At the recent launch of EVA Pharma's Tiotropium in KSA, we were fortunate to hear Dr. Omar Abdelkayoum discuss the GINA Guideline 2024 recommendations for Tiotropium in&nbsp; asthma exacerbation management. He highlighted the potential advantages of the innovative vertical-haler device in improving patient adherence and outcomes.

2 Omar abdelkayoum 1.mp4

Tiotropium EVA launch
GINA Guidelines 2024
COPD Management

Tiotropium EVA launch in KSA and its role in GINA Guideline 2024 by DR. Omar Abdelkayoum.

The 2023 Annual Meeting of the American Academy of Orthopaedic Surgeons<span style="font-size: 24.0pt; font-family: 'var(--arrow-typeface-primary)',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; color: #333333; mso-font-kerning: 18.0pt; mso-ligatures: none;"> 
The annual meeting of the American Academy of Orthopaedic Surgeons was held from March 7 to 11 in Las Vegas and attracted approximately 30,000 participants from around the world. The conference highlighted recent advances in the diagnosis and management of musculoskeletal conditions, with presentations focusing on joint fractures, osteoarthritis, other musculoskeletal injuries, and factors impacting the outcomes of joint replacement procedures.
<p style="background: white; box-sizing: border-box; line-height: var(--arrow-lh-5); font-stretch: normal; word-break: break-word; font-variant-ligatures: normal; font-variant-caps: normal; orphans: 2; text-align: start; widows: 2; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; word-spacing: 0px; margin: 0in 0in 11.25pt 0in;">In one study, David Christopher Ayers, M.D., of the University of Massachusetts Chan Medical School in Boston, and colleagues found that patients of all ages experience significant improvement in knee pain and improved knee function after total knee arthroplasty (TKA), resulting in a dramatic increase in quality of life.
<p style="background: white; box-sizing: border-box; line-height: var(--arrow-lh-5); font-stretch: normal; word-break: break-word; font-variant-ligatures: normal; font-variant-caps: normal; orphans: 2; text-align: start; widows: 2; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; word-spacing: 0px; margin: 0in 0in 11.25pt 0in;">The authors performed a prospective assessment of a cohort of 11,602 patients who underwent a unilateral primary TKA. Comparing four age groups (younger than 55 years, 55 to 64 years, 65 to 74 years, and 75 years and older), the researchers found that the oldest patients experienced significant improvements in knee pain, knee function, and quality of life after TKA. The youngest patients (younger than 55 years) had more pain after TKA compared with the other three age groups. The improvement achieved in pain in the age group younger than 55 years was equal to the other groups, but because they had more pain preoperatively, the final mean pain scores were lower (more pain) than the other cohorts one year after TKA. Those aged younger than 55 years were more likely to be obese before surgery (body mass index &gt;35 kg/m2), more likely to be current smokers, and more likely to have significant pain in their lumbar spine and other joints in their lower extremities than the other three age groups.
<p style="background: white; box-sizing: border-box; line-height: var(--arrow-lh-5); font-stretch: normal; word-break: break-word; font-variant-ligatures: normal; font-variant-caps: normal; orphans: 2; text-align: start; widows: 2; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; word-spacing: 0px; margin: 0in 0in 11.25pt 0in;">"This illustrates that total knee arthroplasty is a life-changing event for patients with advanced arthritis of the knee, regardless of their age," Ayers said. "Patients less than 55 years of age have more pain following total knee arthroplasty than the other three age groups. Surgeons should ensure that patients less than 55 years of age undergoing TKA have realistic expectations regarding pain, knee function, and quality of life after TKA and undergo preoperative optimization programs prior to elective TKA."
<p class="MsoNormal" style="box-sizing: border-box; line-height: var(--arrow-lh-5); font-stretch: normal; word-break: break-word; font-variant-ligatures: normal; font-variant-caps: normal; orphans: 2; text-align: start; widows: 2; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; word-spacing: 0px;">&nbsp;

The annual meeting of the American Academy of Orthopedics Surgeons was held from March 7 to 11 in Las Vegas.

American Academy of Orthopaedic Surgeons, March 7 to 11

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lora, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Applications include pharmaceutical industries, tissue engineering, biomedical industry, and medical industry
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">TUESDAY, Dec. 5, 2023 (HealthDay News) -- Collagen, the most profuse protein in the animal kingdom, has multiple applications in various industries, according to an article published March 2015 in the&nbsp;Journal of Applied Pharmaceutical Science.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Noting that collagen is widely applied, K.S. Silvipriya, from the St. James Hospital Trust Pharmaceutical Research Centre in India, and colleagues described collagen and its application in various fields.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The authors note that collagen is a fibrous structural protein present in the extracellular matrix and connective tissue of animals and is the most profuse protein in the animal kingdom. Nearly 28 types of collagen have been identified, composed of 46 distinct polypeptide chains. Collagen is extracted from multiple animal sources, including bovine, porcine, marine, and fish. Applications of collagen include as micromicroparticles, injectable dispersions, shields in ophthalmology sponges, and drug delivery systems in pharmaceutical industries; in tissue engineering, including as the basic matrix for cell culture systems and in injectable matrices and scaffolds; in the biomedical industry for tissue regeneration scaffolds; and in the medical field, as scaffolds that help in cartilage and bone reconstruction, in cases of grafting failure or avoidance, and in vascular and cardiac reconstruction as well as collagen-based dressings. Collagen has uses in cardiology, dermatology, surgery, orthopedics, ophthalmology, urology, and vascular medicine.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">“Collagen has widespread applications in numerous fields such as pharmaceutical, medical, biomedical, food industry, cosmetics, etc. A wide range of applications of collagen have by now been recognized and many more are waiting be revealed in future,” the authors write.

Article Describes Uses of Collagen in Numerous Industries

Uses of Collagen in Numerous Industries.

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Comprehensive testing is essential to elucidate diagnosis and exclude underlying chronic liver disease
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">WEDNESDAY, July 12, 2023 (HealthDay News) -- In a clinical guideline issued by the American College of Gastroenterology and published in the July issue of the&nbsp;American Journal of Gastroenterology, recommendations are presented for the identification, treatment, and management of acute liver failure (ALF).
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Alexandra Shingina, M.D., from the Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues reviewed the scientific evidence to develop recommendations for identification, treatment, and management of ALF.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The authors developed 10 recommendations (four strong; six conditional) and summarized expert opinions using key concepts when no robust evidence was available. The strong recommendations included use of norepinephrine as the first-line vasopressor for hypotension refractory to fluid resuscitation; early administration of N-acetylcysteine (NAC) in patients with suspected N-acetyl-p-aminophenol (APAP) toxicity; initiation of intravenous NAC in patients with non-APAP ALF; and starting antiviral therapy in patients with ALF due to reactivation of hepatitis B virus. Conditional recommendations included not using routine correction of coagulopathy in the absence of active bleeding or an impending high-risk procedure and not using prophylactic antimicrobial agents routinely, given no improvement in either rate of blood stream infection or 21-day mortality. In terms of general management, comprehensive testing is essential to elucidate a diagnosis and exclude underlying chronic liver disease.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"ALF is a medical emergency and is potentially reversible if recognized and treated early," the authors write. "ALF must be differentiated from acute-on-chronic liver failure and decompensated cirrhosis because management is vastly different."
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none;" href="https://journals.lww.com/ajg/Fulltext/2023/07000/Acute_Liver_Failure_Guidelines.14.aspx" target="_blank" rel="noopener">Abstract/Full Text</a>

Recommendations Developed for Management of Acute Liver Failure

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Digestive Disease Week 2023
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Digestive Disease Week, the annual meeting sponsored by the American Association for the Study of Liver Diseases, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy, and Society for Surgery of the Alimentary Tract, was held from May 6 to 9 in Chicago and attracted more than 10,000 participants from around the world, including researchers and academics in the fields of gastroenterology, hepatology, endoscopy, and gastrointestinal surgery.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">In one study, Amir Zarinnpar, M.D., Ph.D., of the University of California in San Diego, and colleagues found that the gut microbiome, the collection of bacteria, viruses, and fungi living inside the digestive system, follows daily and seasonal rhythms.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The authors analyzed a large number of stool samples from individuals around the world and found that more than half of the different bacteria types change throughout the day. Seasonal patterns were also observed, similar to how the tides ebb and flow. The researchers also found that fluctuations in the gut microbiome can impact an individual's health and make it challenging to define a normal gut microbiome.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"By understanding these daily and seasonal patterns, we, as researchers and doctors, can take them into account when interpreting study results or developing treatments related to the gut microbiome," Zarinnpar said. "This knowledge can help improve the accuracy of research findings and the effectiveness of treatments related to the gut microbiome."

Digestive Disease Week, May 6-9

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lora, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Adjunctive therapeutic approach, including adequate intake of vitamin C and zinc, could mitigate adverse physiological effects of COVID-19
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">TUESDAY, Dec. 26, 2023 (HealthDay News) -- Vitamin C and zinc supplementation could be beneficial for managing COVID-19, according to a meta-analysis recently published in&nbsp;Clinical Nutrition Open Science.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Safieh Firouzi, Ph.D., from the Golestan University of Medical Sciences in Gorgan, Iran, and colleagues examined the potential effectiveness of vitamin C and zinc supplementation during viral infection and specifically COVID-19.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers observed an association between vitamin C and zinc deficiency and a reduction in the innate immune response, which could increase the vulnerability of patients with COVID-19. An adjunctive therapeutic approach, including adequate intake of vitamin C and zinc together with any necessary pharmacological treatments, could mitigate the adverse physiological effects of COVID-19. According to the researchers, the results of ongoing randomized controlled trials are necessary for fully clarifying the role of vitamin C and zinc supplementation in COVID-19 management. To prevent oversupplementation, the toxicity of vitamin C and zinc should be considered; vitamin C oversupplementation can lead to oxalate toxicity, while reduced immune system function can result from increased zinc intake.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">"Adequate intake of immune-enhancing nutrients (vitamin C and zinc) in conjunction with pharmacological agents is necessary during the COVID-19 pandemic," the authors write. "To specifically clarify the role of supplementation with vitamin C and zinc in the management of coronavirus we must wait for the completion of the ongoing randomized controlled trials."
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; text-decoration-line: none; font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif;" href="https://www.clinicalnutritionopenscience.com/article/S2667-2685(22)00035-3/fulltext" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text</a>

Vitamin C, Zinc Supplementation Can Help Management of COVID-19

<div class="text-story-m_header-details__3D-Xf" style="box-sizing: border-box; margin: var(--arrow-fs-huge) 0; color: #333333; font-family: Lora, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 16px; background-color: #ffffff;">
<div class="p-alt arr--sub-headline arrow-component subheadline-m_subheadline__3fd7z subheadline-m_dark__28u00" style="box-sizing: border-box; text-rendering: optimizelegibility; -webkit-font-smoothing: antialiased; font-family: var(--arrow-typeface-primary); font-size: var(--arrow-fs-m); font-stretch: normal; font-style: italic; line-height: var(--arrow-lh-5); -webkit-box-orient: vertical; display: -webkit-box; margin-bottom: var(--arrow-spacing-xs); overflow: hidden; color: var(--arrow-c-mono4); padding-right: 2px;" data-test-id="subheadline">Supplement containing glucomannan, inulin, psyllium, and apple fiber was the most effective for reducing BMI, body weight, CRP</div>
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<div class="text-story-m_gap-16__5BPKQ" style="box-sizing: border-box; margin-top: var(--arrow-spacing-m); color: #333333; font-family: Lora, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 16px; background-color: #ffffff;">
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<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">&nbsp;
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">THURSDAY, Dec. 28, 2023 (HealthDay News) -- Dietary fiber supplements combined with energy restriction (ER) are beneficial for weight loss and metabolic profile, according to a study recently published in&nbsp;Foods.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Zala Jenko Pražnikar, Ph.D., from the University of Primorska in Slovenia, and colleagues examined the additive effects of a combination of ER and four dietary supplements on changes in anthropometric and biochemical parameters in individuals with overweight or obesity. One hundred participants were randomly assigned to one of the dietary fiber supplements containing different dietary fibers or a placebo for eight weeks.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers found that at four and eight weeks after the start of the study, fiber supplements plus ER significantly reduced body weight, body mass index (BMI), fat mass, and visceral fat and improved lipid profiles and inflammation; in the placebo group, significant differences in some parameters were seen only after eight weeks of ER. The most effective fiber supplement for reducing BMI, body weight, and C-reactive protein was a supplement containing glucomannan, inulin, psyllium, and apple fiber.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">"Fiber supplementation may be a potential approach to improve weight and metabolic health in obese and overweight individuals, but it should not replace a balanced diet with fiber-rich foods," the authors write.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Two authors disclosed ties to Biostile Ltd, which funded the study.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none;" href="https://www.mdpi.com/2304-8158/12/11/2122" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text</a>

Dietary Fiber Supplements Beneficial for Weight Loss

Dietary Fiber Supplements Beneficial for Weight Loss.

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lora, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Reduction seen in total cholesterol, LDL levels, fasting blood glucose, two-hour postprandial blood glucose, and fasting insulin
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">THURSDAY, Dec. 28, 2023 (HealthDay News) -- Glucomannan supplementation is beneficial for patients with type 2 diabetes, according to a meta-analysis recently published in&nbsp;Nutrients.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Zhanzhi Zhang, M.D., from Capital Medical University in Beijing, and colleagues assessed the effects of glucomannan supplementation on blood lipid-related indicators, blood glucose-related indicators, blood pressure, and body weight in patients with type 2 diabetes. The analysis included six randomized controlled trials (RCTs) with 440 participants.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers found that compared with control, glucomannan reduced total cholesterol and low-density lipoprotein levels (mean differences [MDs], −0.38 and −0.35, respectively); fasting blood glucose, two-hour postprandial blood glucose, and fasting insulin (MDs, −1.08, −1.92, and −1.59, respectively); and serum fructosamine levels (standardized MD, −1.19).
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">"More RCTs with larger sample sizes, combined drugs, and longer experimental times are needed to further determine the effects of glucomannan on various indicators of type 2 diabetes patients," the authors write. "Perhaps glucomannan can then be developed into a highly effective natural product, thus benefiting more type 2 diabetes patients."
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none;" href="https://www.mdpi.com/2072-6643/15/3/601" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text</a>

Glucomannan Supplementation Beneficial in Type 2 Diabetes

<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Emergency medical services may not be required in case of prompt, complete, and durable response to use of epinephrine
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">TUESDAY, Dec. 26, 2023 (HealthDay News) -- In a practice parameter update published online Dec. 17 in the&nbsp;Annals of Allergy, Asthma &amp; Immunology, new guidelines are presented for the diagnosis and management of anaphylaxis.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">David B. K. Golden, M.D.C.M., from the Johns Hopkins School of Medicine in Baltimore, and colleagues focused on seven areas with new evidence to update recommendations for the diagnosis of anaphylaxis in pediatric and adult patients.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The authors note that diagnostic criteria for anaphylaxis have been revised. For diagnosis of anaphylaxis and identification of underlying mast cell disorders, measurement of serum tryptase is important. Age-specific symptoms may differ for infants and toddlers versus older children and adults; no correlation has been seen for patient age with reaction severity. Anaphylaxis is unlikely to be the initial reaction to first exposure to an allergen. Specific measures for prevention and treatment of anaphylaxis are required for different community settings. Optimal prescribing and use of epinephrine autoinjector devices requires specific counseling and patient and caregiver training, including whether and when to call emergency medical services. Immediate activation of emergency medical services may not be required if the patient experiences a prompt, complete, and durable response to rapid use of epinephrine. For adult patients with severe insect sting anaphylaxis or recurrent idiopathic anaphylaxis, evaluation for mastocytosis, including a bone marrow biopsy, should be considered.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"These guidelines translate recent advances in the understanding of severe allergic reactions to help all health care professionals provide individualized care to each patient at the right time, in the right place, every time," Golden said in a statement.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Several authors disclosed financial ties to the pharmaceutical industry.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none;" href="https://www.annallergy.org/article/S1081-1206(23)01304-2/fulltext" target="_blank" rel="noopener" aria-label="content">Anaphylaxis: Practice Parameter Update</a>

Emergency medical services may not be required in case of prompt, complete, and durable response to use of epinephrine

Updated Guidelines Issued for Management of Anaphylaxis

<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><span style="color: rgba(0, 0, 0, 0.6); font-family: Lora, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-style: italic;">Significant difference seen between treatment and placebo groups regarding disappearance of presenting symptoms on days 5, 10 of follow-up
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">TUESDAY, Feb. 6, 2024 (HealthDay News) -- For patients with COVID-19 or COVID-19-like illness presenting to the emergency department, a daily zinc multivitamin supplement and melatonin significantly reduce the duration of symptoms, according to a study published online June 20, 2023, in&nbsp;Explore.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Lobna Mahjoub, from Sahloul University Hospital in Tunisia, and colleagues conducted a prospective, randomized, double-blind trial involving patients with no medical history consulting the emergency department for COVID-19 and COVID-19-like illness. Participants were randomly assigned to receive a zinc multivitamin supplement and melatonin or placebo.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers found a significant difference between the groups on the fifth day of follow-up and on the 10th day of follow-up regarding disappearance of all initial presenting symptoms. No significant differences were seen between the groups in terms of recovery on the 15th day of follow-up. Overall, 100 percent of patients in the treatment group and 98.8 percent of patients in the placebo group fully recovered. There were no reports of severe adverse events throughout the trial.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">"Daily doses of melatonin, zinc and multivitamins supplements (vitamin C and D) did significantly reduce the duration of COVID-19 and COVID-like illnesses symptoms and reduced its burden among nonhospitalized patients considered healthy," the authors write.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none;" href="https://www.sciencedirect.com/science/article/pii/S1550830723001295?via%3Dihub" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text (subscription or payment may be required)</a>

Zinc Multivitamin Plus Melatonin Cut Duration of COVID-19 Symptoms

Zinc Plus Multivitamin Cut Duration of COVID-19 Symptoms

Study published in the Annals of internal medicine where the researchers reviewed Health data from about 950 adults with the diabetes,.

New research finds adult-onset type 1 diabetes may be just as common as type 1 diabetes onset.

<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><span style="color: rgba(0, 0, 0, 0.6); font-family: Lora, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-style: italic;">Prevalence of vitamin C deficiency was 27.7 percent based on review of 23 articles with 2,494 patients
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">TUESDAY, Feb. 13, 2024 (HealthDay News) -- Vitamin C deficiency (VCD) is prevalent among hospitalized patients in high-income countries, according to a study published online Jan. 14 in&nbsp;Nutrition Reviews.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Janet E. Golder, from Monash University in Australia, and colleagues conducted a scoping review to explore the prevalence of VCD in adult hospitalized patients in high-income countries. Data were included from 23 articles, representing 22 studies.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers found that the cumulative prevalence of VCD was 27.7 percent in 2,494 patients. Patients with severe acute illness and poor nutritional status had a high prevalence of VCD. Of 71 patients with VCD assessed in two studies, scurvy was present in 48 to 62 percent. Independent risk factors for VCD included being retired and using excessive amounts of alcohol and tobacco in 184 participants. Among 631 participants, age was not conclusively associated with VCD. Two studies with 309 participants examined nutrition associations, with inconsistent results observed. Increased risks for frailty and cognitive impairment were clinical outcomes of VCD (adjusted odds ratios, 4.3 and 2.93, respectively).
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">"In adequately powered studies, research should focus on identification of risk factors and clinical outcomes, assess the relationship between VCD and nutritional status assessment using validated tools, and identify gaps, barriers, and enablers in VCD clinical assessment and management practices to inform policies for prevention, screening, diagnosis, and treatment of VCD in acute healthcare settings," the authors write.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s ease 0s;" href="https://academic.oup.com/nutritionreviews/advance-article/doi/10.1093/nutrit/nuad157/7536064" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text</a>

Vitamin C Deficiency Prevalent in inpatients  with severe acute illness.

<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">SATURDAY, March 18, 2023 (HealthDay News) -- Cutting out nutrients such as carbs, fat or protein may be a popular way to shed pounds but doing so can have unintended consequences.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Instead, aim for a balance of those macronutrients to fuel your life and activities, said&nbsp;<a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s ease 0s;" href="https://uofmhealthwest.org/doctors/elizabeth-albright/" target="_blank" rel="noopener">Dr. Elizabeth Albright</a>&nbsp;of University of Michigan Health-West in Wyoming, Mich.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">In a university news release, she offered some suggestions for a balanced diet that will fit your lifestyle and offer the right fuel.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Food is necessary to live, so don't think of it as "good" or "bad":&nbsp;Just because certain foods may fuel you toward your goals more effectively doesn’t make other foods bad, Albright said. Like putting unleaded gas in a diesel engine, some foods just aren't the right fuel for you and can damage your body. Gender, race, genetics, metabolism and hormone levels all affect nutrition needs.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Change your mindset:&nbsp;Rather than following a “diet” that has an end date, make your food habits a lifestyle.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Pass on processed foods:&nbsp;Reducing your intake of processed foods will improve your general sense of well-being and lead to improvements in chronic disease and often weight loss. The chemicals used to increase foods' shelf life are often highly inflammatory to the body, Albright said, which can put stress on organ systems and, eventually, cause dysfunction.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Choose these foods:&nbsp;Build your menu around lean meats and proteins. Include fruits and veggies for bulk. Then add a carbohydrate for texture, flavor or crunch, Albright suggested. Carbs should be the side, not the focus of the meal.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Be a hacker:&nbsp;Food hacks can help you at times when you most struggle with nutrition. They can include meal prepping, meal kits, slow-cooker meals or healthy grab-and-go snacks.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Do your prep work before dining out:&nbsp;Review the menu and choose your meal before you go. This limits temptations in the moment. Find a few nutritious options to rotate through if you eat out often.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Food can taste good and be good for you:&nbsp;You can't scrap both fat and sugar and stay healthy; your body needs both, in moderation. Watch your salt intake. Be generous with spices. Experiment with different flavor combinations, Albright suggested.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Involve your family:&nbsp;Prepare foods together. Let the kids safely cut up veggies or measure out dry ingredients when you cook. Introduce them to healthy eating at a young age.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Dietary needs are individual:&nbsp;Getting a well-rounded diet that has the balance of all the nutrients that your body needs is the most important. Ask your doctor or registered dietitian about specific needs for your situation.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">More information
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It's National Nutrition Month: Here's Tips to Eating Right

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Higher risk for cardiovascular mortality, kidney disease progression seen with serum 25(OH)D &lt;10 ng/mL
<span style="background-color: #ffffff; font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px;">Vitamin D deficiency is associated with increased risks for cardiovascular mortality and chronic kidney disease (CKD) progression in patients with early-stage disease, according to a study published online May 11 in <em style="font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; box-sizing: border-box;">the Journal of Endocrinological Investigation<span style="background-color: #ffffff; font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px;">.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Yanhong Lin, from Southern Medical University in Guangzhou, China, and colleagues examined the effects of 25-hydroxyvitamin D (25[OH]D) deficiency on cardiovascular mortality and kidney outcomes in patients with early-stage CKD. The analysis included 9,229 adult patients with CKD (stages 1 to 3) from 19 medical centers across China (January 2000 to May 2021).
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers found that compared with patients having 25(OH)D ≥20 ng/mL, a there was a significantly higher risk for cardiovascular mortality (hazard ratio, 1.90) and CKD progression (hazard ratio, 2.20) as well as a steeper annual decline in estimated glomerular filtration rate (estimate, −7.87 percent per year) in those with serum 25(OH)D &lt;10 ng/mL.
&nbsp;
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"In conclusion, 25(OH)D deficiency was common in patients with early-stage CKD," the authors write. "Vitamin D status should be closely monitored in patients with early CKD. Well-designed randomized clinical trials are needed to determine whether timely vitamin D supplementation can prevent cardiovascular events and loss of kidney function in patients with early-stage CKD and 25(OH)D deficiency."
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s ease 0s;" href="https://link.springer.com/article/10.1007/s40618-024-02383-6" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text&nbsp;(subscription or payment may be required)</a>

Vitamin D Deficiency Tied to Worse Outcomes With Early Kidney Disease

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lora, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Combination promotes recovery and better resolution of inflammatory signs and symptoms due to tissue injury
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">FRIDAY, May 24, 2024 (HealthDay News) -- The oral combination trypsin:chymotrypsin is promising for promotion of rapid recovery and resolution of inflammation due to tissue injury, according to a study published online Dec. 5, 2017, in&nbsp;Advances in Therapy.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Dilip Shah, M.D., from Nanavati Hospital, and Kushal Mital, M.B.B.S., from Medicare Hospital, both in Mumbai, India, discussed use of the proteolytic enzyme preparation trypsin:chymotrypsin, which has been used to facilitate tissue repair since the 1960s.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The authors note that trypsin:chymotrypsin is widely used to hasten repair of traumatic, surgical, and orthopedic injuries. It shows high bioavailability, and its biological activities as an anti-inflammatory, anti-edematous, fibrinolytic, antioxidant, and anti-infective agent help resolve signs and symptoms of inflammation due to tissue injury. In addition, it has an analgesic effect, reducing the pain associated with healing. Postulated mechanisms of action include targeting the early stage of inflammation, characterized by a steep rise in α1-antitrypsin and α2-macroglobulin, which leads to fibrinolytic shutdown and consequent maintenance of inflammation and edema following acute injury; and assisting with maintenance of α1-antitrypsin for a long duration, countering the activity of proteolytic enzymes and their degradative effects, leading to a reduction in inflammatory milieu as well as faster healing. The trypsin:chymotrypsin combination is efficacious and safe for resolving inflammation and edema and improving healing, and is used in clinical indications such as accidental, surgical, and orthopedic injuries; burn injuries; and sciatica.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">"Owing to anti-inflammatory, anti-edematous, fibrinolytic, anti-infective, and analgesic effects, trypsin:chymotrypsin oral combination has emerged as a promising treatment to facilitate healing of traumatic injuries," the authors write.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The study was funded by Torrent Pharmaceuticals Ltd.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s ease 0s;" href="https://link.springer.com/article/10.1007/s12325-017-0648-y" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text (subscription or payment may be required)</a>

Trypsin and Chymotrypsin promotes recovery and better resolution of inflammatory signs.
allzyme

Trypsin and Chymotrypsin promotes recovery and better resolution of inflammatory signs.

<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">&nbsp;
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><span style="color: rgba(0, 0, 0, 0.6); font-family: Lora, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-style: italic;">Some evidence seen for therapeutic effect for post-herpetic neuralgia and treatment of painful peripheral neuropathy
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Vitamin B12 supplementation is beneficial for post-herpetic neuralgia and painful peripheral neuropathy, according to a systematic review published July 25, 2020, in&nbsp;Nutrients.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Thomas Julian, from the University of Sheffield in the United Kingdom, and colleagues reviewed the evidence for Vitamin B12 as a drug treatment for neuropathic pain. Data were included from 24 published articles in which a range of treatment regimens were evaluated, including both B12 monotherapy and B12 in combination with other vitamins or conventional treatments.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers found some evidence for the therapeutic effect of B12 on post-herpetic neuralgia and the treatment of painful peripheral neuropathy (level II and level III evidence, respectively). When examining peripheral neuropathy of specific etiologies, the same level of evidence applied to diabetic polyneuropathy and alcoholic neuropathy.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">On the basis of the available evidence, the areas of strongest research supporting the use of treatments inclusive of B12 are post-herpetic neuralgia, alcohol-related neuropathy and diabetic neuropathy, but these areas along with pain caused by peripheral neuropathy of other causes, require further exploration. Currently, there are no areas in which B12 is strongly disproven.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s ease 0s;" href="https://www.mdpi.com/2072-6643/12/8/2221" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text (subscription or payment may be required)</a>

Role of B12 Supplementation Examined for Neuropathic Pain

B12 for Neuropathic Pain.

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lora, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">FEV1 values were significantly higher after the TIO add-on therapy to fluticasone propionate/formoterol fumarate
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">&nbsp;For patients with asthma-chronic obstructive pulmonary disease overlap (ACO), Tiotropium Bromide (TIO) add-on therapy to fluticasone propionate/formoterol fumarate (FP/FM) results in improved lung function, according to a study published May 23, 2022, in the&nbsp;Journal of Asthma and Allergy.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Yoshihisa Ishiura, M.D., Ph.D., from Kansai Medical University in Japan, and colleagues conducted a 12-week open-label crossover pilot study in 18 male patients with stable ACO to examine the effect of TIO 5 µg/day add-on therapy to FP/FM 500/20 µg/day compared with FP/FM alone. The study included a four-week run-in period and two four-week treatment periods.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">All patients were ex-smokers. The researchers found that for forced expiratory volume in one second (FEV1), the mean values were 1.21 ± 0.49, 1.20 ± 0.51, and 1.30 ± 0.48 L after the run-in period, after the FP/FM combination therapy period, and after the TIO add-on therapy to FP/FM period, respectively. After the TIO add-on therapy FP/FM period, FEV1&nbsp;values were significantly higher than those after the run-in period.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The present findings support the potential for TIO add-on therapy via SMI [Soft Mist inhaler], to be known to generate a high fine-particle fraction, to FP/FM as a therapeutic option for ACO. Further, larger studies are required to define the precise etiology of the clinical efficacy of this combination therapy.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s ease 0s;" href="https://www.dovepress.com/tiotropium-add-on-and-treatable-traits-in-asthma-copd-overlap-a-real-w-peer-reviewed-fulltext-article-JAA" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text (subscription or payment may be required)</a>

Add-On Tiotropium Bromide Improves Lung Function in Asthma-COPD Overlap

<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><span style="color: rgba(0, 0, 0, 0.6); font-family: Lora, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-style: italic;">Greater reduction of mean neuropathic symptoms and pain score for patients receiving vitamin B12 versus controls
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">For patients with diabetic peripheral neuropathy, Vitamin B12 supplementation can improve neuropathic symptoms and reduce pain, according to a systematic review published Nov. 22, 2022, in&nbsp;Cureus.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Jithin Karedath, from James Cook University Hospital in the United Kingdom, and colleagues reviewed the efficacy of Vitamin B12 supplementation in isolation or in combination therapy for treatment of diabetic peripheral neuropathy. Randomized controlled trials assessing the impact of Vitamin B12 outcomes were identified and reviewed. Neuropathic symptoms and vibration perception threshold (VPT) were the primary outcomes examined in the meta-analysis, which included six articles.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers found greater reductions in mean neuropathic symptoms and pain score among patients receiving Vitamin B12 (standardized mean differences, –0.39 and –3.60) compared with the control group.&nbsp;
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">This is the first meta-analysis conducted on the impact of Vitamin B12 on clinical outcomes in patients with diabetic neuropathy that can give some idea of the utilization of Vitamin B12 in patients with diabetic neuropathy. In the future, more prospective randomized controlled trials are required to guide clinical practice.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s ease 0s;" href="https://www.cureus.com/articles/126132-the-impact-of-vitamin-b12-supplementation-on-clinical-outcomes-in-patients-with-diabetic-neuropathy-a-meta-analysis-of-randomized-controlled-trials#!/" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text (subscription or payment may be required)</a>

Vitamin B12 Supplementation Reviewed for Diabetic Peripheral Neuropathy

How could a greater reduction in neuropathic symptoms and be achieved?

<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The annual meeting of the Endocrine Society (<a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s ease 0s;" href="https://www.endocrine.org/meetings-and-events/endo-2024" target="_blank" rel="noopener" aria-label="content">ENDO 2024</a>) was held from June 1 to 4 in Boston, attracting approximately 7,000 participants, including clinicians, academicians, allied health professionals, and others interested in endocrine and metabolic disorders. The conference highlighted recent advances in the diagnosis and management of obesity, endocrine disorders, diabetes, and growth hormone and thyroid diseases.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">In one study, Alexander Turchin, M.D., of Brigham and Women's Hospital and Harvard Medical School in Boston, and colleagues found that it is important to reduce the weight of individuals with overweight/obesity to decrease their risk for heart attack and stroke, and they noted this should be addressed at the earliest age possible.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Using data from the Nurses' Health Study and Health Professionals Follow-Up Study, the authors evaluated individuals with a body mass index (BMI) greater than 25 kg/m2&nbsp;at least once during a 10-year period (1990 to 1999) to determine how having overweight/obesity impacted cardiovascular risk (heart attack or stroke) between 2000 and 2020.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers found that individuals who were exposed to excess weight for a prolonged period of time had an increased risk for heart attack and stroke. In addition, prolonged exposure had a greater impact on heart attack and stroke risk than someone's weight at a single point in time. The increase in risk for heart attack and stroke from the prolonged excess weight was only observed in younger individuals (younger than 50 years for women and younger than 65 years for men).
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"The key conclusion is that a person's weight at a given point in time is not the final 'sentence' -- one can 'appeal,'" Turchin said. "What matters is what is done about it next. I see this as a glass half-full: even if someone has overweight/obesity at some point in time, they can reduce their risk for heart attack/stroke if they lower their weight over time."
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Endocrine Society, June 1-4

<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The&nbsp;<a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s ease 0s;" href="https://accscientificsession.acc.org/" target="_blank" rel="noopener" aria-label="content">annual meeting of the American College of Cardiology</a>&nbsp;was held from April 6 to 8 in Atlanta and attracted more than 12,000 participants, including clinicians, academicians, allied health professionals, and others interested in cardiology. The conference highlighted recent advances in the treatment, management, and prevention of cardiovascular diseases, with presentations focusing on novel drugs and surgical approaches to improve the quality of care for patients with cardiovascular diseases.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">In one study, Zhuo Chen, Ph.D., of the Case Western Reserve University and University Hospitals Health System in Cleveland, and colleagues identified a significant association between higher visibility of trees and sky and the presence of sidewalks near residences and a lower risk for major adverse cardiovascular events, even when accounting for socioeconomic, environmental, and clinical risk factors.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The authors evaluated the relationship between the built environment near individuals' residences, specifically vertical greenspaces and sidewalks, and cardiovascular risk. Utilizing advanced deep learning techniques to analyze Google Street View images, exposure to these environmental features for individuals participating in a low-cost/free coronary calcium scan program was quantified. The researchers found a significant, independent association between increased visibility of vertical greenspaces and the presence of sidewalks with reduced cardiovascular risk.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"This suggests that urban planning strategies emphasizing the enhancement of residential greenspaces and pedestrian-friendly infrastructure could play a vital role in cardiovascular health promotion and disease prevention," Chen said. "Our research offers novel insights into the importance of the built environment as a modifiable risk factor for cardiovascular diseases."

American College of Cardiology, April 6 to 8

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lora, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Classification of COPD is specific to patients; treatment regimens should be tailored to individual patients
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">TUESDAY, June 25, 2024 (HealthDay News) -- Recommendations have been developed for diagnosis, classification, and management of chronic obstructive pulmonary disorder (COPD), according to updated guidelines published July 21, 2021, in&nbsp;U.S. Pharmacist.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Mackenzie Laisure, Pharm.D., from Western New England University College of Pharmacy &amp; Health Sciences, and colleagues updated the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, which classify COPD and provide treatment recommendations.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The authors note that diagnosis of COPD is made through a combination of spirometry and medical history. Spirometry is required for an official diagnosis of COPD, with persistent airflow limitation confirmed by a post-bronchodilator forced expiratory volume in one second/forced vital capacity &lt;0.70. Based on the level of airflow limitation, the guidelines classify patients into four categories: mild, moderate, severe, or very severe (GOLD 1, 2, 3, or 4). Symptom burden and risk for exacerbation also further classified patients into groups A through D, which can guide therapy. Classification is specific to patients and treatment regimens should be tailored specifically to individual patients. A long-acting muscarinic antagonist, such as tiotropium, is recommended for patients in group C. Two cited studies demonstrated the superiority of tiotropium over salmeterol and indacaterol in extending time to first exacerbation and reducing the annual number of moderate-to-severe exacerbations.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Smoking cessation, physical activity, and vaccination are nonpharmacologic therapies for COPD; smoking cessation is important for preventing disease progression. The recommended treatment for smoking cessation is nicotine replacement therapy; the guidelines do not recommend the use of electronic cigarettes for smoking cessation due to possible risks and lack of data.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">"All patients with COPD should be prescribed a short-acting bronchodilator for immediate relief. New findings regarding triple therapy suggest that there is a significant decrease in mortality in comparison to dual bronchodilation therapy and a decrease in exacerbations and hospitalization," the authors write.
<a style="font-family: var(--arrow-typeface-secondary); font-size: 20px; box-sizing: border-box; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://www.uspharmacist.com/article/summarizing-the-2021-updated-gold-guidelines-for-copd" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text (subscription or payment may be required)</a>

Guidelines for Diagnosis, Management of COPD.
 colleagues updated the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, which classify COPD and provide treatment recommendations.

Guidelines for Diagnosis, Management of COPD.

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lora, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Postoperative edema, seroma, and hematoma formation significantly reduced
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">TUESDAY, June 25, 2024 (HealthDay News) -- Chymotrypsin and trypsin oral combination prophylaxis reduces postoperative edema, seroma, and hematoma formation and can hasten the healing process, according to a study published in the January 2019 issue of the&nbsp;International Surgery Journal.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Suhas Kondreddy and Palli Shirin, from the Alluri Sitarama Raju Academy of Medical Sciences in India, and colleagues examined the efficacy of chymotrypsin and trypsin in reducing postoperative edema and hematoma formation in a prospective study involving 50 electively posted surgical patients. The patients were assigned to receive oral preparation of trypsin:chymotrypsin or placebo (25 in each group).
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers found a significant reduction in postoperative edema, seroma, and hematoma formation in the trypsin:chymotrypsin combination group, and they had a reduction in pain and incidence of suture site infection. In addition, cosmetic appearance of the scar was better and the need for secondary suturing was reduced in the trypsin:chymotrypsin combination group. Recovery time was shorter in the chymotrypsin and trypsin group; recovery time was less than one week in 80 and 68 percent of patients in the chymotrypsin and trypsin and placebo groups, respectively.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">"Trypsin &amp; chymotrypsin combination hastens repair in surgical patients, shows high bioavailability without losing its biological activities as an anti-inflammatory, anti-edematous, fibrinolytic, antioxidant, and anti-infective agent. These properties help in resolving signs and symptoms of inflammation due to tissue injury and facilitate the repair process," the authors write.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://www.ijsurgery.com/index.php/isj/article/view/3572" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text (subscription or payment may be required)</a>

Trypsin & chymotrypsin combination
symptoms of inflammation due to tissue injury and facilitate the repair process,
anti-inflammatory, anti-edematous, fibrinolytic, antioxidant,

Facilitate the repairing process in tissue injury.

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alpha-amylase enzyme
 concentration of 60 mg. (300 U.CEIP /ml)

FORTALASE is the 1st natural and safe Anti-inflammatory in KSA market.

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">All-cause dementia risk greater for those with treated and untreated hypertension compared with healthy controls
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">WEDNESDAY, Aug. 14, 2024 (HealthDay News) -- Individuals with treated hypertension have a reduced risk for Alzheimer dementia (AD) compared with those with untreated hypertension, according to research published online Aug. 14 in&nbsp;Neurology.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Matthew J. Lennon, M.D., from the University of New South Wales in Sydney, and colleagues examined whether previous hypertension or antihypertensive use modifies AD or non-AD (all-cause dementia) risk in late life in an individual participant data meta-analysis that included community-based longitudinal studies of aging. The risks for developing AD and non-AD were examined as the main outcomes, while the main exposures were hypertension history/antihypertensive use and baseline systolic and diastolic blood pressure (BP). The analysis included 31,250 participants (mean baseline age, 72 years) from 14 nations.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers found that compared with healthy controls and those with treated hypertension, participants with untreated hypertension had a significantly increased risk for AD (hazard ratios, 1.36 and 1.42, respectively). Both those with treated and untreated hypertension had greater non-AD risk compared with healthy controls (hazard ratios, 1.29 and 1.69, respectively), with no difference seen between the treated and untreated groups. In an analysis restricted to those with five-year follow-up, baseline BP had a significant U-shaped relationship with non-AD risk, but there were no other relationships seen between baseline BP and AD or non-AD risk.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"Throughout late life those with treated hypertension had a lower risk of AD compared with those with untreated hypertension, suggesting that antihypertensive use should be part of any AD prevention strategy even in late life," the authors write.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Several authors disclosed ties to the pharmaceutical industry.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://n.neurology.org/lookup/doi/10.1212/WNL.0000000000209715" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text (subscription or payment may be required)</a>

Risk for Alzheimer Dementia Lower with Treated Versus Untreated HTN.

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Net savings of $540 billion in direct costs and $2.7 trillion in societal costs seen in association with routine childhood vaccinations
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">FRIDAY, Aug. 9, 2024 (HealthDay News) -- Childhood vaccinations continue to provide substantial health and economic benefits, according to research published in the Aug. 8 issue of the U.S. Centers for Disease Control and Prevention&nbsp;Morbidity and Mortality Weekly Report.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Noting that the U.S. Vaccines for Children (VFC) program has covered the cost of vaccines for children whose families might not be able to afford vaccines since 1994, Fangjun Zhou, Ph.D., from the CDC in Atlanta, and colleagues assessed and quantified the health benefits and economic impact of routine U.S. childhood immunizations among VFC-eligible and non-VFC-eligible children born during 1994 to 2023. Established economic models were used to estimate averted illnesses and deaths and associated costs over the lifetimes of 30 annual cohorts of children; net savings were calculated from the perspectives of payers and society.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers found that routine childhood vaccinations will have prevented approximately 508 million lifetime cases of illness, 32 million hospitalizations, and 1,129,000 deaths among approximately 117 million children born during 1994 to 2023; the associated net savings were $540 billion in direct costs and $2.7 trillion in societal costs.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"This analysis demonstrates the continued and substantial health benefits associated with vaccinating young children, rendering the investment in vaccines and immunization services an important and cost-saving public health strategy," the authors write.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://www.cdc.gov/mmwr/volumes/73/wr/mm7331a2.htm?s_cid=mm7331a2_w" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text</a>

Childhood Vaccinations Have Prevented ~508 Million Lifetime Cases of Illness

Childhood Vaccinations Have Prevented ~508 million Lifetime Cases of Illness

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Association between short sleep duration and microvascular disease amplified by age, with risk increased for older adults
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">&nbsp;For individuals newly diagnosed with type 2 diabetes mellitus (T2DM), both short and long sleep duration are associated with microvascular disease, according to a study scheduled to be presented at the annual meeting of the European Association for the Study of Diabetes, being held from Sept. 9 to 13 in Madrid.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Mette S. Johansen, from Odense University Hospital in Denmark, and colleagues explored the relationship between sleep duration and the presence of microvascular disease among individuals newly diagnosed with T2DM in a cross-sectional analysis. Sleep duration at night was measured using accelerometers worn for a period of 10 days and was categorized into short (less than seven hours), optimal (seven to less than nine hours), and long (at least nine hours).
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Overall, 396 participants had valid sleep duration measures, as well as urine albumin/creatinine ratio measurement and eye examination (used to define microvascular disease). The researchers found that 12, 60, and 28 percent of the participants had short, optimal, and long sleep duration, respectively. Within these categories, the prevalence of microvascular damage was 38, 18, and 31 percent, respectively. Both short and long sleep duration were significantly associated with microvascular disease (odds ratios, 2.63 and 2.29, respectively). Age accentuated the association between short sleep duration and microvascular disease for participants aged younger than 62 years compared with those aged older than 62 years.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"Age amplifies the association between short sleep duration and microvascular disease, suggesting increased vulnerability among older individuals," the authors write.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://www.easd.org/annual-meeting/easd-2024.html" target="_blank" rel="noopener" aria-label="content">More Information</a>

Short, Long Sleep Duration Tied to Microvascular Disease in Type 2 Diabetes

Annual meeting of the European Diabetes Association.

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Intake during the three months before conception associated with odds of HDP
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">People with higher intakes of calcium and zinc before pregnancy appear to have a significantly lower risk for hypertensive disorders of pregnancy (HDP), according to research presented during NUTRITION 2024, the annual meeting of the American Society for Nutrition, held from June 29 to July 2 in Chicago.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Liping Lu, M.D., Ph.D., from Ball State University in Muncie, Indiana, and colleagues used data from 7,737 pregnant women without chronic hypertension participating in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be to assess the association between preconceptional calcium intake (three months before pregnancy) and odds of HDP. There was a modest inverse association between energy density-adjusted calcium intake and HDP when adjusting for sociodemographic, lifestyle, clinical, and other dietary factors. The odds of HDP were 21 percent lower for participants in the highest quintile of calcium intake versus those in the lowest quintile.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">In a second analysis using the same dataset, the researchers examined the association of preconception maternal zinc intake and the risk for HDP. Similarly, when adjusting for age, race, marital status, body mass index, insurance, education, sex of the baby, conception season, poverty, smoking, prenatal vitamin use, and other dietary variables, zinc intake was inversely associated with HDP, with those in the highest quartile for preconception zinc intake being 38 percent less likely to experience HDP than those in the lowest quartile.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"The health of women during the preconception period is strongly linked to the pregnancy outcome," Lu said in a statement. "Adequate nutrient or mineral stores in the body prior to conception can ensure optimal nutrient status for conception and support the early stages of fetal growth and development."
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://nutrition.org/N24/" target="_blank" rel="noopener" aria-label="content">More Information</a>

Calcium, Zinc Intake Tied to Lower Risk for Hypertensive Disorders of Pregnancy

Role of Calcium, Zinc Intake in Lowering the Risk for Hypertensive Disorders of Pregnancy

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Twenty-six positive, five negative correlations seen, as well as link between insulin resistance and all-cause mortality in women
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">MONDAY, Sept. 9, 2024 (HealthDay News) -- Insulin resistance (IR) is associated with multiple systemic diseases, according a study presented at the annual meeting of the European Association for the Study of Diabetes, held from Sept. 9 to 13 in Madrid.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Jing Wu and Y. Song, from the Cheeloo College of Medicine at Shandong University in Jinan, China, explored the correlation between IR and systemic diseases using data from the U.K. Biobank, which recruited more than 500,000 participants aged 40 to 69 years. The degree of IR was measured using the triglyceride-glucose index and triglyceride/high-density lipoprotein cholesterol ratio.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers identified a correlation between IR and 31 diseases (26 positive and five negative correlations) during a median follow-up of 13 years, and for all-cause mortality among women. Strong associations were seen for IR with diabetes, gout, disorders of lipoprotein metabolism, and other lipidemias. A novel finding of an association between IR and diseases such as gout, Parkinson disease, and sciatica was seen.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"We have shown that by assessing the degree of insulin resistance, it is possible to identify individuals who are at risk of developing obesity, hypertension, heart disease, gout, sciatica, and some other diseases," Wu said in a statement. "This provides a basis for early intervention measures to reduce the risk of disease and also offers new ideas for disease prevention and treatment."
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://news.easd.org/media-centre/home.html#!resources/b-insulin-resistance-is-associated-with-31-diseases-and-all-cause-mortality-in-females-in-the-uk-biobank-a-prospective-cohort-study-b" target="_blank" rel="noopener" aria-label="content">Abstract</a>
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://www.easd.org/annual-meeting/easd-2024.html" target="_blank" rel="noopener" aria-label="content">More Information</a>

Insulin Resistance Linked to Risk for More Than 30 Diseases

<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Vitamin supplements are a big business, with Americans spending roughly $45 billion out of more than $177 billion worldwide on pills, gummies and powders meant to boost health.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">About 59 million Americans regularly use some type of vitamin or supplement, spending an average $510 each year.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">But most folks are wasting that money, experts say.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">A balanced daily diet provides all the nutrients a person typically needs to maintain their health, said&nbsp;<a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://www.pennstatehealth.org/doctors/matthew-l-silvis-md" target="_blank" rel="noopener" aria-label="content">Dr. Matthew Silvis</a>, vice chair of clinical operations for Penn State Health Family and Community Medicine.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">“If you have a well-balanced diet and you're able to eat nutritious foods ― fruits, vegetables, etc. ― you don’t need a multivitamin or a supplement,” Silvis said in a news release.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">“The broad answer is most people don't need them, despite the multibillion-dollar industry that the vitamin industry is,” he continued. “But there are populations of individuals who do need to consider a multivitamin or a supplement. And that is individualized.”
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Examples of people who do need specific supplements include:
<ul style="box-sizing: border-box; margin: 0px; padding: var(--arrow-spacing-m) var(--arrow-spacing-xl) 0 var(--arrow-spacing-xl); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; list-style: initial; font-size: 20px; background-color: #ffffff;">
<li style="box-sizing: border-box; font-family: var(--arrow-typeface-secondary); font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); margin-bottom: 4px; word-break: break-word;">
<p style="box-sizing: border-box; padding: 0px; font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; margin: 0px 0px unset 0px;">- Pregnant women who need folic acid to prevent birth defects.
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<li style="box-sizing: border-box; font-family: var(--arrow-typeface-secondary); font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); margin-bottom: 4px; word-break: break-word;">
<p style="box-sizing: border-box; padding: 0px; font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; margin: 0px 0px unset 0px;">- Seniors with osteoporosis who can benefit from calcium and Vitamin D supplements.
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<li style="box-sizing: border-box; font-family: var(--arrow-typeface-secondary); font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); margin-bottom: 4px; word-break: break-word;">
<p style="box-sizing: border-box; padding: 0px; font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; margin: 0px 0px unset 0px;">- Vegans or people with Celiac disease who need a multivitamin to supplement the nutrients they aren’t absorbing from their diet.
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<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">High-intensity athletes who regularly participate in draining workouts and fierce competition also might be justified in turning to some supplements, said Silvis, who also serves as medical director of primary care sports medicine for Penn State Health.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">“Professional hockey players burn an incredible amount of fuel on a day-to-day-to-week basis,” he said. “We look at their protein intake and they can’t possibly eat enough chicken and steak and protein to make up for those losses and we can’t have them losing muscle mass. They often supplement with protein shakes, because that is a quick, easy way for them to maintain their protein intake.”
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">However, that doesn’t include average folks participating in athletics as a pastime, Silvis noted.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">“Do all athletes need to take protein shakes? Absolutely not,” he said. “Your child on a T-ball team does not need a protein shake.”
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Silvis said it’s best to talk with a doctor about whether you need a vitamin or supplement before hitting your local nutrition center, drug store or supermarket.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">If your body doesn’t need a particular nutrient, more likely than not the excess will be flushed out.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Essentially, the money spent on most unnecessary supplements goes straight down the toilet.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">“If you have a well-balanced diet, well, you just literally urinate out the vitamins and minerals that you are taking with the multivitamin,” Silvis said. “You can only absorb so much, and once you are past that limit, you just excrete the vitamin.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">“So, the mentality that, ‘if something is good, more must be better,’ is not true,” he added.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">For example, there’s no evidence that taking loads of Vitamin C can ward off colds, and little to suggest it helps speed recuperation, Silvis said.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">“There’s a lot of debate about whether or not Vitamin C actually changes how long you are going to have your illness,” Silvis said. “But as with other vitamins, if you have a healthy, well-balanced diet with fruits and vegetables, you’ll meet your dietary needs day to day.”
<div class="text-story-m_story-tags__Roh7y" style="box-sizing: border-box; color: #333333; font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">&nbsp;</div>
<div class="arr--story-page-card-wrapper" style="box-sizing: border-box; color: #333333; font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">
<div class="arr--element-container story-element-card-m_element-container__1ZeJL story-element-card-m_dark__1AX15" style="box-sizing: border-box; margin: var(--arrow-spacing-xl) 0; color: var(--arrow-c-mono2);">
<div class="arrow-component arr--text-element text-m_textElement__e3QEt text-m_dark__1TC18 " style="box-sizing: border-box; -webkit-font-smoothing: antialiased; font-family: var(--arrow-typeface-primary); font-weight: var(--arrow-fw-normal); text-rendering: optimizelegibility; font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); color: #000000;" data-test-id="text">
<p style="box-sizing: border-box; font-weight: 400; margin: 0px 0px 15px; padding: 0px; font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; font-style: normal; letter-spacing: normal; word-break: break-word;">Worse, people can actually cause a health problem for themselves if they take too much of certain vitamins, he said.
<p style="box-sizing: border-box; font-weight: 400; margin: 0px 0px 15px; padding: 0px; font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; font-style: normal; letter-spacing: normal; word-break: break-word;">For example, excess Vitamin A can lead to a toxic condition called hypervitaminosis, which can cause vision and skin changes, bone pain and even liver damage.
<p style="box-sizing: border-box; font-weight: 400; margin: 0px 0px 15px; padding: 0px; font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; font-style: normal; letter-spacing: normal; word-break: break-word;">If a person is intent on taking supplements, they should make sure what they are ingesting is as safe as possible, Silvis said.
<p style="box-sizing: border-box; font-weight: 400; margin: 0px 0px 15px; padding: 0px; font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; font-style: normal; letter-spacing: normal; word-break: break-word;">When shopping for vitamins, consumers should look for the United States Pharmacopeia verified mark on the product, to ensure that what is on the label is actually in the product, Silvis said.
<p style="box-sizing: border-box; font-weight: 400; margin: 0px 0px 15px; padding: 0px; font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; font-style: normal; letter-spacing: normal; word-break: break-word;">Folks buying sports performance enhancers should look for products approved by the NSF Certified for Sport, a nonprofit that requires strict standards for supplements, Silvis said.
<p style="box-sizing: border-box; font-weight: 400; margin: 0px 0px 15px; padding: 0px; font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; font-style: normal; letter-spacing: normal; word-break: break-word;">“Those are the checks and balances that you can provide patients. Because there are walls and walls and rows and rows of options when you go to the store,” Silvis said. “So, if you don’t arm the person with the knowledge of what to look for, both in terms of the content of the vitamin or supplement and to make sure that it’s going to be safe for the patient, then I don’t think I’ve done my job.”
<p style="box-sizing: border-box; font-weight: 400; margin: 0px 0px 15px; padding: 0px; font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; font-style: normal; letter-spacing: normal; word-break: break-word;">SOURCE: Penn State Health, news release, March 20, 2024
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Do You Need to Take Supplements If You Eat a Healthy Diet?

Differentiating COPD and Asthma: The Role of Tiotropium in Management According to&nbsp;&nbsp;GOLD and GINA Guidelines by Dr. Doaa Gad Consultant pulmonologist at Mouwasat hospital.

Differentiation between COPD and Asthma 
Gold guidelines

Differentiation between COPD and Asthma by Dr. Doaa Gad

<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">TUESDAY, Nov. 5, 2024 (HealthDay News) -- For patients with gout, Febuxostat at a daily dose of 80 to 120 mg is noninferior to allopurinol with respect to its effect on adverse cardiovascular events, according to a study published online Nov. 28, 2020, in&nbsp;The Lancet.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Isla S. Mackenzie, M.B.Ch.B., from the University of Dundee in the United Kingdom, and colleagues conducted a prospective, randomized, noninferiority trial of Febuxostat versus allopurinol in patients aged 60 years or older with gout. After a lead-in phase during which the allopurinol dose was optimized toward achieving serum urate &lt;6 mg/dL, patients were randomly assigned to allopurinol or to start Febuxostat at 80 mg/day, increasing to 120 mg/day if necessary.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">A total of 6,128 patients were enrolled and randomly assigned to allopurinol or Febuxostat (3,065 and 3,063 patients, respectively). The researchers found that for the incidence of the primary end point (composite of hospitalization for nonfatal myocardial infarction or biomarker-positive acute coronary syndrome; nonfatal stroke; or cardiovascular death), Febuxostat was noninferior to allopurinol (1.72 versus 2.05 events per 100 patient-years; adjusted hazard ratio, 0.85 [95 percent confidence interval, 0.70 to 1.03]; P &lt; 0.0001). Overall, 7.2 percent of patients in the Febuxostat group died and 57.3 percent in the safety analysis set had at least one serious adverse event. In the allopurinol group, 8.6 percent of patients died and 59.4 percent had one or more serious adverse events.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">"In light of these findings, regulatory advice to avoid the use of Febuxostat in patients with cardiovascular disease should be reconsidered and modified," the authors write.
<div class="text-story-m_story-tags__Roh7y" style="box-sizing: border-box; color: #333333; font-family: Lora, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">&nbsp;</div>
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<div class="arrow-component arr--text-element text-m_textElement__e3QEt text-m_dark__1TC18 " style="box-sizing: border-box; -webkit-font-smoothing: antialiased; font-family: var(--arrow-typeface-primary); font-weight: var(--arrow-fw-normal); text-rendering: optimizelegibility; font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); color: #000000;" data-test-id="text">
<p style="box-sizing: border-box; font-weight: 400; margin: 0px 0px 15px; padding: 0px; font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; font-style: normal; letter-spacing: normal; word-break: break-word;"><a style="box-sizing: border-box; background-color: transparent; color: var(--textelementhyperlinkcolor); text-decoration: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32234-0/abstract" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text (subscription or payment may be required)</a>
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Discover groundbreaking research comparing Febuxostat and allopurinol in treating gout patients over 60. Learn about cardiovascular safety outcomes, mortality rates, and adverse events from this large-scale clinical trial involving 6,128 patients. Key findings challenge current regulatory guidance on Febuxostat use

Febuxostat Noninferior to Allopurinol for Adverse CV Events in Gout

The GOLD Guidelines 2025 introduced notable pharmacological updates

The GOLD Guidelines 2025 introduced notable pharmacological updates to enhance the management of COPD

The GOLD COPD 2025 Guidelines introduced several key updates in diagnostic approaches to enhance accuracy and equitable care

What Arthfre is and what it's used for?
Arthfre belongs to a group of medicines called anticheumatic medicines, it contains active substance lefluonamide.
Arthfre is used to treat adult patients with active rheumatold arthritis or with active psoriatic arthritis.
Symptoms of rheumatoid arthribs include inflammation of joints, swelling, Difficulty&nbsp;moving and pain.
Other symptoms that affect the entire body include loss of appetite, fever, loss of energy and anaemia (lack of red blood cells).
Symptoms of active psoriatis arthritis includeinfammation of joints, swelling, difficulty moving, pain and patches of red, scaly skin (skin lesions).

Arthfre Available Now In KSA

Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) in People with Diabetes: The Need for Screening and Early Intervention. A Consensus Report of the American Diabetes Association
·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Approximately 15%–20% of adults with type 2 diabetes have at-risk MASH and are on a path to develop cirrhosis if untreated. About 1 in 5 with T2D have advanced liver fibrosis. 
o&nbsp;&nbsp; This high prevalence is comparable with or higher than that for other diabetes related complications such as diabetic nephropathy, retinopathy, or neuropathy.&nbsp;&nbsp; 
·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Although no glucose-lowering medication is approved for the treatment of MASLD, preference in treating diabetes should be given to those treatments with evidence of safety and effectiveness for steatohepatitis from high-quality phase 2 RCTs and a phase 3 RCT (e.g., GLP-1RA and/ or pioglitazone, or dual GIP/GLP-1RA tirzepatide), with the dual purpose of treating hyper glycemia and steatohepatitis. 
o&nbsp;&nbsp; Net weight loss is observed when pioglitazone is combined with a GLP-1RA or a sodium– glucose cotransporter 2 (SGLT2) inhibitor.&nbsp; 
o&nbsp;&nbsp; SGLT2 inhibitors have not been rigorously tested with histological outcomes in MASH, but their cardiometabolic benefits make them an attractive option for people with MASLD. 
o&nbsp;&nbsp; The prevalence of MASLD is increasing among people with type 1 diabetes, optimizing glycaemic management with insulin therapy may reduce steatosis&nbsp; 
For More info Kindly Check the original Article :
&nbsp;
<a href="https://diabetesjournals.org/care/article/doi/10.2337/dci24-0094/160536/Metabolic-Dysfunction-Associated-Steatotic-Liver">Metabolic Dysfunction–Associated Steatotic Liver D</a><a name="_Hlt201219024"></a><a name="_Hlt201219023"></a>isease (MASLD) in People With Diabetes: The Need for Screening and Early Intervention. A Consensus Report of the American Diabetes Association | Diabetes Care | American Diabetes Association
&nbsp;

Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) in People with Diabetes

Can Early Use of SGLT-2 Inhibitors Transform Chronic Kidney Disease Management in High-Risk Populations?
This article presents a consensus from a panel of 210 nephrologists across India on the early introduction of Sodium-Glucose Cotransporter 2 (SGLT-2) inhibitors to improve the management of Chronic Kidney Disease (CKD) in individuals with or without diabetes. The consensus highlights the increasing burden of CKD globally and emphasizes the significant role primary care physicians can play in the early detection and management of the disease.
SGLT-2 inhibitors are demonstrated to have significant renoprotective and cardioprotective benefits that go beyond their glucose-lowering effects. The article states, "SGLT-2 inhibitors have shown substantial efficacy in improving renal and cardiovascular outcomes in CKD patients." This consensus emphasizes the need for early CKD screening, particularly for high-risk groups, such as individuals with diabetes, hypertension, or a family history of kidney disease. It further asserts, "The majority (48.57%) of clinicians strongly agreed that primary care physicians play a vital role in early CKD management."
Key diagnostic tests for confirming CKD include serum creatinine, proteinuria measurement, and glomerular filtration rate (GFR), with early use of SGLT-2 inhibitors recommended to delay disease progression, especially in patients with Type 2 Diabetes. The article states, "The consensus supported the incorporation of SGLT-2 inhibitors into early CKD management to delay disease progression, especially in patients with T2D, with evidence suggesting significant cardiovascular and renal benefits."
Additionally, clinical trials such as CREDENCE, DAPA-CKD, and EMPA-KIDNEY are referenced to illustrate the success of SGLT-2 inhibitors in improving kidney outcomes. As noted in the paper: "SGLT-2 inhibitors offer significant advantages in thwarting the onset and progression of CKD among individuals with T2D, surpassing the anticipated benefits solely attributable to glucose-lowering interventions."
This article provides practical recommendations for integrating SGLT-2 inhibitors into CKD management, aiming to improve patient outcomes by addressing early stages of the disease through a collaborative approach between nephrologists and primary care physicians. The paper concludes, "Early integration of SGLT-2 inhibitors in CKD management, particularly in high-risk groups, can slow disease progression, reduce complications, and improve patient outcomes." For More info Kindly Check the original Article : <a href="https://journals.lww.com/jodb/fulltext/2025/04000/early_introduction_of_sglt_2_inhibitors_to_improve.4.aspx">https://journals.lww.com/jodb/fulltext/2025/04000/early_introduction_of_sglt_2_inhibitors_to_improve.4.aspx</a>
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Early use of SGLT2 inhibitors & chronic kidney disease management

Dapagliflozin plus calorie restriction for remission of type 2 diabetes: multicentre, double blind, randomised, placebo-controlled trial This article reports on a randomized, double-blind, placebo-controlled trial designed to assess the effectiveness of dapagliflozin combined with calorie restriction in achieving remission of type 2 diabetes (T2D). Conducted across 16 centers in mainland China, the trial included 328 overweight or obese patients with T2D who were either given dapagliflozin (10 mg/day) or a placebo alongside a calorie-restricted diet.
The primary outcome of the study was the incidence of diabetes remission, defined as HbA1c &lt;6.5% and fasting plasma glucose &lt;126 mg/dL without the use of any antidiabetic drugs for at least two months. The results revealed that 44% of the dapagliflozin group achieved remission compared to 28% in the placebo group, indicating a statistically significant improvement with the combination therapy.
Secondary outcomes, such as body weight, waist circumference, and metabolic risk factors, also showed significant improvements in the dapagliflozin group. For instance, body weight was reduced by 5.0 kg in the dapagliflozin group compared to 3.2 kg in the placebo group. Additionally, the dapagliflozin group showed a greater reduction in insulin resistance (measured by HOMA-IR) and improved blood pressure and lipid levels.
The study concludes that the combination of dapagliflozin and calorie restriction is an effective and feasible approach for achieving remission in overweight or obese patients with early-stage T2D. 
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It offers a more practical alternative to intensive weight management programs like those seen in bariatric surgery and may serve as a viable option for long-term diabetes management. 
The findings provide valuable insights into potential treatment strategies for T2D remission, supporting the idea that a pharmacological approach like dapagliflozin combined with lifestyle interventions could be a promising alternative to traditional therapies. For More Information kindly check the Original Article : <a href="https://www.bmj.com/content/388/bmj-2024-081820">Dapagliflozin plus calorie restriction for remission of type 2 diabetes: multicentre, double blind, randomised, placebo controlled trial | The BMJ</a>
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Dapagliflozin plus calorie restriction for remission of type 2 diabetes

Impact of sodium‒glucose cotransporter‐2 inhibitors in patients with recent versus previous myocardial infarction: a systematic review and meta-analysis
 Key Findings: Study Selection: The analysis incorporated 10 randomized controlled trials (RCTs) involving 22,266 patients, of whom 51.2% had type 2 diabetes (T2DM). These trials compared SGLT2 inhibitors with placebo over an average follow-up of 21 months.
Primary Outcome: SGLT2 inhibitors significantly reduced hospitalization rates for HF compared to placebo (Risk Ratio [RR] 0.77, 95% Confidence Interval [CI] 0.69, 0.85).
Secondary Outcomes:
MACE: A reduction in MACE was observed in patients using SGLT2 inhibitors (RR 0.88; 95% CI 0.79, 0.97).
All-Cause Mortality: No significant difference was found between SGLT2 inhibitors and placebo (RR 0.88; 95% CI 0.78, 1.00).
Subgroup Analysis: Both patients with recent MI (within 8 weeks) and those with previous MI (more than 8 weeks ago) benefitted from SGLT2 inhibitors, showing no significant difference in the treatment effect based on MI timing.
Additional Observations:
The benefits of SGLT2 inhibitors were consistent across subgroups, including patients with or without T2DM.
No significant effect was observed on the recurrence of MI, CV death, or stroke.
Sensitivity analyses confirmed the robustness of the primary results, indicating that the benefits of SGLT2 inhibitors are reliable for both recent and prior MI patients.
Conclusion: The study supports the use of SGLT2 inhibitors in both recent and previous MI patients to reduce hospitalizations for HF and improve cardiovascular outcomes. However, further large-scale studies are required to better understand their impact on mortality and to confirm the benefits in patients without T2DM.
This meta-analysis highlights the potential of SGLT2 inhibitors in improving cardiovascular health post-MI, regardless of whether the MI was recent or prior. <a href="https://cardiab.biomedcentral.com/articles/10.1186/s12933-024-02540-4"> Impact of sodium‒glucose cotransporter‐2 inhibitors in patients with recent versus previous myocardial infarction: a systematic review and meta-analysis</a>
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Impact of sodium‒glucose cotransporter‐2 inhibitors in patients with recent versus previous myocardial infarction

The Modern Role of Basal Insulin in Advancing Therapy in People With Type 2 Diabetes
 The article examines the evolving role of basal insulin (BI) in managing Type 2 Diabetes Mellitus. Summary of its key points:
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Basal Insulin (BI) and Its Physiological Role: BI plays a crucial role in maintaining normal glucose homeostasis by continuously regulating plasma glucose levels through its impact on hepatic glucose production. In T2DM, BI deficiency contributes to elevated fasting plasma glucose and hyperglycemia due to insufficient insulin secretion, combined with insulin resistance.&nbsp;
Clinical Use of BI: Although newer medications like GLP-1RA and SGLT2i have become prominent, BI remains essential in managing T2DM. It is often used when other therapies fail to maintain glucose control, and it can be combined with newer drugs to improve efficacy, reduce hypoglycemia risk, and mitigate weight gain.&nbsp;
Advancements in BI Therapy: Insulin therapy has evolved since its introduction, with newer long-acting insulin analogs like insulin glargine and insulin degludec offering more stable and prolonged effects compared to older formulations. These innovations have reduced the risk of hypoglycemia and improved patient compliance.&nbsp;
Combination Therapies: BI is increasingly used in combination with other medications, such as GLP-1RA and SGLT2i, to target different aspects of glucose control. These combinations take advantage of the complementary mechanisms of action to improve long-term outcomes, reduce side effects, and manage comorbidities like cardiovascular and kidney diseases.&nbsp;
Challenges and Considerations: Although effective, BI therapy presents challenges, including the risk of hypoglycemia, weight gain, and the need for regular titration. However, modern insulin formulations and technologies, such as continuous glucose monitoring, have helped mitigate these risks. BI is particularly valuable in situations of insulin deficiency, metabolic stress, and comorbid conditions like pregnancy or organ failure.&nbsp;
In conclusion, while newer drugs have reshaped T2DM management, basal insulin remains a cornerstone therapy, particularly in advanced stages of the disease or&nbsp; in patients with marked insulin deficiency. <a href="file:///C:/Users/mina.mazouz/Desktop/KSA/KSA%20HCP%20Portal/The%20Modern%20Role%20of%20Basal%20Insulin%20in%20Advancing%20Therapy%20in%20People%20With%20Type%202%20Diabetes">The Modern Role of Basal Insulin in Advancing Therapy in People With Type 2 Diabetes – Diabetes Care</a> 
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The Modern Role of Basal Insulin in Advancing Therapy in People With Type 2 Diabetes

HbA1c variability and all-cause mortality in type 1 and type 2 diabetes: A population-based cohort study using electronic health records Higher A1c variability, assessed over a 4-year period, was associated with a substantially increased risk for subsequent mortality outcomes in patients with type 1 diabetes (T1D) and those with type 2 diabetes (T2D), regardless of average A1c levels
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Variability measures were generally higher in T2D, with 38% of patients with T2D vs 33% of those with T1D having an A1c variability score ≥ 50.
Predictors of high A1c variability were younger age, obesity, comorbidities, and residence in deprived areas for both T1D and T2D, whereas non-White ethnicity was a predictor of high variability only in T1D.
A higher vs lower A1c variability score (≥ 80 vs &lt; 20) was associated with nearly a threefold increase in mortality risk for patients with T1D and a twofold increased risk for those with T2D (hazard ratio [HR] for T1D, 2.78; 95% CI, 2.15-3.60; HR for T2D, 1.91; 95% CI, 1.83-1.99).
The impact of average A1c levels on mortality was less pronounced than that of A1c variability, as evidenced by higher population attributable fractions for variability (A1c variability score ≥ 20) than for average A1c levels in both T1D and T2D. <a href="https://www.sciencedirect.com/science/article/pii/S0168822725002438">HbA1c variability and all-cause mortality in type 1 and type 2 diabetes: A population-based cohort study using electronic health records - Diabetes Research and Clinical Practice</a>
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HbA1c variability and all-cause mortality in type 1 and type 2 diabetes: A population-based cohort study using electronic health records

The Association Between Hemoglobin A1c&nbsp;and Complications Among Individuals With Diabetes and Severe Chronic Kidney Disease
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A Danish nationwide study of nearly 30,000 patients with diabetes and severe <a href="https://emedicine.medscape.com/article/238798-overview">chronic kidney disease</a> (CKD) showed that maintaining A1c levels between 6.7% and 7.1% minimised long-term complications, challenging current conservative glycaemic targets in this high-risk population.
<ul style="margin-top: 0cm;" type="disc">
<li class="MsoNormal" style="mso-list: l0 level1 lfo1; tab-stops: list 36.0pt;">The risk for major adverse cardiovascular events significantly increased at A1c levels ≥ 7.2% and &lt; 5.8% compared with an A1c level of 6.3%-6.6% (P &lt; .01 and P &lt; .001, respectively).</li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo1; tab-stops: list 36.0pt;">The risk for microvascular complications significantly increased at A1c levels ≥ 7.2% (P &lt; .001), and the risk for hospitalisation due to hypoglycaemia significantly increased at A1c levels ≥ 6.7% (P &lt; .001).</li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo1; tab-stops: list 36.0pt;">The relationship between A1c and outcomes remained consistent across sex, age, and diabetes type subgroups.</li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo1; tab-stops: list 36.0pt;">Also, the relationship between A1c and long-term complications in patients with severe CKD mirrored that seen in those with no-to-mild or mild-to-moderate CKD.</li>
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<a href="https://diabetesjournals.org/care/article/48/8/1400/160550/The-Association-Between-Hemoglobin-A1c-and">The Association Between Hemoglobin A1c&nbsp;and Complications Among Individuals With Diabetes and Severe Chronic Kidney Disease- ADA</a>
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The Association Between Hemoglobin A1c and Complications Among Individuals With Diabetes and Severe Chronic Kidney Disease

Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes | New England Journal of Medicine
Key Points: Objective: The aim was to compare the effects of SGLT2 inhibitors versus placebo in patients with recent (within 8 weeks) and previous (more than 8 weeks) MI, with a focus on heart failure (HF) hospitalization, major adverse cardiovascular events (MACE), and all-cause mortality.
Methodology: A systematic review and meta-analysis was conducted, involving 10 randomized controlled trials (RCTs) with 22,266 patients. The primary outcome was HF hospitalization, and secondary outcomes included MACE, MI recurrence, stroke, and all-cause mortality.
Findings:
HF Hospitalization: SGLT2 inhibitors reduced HF hospitalization rates significantly compared to placebo (RR 0.77; 95% CI 0.69–0.85).
MACE: The risk of MACE was also lower in the SGLT2 inhibitor group (RR 0.88; 95% CI 0.79–0.97).
Mortality: No significant difference in all-cause mortality was found (RR 0.88; 95% CI 0.78–1.00).
Subgroup Analysis: Both patients with recent MI and those with previous MI benefited from SGLT2 inhibitors, with no significant difference in treatment effectiveness based on the timing of MI (p for interaction = 0.56).
Conclusion: SGLT2 inhibitors were associated with lower rates of HF hospitalization and MACE, regardless of whether the MI was recent or prior. However, the benefit on mortality remains inconclusive, and further research is needed, especially regarding the optimal timing for starting SGLT2 inhibitors post-MI.
This meta-analysis provides robust evidence supporting the use of SGLT2 inhibitors in MI patients to reduce HF hospitalizations and improve cardiovascular outcomes, but highlights the need for additional studies to confirm their impact on mortality.
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<a href="https://www.nejm.org/doi/10.1056/NEJMoa2307563?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubmed">Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes | New England Journal of Medicine</a>- NEJM
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Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes | New England Journal of Medicine

Internal Medicine

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Severity of illness remained similar to prepandemic seasons
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">WEDNESDAY, Oct. 11, 2023 (HealthDay News) -- Emerging from the COVID-19 pandemic, respiratory syncytial virus (RSV)-associated hospitalizations in Canadian pediatric hospitals were substantial, particularly among infants younger than 6 months of age, according to a study published online Oct. 4 in&nbsp;JAMA Network Open.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Malou Bourdeau, M.D., from McGill University in Montreal, and colleagues examined the epidemiology and burden of RSV-associated hospitalizations among children and adolescents in Canadian tertiary pediatric hospitals from five RSV seasons (2017 to 2022).
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers identified 11,014 RSV-associated hospitalizations, including 23.6 percent that involved admission to the intensive care unit, of which 60.8 percent were among children aged younger than 6 months of age. There were 58 RSV-associated hospitalizations reported in 2020 to 2021 and 3,170 hospitalizations in 2021 to 2022 compared with a mean number of 2,522 hospitalizations during prepandemic seasons. Compared with the prepandemic period, age, sex, intensive care unit admission, prolonged length of stay, and case fatality rate did not change in 2021 to 2022. Regional variation was seen for RSV activity and timing.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"These findings suggest that RSV preventive strategies for infants aged less than 6 months would be associated with decreased RSV disease burden in children," the authors write.

Pediatric RSV Hospitalizations Increased in 2021 to 2022 Season

Pediatric RSV Hospitalizations Increased in 2021 to 2022 Season.

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Updated guidelines recommend annual screening for those aged 50 to 80 years who currently smoke, or formerly smoked
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">THURSDAY, Nov. 9, 2023 (HealthDay News) -- In a guideline update issued by the American Cancer Society and published online Nov. 1 in&nbsp;CA: A Cancer Journal for Clinicians,&nbsp;the authors recommend increasing eligibility for lung cancer screening (LCS).
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Andrew M.D. Wolf, M.D., from the University of Virginia School of Medicine in Charlottesville, and colleagues updated the American Cancer Society 2013 LCS guidelines for adults at high risk for lung cancer.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The Guideline Development Group judged that the evidence was moderate and sufficient to support a strong recommendation for screening those who meet eligibility criteria. In men and women aged 50 to 80 years, LCS is associated with a reduction in lung cancer deaths; inferential evidence supports screening for those older than 80 years in good health. For asymptomatic individuals aged 50 to 80 years, annual LCS with low-dose computed tomography is recommended for those who currently smoke or formerly smoked and have a ≥20 pack‐year smoking history. Individuals should engage in a shared decision-making discussion with a qualified health professional before the decision is made to initiate LCS. The number of years since quitting smoking is not an eligibility criterion for screening initiation or cessation among individuals who formerly smoked. Screening should not be undertaken by individuals with comorbid conditions that substantially limit life expectancy.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"This updated guideline continues a trend of expanding eligibility for lung cancer screening in a way that will result in many more deaths prevented by expanding the eligibility criteria for screening to detect lung cancer early," lead author Robert Smith, M.D., from the American Cancer Society, said in a statement.

2023 Guidelines Update Eligibility for Lung Cancer Screening

2023 Guidelines Update Eligibility for Lung Cancer Screening.

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Pulmonary function tests may be beneficial every six months, may be of use in initiating noninvasive ventilation when indicated
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">THURSDAY, March 16, 2023 (HealthDay News) -- In an American College of Chest Physicians clinical practice guideline and expert panel report, published online March 13 in&nbsp;CHEST, recommendations are presented for the respiratory management of patients with neuromuscular disease (NMD), including the use of pulmonary function testing every six months and initiating noninvasive ventilation (NIV) when clinically indicated.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Akram Khan, M.D., from the Oregon Health &amp; Science University in Portland, and colleagues developed recommendations to address the respiratory management of NMD. Fifteen graded recommendations, one good practice statement, and one consensus-based statement were generated based on 128 studies.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The authors note that there is limited evidence of best practices for respiratory management in NMD, which is mainly based on observational data in amyotrophic lateral sclerosis. Pulmonary function tests every six months may be beneficial and have use for initiation of NIV when clinically indicated. Patients with chronic respiratory failure and sleep-disordered breathing related to NMD may benefit from an individualized approach to NIV. Polysomnography or overnight oximetry can help guide initiation of NIV, when resources allow. The authors also provide guidance for mouthpiece ventilation, transition to home mechanical ventilation, salivary secretion management, and airway clearance therapies.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"Respiratory muscle weakness is a serious concern in patients with neuromuscular diseases. It can lead to inadequate ventilation, nighttime hypoventilation and the inability to mobilize secretions, which is frequently the cause of death in this population," Khan said in a statement. "We anticipate this guideline will standardize and improve the care provided to patients with neuromuscular diseases and subsequent weakness."
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s ease 0s;" href="https://journal.chestnet.org/article/S0012-3692(23)00353-7/fulltext" target="_blank" rel="noopener">(Abstract/Full Text )</a>

Guidelines Developed for Respiratory Management of Neuromuscular Disease

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Chronic respiratory diseases were third leading cause of death, accounting for 4.0 million deaths and prevalence of 454.6 million cases in 2019
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">THURSDAY, May 18, 2023 (HealthDay News) -- Chronic respiratory diseases (CRDs) were the third leading cause of death globally, accounting for 4.0 million deaths in 2019, according to a study published online April 25 in&nbsp;eClinicalMedicine.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Sara Momtazmanesh, M.D., from the Endocrinology and Metabolism Population Sciences Institute in Tehran, Iran, and an international group of chronic respiratory disease collaborators estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs from 1990 to 2019 by sex, age, region, and sociodemographic index in 204 countries and territories. CRDs included chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease, pulmonary sarcoidosis, and others.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers found that CRDs were the third leading cause of death in 2019, responsible for 4.0 million deaths with a global prevalence of 454.6 million cases. From 1990 to 2019, total deaths and prevalence of CRDs increased by 28.5 and 39.8 percent, respectively, while age-standardized rates decreased by 41.7 and 16.9 percent, respectively. The primary cause of deaths from CRDs was COPD, with 212.3 million prevalent cases, accounting for 3.3 million deaths. Asthma had the highest prevalence among CRDs, with 262.4 million prevalent cases. From 1990 to 2019, the age-standardized rates of burden measures of COPD, asthma, and pneumoconiosis reduced globally, but throughout the study period, the age-standardized rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis increased. The highest deaths and DALYs from CRDs were due to smoking, followed by air pollution and occupational risks.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"Full global adherence to tobacco control measures and air quality improvement strategies are crucial in reducing the burden attributed to CRD," the authors write. "The high death and DALYs rates in low and low-middle sociodemographic index countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures."
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Several authors disclosed financial ties to the biopharmaceutical industry.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none;" href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00113-X/fulltext" target="_blank" rel="noopener">Abstract/Full Text</a>
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Global Burden of Chronic Respiratory Diseases Quantified

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lora, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Individuals with higher intakes of zinc and vitamin C also had lower C-reactive protein, erythrocyte sedimentation rate
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">TUESDAY, Dec. 26, 2023 (HealthDay News) -- Higher dietary intake of zinc and vitamin C is associated with lower odds of severe COVID-19, according to a study recently published in&nbsp;Clinical Nutrition ESPEN.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Farzaneh Asoudeh, from the Tehran University of Medical Sciences in Iran, and colleagues conducted a cross-sectional study involving 250 recovered COVID-19 patients aged 18 to 65 years from June to September 2021 to examine the association between zinc and vitamin C intakes and the risk for disease severity and symptoms. Dietary intake was assessed using a 168-item food frequency questionnaire.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Forty-six percent of the participants had a severe form of the disease. The researchers found that individuals with a higher dietary intake of zinc had lower levels of inflammatory cytokines, including C-reactive protein (CRP) (13.6 versus 25.8 mg/L) and erythrocyte sedimentation rate (ESR; 15.9 versus 29.3). Higher zinc intake was also associated with a lower risk for severe disease in a fully adjusted model (odds ratio, 0.43). After controlling for potential covariates, participants with a higher dietary vitamin C intake also had lower CRP (10.3 versus 31.5 mg/L) and ESR serum concentrations (15.6 versus 35.6) and lower odds of severe disease (odds ratio, 0.31). There was an inverse association observed between dietary zinc intake and COVID-19 symptoms, including dyspnea, cough, weakness, nausea and vomiting, and sore throat. A lower risk for dyspnea, cough, fever, chills, weakness, myalgia, nausea and vomiting, and sore throat was seen in association with higher vitamin C intake.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">"Future prospective studies with a large sample size are necessary to further build on our findings," the authors write.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none;" href="https://clinicalnutritionespen.com/article/S2405-4577(23)00080-3/fulltext" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text</a>

Higher Dietary Intake of Zinc, Vitamin C Tied to Lower Odds of Severe COVID-19

Lung cancer is now the leading cause of cancer related deaths in both men and women worldwide,
In the fight to save lives the American Cancer Society is updating it's guidelines for lung cancer screening.

American cancer society updates in lung cancer screening.

American cancer society guidelines updates in lung cancer screening.

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">A new study suggests people with a history of COVID-19 may face increased odds for autoimmune and autoinflammatory disorders, including alopecia, Crohn’s disease and vasculitis.

A new study suggests people with a history of COVID-19 may face increased odds for autoimmune and autoinflammatory disorders, including alopecia, Crohn’s disease and vasculitis.

COVID-19 May Raise Risk for Immune Disorders.

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lora, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Some recommendations remained unchanged from 2007 guidelines, while others were revised in 2019 guideline
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">TUESDAY, March 19, 2024 (HealthDay News) -- Recommendations on selected diagnostic and treatment strategies were updated for adults with community-acquired pneumonia, according to a clinical practice guideline published online in the August 2019 issue of the&nbsp;American Journal of Respiratory and Critical Care Medicine.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Joshua P. Metlay, M.D., Ph.D., from Massachusetts General Hospital in Boston, and colleagues developed evidence-based guidelines on the management of adult patients with community-acquired pneumonia. Sixteen specific areas were addressed for recommendations on issues relating to diagnostic testing, determination of site of care, selection of initial empiric antibiotic therapy, and subsequent management.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers note that some recommendations remained unchanged from the 2007 guidelines, while other recommendations were revised, specifically for empiric treatment strategies and additional management decisions, based on results from new therapeutic trials and epidemiological investigations. The proportion of patients in whom routinely obtaining respiratory tract samples for microbiological studies is recommended was increased in this guideline; this was largely based on the goal of reducing overuse of methicillin-resistant&nbsp;Staphylococcus aureus&nbsp;and antipseudomonal therapy.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">"Despite substantial concern over the rise of antibiotic-resistant pathogens, most patients with CAP [community-acquired pneumonia] can be adequately treated with regimens that have been used for multiple decades," the authors write.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Several authors disclosed ties to the pharmaceutical and medical technology industries.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s ease 0s;" href="https://www.atsjournals.org/doi/10.1164/rccm.201908-1581ST" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text (subscription or payment may be required)</a>

Some recommendations remained unchanged from 2007 guidelines, while others were revised in 2019 guideline.

Recommendations Updated for Treatment of Community-Acquired Pneumonia

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lora, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Tioptropium significantly reduced CID risk and delayed time to first clinically important deterioration
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">WEDNESDAY, May 8, 2024 (HealthDay News) -- For patients with mild-to-moderate chronic obstructive pulmonary disease (COPD), Tiotropium reduces clinically important deterioration (CID), according to a study published in the February issue of&nbsp;Respiratory Medicine.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Fan Wu, from The First Affiliated Hospital of Guangzhou Medical University in China, and colleagues conducted a post-hoc analysis of the 24-month Tie-COPD study comparing 18 μg Tiotropium to placebo for mild-to-moderate COPD. A decrease of ≥100 mL in trough forced expiratory volume in one second, an increase of ≥2 units in COPD Assessment Test (CAT) score, or moderate-to-severe exacerbation was used to define CID.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The full analysis set included 771 patients. The researchers found that 83.4 percent of patients experienced at least one CID event. Compared with placebo, Tiotropium significantly reduced CID risk and delayed the time to first CID (adjusted hazard ratio, 0.58). In various subgroups, including patients with a CAT score &lt;10, modified Medical Research Council score &lt;2, and mild COPD, significant reductions in CID risk were also observed.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">"These findings emphasize the efficacy of Tiotropium in patients with mild disease from the perspective of reducing composite CID," the authors write.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The study was partly supported by an investigator-initiated study program by Boehringer Ingelheim.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s ease 0s;" href="https://www.resmedjournal.com/article/S0954-6111(24)00001-5/abstract" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text (subscription or payment may be required)</a>

Tioptropium significantly reduced CID risk and delayed time to first clinically important deterioration

Tiotropium Reduces Clinically Important Deterioration in COPD

<h3>Tiotropium Eva 18 mcg Capsules:</h3>
<ul>
<li>Name: Tiotropium Eva 18 mcg Capsules</li>
<li>Form: Inhalation dry powder in hard gelatin capsules</li>
<li>Active Ingredient: Tiotropium bromide monohydrate</li>
<li>Intended Use: Long-term maintenance treatment of Chronic Obstructive Pulmonary Disease (COPD), including chronic bronchitis and emphysema.</li>
</ul>
How It Works:
<ul>
<li>Tiotropium is a bronchodilator that helps open up the airways in the lungs, making it easier to breathe. It provides relief from COPD symptoms but is not a rescue inhaler for sudden breathing problems.</li>
</ul>
Dosage Instructions:
<ul>
<li>Usual Dose: Inhale the contents of one capsule once daily using the Vertical Haler device.</li>
<li>Instructions:
<ol>
<li>Insert the capsule into the Vertical Haler device.</li>
<li>Press the button to pierce the capsule.</li>
<li>Breathe in the medication through the mouthpiece.</li>
</ol>
</li>
</ul>
Side Effects:
<ul>
<li>Common: Dry mouth, sore throat, and coughing.</li>
<li>Serious: Allergic reactions, difficulty swallowing, or breathing issues. Seek medical attention if these occur.</li>
</ul>
Storage:
<ul>
<li>Store in the original packaging to protect from moisture.</li>
<li>Do not store above 25°C.</li>
<li>Keep out of reach of children.</li>
</ul>
Precautions:
<ul>
<li>Not intended for initial treatment of acute episodes of bronchospasm.</li>
<li>Consult with a doctor if you have kidney problems, glaucoma, or prostate issues.</li>
<li>Do not use if allergic to tiotropium bromide or any other components of the product.</li>
</ul>
Missed Dose:
<ul>
<li>If you miss a dose, take it as soon as you remember, but do not take more than one dose in a day.</li>
</ul>
Use During Pregnancy and Breastfeeding:
<ul>
<li>Consult your healthcare provider before using if you are pregnant or breastfeeding.</li>
</ul>

Tiotropium EVA is now Available in KSA.
COPD
ASTHMA
RESPIRATORY infection
chest
cough
breathlessness

Tiotropium EVA is now Available in KSA.

<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Overprescribing of antibiotics for acute upper respiratory infections (aURIs) causes significant patient harm, according to a study published in the April issue of the&nbsp;Journal of Internal Medicine.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Harris Carmichael, M.D., from the Stanford University School of Medicine in California, and colleagues analyzed data from 51 million patient encounters to determine the odds of clinically detectable adverse events following antibiotic use compared with events among unexposed individuals with aURIs.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers found that 62.4 percent of the population received antibiotics in an aURI encounter. In the antibiotic-exposed group, observed adverse events included 54,279 for diarrhea and 46,936 for candidiasis (adjusted odds ratios [aORs], 1.24 and 1.61, respectively; number needed to harm: 3,126 and 1,975, respectively). For&nbsp;Clostridium difficile&nbsp;infection (CDI), the exposed group had 30,133 observed events (aORs of isolated CDI and combined adverse events were 1.07 and 1.30, respectively; number needed to harm: 17,695 and 1,150, respectively). Adverse events were more common among females. Following a URI, antibiotics resulted in 5.7 additional cases of CDI per 100,000 outpatient prescriptions. "These findings underscore that inappropriately giving patients antibiotics is causing real and widespread harm," Carmichael said in a statement. "Having these kinds of side effects for one in a few hundred, or even a thousand, patients may not seem like a lot, but when you look at this problem on a population health level, we're talking about hundreds of thousands of adverse events severe enough that these patients needed additional care from a doctor."

Describing the danger of overprescribing antibiotics, especially in upper respiratory infections

Overprescribed Antibiotics for Colds Causes Patient Harm

<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Every cold and flu season, folks are flooded with ads for zinc lozenges, sprays and syrups that promise to shorten their sniffles.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Zinc might indeed reduce the duration of common&nbsp;<a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://www.healthday.com/a-to-z-health/allergies/cold-vs-allergies-2659968983.html" target="_blank" rel="noopener" aria-label="content">cold</a>&nbsp;symptoms by about two days, a new evidence review says.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">However, the evidence is not conclusive, and taking zinc can come with some unpleasant side effects, researchers said.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">“The evidence on zinc is far from settled,” senior researcher&nbsp;<a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://www.medschool.umaryland.edu/profiles/wieland-lisa-susan/" target="_blank" rel="noopener" aria-label="content">Susan Wieland</a>, an assistant professor at the University of Maryland School of Medicine, said in a news release. “We need more research before we can be confident in its effects.”
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The theory behind zinc is that the essential mineral, which is found in many foods, might interfere with the cold virus’ ability to replicate in the nose, mouth and throat, researchers said.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Lab studies have shown zinc can do this in petri dishes and mice, but human studies are needed to show if it will work in real people.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">For this review, researchers evaluated 19 human trials examining zinc as a cold treatment and 15 as a means of preventing colds.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">In particular, eight studies with nearly 1,000 participants combined investigated zinc as a treatment to reduce cold duration.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The pooled results of those studies showed that it might help reduce the length of a cold by about two days, down from an average week-long duration in people who received a placebo.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">However, the overall evidence did not support zinc’s ability to ward off a cold or to reduce the severity of cold symptoms.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The research team also noted that taking zinc comes with side effects like&nbsp;bowel problems, nausea and unpleasant taste.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">“People considering zinc to treat a cold should be aware of the limited evidence base and possible side-effects,” lead researcher&nbsp;<a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://muih.edu/faculty/daryl-nault/" target="_blank" rel="noopener" aria-label="content">Daryl Nault</a>, an assistant professor at Maryland University of Integrative Health, said in a news release. “Ultimately, it’s up to the individual to decide whether the risk of potential unpleasant side-effects is worth the benefit of potentially shortening their illness by a few days.”
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Nault said the best advice remains to call your doctor if you don't feel well and let them know if you use any supplements.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">“While there have been many trials investigating zinc, the approaches vary, so it is difficult to draw conclusions with certainty,” she added.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Part of the problem with this evidence review is that zinc doses and delivery methods varied widely between studies, as well as how people’s health was reported and measured, researchers said.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">“Future studies should adopt standardized methods for administering and reporting treatments and defining and reporting outcomes,” Wieland said. “Additional studies focusing on the most promising types and doses of zinc products and using appropriate statistical methods to assess outcomes that are important to patients will enable us to understand whether zinc may have a place in treatment of the common cold.”
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The new study appears in the Cochrane Database of Systematic Reviews.
&nbsp;

The role of zinc in common cold management 
Common cold 
minerals
Every cold and flu season

Can Zinc Really Shorten a Cold?

Asthma: What It Is, Symptoms, Causes, Types & Treatment

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lora, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Nighttime awakenings associated with increased nocturnal rescue medication use and lower HRQoL
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">For patients with chronic obstructive pulmonary disease (COPD), Tiotropium is associated with reduced COPD-related nighttime awakenings, according to a study published online March 12, 2016, in&nbsp;Respiratory Research.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Peter M. A. Calverley, M.D., from the University of Liverpool in the United Kingdom, and colleagues conducted a post-hoc, exploratory, pooled analysis of twin, randomized, placebo-controlled, parallel-group trials involving patients with stable moderate-to-severe COPD. Participants were randomly assigned to Tiotropium or placebo (550 and 371 patients, respectively) and followed for 13 weeks. Self-reported nighttime awakenings due to COPD symptoms, rescue medication use, and morning and evening peak expiratory flow rate (PEFR) were recorded daily during a two-week, pretreatment baseline period and for 13 weeks on treatment.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">At baseline, 51.5 and 50.1 percent of patients taking Tiotropium and placebo, respectively, reported one or more COPD-related nighttime awakening per week. The researchers found that Tiotropium was associated with fewer nighttime awakenings during the 13-week treatment, with mean overall awakening scores of 0.356 ± 0.006 versus 0.421 ± 0.007 per week for placebo. In patients with baseline awakenings, but not those without baseline awakenings, means were significantly lower for Tiotropium versus placebo. In both treatment arms, COPD-related nighttime awakenings were associated with increased nocturnal rescue medication use and lower health-related quality of life ratings. Tiotropium reduced rescue medication use versus placebo, and higher morning and evening adjusted means for PEFR were seen with Tiotropium versus placebo.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">"Morning-dosed Tiotropium appears to decrease nighttime symptoms and reduce the need for rescue treatment," the authors write.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Several authors disclosed ties to the pharmaceutical industry, including Boehringer Ingelheim and Pfizer, which funded the study.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4789269/" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text (subscription or payment may be required)</a>

Tiotropium Linked to Decrease in COPD-Related Nighttime Awakenings

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lora, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Tiotropium given in morning or evening improved mean FEV1 and nocturnal FEV1 compared with placebo
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">&nbsp;For patients with chronic obstructive pulmonary disease (COPD), Tiotropium yields sustained bronchodilation throughout the 24-hour day, according to a study published in the October 2003 issue of&nbsp;Thorax.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Peter M. A. Calverley, M.D., from the University of Liverpool in the United Kingdom, and colleagues conducted a randomized trial involving 121 patients with stable COPD (forced expiratory volume in one second [FEV1], 41 percent predicted) who were randomly assigned to Tiotropium 18 mg once daily in the morning (09.00 hours) or evening (21.00 hours) or to an identical placebo. At baseline and after six weeks of treatment, patients underwent spirometric tests every three hours for 24 hours.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers reported no significant differences between the groups at baseline. At six weeks, mean FEV1&nbsp;was improved over 24 hours with Tiotropium in the morning and evening versus placebo (1.11 and 1.06 versus 0.90 l); nocturnal FEV1&nbsp;(mean, 03.00 to 06.00 hours) was also improved with Tiotropium in the morning and evening groups versus placebo (1.03 and 1.04 versus 0.82 l). FEV1&nbsp;was similar before morning and evening dosing, while with active treatment, the peak FEV1&nbsp;moved later in the day. From 09.00 to 03.00 hours (nocturnal), the mean percentage change in FEV1&nbsp;was –2.8, –1.0, and –12.8 percent in the morning, evening, and placebo groups, respectively. The magnitude of the peak to trough change in FEV1&nbsp;was not statistically significant.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">"We have found that circadian variations in FEV1&nbsp;are present in patients with COPD," the authors write. "Our findings show that Tiotropium once daily, whether administered in the morning or evening, results in sustained improvements in spirometric indices throughout the 24 hours."
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The study was funded by Boehringer Ingelheim Pharmaceuticals Inc.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1746483/" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text (subscription or payment may be required)</a>

Tiotropium Yields Sustained Bronchodilation Throughout 24-Hour Day

<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">For patients with chronic obstructive pulmonary disease (COPD), Tiotropium is associated with improvements in lung function during a four-year period, according to a study published online Oct. 9, 2008, in the&nbsp;New England Journal of Medicine.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Donald P. Tashkin, M.D., from the University of California in Los Angeles, and colleagues conducted a randomized, double-blind trial comparing four years of Tiotropium to placebo in patients with COPD, aged at least 40 years, with a forced expiratory volume in one second (FEV1) of 70 percent or less after bronchodilation and a ratio of FEV1&nbsp;to forced vital capacity of 70 percent or less. The trial included 5,993 patients: 2,987 were randomly assigned to Tiotropium and 3,006 to placebo.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers found that throughout the trial, mean absolute improvements in FEV1&nbsp;in the Tiotropium group were maintained (from 87 to 103 mL before bronchodilation and from 47 to 65 mL after bronchodilation) compared with the placebo group. The differences between the groups in the rate of decline in the mean FEV1&nbsp;before and after bronchodilation were not significant after day 30. At each point throughout the four-year period, the mean absolute total score on the St. George's Respiratory Questionnaire was improved (lower) in the Tiotropium group. Tiotropium was associated with reductions in the risks for exacerbations, related hospitalization, and respiratory failure at four years and 30 days.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">"There were important lung-function benefits associated with Tiotropium that were maintained during the four years," the authors write.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Several authors disclosed ties to the pharmaceutical industry, including Boehringer Ingelheim and Pfizer, which funded the study.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://www.nejm.org/doi/full/10.1056/NEJMoa0805800" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text (subscription or payment may be required)</a>

Mean absolute improvement in FEV1 seen in Tiotropium group, but no significant difference seen in rate of decline in mean FEV1

Tiotropium and the Improvement in Lung Function in COPD Patients

Respiratory

<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">WEDNESDAY, Dec. 20, 2023 (HealthDay News) -- The first step in treating vertigo is understanding its cause. Many conditions can trigger vertigo an expert says.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Middle ear fluid, dislodged crystals in the inner ear, Meniere's disease, vestibular neuritis and vestibular migraine all can cause vertigo, according to&nbsp;<a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none;" href="https://mountainsidemedicalgroup.com/provider/mina-le" target="_blank" rel="noopener" aria-label="content">Dr. Mina Le</a>. She is an otolaryngologist-head and neck surgeon with Mountainside Medical Group in New Jersey.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"If your vertigo is from middle ear fluid, you likely have trouble hearing and it may sound like you're underwater," Le said in a news release from Hackensack Meridian Health.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"You may have pain or pressure in the affected ear," she continued. "The problem commonly begins after a head cold. A physician can look at your eardrum to confirm this diagnosis. You will get antibiotics if it's an acute infection, and decongestants and nasal balloon therapy if it's chronic."
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Short bouts of dizziness may be due to benign paroxysmal positional vertigo (BPPV).
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"If your vertigo only lasts for a few seconds at a time, and if it is brought on by turning your head or rolling over in bed, you most likely have BPPV, in which the crystals in your inner ear are dislodged," Le said. "A physician can confirm this diagnosis with a Dix-Hallpike test."
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">If you have BPPV, you will be treated with a method called the Epley maneuver, in which the head is turned from side to side to reset your inner ear crystals.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"Working with a physical therapist can help," Le said.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Debilitating episodes of vertigo that interfere with daily tasks may indicate Meniere's disease.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"Meniere's disease is characterized by distinct episodes of spinning vertigo, usually with nausea and vomiting, that are accompanied by a roaring sound, a fullness in your ears and hearing loss," Le said.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Episodes, which are disabling, tend to last for hours.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"Treatment begins with a low-salt diet, reduction of caffeine and diuretic pills to decompress the inner ear," Le said. "Migraines are a common concurrent diagnosis that Meniere's patients need to address in managing the disease."
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Vestibular neuritis -- inflammation of a nerve in the inner ear -- is another condition that can cause vertigo.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"Vestibular neuritis is a self-limited illness in which you are essentially confined to bed with severe vertigo that causes nausea and vomiting, but it improves in a few days and is gone in a few weeks," Le said.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"This is most likely the result of a viral infection, so the treatment is rest and time," she added. "Over-the-counter medications, like meclizine, can help with the symptoms."
<div class="text-story-m_story-tags__Roh7y" style="box-sizing: border-box; color: #333333; font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">&nbsp;</div>
<div class="arr--story-page-card-wrapper" style="box-sizing: border-box; color: #333333; font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">
<div class="arr--element-container story-element-card-m_element-container__1ZeJL story-element-card-m_dark__1AX15" style="box-sizing: border-box; margin: var(--arrow-spacing-xl) 0; color: var(--arrow-c-mono2);">
<div class="arrow-component arr--text-element text-m_textElement__e3QEt text-m_dark__1TC18 " style="box-sizing: border-box; text-rendering: optimizelegibility; -webkit-font-smoothing: antialiased; font-family: var(--arrow-typeface-primary); font-weight: var(--arrow-fw-normal); font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); color: #000000;" data-test-id="text">
<p style="box-sizing: border-box; font-weight: 400; margin: 0px 0px 15px; padding: 0px; font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; font-style: normal; letter-spacing: normal; word-break: break-word;">If your vertigo isn't due to any of the previous conditions and it lasts for minutes to days but happens over and over, it's most likely caused by vestibular migraine.
<p style="box-sizing: border-box; font-weight: 400; margin: 0px 0px 15px; padding: 0px; font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; font-style: normal; letter-spacing: normal; word-break: break-word;">"The first step is to identify and remove common migraine triggers such as stress, poor sleep, sensory overload and food elements such as MSG, preservatives, alcohol and caffeine. If that's not enough, you may be started on a preventative medication," Le said.
<p style="box-sizing: border-box; font-weight: 400; margin: 0px 0px 15px; padding: 0px; font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; font-style: normal; letter-spacing: normal; word-break: break-word;">More information
<p style="box-sizing: border-box; font-weight: 400; margin: 0px 0px 15px; padding: 0px; font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; font-style: normal; letter-spacing: normal; word-break: break-word;">There's more on vertigo at the&nbsp;<a style="box-sizing: border-box; background-color: transparent; color: var(--textelementhyperlinkcolor); text-decoration: none;" href="https://medlineplus.gov/dizzinessandvertigo.html" target="_blank" rel="noopener" aria-label="content">U.S. National Library of Medicine</a>.&nbsp;
<p style="box-sizing: border-box; font-weight: 400; margin: 0px 0px 15px; padding: 0px; font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; font-style: normal; letter-spacing: normal; word-break: break-word;">SOURCE: Hackensack Meridian Health, news release, April 20, 2021
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Vertigo: A Common Symptom With Many Different Causes

<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">FRIDAY, Jan. 5, 2024 (HealthDay News) -- Hearing loss is associated with an increased risk for dementia, with further increased risk for those not using hearing aids, according to a study published online Jan. 4 in&nbsp;JAMA Otolaryngology-Head and Neck Surgery.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Manuella Lech Cantuaria, Ph.D., from Odense University Hospital and the University of Southern Denmark, and colleagues examined the association between hearing loss and incident dementia and how hearing aids contribute to this association in a population-based study involving all residents of Southern Denmark aged 50 years and older. The analysis included 573,088 persons, with 23,023 cases of dementia, who were followed for 8.6 years.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers found that hearing loss was associated with an increased risk for dementia compared with no hearing loss (adjusted hazard ratio, 1.07). An increased risk for dementia was seen with severe hearing loss in the better ear and worse ear, with hazard ratios of 1.20 and 1.13, respectively, compared with no hearing loss in the corresponding ear. The risk for dementia was higher among people with hearing loss who were not using hearing aids than those with hearing loss who were using hearing aids compared with those without hearing loss, with hazard ratios of 1.20 and 1.06, respectively.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"Although the clinical relevance of these findings is still unclear, the study results suggest that treatment of hearing loss with hearing aids may be associated with reduced risk of dementia, which calls for a better understanding of the association between hearing loss and dementia as a critical step for the development of prevention strategies," the authors write.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">One author disclosed financial ties to Oticon, GN Hearing, and Widex-Sivantos.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s ease 0s;" href="https://jamanetwork.com/journals/jamaotolaryngology/article-abstract/2813302" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text (subscription or payment may be required)</a>

Higher risk for dementia seen for those with hearing loss not using hearing aids compared with those who were using hearing aids

Hearing Loss Linked to Increased Risk for Dementia

<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">FRIDAY, Sept. 13, 2024 (HealthDay News) -- For children with acute diarrhea, the addition of probiotics can shorten the duration of diarrhea and the length of hospital stay, according to a study published in December 2021 in&nbsp;Translational Pediatrics.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Rao Huang, from the Haikou Hospital of Maternal and Child Health in China, and colleagues conducted a meta-analysis to examine the therapeutic effect of probiotics on acute diarrhea in children. Articles reporting on randomized controlled trials (RCTs) of probiotics in treating acute diarrhea in children were extracted; 12 articles with 744 patients were included in the analysis.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers found that the duration of diarrhea was shorter in the probiotics group versus the control group (standard mean difference, –0.74). In addition, in the probiotics group, the two-day treatment efficacy for diarrhea was greater (odds ratio, 2.12) and the length of hospital stay was shorter (standard mean difference, –0.60) than in the control group. Compared with single probiotic use, combined probiotics shortened the duration of diarrhea, and a better therapeutic effect was seen for&nbsp;Lactobacillus reuteri&nbsp;and&nbsp;Saccharomyces boulardii&nbsp;than&nbsp;Lactobacillus rhamnosus&nbsp;or&nbsp;Lactobacillus acidophilus.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">"Because of the possibility of publication bias in this meta-analysis, more high-quality RCT studies in clinical practice are needed to verify the current findings and continue the exploration of this topic," the authors wrote.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8753473/" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text (subscription or payment may be required)</a>

Addition of probiotics can also increase treatment efficacy after two days of treatment, shorten length of hospital stay

Probiotics Can Reduce Duration of Diarrhea in Children

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lora, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Mix of two strains in association with antibiotics reduces antibiotic-associated diarrhea, Clostridium difficile infection
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">FRIDAY, Sept. 13, 2024 (HealthDay News) -- A combination of two specific probiotic strains (Limosilactobacillus reuteri&nbsp;LMG P-27481 and&nbsp;Lacticaseibacillus rhamnosus&nbsp;GG ATCC 53103; Reuterin GG) can reduce antibiotic-associated diarrhea and&nbsp;Clostridium difficile&nbsp;infection (CDI) during antibiotic treatment, according to a study published online Jan. 18 in&nbsp;Microorganisms.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">Angela Saviano, from Polyclinic A. Gemelli Hospital in Italy, and colleagues examined the efficacy of a mix of two probiotic strains in association with antibiotics for reducing antibiotic-associated diarrhea, CDI, and other gastrointestinal symptoms in adult hospitalized patients. A total of 113 hospitalized adults treated with antibiotics were enrolled. Patients were randomly assigned to receive probiotics 1.4 g twice daily in addition to antibiotics (Reuterin GG group) or antibiotics only (56 and 57 patients, respectively).
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers found that patients receiving Reuterin GG had a significant reduction in diarrhea and CDI. Specifically, 28 and 11 percent of patients in the antibiotic-only and Reuterin GG groups presented with diarrhea during treatment; 11 and 0 percent of patients in the antibiotic-only and Reuterin GG groups developed CDI; and 9 and 2 percent of patients in the antibiotic-only and Reuterin GG groups presented with vomiting.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;">"Based on these results, we hypothesize that the use of specific probiotic strains during antibiotic therapy can play an important role in preventing dysbiosis and subsequent AAD [antibiotic-associated diarrhea] and CDI, with both patient and economic health care benefits," the authors write.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://www.mdpi.com/2076-2607/12/1/198" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text (subscription or payment may be required)</a>

Two Probiotic Strains Combined With Antibiotics Reduces Diarrhea

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Fourteen metabolites from routine newborn screening significantly associated with SIDS
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">&nbsp;Infants with sudden infant death syndrome (SIDS) have a distinct metabolic profile at birth, according to a study published online Sept. 9 in&nbsp;JAMA Pediatrics.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Scott P. Oltman, from the University of California San Francisco, and colleagues examined and modeled the association between routinely measured newborn metabolic markers and SIDS in a case-control study nested within a retrospective cohort. The study population included infants born in California between 2005 and 2011, with full metabolic data collected as part of routine newborn screening (NBS). SIDS cases were matched to controls in a 1:4 ratio; the study included 354 cases and 1,416 controls.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers found that in a multivariate analysis, 14 NBS metabolites were significantly associated with SIDS. For a 14-marker SIDS model, including eight metabolites, the area under the receiver operating characteristic curve was 0.75 and 0.70 in the training and test sets, respectively. A total of 20 of 32 infants (62.5 percent) in the test set with model-predicted probability greater than 0.5 had SIDS. Compared with those with a model-predicted probability less than 0.1, these infants had 14.4-fold higher odds of having SIDS
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"These findings suggest that metabolic profiles at birth may have utility for individualized, targeted counseling aimed at identifying infants with an increased vulnerability to SIDS," the authors write.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Several authors disclosed having related patents pending; one author reported having a patent issued.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://jamanetwork.com/journals/jamapediatrics/fullarticle/2823155" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text (subscription or payment may be required)</a>

Metabolic Pattern at Birth Linked to Sudden Infant Death Syndrome

<span style="color: rgba(0, 0, 0, 0.6); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 20px; font-style: italic; background-color: #ffffff;">Use of gel-based spray or saline spray reduced the duration of illness, while all interventions cut antibiotic use
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Use of nasal sprays and a behavioral intervention promoting physical activity and stress management can reduce antibiotic use for respiratory illness, according to a study published online July 11 in&nbsp;The Lancet Respiratory Medicine.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Paul Little, M.B.B.S., M.D., from the University of Southampton in the United Kingdom, and colleagues examined the effect of nasal sprays or a behavioral intervention promoting physical activity and stress management on respiratory illness in a randomized trial conducted at 332 general practitioner practices. Eligible adults were randomly assigned to usual care, gel-based spray, saline spray, or a brief behavioral intervention promoting physical activity and stress management (3,451, 3,448, 3,450, and 3,450, respectively).
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The researchers found that the mean number of days of illness was 8.2 in the usual care group. The mean number of days of illness was significantly lower in the gel-based spray group and saline spray group (mean, 6.5 and 6.4 days, respectively), but not in the group allocated to the behavioral website (mean, 7.4 days). The most common adverse event was headache or sinus pain in the gel-based group (7.8 percent compared with 4.8, 4.5, and 4.5 percent in the usual care group, saline group, and behavioral intervention group, respectively). Antibiotic use was lower for all interventions compared with usual care (incidence rate ratios, 0.65, 0.69, and 0.74 for the gel-based spray group, saline spray group, and behavioral intervention group, respectively).
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"These simple scalable interventions could potentially have an important impact on antimicrobial stewardship, and in reducing the impact of respiratory viruses for patients, the health service, and the wider economy," the authors write.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;"><a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(24)00140-1/fulltext" target="_blank" rel="noopener" aria-label="content">Abstract/Full Text</a>

Use of gel-based spray or saline spray reduced the duration of illness, while all interventions cut antibiotic use

Nasal Sprays, Behavioral Intervention Aid in Treatment of Respiratory Illness

Newborn screening definition and importance 
Child health
Newborn

Newborn Screening: What It Is, What It Covers and Why It’s Important

<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Backpacks. Notebooks. Folders. Pencils. These are all essentials for a good start to your children's school year, but what about their nutrition?
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">As summer ends and kids return to classrooms, one culinary medicine expert offers up easy ways to help your children eat healthy foods during the school day.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">School lunches have gotten healthier since last April, when the U.S. Department of Agriculture released&nbsp;<a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://www.fns.usda.gov/cn/school-nutrition-standards-updates" target="_blank" rel="noopener" aria-label="content">new guidelines</a>&nbsp;that lower sugar and salt levels and focus on whole grains.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Still, packing lunch at home can be a good choice if you want more control over what your child eats during the day, said&nbsp;<a style="box-sizing: border-box; background-color: transparent; text-decoration-line: none; border-bottom: 1px solid var(--textElementHyperlinkColor); transition: border 0.3s;" href="https://utswmed.org/doctors/jaclyn-albin/" target="_blank" rel="noopener" aria-label="content">Dr. Jaclyn Albin</a>, an associate professor of internal medicine, pediatrics and public health at UT Southwestern School of Medicine.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"You and your kids don’t have to choose between nutritious and delicious," Albin said in a UT Southwestern news release. "With a little planning, you can craft healthy, tasty lunches that leave your kids full and satisfied. You don’t have to reinvent the wheel -- a lot of what my kids pack for lunch are leftovers from the previous day."
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Where to start?
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">A well-balanced lunch should be about 50%&nbsp;fruits and vegetables. Incorporating a variety of colorful fruits and vegetables in school lunches boosts nutritional value and makes the meal more fun.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">The remaining half of the meal should be whole grains, proteins and healthy fats that boost your child’s energy levels, Albin said.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Healthy fats can be found in avocados, nuts and seeds (just check school allergy policies first), and in fish such as trout, cod or salmon. Protein options include chicken, fish, turkey and tofu, Albin said.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"My favorite proteins are beans and lentils, which are versatile, affordable, and full of fiber," she added.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">You can also pack simple snacks for your kids to keep their energy levels high throughout the day, such as fresh fruit, popcorn, low-sugar granola bars or homemade energy bites.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Now, some parents may worry that lunch will spoil before it’s time to eat, but a cold pack or insulated container can keep that from happening. Hot food should stay warm enough to be palatable, Albin said, but you can avoid cream or dairy-based foods if you are worried abut food going bad.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Still, even the tastiest meals can go to waste if your child has allergies or is a picky eater, Albin noted.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Many schools enforce food allergen restrictions, particularly for peanuts and tree nuts (such as almonds and hazelnuts), as well as shellfish. All students and visitors have to adhere to these restrictions, even if your own child doesn’t have allergies.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">If your child does have allergies, there are often safe food alternatives, Albin said. For example, if your child loves peanut butter, try sunflower butter instead. Sunflower allergies exist, but they’re very rare, she added.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">What if your child is a picky eater? First ask your child to write down everything he or she likes to eat: You might be surprised by the proteins, fruits and veggies they mention. If they need a little inspiration, ask them to think of foods in five different colors, Albin suggested.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">Getting your kid involved in meal prep can be another way to curb picky eating, she added, because kids might be more willing to eat something they prepared.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">When packing your child's lunch, don't forget they also need hydration during the day, Albin said.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">According to the U.S. Centers for Disease Control and Prevention, half of all kids and adolescents are under-hydrated, and 1 in 5 don’t drink plain water during the day.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">It can be a surprising struggle to get kids to drink water, Albin acknowledged.
<p style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 20px; line-height: var(--arrow-lh-5); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-stretch: normal; word-break: break-word; background-color: #ffffff;">"One way my family has dealt with keeping our kids properly hydrated is by making water fun," she said. "Flavor it with frozen fruit and herbs, such as strawberry and mint or pineapple and mango dropped in a pitcher to soak overnight."
<div class="arr--element-container story-element-card-m_element-container__1ZeJL story-element-card-m_dark__1AX15" style="box-sizing: border-box; margin: var(--arrow-spacing-xl) 0; color: var(--arrow-c-mono2); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">
<div class="arrow-component arr--summary-element arr-custom-style summary-m_summary-border__M9hrr " style="box-sizing: border-box; -webkit-font-smoothing: antialiased; font-family: var(--arrow-typeface-primary); font-weight: var(--arrow-fw-normal); text-rendering: optimizelegibility;" data-test-id="summary">
<div class="summary-m_content__37n8C summary-m_content-border__3ilmJ summary-m_dark__1ZuzR summary-m_dark__1ZuzR" style="box-sizing: border-box; color: var(--arrow-c-mono1); font-size: var(--arrow-fs-m); border: 1px solid var(--arrow-c-mono5); padding: var(--arrow-spacing-l);">&nbsp;</div>
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<div class="arr--element-container story-element-card-m_element-container__1ZeJL story-element-card-m_dark__1AX15" style="box-sizing: border-box; margin: var(--arrow-spacing-xl) 0; color: var(--arrow-c-mono2); font-family: Lato, -apple-system, 'system-ui', 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue', sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">
<div class="arrow-component arr--text-element text-m_textElement__e3QEt text-m_dark__1TC18 " style="box-sizing: border-box; -webkit-font-smoothing: antialiased; font-family: var(--arrow-typeface-primary); font-weight: var(--arrow-fw-normal); text-rendering: optimizelegibility; font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); color: #000000;" data-test-id="text">
<p style="box-sizing: border-box; font-weight: 400; margin: 0px 0px 15px; padding: 0px; font-size: var(--arrow-fs-m); line-height: var(--arrow-lh-5); font-family: var(--arrow-typeface-secondary); font-stretch: normal; font-style: normal; letter-spacing: normal; word-break: break-word;">SOURCE: UT Southwestern, news release, Aug. 21, 2024
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tips for better and healthy lunches for kids

Follow These Steps to Tasty, Healthy School Lunches

Dear Doctors,
Thank you for participating in the&nbsp;EVA PHARMA Pharmacists Competition.
&nbsp;Congratulations to our winners:
<ul data-start="205" data-end="296">
<li data-start="205" data-end="240">
Dr. Ibrahim Abdelghafar Sharaky
</li>
<li data-start="241" data-end="273">
Dr. Mohamad Najeeb Almaqtary
</li>
<li data-start="274" data-end="296">
Dr. Mahmoud Dawoud
</li>
</ul>
Correct answer to the competition question: Limitless Fortalase dosage by age group:
<ul data-start="398" data-end="502">
<li data-start="398" data-end="450">
6 months to 3 years&nbsp;→ 5 ml twice daily (BID)
</li>
<li data-start="451" data-end="502">
4 years to 15 years&nbsp;→ 10 ml twice daily (BID)
</li>
</ul>
&nbsp;Limitless Fortalase has a&nbsp;palatable toffee cream flavor, making it child-friendly and easy to administer.
Once again, congratulations to the winners, and stay tuned for our next exciting competition!
&nbsp;
EVA PHARMA Team

Discover the correct pediatric dosing of Limitless Fortalase by EVA PHARMA. Congratulations to the competition winners! Learn about Fortalase’s child-friendly toffee cream flavor and stay updated on future events.

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