Press reviews


Primary hyperparathyroidism is a surgically treated endocrine disorder. Researchers assume a correlation between lesion size and preoperative clinical data. In this study, researchers attempted to predict lesion volume from preoperative clinical data. Removed parathyroid gland volume was used as the primary endpoint, and associations with preoperative clinical data were assessed by multivariate analysis. A positive correlation was identified between parathyroid tumor volume and preoperative intact parathyroid hormone and calcium values. Multiple regression analysis revealed that male gender, intact PTH and calcium values were significant predictors of lesion volume. 

Source(s) :
Tomoyoshi Nakai et al. Predicting tumor volume in primary hyperparathyroidism from preoperative clinical data. J Clin Endocrinol Metab. 2024 Mar 25:dgae185. ;

The first systematic review provides an overview of available diagnostic tools for attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. A total of 231 studies were included, having evaluated: parent ratings, teacher ratings, youth self-reports, clinician tools, neuropsychological tests, biological samples, EEG and neuroimaging. Several tools showed promising diagnostic performance, but estimates varied considerably from study to study, with generally low strength of evidence. The second systematic review takes stock of currently available treatment options. This time, 312 studies were considered. While drugs play a key role, they are also associated with adverse effects. 

Source(s) :
Bradley S Peterson et al. Tools for the Diagnosis of ADHD in Children and Adolescents: A Systematic Review. Pediatrics. 2024 Mar 25:e2024065854. ;

2024-03-28

Ultra-processed foods and irritable bowel syndrome

Gastroenterology and Hepatology

In this large-scale prospective study, British researchers examined the long-term risk of developing irritable bowel syndrome in association with the consumption of ultra-processed foods. A total of 178,711 participants were included in the study and followed for a median of 11.3 years. Ultra-processed foods accounted for 21.0% of the total diet. Of the participants, 2,690 developed irritable bowel syndrome. For every 10% increase in the consumption of ultra-processed foods in the total diet, the risk of developing irritable bowel syndrome increased by 8%. Data were similar in subgroups according to age, gender, BMI, smoking status or alcohol consumption. 

Source(s) :
Shanshan Wu et al. Ultra-Processed Food Consumption and Long-Term Risk of Irritable Bowel Syndrome: A Large-Scale Prospective Cohort Study. Clin Gastroenterol Hepatol. 2024 Mar 21:S1542-3565(24)00168-X. ;

2024-03-28

NDNF in syphilis nephropathy

Urology-nephrology

In this case study, researchers report the case of a 61-year-old man who developed nephrotic syndrome following secondary membranous nephropathy associated with syphilis. With antibiotic treatment of syphilis, the patient showed remission of the nephrotic syndrome. Pathologically, the target antigen of immune complexes accumulated on glomerular basement membranes in syphilis-induced secondary nephropathy was neuron-derived neurotrophic factor (NDNF). The researchers found that anti-NDNF autoantibodies in acute-phase serum disappeared in the patient's convalescent-phase serum. 

Source(s) :
Daisuke Honda et al. Anti-Neuron-Derived Neurotrophic Factor Antibodies in Secondary Membranous Nephropathy Caused by Syphilis: A Case Report. Am J Kidney Dis. 2024 Mar 22:S0272-6386(24)00685-1 ;

Phage therapy is a promising anti-infective option for combating antimicrobial resistance. However, its clinical use is compromised by the potential emergence of phage resistance. A better understanding of phage resistance mechanisms and their influence on the efficacy of phage-antibiotic combinations is crucial. In this study, researchers investigated phage resistance mechanisms in the bacterium Klebsiella pneumoniae. They identified various phage resistance mechanisms: disruption of phage binding, extension of the phage latency period and increased mutation frequency. These resistance mechanisms could lead to an increase or reduction in the bacterium's sensitivity to the associated antibiotics. 

Source(s) :
Sue C Nang et al. Phage resistance in Klebsiella pneumoniae and bidirectional effects impacting antibiotic susceptibility. Clin Microbiol Infect. 2024 Mar 22:S1198-743X(24)00145-9. ;

2024-03-27

Nephroprotection in diabetic kidney disease

Urology-nephrology

Aggressive, early treatment of diabetic kidney disease can not only slow disease progression, but also stabilize or even reverse the decline in renal function. Standard treatment of diabetic kidney disease is currently based on blocking the renin-angiotensin system with converting enzyme inhibitors or angiotensin II receptor antagonists. These monotherapy treatments prevent or slow the progression of renal disease, but do not stabilize or reverse the decline in renal function, unless initiated very early. The addition of a sodium-glucose-2 cotransporter inhibitor and/or a mineralocorticoid receptor blocker may further slow the decline in renal function. Similarly, the use of glucagon-like peptide-1 (GLP-1) agonists has shown promise in slowing the progression of renal disease. Other drugs of interest include dipeptidyl peptidase-4 inhibitors, pentoxifylline, statins and vasodilator beta-blockers. 

Source(s) :
David S H Bell et al. The potential for improved outcomes in the prevention and therapy of diabetic kidney disease through 'stacking' of drugs from different classes. Diabetes Obes Metab. 2024 ;

2024-03-27

Acne vulgar and oxidative stress

Dermatology and Venereology

The links between acne vulgaris and biomarkers of oxidative stress are not clearly established. In this systematic literature review and meta-analysis, researchers explored the links between acne vulgaris and various biomarkers of oxidative stress (superoxide dismutase, malondialdehyde and total antioxidant capacity). A total of 14 trials involving 1,191 participants were included. The data showed that acne vulgaris was associated with malondialdehyde concentrations. Acne vulgaris severity correlated with levels of oxidative stress biomarkers. Total antioxidant capacity was significantly lower in patients with moderate acne vulgaris than in controls.

Source(s) :
Liang Su et al. Circulating biomarkers of oxidative stress in people with acne vulgaris: a systematic review and meta-analysis. Arch Dermatol Res. 2024 Mar 15;316(4):105 ;

2024-03-27

Selective vulnerability to Epstein-Barr virus

Allergology and Immunology

Infection with Epstein-Barr virus may be asymptomatic, cause infectious mononucleosis or cause serious B-cell lymphoproliferative diseases. A selective vulnerability to the virus has been reported in combination with hereditary mutations altering T-cell immunity. In this study, The researchers describe biased variants associated with involvement of the IL-27 pathway, resulting in acute and severe primary EBV infection with a favorable outcome requiring minimal treatment. In in vitro studies, IL-27 exerts a synergistic effect on the proliferation of T lymphocytes dependent on T7 lymphocytes receptors. This proliferation is deficient in some patients, resulting in impaired expansion of cytotoxic CD8+ T lymphocytes, anti-EBV effectors.

Source(s) :
Emmanuel Martin et al. Role of IL-27 in Epstein-Barr virus infection revealed by IL-27RA deficiency. Nature. 2024 Mar 20. ;

Elevated levels of lipoproteins containing apoB are a risk factor for atherosclerotic cardiovascular disease, including peripheral arterial disease and myocardial infarction. In this study, Danish researchers analyzed levels of apoB-containing lipoproteins, residual cholesterol and LDL-cholesterol in 93,461 statin-naive patients at baseline. During follow-up of up to 15 years, 1,207 patients developed CAD, 522 developed chronic ischemic limb disease and 2,202 developed myocardial infarction. In the association between increased apoB and increased risk of peripheral arterial disease, residual cholesterol and LDL-cholesterol accounted for 73% and 8% respectively. 

Source(s) :
Benjamin N Wadström et al. Remnant Cholesterol, Not LDL Cholesterol, Explains Peripheral Artery Disease Risk Conferred by apoB: A Cohort Study. Arterioscler Thromb Vasc Biol. 2024 Mar 21. ;

Research into neurodegenerative diseases has long focused on neuronal cells, their dysfunction and selective vulnerability. At the same time, the involvement of other major cell types has been little explored. In this study, researchers used spatial gene expression, structural MRI and cellular deconvolution data to describe the cerebral distribution of different cell types in tissue lesions of 13 neurodegenerative diseases (early and late Alzheimer's disease, Parkinson's disease, Lewy body dementia, amyotrophic lateral sclerosis, frontotemporal lobar degeneration, ...). The researchers were able to develop comprehensive reference maps of cell abundance across the whole brain for six major cell types, and identified characteristic axes of spatial overlap with atrophy. 

Source(s) :
Veronika Pak et al. Distinctive whole-brain cell types predict tissue damage patterns in thirteen neurodegenerative conditions. Elife. 2024 Mar 21:12:RP89368 ;

Nasal intermittent positive airway pressure (NIPPV) has been shown to be superior to post-extubation nasal continuous positive airway pressure (CPAP) in premature neonates. In this comparative efficacy and non-inferiority study, Canadian researchers hypothesized that CPAP would not be inferior to IPPV. In total, data were collected on 843 infants extubated with CPAP and 974 infants extubated with IPPV in 22 neonatal intensive care units. All infants were born before 29 weeks' gestation. The primary endpoint was failure of the initial mode of extubation ≤72 hours. Secondary judgment criteria included failure ≤7 days and reintubation ≤72 hours and ≤7 days. 

Source(s) :
Amit Mukerji et al. CPAP Versus NIPPV Postextubation in Preterm Neonates: A Comparative-Effectiveness Study. Pediatrics. 2024 Mar 21:e2023064045. ;

2024-03-26

Management of Clostridioides difficile infections

Public health and social medicine

Clostridioides difficile infection is the most common nosocomial infection in the United States. On an individual level, it is associated with potentially fatal complications, while representing a significant burden in terms of healthcare costs for the healthcare system. Proper use of antibiotics and discontinuation of chronic antacids are essential for its prevention and treatment. Effective management of the infection requires appropriate interpretation of diagnostic tests, and first-line prescription of vancomycin and fidaxomicin. New treatments such as bezlotoxumab, fecal microbiota transplantation and live biotherapeutics have proved effective in recurrent C. difficile infections, thanks to their action on dysbiosis.

Source(s) :
Michael Cymbal et al. Management of Clostridioides difficile infection: Diagnosis, Treatment, and Future Perspectives. Am J Med. 2024 Mar 18:S0002-9343(24)00167-0. ;

Thanks to advances in diagnosis and treatment, life expectancy for patients with congenital heart disease has increased in recent years. However, these patients still have a high morbidity and mortality rate. In this study, researchers described the frailty and cognitive profile of middle-aged and older adults with congenital heart disease. In all, they included 814 patients aged at least 40, living in 11 different countries. Of all patients, 41.9% were considered pre-fragile and 5.8% frail, based on the results of the Fried method. Frailty was associated with advanced age, female gender and comorbidities. Surprisingly, high complexity of cardiac disease seemed to protect against frailty.

Source(s) :
Bo Daelman et al. Frailty and Cognitive Function in Middle-Aged and Older Adults With Congenital Heart Disease. J Am Coll Cardiol. 2024 Mar 26;83(12):1149-1159. ;

In this Phase 3, multicenter, randomized, double-blind, placebo-controlled clinical trial, researchers evaluated the efficacy and safety of givinostat in the treatment of Duchenne muscular dystrophy. Givinostat is a histone deacetylase inhibitor which may help counter the effects of dystrophin deficiency. The study involved 179 boys with a median age of 9.8 years. Functional abilities, as assessed by the four-step test, deteriorated in both groups of patients. However, the deterioration was less severe with givinostat than with placebo. The most frequent adverse events in the givinostat group were diarrhea and vomiting. An ongoing extension study is evaluating the long-term safety and efficacy of givinostat in patients with Duchenne muscular dystrophy.

Source(s) :
Eugenio Mercuri et al. Safety and efficacy of givinostat in boys with Duchenne muscular dystrophy (EPIDYS): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Neurol. 2024 Apr;23(4):393-403. ;

2024-03-26

Covid-19 in cystic fibrosis patients

Infectiology

Cystic fibrosis patients are considered to be at risk of developing severe forms of respiratory infection. In this study of 171 participants, including 65 with cystic fibrosis, researchers investigated the consequences of Covid-19 and virus-host cell interactions in cystic fibrosis patients, compared with non-cystic fibrosis patients. Symptomatic SARS-CoV2 infections were observed in 8 people with cystic fibrosis (2 of whom required hospitalization) and in 11 people without cystic fibrosis (6 requiring hospitalization). Clinical forms of Covid-19 did not appear to be more severe in cystic fibrosis patients. This could be explained by an unfavorable environment for SARS-CoV2 replication.


Source(s) :
Fabiana Ciciriello et al. Covid-19 in cystic fibrosis patients compared to the general population: Severity and virus-host cell interactions. J Cyst Fibros. 2024 Mar 19:S1569-1993(24)00036-5 ;