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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Low-Energy Total Diet Replacement Does Not Worsen Eating Disorder Symptoms in High-Risk Patients: Lancet

Researchers have found in a new study that a 12-week low-energy total diet replacement program did not exacerbate eating disorder symptoms in individuals with overweight or obesity and type 2 diabetes who were at high risk of developing such disorders. The study was conducted by Elena T. and fellow researchers published in The Lancet Psychiatry journal.

Low-calorie TDR diets, usually formula products of nutritionally complete fare like soups, shakes, and bars, are most frequently employed for inducing fast weight loss in those with obesity. Their strict composition and emphasis on weight loss have, however, fueled worry over their capacity to induce disordered eating, particularly in susceptible individuals. That fear was addressed by this trial in a rigorous assessment of the safety and psychological effects of TDR in a high-risk group.

The trial was a randomized, controlled, non-inferiority trial in England involving participants with type 2 diabetes, overweight, and exhibiting signs of eating disorder symptoms. Participants were allocated (1:1) to a low-energy TDR program or standard care for diabetes.

Intervention comprised:

  • 12 weeks of low-energy diet with formula products

  • 8 weeks of stepped reintroduction of foods

  • 4 weeks of weight maintenance advice tailored to participants’ preferences

Behavioral treatment was provided remotely. The main outcome was modification in the Eating Disorder Examination Questionnaire (EDE-Q) global score at 6 months. Safety was measured by tracking the development of any new cases of eating disorder. The non-inferiority bound was +1 SD (0.72) for the EDE-Q score.

Participant Profile

  • From March 8 to September 12, 2023, 56 participants were enrolled altogether

  • 28 in intervention group and 28 in control group

  • Mean age: 49.9 years (SD 8.1)

  • Gender: 35 (63%) women, 20 (36%) men, 1 (2%) non-binary

  • Ethnicity: 54 (96%) White, 2 (4%) Asian

  • Mean BMI: 39.6 kg/m² (SD 7.8)

  • Mean baseline EDE-Q score: 3.3 (SD 0.4)

Key Findings

At 6 months, when TDR program concluded:

  • Mean weight loss in the intervention group was –13.9 kg (SD 11.2)

  • Control group lost –3.7 kg (SD 7.9)

  • Between-group difference in weight: –10.2 kg (95% CI: –14.2 to –6.2)

Symptoms of eating disorders improved:

  • Between-group difference in EDE-Q global score: –0.8 points (95% CI: –1.4 to –0.3), establishing non-inferiority

  • No participant was suspected of having a new eating disorder

  • At 12 months, while between-group differences in weight change were no longer statistically significant, EDE-Q score improvement was maintained, suggesting psychological benefit over the long term.

Engagement in a remotely delivered, structured total diet replacement (TDR) program did not exacerbate eating disorder symptoms in individuals with type 2 diabetes and obesity who were at elevated risk for disordered eating. The program resulted in significant weight reduction and even demonstrated evidence of decreasing eating disorder scores. This study justifies the safe implementation of TDR with adjunctive behavioral treatment in clinical practice.

Reference:

Tsompanaki, E., Aveyard, P., Park, R. J., Jebb, S. A., & Koutoukidis, D. A. (2025). An intensive weight loss programme with behavioural support for people with type 2 diabetes at risk of eating disorders in England (ARIADNE): a randomised, controlled, non-inferiority trial. The Lancet. Psychiatry, 12(7), 483–492. https://doi.org/10.1016/S2215-0366(25)00126-9

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New PET tracer delivers high-quality images of brain inflammation activity: Study

A newly developed PET radiotracer has shown the ability to produce high-quality images of real-time brain inflammation, according to research presented at the Society of Nuclear Medicine and Molecular Imaging 2025 Annual Meeting. By identifying activated immune cells in the brain, the tracer may pave the way for earlier diagnosis and more personalized treatment of a range of neurological diseases including Alzheimer’s, Parkinson’s, ALS, and multiple sclerosis.

Neuroinflammation-an immune response triggered by infection, toxin buildup, or injury in the central nervous system-is a key driver in the progression of many neurodegenerative and psychiatric disorders. Imaging neuroinflammation plays a critical role in diagnosis, monitoring, and treatment.

“Current clinical PET imaging for neuroinflammation primarily uses tracers that target TSPO, a downstream marker that is broadly expressed across multiple cell types,” said Jiahui Chen, PhD, associate scientist in the Department of Radiology and Imaging Sciences at Emory University School of Medicine in Atlanta, Georgia. “Our study presents ¹⁸F-PDE-1905, a novel PET tracer specifically developed to target phosphodiesterase 4B (PDE4B)-a crucial intracellular enzyme that regulates inflammatory signaling within microglia, the immune cells of the central nervous system.”

Researchers began by analyzing a genomics database to assess PDE4B expression in neuroinflammatory diseases using bioinformatics tools. They then developed a mouse model of neuroinflammation and performed dynamic PET imaging using the ¹⁸F-PDE-1905 alongside the TSPO-specific tracer ¹⁸F-D2-LW223. Follow-up analyses were conducted to evaluate protein expression and confirm its correlation with the PET imaging findings.

Bioinformatics analysis revealed elevated PDE4B levels in both Parkinson’s disease and multiple sclerosis patients, as well as in corresponding mouse models. PET imaging showed significantly higher uptake of ¹⁸F-PDE-1905 in the brains of diseased mice compared to controls, indicating increased tracer activity in neuroinflammatory conditions. When compared to the TSPO-specific tracer ¹⁸F-D2-LW223, ¹⁸F-PDE-1905 demonstrated superior image quality and greater brain distribution, underscoring its promise for imaging neuroinflammation.

“By directly targeting PDE4B, ¹⁸F-PDE-1905 provides a more specific and upstream view of microglial activation—an early and critical factor in the progression of many neurological diseases,” said Chen. “For patients, this could mean earlier and more accurate diagnoses, better tracking of treatment effectiveness, and more personalized therapies based on direct measures of neuroinflammation. Ultimately, ¹⁸F-PDE-1905 has the potential to drive a major shift toward precision-guided care in neurodegenerative disorders.”

Reference:

Jiahui Chen, Yabiao Gao, Xin Zhou,Visualization of phosphodiesterase 4B in neuroinflammation mouse models with positron emission tomography, Journal of Nuclear Medicine.

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Higher Visceral Fat-to-Muscle Ratio Linked to Severe COPD Exacerbations and Heart Risks: Study Shows

China: A recent prospective cohort study published in Respirology has revealed a significant association between the visceral fat-to-muscle ratio (VMR) and the risk of severe exacerbations in individuals with chronic obstructive pulmonary disease (COPD). Led by Yuanyuan Li from the School of Public Health at Xinjiang Medical University in Urumqi, China, the study emphasizes the potential role of VMR as a predictive marker for COPD-related hospitalizations.

The research was conducted as part of the Xinjiang Multi-Ethnic Cohort study, spanning from May 2018 to December 2023. It included 631 patients diagnosed with COPD. At baseline, participants underwent bioelectrical impedance analysis to assess visceral fat and muscle mass, from which VMR was calculated. Over the study period, researchers tracked severe COPD exacerbations that required hospitalization and evaluated the relationship between VMR and these exacerbations using logistic regression and zero-inflated Poisson regression models.

The study revealed the following findings:

  • Patients with a higher visceral fat-to-muscle ratio (VMR) had a significantly increased risk of experiencing severe COPD exacerbations during both one-year and five-year follow-up periods.
  • Each unit increase in VMR was linked to a 34% higher risk of hospitalization due to COPD exacerbation within one year and a 44% increase over five years.
  • VMR proved to be a more reliable predictor of severe exacerbations compared to conventional metrics like body mass index (BMI) and other obesity-related measures.
  • Subgroup analyses showed that the association between elevated VMR and exacerbation risk was especially marked in women and individuals classified as overweight.
  • In women, the odds of having a severe exacerbation rose by 89% within one year and by 99% over five years for every one-unit rise in VMR.
  • Among overweight participants, each unit increase in VMR corresponded to an 80% increased risk of exacerbation at one year and 88% at five years.
  • Additional analysis indicated that for every one-point increase in VMR, the number of COPD exacerbations rose by 46%.
  • These associations remained consistent even after controlling for potential confounding factors like smoking history and removing underweight individuals from the analysis.
  • The results were further validated through sensitivity analyses and remained unchanged even when considering competing risks, such as deaths from causes unrelated to COPD.
  • Although the study’s main focus was on severe COPD exacerbations, it also referenced related findings where elevated VMR levels were associated with greater cardiovascular risks in COPD patients.
  • In those cases, each standard deviation increase in VMR was tied to a 50% higher likelihood of experiencing a major adverse cardiovascular event (MACE), and patients in the highest VMR quartile had a five-fold greater risk of MACE compared to those in the lowest quartile.

The authors concluded that VMR is a valuable risk indicator for COPD exacerbations. Proactively measuring and monitoring VMR could help clinicians better identify high-risk patients and tailor interventions to reduce hospitalizations and improve outcomes in COPD management.

Reference:

Li, Y., Wang, L., Li, Z., Luo, T., Sun, Q., Lynn, H. S., & Dai, J. (2025). Association Between the Visceral Fat-to-Muscle Ratio and Severe Exacerbation of COPD: A Prospective Cohort Study. Respirology, 30(5), 398-407. https://doi.org/10.1111/resp.14883

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New: Recommendations for antirheumatic treatment in men and women planning a family

The European Alliance of Associations for Rheumatology-published points-to-consider on the use of antirheumatic drugs in reproduction, pregnancy, and lactation. Since then, new evidence has become available, so the points have been reviewed and updated–including an upgrade to full recommendations.

Rheumatic and musculoskeletal diseases (RMD) often affect people during the years when they might be planning a family. The underlying nature of these diseases can affect people’s fertility, and may make women more at risk of some poor pregnancy outcomes, such as having small or premature babies. Some of the antirheumatic treatments used can also affect fertility, and may not be safe to use during pregnancy. What drugs are used for a person’s RMD when they are planning a family is therefore a consideration for both men and women, and impact show treatment might need to be tailored around conception, as well as during pregnancy and breastfeeding.

A series of points-to-consider were released in 2016, but since then treatment approaches have evolved –moving towards a treat-to-target concept that can help to avoid some of the negative impacts of active disease on fertility and pregnancy outcomes. Alongside this, there has been new relevant data published about antirheumatic drugs in the context of pregnancy and breastfeeding –as well as in male reproductive health. To address this, EULAR has reviewed the evidence and upgraded the advice to full recommendations.

The new work, published in the April 2025 issue of the Annals of the Rheumatic Diseases, includes 12 individual recommendations and five overarching principles. These principles emphasise that everyone with an RMD–both men and women –should be offered early and regular counselling about their reproductive health and the need to adjust therapy in relation to pregnancy. But treatment of the RMD before conception and during and after pregnancy should still aim at remission or low disease activity. Importantly, the potential risk to the child should be weighed against the risk to the mother of having a period of untreated disease. Given the known benefits, women should not be discouraged from breastfeeding and there are compatible medications they can take during this period. Finally, the choice of treatment before, during, and after pregnancy should be a shared decision-making process between the treating healthcare providers and the patient.

The 12 new recommendations focus on three areas. First, the specific antirheumatic drugs that can be used for women before and during pregnancy, including which are compatible and which should be discontinued before attempting to conceive a child. They also look at which vaccines can be used in infants who have been exposed to antirheumatic drugs in the womb. Second, the drugs that are compatible with breastfeeding, and thirdly drug choices for men wishing to father a child. 

EULAR hopes that these recommendations will help to improve treatment and outcomes for people with an RMD during their reproductive years. It will be important to share the updated knowledge widely, as it will be helpful to many healthcare professionals outside rheumatology, including those working in internal medicine, gynaecology and obstetrics, family medicine, paediatrics, and pharmacology.

Reference:

Rüegg L, et al. EULAR recommendations for use of antirheumatic drugs in reproduction, pregnancy, and lactation: 2024 update. Ann Rheum Dis 2025;doi: 10.1016/j.ard.2025.02.023.

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Metabolic Syndrome May Drive Treatment Resistance in Psoriatic Arthritis, Study Finds

Italy: A recent study published in RMD Open: Rheumatic & Musculoskeletal Diseases highlights a critical link between metabolic syndrome (MetS) and treatment resistance in patients with psoriatic arthritis (PsA). Conducted by Dr. Damiano Currado and colleagues from the University of Rome Campus Biomedico, the research reveals that the presence of MetS significantly increases the risk of developing a difficult-to-treat (D2T) PsA phenotype.

Psoriatic arthritis is a chronic inflammatory condition often marked by joint pain, skin involvement, and a range of musculoskeletal symptoms such as enthesitis and dactylitis. While many patients respond well to current therapies, a subset faces persistent symptoms and poor therapeutic outcomes, termed the “difficult-to-treat” phenotype. This study aimed to examine whether metabolic dysfunction contributes to this challenging clinical profile.

The cross-sectional study was carried out at the Rheumatology Clinic of Fondazione Policlinico Campus Bio-Medico of Rome and involved 182 patients diagnosed with PsA. Disease activity and the presence of metabolic syndrome were assessed using established criteria. The D2T classification was based on modified definitions drawn from rheumatoid arthritis guidelines and adapted for PsA.

The key findings were as follows:

  • 42.9% of the total psoriatic arthritis (PsA) cohort met the criteria for metabolic syndrome (MetS).
  • Among patients with the difficult-to-treat (D2T) phenotype, 81.8% had comorbid MetS.
  • In contrast, only 29.4% of patients in the non-D2T group had MetS.
  • Statistical analysis showed a strong association between MetS and the D2T phenotype, with an odds ratio of 7.56.
  • Patients with MetS were over seven times more likely to show treatment resistance.
  • Path analysis confirmed MetS as an independent factor contributing to the development of the D2T phenotype.

These findings emphasize the role of metabolic health in influencing the course and severity of PsA. The authors emphasize that managing metabolic dysfunctions—such as obesity, hypertension, and insulin resistance—may be crucial in improving therapeutic response and reducing disease burden.

While the study provides valuable insight, the authors acknowledge certain limitations. These include reliance on D2T criteria adapted from rheumatoid arthritis, a single-center design, and the inability to capture certain variables like treatment adherence or patient-reported outcomes. Moreover, as a cross-sectional study, the data cannot establish causality between MetS and the D2T phenotype.

The research represents the first to establish a clear association between metabolic syndrome and treatment resistance in PsA. It suggests that integrated care approaches targeting both PsA and its metabolic comorbidities could enhance treatment outcomes. Strategies such as lifestyle modifications, interdisciplinary collaboration with metabolic specialists, and the use of therapies with minimal metabolic impact may offer a more effective path forward for patients facing this difficult-to-manage form of PsA.

The authors concluded, “Further studies are needed across diverse patient populations to confirm these findings and help refine clinical definitions and treatment pathways for D2T PsA.”

Reference:

Damiano Currado, Francesca Trunfio, Francesca Saracino, Lyubomyra Kun, Annalisa Marino, Erika Corberi, Antonio Orlando, Ludovica Lamberti, Leonardo Frascà, Marta Gatti, Onorina Berardicurti, Marta Vomero, Vasiliki Liakouli, Roberto Giacomelli, Luca Navarini – Patients with psoriatic arthritis and comorbid metabolic syndrome show a difficult-to-treat phenotype: another mosaic tile in the definition of a still undefined subset of patients: RMD Open 2025;11:e005717.

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Childhood Hypertension Triples Long-Term Risk of Serious Kidney Events, Lancet Study Finds

Canada: A landmark population-based study published in The Lancet Child & Adolescent Health has revealed that children and adolescents diagnosed with hypertension face a significantly higher risk of developing serious long-term kidney complications compared to their non-hypertensive peers.

Conducted by Dr. Junayd Hussain and colleagues from the Michael G. DeGroote School of Medicine, McMaster University, the retrospective cohort study assessed kidney outcomes in youth aged 3 to 18 years across Ontario, Canada. The study spanned over two decades—from April 1996 to March 2023—and utilized data from validated health administrative databases to explore the relationship between childhood hypertension and major adverse kidney events (MAKEs), including chronic kidney disease (CKD), kidney failure, or death.

Researchers matched 26,324 children and adolescents with hypertension to 126,834 non-hypertensive controls using propensity score methods. Matching criteria included key factors such as age, sex, birthweight, maternal gestational hypertension, and pre-existing health conditions like diabetes, obesity, and previous kidney injury. This approach ensured a balanced comparison between the groups, eliminating potential biases that might influence the risk of kidney outcomes.

The study revealed the following findings:

  • The incidence of major adverse kidney events (MAKEs) in children and adolescents with hypertension was 5.52 per 1,000 person-years.
  • In comparison, the incidence in non-hypertensive controls was 1.66 per 1,000 person-years.
  • Overall, 7.7% of hypertensive participants experienced a MAKE versus 2.4% in the control group.
  • The risk of MAKEs was three times higher in hypertensive youth, with a hazard ratio of 3.03 (95% CI: 2.86–3.21).
  • The median age at the diagnosis of hypertension among study participants was 15 years.
  • Males made up 58.7% of the hypertensive cohort, indicating a slight male predominance.
  • Most participants had no significant prior medical conditions.
  • A small proportion had congenital heart disease (4.4%), malignancy (6.8%), or were born to mothers with hypertension (3%).

These findings highlight the crucial importance of early detection and effective management of high blood pressure in children and adolescents. Despite being traditionally viewed as a condition of adulthood, hypertension in the pediatric population is becoming increasingly common, now affecting around 6% of youth. Until now, direct evidence connecting childhood hypertension to future kidney health has been limited.

“Recognizing and treating hypertension during childhood could play a pivotal role in preventing progressive kidney damage later in life,” the authors noted. They further emphasized the importance of future large-scale, prospective studies to confirm these results and guide targeted interventions.

“With the burden of chronic kidney disease rising globally, especially among young populations, this study emphasizes the urgency of prioritizing pediatric hypertension as a public health concern,” the authors concluded.

Reference: https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(25)00127-0/abstract

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Early Childbirth and Having No Children Linked to Higher Mortality in Postmenopausal Women, Study Shows

Florida: A large-scale study published in the American Journal of Obstetrics and Gynecology highlights how reproductive patterns such as the number of children and the timing of childbirth may influence long-term mortality risk in postmenopausal women.

The research, led by Dr. Zailing Xing from the College of Public Health at the University of South Florida, examined data from over 100,000 women to understand how parity and age at childbirth relate to lifespan—finding that early childbirth and childlessness are linked to higher all-cause mortality, with premature menopause playing a key mediating role.

The study analyzed data from the Women’s Health Initiative, involving 106,760 postmenopausal women. Using propensity score matching and multilevel Cox proportional hazard models, the researchers assessed the association between different reproductive factors and mortality, adjusting for demographic and clinical variables. Mediation analysis was also conducted to explore the role of premature menopause in these associations.

The study led to the following findings:

  • Women with no children had a 9% higher risk of all-cause mortality compared to those with two children.
  • Women with only one child had an 11% higher risk of death later in life.
  • Having three or more children did not significantly affect mortality rates.
  • Women who gave birth to their first child before age 20 had a 14% increased risk of mortality.
  • Last childbirth before age 25 was associated with a 6% higher risk of death.
  • Last childbirth at or after age 40 was linked to a 7% higher mortality risk.
  • Both early and late childbirth negatively impacted long-term survival.
  • Premature menopause was identified as a significant mediator between reproductive history and mortality risk.
  • Women with early childbirth or no children were more likely to experience early menopause.
  • Early menopause was associated with a shorter lifespan among postmenopausal women.

The findings emphasize the potential long-term health implications of reproductive choices and timing. According to the authors, these results highlight the need for early identification of women who may be at increased risk due to their reproductive history. This could help guide interventions aimed at improving long-term health outcomes and survival.

The authors concluded, “The study sheds light on how early-life reproductive factors can shape a woman’s health trajectory well into older age. Recognizing and addressing these risks early may be crucial to supporting healthy aging among women.”

Reference: https://www.ajog.org/article/S0002-9378(25)00379-5/abstract

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New study may pave the way for targeted cancer treatments

Imagine a drug that halts cancer without side effects or risks. That future may be a bit nearer thanks to recent research led by Raj Kumar, Ph.D., chair of the Department of Pharmaceutical and Biomedical Sciences at Touro College of Pharmacy.

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How a drug used to treat Parkinson’s disease might affect the brain

Simon Fraser University researchers are using a new approach to brain imaging that could improve how drugs are prescribed to treat Parkinson’s disease.

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