receiving MTX monotherapy; 10 RA patients without immunosuppressive therapy; and 29 healthy controls. The researchers analyzed CD4 T cell and B cell responses 7 days and 3–6 months after two doses of the SARS-CoV-2 messenger RNA vaccines. To this end, they studied whole blood samples, antigen-specific CD4 T cells, and B cell activity through high-dimensional flow cytometry.

  • 7 days after vaccination with two injections of the SARS-CoV-2 vaccines, MTX-treated patients had equivalent overall B and T cells count compared to controls.

  • The frequencies of spike-specific B cells were unchanged by MTX treatment. More remarkably, MTX treatment reduced antigen-specific CD4 T cells to a very minimal level, which was well correlated with the levels of anti-RBD IgG antibodies.

  • Patients in the MTX-treated group had inductions that were significantly lower than those of patients not treated with MTX, with a median of 0.17 (95% CI, 0.12 to 0.21) in comparison to 0.29 (95% CI, 0.18 to 0.39) for those not on MTX (P = 0.017).

  • Antibody response was associated with very low antibody responses, as the level of induction of CD4 T cells could be inversely correlated with antibody responses, indicating that perhaps the treatment with MTX may delay the vaccination-induced immune response in RA patients.

  • While the CD4 T cell activity was lower in the patients treated with MTX, the frequencies of spike-specific B cells were similar between these patients and controls.

The study concludes that MTX decreases specific CD4 T cell responses in patients with RA, an effect seemingly leading to kinetics of antibodies significantly decelerated. The clinical relevance of it all, as a whole, has yet to be shown however, the immune responses in such patients on MTX therapy would be vital toward being monitored as vaccination efforts proceed.

Reference:

Kummer LYL, Fernández Blanco L, Kreher C On behalf of the T2B! Immunity Against SARS-CoV-2 Study Group, et al. Methotrexate treatment hampers induction of vaccine-specific CD4 T cell responses in patients with IMID. RMD Open 2024;10:e004664. doi: 10.1136/rmdopen-2024-004664

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Early Life Adipose Tissue Development Tied to Cardiovascular Risks in Adolescents: JAMA

Netherlands: A recent cohort study published in JAMA Network Open has unveiled critical insights into how early-life growth parameters influence adolescent cardiovascular health. The research, conducted with 232 participants, highlights the significant role of abdominal visceral adipose tissue (VAT) in predicting increased carotid intima-media thickness (cIMT) and carotid stiffness—a key indicator of arterial health.

The findings indicate that evaluating adipose tissue development in childhood can help identify lifelong risk patterns and inform personalized cardiovascular prevention and management strategies.

Carotid intima-media thickness is a widely recognized marker for atherosclerosis and cardiovascular disease risk. Increased cIMT and carotid stiffness during adolescence can foreshadow cardiovascular issues in later life, making early detection essential.

Atherogenesis begins in childhood, highlighting this period as a crucial opportunity to prevent atherosclerotic cardiovascular disease in later life. Considering this, Isabelle A. van der Linden, University Medical Center Utrecht, Utrecht, the Netherlands, and colleagues aimed to identify early-life risk factors for preclinical atherosclerosis in adolescence.

For this purpose, the researchers conducted a cohort study as part of the ongoing Wheezing Illness Study in Leidsche Rijn (WHISTLER) prospective birth cohort, which includes 3,005 healthy newborns born between December 2001 and December 2012 in the Leidsche Rijn area of Utrecht, the Netherlands. The study focused on participants from this cohort who attended adolescent follow-up visits between March 2019 and October 2020, with analyses carried out in January 2024.

To assess early-life growth, the researchers evaluated participants at multiple stages: from birth to 6 months, at five years, and again at ages 12 to 16. They utilized abdominal ultrasonography to measure both abdominal subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) depth, alongside calculating blood pressure percentiles and body mass index (BMI) z scores.

Carotid ultrasonography was performed when participants reached ages 12 to 16 years to evaluate carotid intima-media thickness (cIMT) and the distensibility coefficient (DC), which are well-established measures of preclinical atherosclerosis. Multivariable linear regression models were employed to identify early-life risk factors for cIMT and DC during adolescence.

The following were the key findings of the study:

  • In total, 232 adolescents (median age, 14.9 years; 52.2% females) were included.
  • More postnatal weight gain (B = 12.34), higher systolic BP at five years (B = 0.52), more VAT at five years (B = 3.48), and a larger change in VAT between 5 and 12 to 16 years (B = 3.13) were associated with a higher cIMT in adolescence.
  • A higher BMI (B = −2.70) and VAT at five years (B = −0.56), as well as a larger change in BMI between 5 and 12 to 16 years (B = −3.63), were associated with a higher carotid stiffness in adolescence.
  • A larger change in SAT between 5 and 12 to 16 years (B = 0.37) was associated with a higher carotid DC in adolescence.

“In the study involving 232 participants, we found that early-life growth parameters—especially the development of abdominal VAT—were linked to increased carotid intima-media thickness and carotid stiffness during adolescence,” the researchers wrote.

“These results indicate that evaluating adipose tissue growth in childhood can help identify lifetime risk patterns and inform personalized cardiovascular prevention and management strategies,” they concluded.

Reference:

van der Linden IA, Roodenburg R, Nijhof SL, et al. Early-Life Risk Factors for Carotid Intima-Media Thickness and Carotid Stiffness in Adolescence. JAMA Netw Open. 2024;7(9):e2434699. doi:10.1001/jamanetworkopen.2024.34699

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Early age of menarche associated with physical and psychological health of the women, reveals survey

Adolescence is the transitional stage between childhood and
maturity. The onset of puberty is caused by the activation of complex
neuroendocrine regulatory mechanisms, which releases pulsatile GnRH (gonadotropin-releasing-hormone)
output. The age of menarche, which is an indication that a female has reached
reproductive maturity, has a significant impact on the health of women.

Numerous variables, which would include nutritional status,
socioeconomic status, diet, environment, sibling relationships, hereditary and
genetic factors, religion, ethnicity, psychological stress, migration, and
chronic illness, have been theorised to influence the age of menarche, opinions
for and against the theory have varied among clinicians and researchers. Both
in industrialised and emerging nations, the average age at menarche has fallen,
probably as a result of better nutrition and health.

Women who reach menarche before the average age of 12 years
are more likely to face psychosocial challenges, putting them at risk for
diseases such as obesity, diabetes, cardiovascular disease, and breast cancer.
5 Early menarche has been implicated as a risk factor for dyslipidaemia,
hypertension, and hyperglycaemia in a number of studies. The date of menarche
has been associated with cardiovascular disease (CVD), which is assumed to be
due, at least in part, to increased lifelong oestrogen consumption.

Reproductive period duration is closely linked to age at
menarche and menopausal age, which have been implicating various health
consequences for women in later life. Relationship between menarche and
menopause helps us understand the importance of effective prevention and
management of health problems such as CVD, Osteoporosis, Breast cancer, type 2
DM (diabetes mellitus) etc.

The HRQOL (health related quality of life) of middle aged
women in South India is lower than the natural average and has and increased
correlation with BMI.

Authors anticipate
that the outcome of the current study would provide an insight about
availability, attitude and awareness about physiotherapy towards the addressing
of health issues among female population, thereby reducing morbidity and
mortality and improve the overall HRQOL among the middle-aged female
population.

Women matching the study criteria and willing to participate
in the survey were approached and informed consent was taken. An interview was
conducted on either a physical or virtual mode by a trained therapist as per
the check list designed for this study. The content of the checklist was
validated with the help of experts in this study domain and subjected to
statistical tests which yielded a Cronbach’s score of 0.967. The participants
response on this checklist was analyzed and a strong association of physical
and psychological health issue was documented particularly among working women,
multiparous women, and with type of delivery women had undergone during 1s t
pregnancy.

The average menarcheal age in Indian women was documented as
13±1.1 years. The age of menarche plays a major role as an indicator for sexual
maturation and other factors i.e., family size, environmental and genetic
conditions, BMI and level of education. Early menstrual age is associated with
a high risk of the disease conditions, namely, uterine leiomyomata, endometrial
cancer, breast cancer, and obesity; besides having an influence on reproductive
performance, age of initial sexual activity, age of first pregnancy, and
likelihood of additional miscarriages.

This checklist may be used in the future studies to assess
physiological and psychological health issues faced by middle aged Indian
women, given the ease of administration and shorter time required to respond to
it. This survey form may specifically be helpful to cater to a larger women
population at the community level.

Source: Sneha S, Sharma K N and Visarapu / Indian Journal of
Obstetrics and Gynecology Research 2024;11(3):426–430

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Obesity in mothers doubles risk of autism in babies, finds study

Children born to mothers with obesity both before and during pregnancy have an increased risk of neuropsychiatric and behavioural conditions, including autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD), according to new research from the University of South Australia.

Funded by Centre of Research Excellence Health in Preconception & Pregnancy and conducted in partnership with Curtin University, Monash University, SAHMRI and a team of national institutions*, the systematic review and meta-analysis of more than 3.6 million mother-child pairs across 42 epidemiological studies found that obesity during pregnancy:

• increases the risk of ADHD in children by 32%.

• doubles the risk of developing ASD in children (by 2.23 times).

• increases the risk of conduct disorders by 16%

The study also found that maternal pre-conception obesity or overweight was linked with an increased risk of ADHD, ASD, conduct disorder and psychotic disorder as well as a 30% increased risk in both externalising symptoms, and peer relationship problems.

Lead researcher UniSA’s Dr Bereket Duko says the study provides new insights into the long-term impact of maternal body weight on child mental health.

“Maternal obesity has long been associated with a range of adverse perinatal outcomes, including preterm birth, low birthweight, stillbirth, and it is also linked with macrosomia, or high birthweight,” Dr Duko says.

“In this study, we examined maternal overweight and obesity before and during pregnancy, finding that both are significantly linked with psychiatric and behavioural problems in children later in life, specifically ASD, ADHD and peer relationship problems.

“Given the rising global obesity rates among women of reproductive age, and the growing numbers of children identified with neurodiverse conditions, it’s important that we acknowledge the potential long-term consequences of maternal adiposity on child mental health.”

In Australia, about one in 150 people have ASD with more than 8% of children aged 4-11 diagnosed with ADHD. Globally, one in eight people live with obesity.

Dr Duko says the study’s results underscore the need for interventions targeting maternal weight management before and during pregnancy.

“Public health efforts that target improving maternal health could help mitigate some of the risks of neuropsychiatric and behavioural disorders in children,” Dr Duko says.

“While further research is needed to explore the biological mechanisms underlying these associations, the findings do stress the need for health interventions that promote healthy living and weight among parents to be.”

Reference:

Bereket Duko, Tesfaye S. Mengistu, David Stacey, Lisa J Moran, Gizachew Tessema, Gavin Pereira, Asres Bedaso, Amanuel Tesfay Gebremedhin, Rosa Alati, Oyekoya T Ayonrinde, Beben Benyamin, S. Hong Lee, Elina Hyppönen, Associations between maternal preconception and pregnancy adiposity and neuropsychiatric and behavioral outcomes in the offspring: A systematic review and meta-analysis, Psychiatry Research, https://doi.org/10.1016/j.psychres.2024.116149.

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Nonsurgical root canal treatment or retreatment of teeth with large apical periodontitis lesions tied to favourable outcomes: Study

Nonsurgical root canal treatment or retreatment of teeth with large apical periodontitis lesions tied to favourable outcomes suggests a study published in the Journal of Endodontics.

This study reported on the outcome of the nonsurgical root canal treatment/retreatment of teeth with large apical periodontitis lesions. The influence of some variables on the prognosis was also evaluated. The study included 199 teeth with large apical periodontitis lesions from 184 patients, treated/retreated by a single operator. Most teeth were managed in a single visit using NaOCl irrigation. Cases were followed up periodically from >1 to 8 years. Treatment/retreatment outcome was evaluated by clinical and radiographic/tomographic criteria and categorized as healed, healing, or diseased. For statistical analysis, data were dichotomized so that healing cases were considered as success in a loose criterion or failure in a rigid one. Results: Clinical/radiographic analyses revealed that 67% of the initial treatment cases were classified as healed, 22.5% as healing, and 11% as diseased. Treatment success rates were 89% (loose) and 67% (rigid). Variables influencing the treatment outcome included previous abscess and antibiotic use, large lesions (≥10 mm), and a sinus tract. The median follow-up time for treatment was 31.5 months. As for retreatment cases, 47% were healed, 32% were healing, and 21% were diseased. Retreatment success rates were 79% (loose) and 47% (rigid), in a median follow-up of 32 months. Cases evaluated by cone-beam computed tomography had lower healed rates. Findings demonstrate that high favourable outcome rates can be achieved by nonsurgical root canal treatment or retreatment of teeth with large apical periodontitis lesions.

Reference:

Artaza L, Campello AF, Soimu G, Alves FRF, Rôças IN, Siqueira JF Jr. Outcome of Nonsurgical Root Canal Treatment of Teeth With Large Apical Periodontitis Lesions: A Retrospective Study. J Endod. 2024 Aug 15:S0099-2399(24)00441-2. doi: 10.1016/j.joen.2024.08.003. Epub ahead of print. PMID: 39151889.

Keywords:

Nonsurgical, root, canal, treatment, retreatment, teeth, large, apical, periodontitis, lesions, tied, favourable, outcomes, study, Artaza L, Campello AF, Soimu G, Alves FRF, Rôças IN, Siqueira JF, Journal of Endodontics, Apical periodontitis, outcome, retrospective study, root canal treatment

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Ciprofol less painful and safer than propofol for induction of GA and sedation: Study

Propofol has been utilized in the medical field as an anesthetic agent for inducing and maintaining general anesthesia due to its benefits. Nevertheless, it is associated with limitations such as pain upon injection. A new anaesthetic drug called ciprofol has recently garnered attention as a potential solution to address several drawbacks linked to propofol. Recent systematic review and meta-analysis evaluated the anesthetic and sedative efficacy and safety of ciprofol compared to propofol in adult patients undergoing various procedures. The analysis included 19 randomized controlled trials with a total of 2,841 participants. The key findings are as follows:

Efficacy

Efficacy: There was no significant difference between ciprofol and propofol in the success rate of endoscopy procedures. However, ciprofol showed a small but statistically significant increase in the success rate of general anesthesia/sedation induction compared to propofol. There were also no differences between the two drugs in induction time, time to eyelash reflex disappearance, insertion time, or discharge time. Ciprofol did show a significantly longer awakening time compared to propofol.

Safety

Safety: Ciprofol demonstrated significantly less pain on injection compared to propofol. Ciprofol also had a significantly lower incidence of adverse events overall compared to propofol, though there was no difference in the rate of serious adverse events between the two drugs.

Patient and Provider Satisfaction

Patient and provider satisfaction: Ciprofol showed significantly higher patient satisfaction compared to propofol, though there was no difference in anesthesiologist satisfaction between the two drugs.

Vital Signs

Vital signs: Ciprofol was associated with a significant increase in systolic and diastolic blood pressure compared to propofol, though there were no differences in other vital signs like heart rate, mean arterial pressure, and oxygen saturation.

Conclusion

In summary, this comprehensive meta-analysis found that ciprofol exhibited comparable efficacy to propofol in inducing general anesthesia and sedation, with some advantages in terms of reduced injection pain, fewer adverse events, and higher patient satisfaction. These findings suggest that ciprofol may be a viable alternative to propofol for anesthesia and sedation in various clinical settings. However, the authors note the need for further research, particularly studies conducted outside of China, to confirm these results and establish broader clinical guidelines for the use of ciprofol.

Key Points

1. Efficacy: There was no significant difference between ciprofol and propofol in the success rate of endoscopy procedures, but ciprofol showed a small but statistically significant increase in the success rate of general anesthesia/sedation induction compared to propofol. There were also no differences between the two drugs in induction time, time to eyelash reflex disappearance, insertion time, or discharge time, though ciprofol did show a significantly longer awakening time.

2. Safety: Ciprofol demonstrated significantly less pain on injection compared to propofol and had a significantly lower incidence of adverse events overall, though there was no difference in the rate of serious adverse events between the two drugs.

3. Patient and Provider Satisfaction: Ciprofol showed significantly higher patient satisfaction compared to propofol, though there was no difference in anesthesiologist satisfaction between the two drugs.

4. Vital Signs: Ciprofol was associated with a significant increase in systolic and diastolic blood pressure compared to propofol, though there were no differences in other vital signs like heart rate, mean arterial pressure, and oxygen saturation.

5. The comprehensive meta-analysis found that ciprofol exhibited comparable efficacy to propofol in inducing general anesthesia and sedation, with some advantages in terms of reduced injection pain, fewer adverse events, and higher patient satisfaction.

6. The authors note the need for further research, particularly studies conducted outside of China, to confirm these results and establish broader clinical guidelines for the use of ciprofol.

Reference –

Saeed A, Elewidi M, Nawlo A, Elzahaby A, Khaled A, Othman A, et al. Efficacy and safety of ciprofol versus propofol for induction of general anaesthesia or sedation: A systematic review and meta‑analysis of randomised controlled trials. Indian J Anaesth 2024;68:776‑94

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Can aerobic exercise help prevent brain fog caused by chemotherapy?

Many women who receive chemotherapy experience a decreased ability to remember, concentrate, and/or think-commonly referred to as “chemo-brain” or “brain fog”-both short- and long-term. In a recent clinical trial of women initiating chemotherapy for breast cancer, those who simultaneously started an aerobic exercise program self-reported greater improvements in cognitive function and quality of life compared with those receiving standard care. The findings are published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.

The study, called the Aerobic exercise and CogniTIVe functioning in women with breAsT cancEr (ACTIVATE) trial, included 57 Canadian women in Ottawa and Vancouver who were diagnosed with stage I–III breast cancer and beginning chemotherapy. All women participated in 12–24 weeks of aerobic exercise: 28 started this exercise when initiating chemotherapy and 29 started after chemotherapy completion. Cognitive function assessments were conducted before chemotherapy initiation and after chemotherapy completion (therefore, before the latter group started the exercise program).

Women who participated in the aerobic exercise program during chemotherapy self-reported better cognitive functioning and felt their mental abilities improved compared with those who received standard care without exercise. Neuropsychological testing-a performance-based method used to measure a range of mental functions—revealed similar cognitive performance in the two groups after chemotherapy completion, however.

“Our findings strengthen the case for making exercise assessment, recommendation, and referral a routine part of cancer care; this may help empower women living with and beyond cancer to actively manage both their physical and mental health during and after treatment,” said lead author Jennifer Brunet, PhD, of the University of Ottawa.

Dr. Brunet noted that many women undergoing chemotherapy for breast cancer remain insufficiently active, and there are limited exercise programs tailored to their needs. “To address this, we advocate for collaboration across various sectors-academic, healthcare, fitness, and community-to develop exercise programs specifically designed for women with breast cancer,” she said. “These programs should be easy to adopt and implement widely, helping to make the benefits of exercise more accessible to all women facing the challenges of cancer treatment and recovery.”

Reference:

Jennifer Brunet, Sitara Sharma, Kendra Zadravec, Monica Taljaard, Aerobic exercise and CogniTIVe functioning in women with breAsT cancEr (ACTIVATE): A randomized controlled trial, Cancer,https://doi.org/10.1002/cncr.35540.

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