Fruit-Flavored E-Cigarettes Linked to Increased Risk of Nocturnal Dry Cough, Docvidya, Medshorts, Fruit flavors, Electronic cigarettes, Nocturnal dry cough, Respiratory inflammation, Pulmonary toxicity.

Fruit-Flavored E-Cigarettes Linked to Increased Risk of Nocturnal Dry Cough

Although in vitro and animal studies have identified the pulmonary toxicity of electronic cigarette (ECIG) flavors, epidemiological evidence on their respiratory effects remains limited. This study explored the longitudinal association between exposure to flavored ECIGs and the occurrence of nocturnal dry cough among users using data from the Population Assessment of Tobacco and Health Study (2014-2019).
 A secondary analysis was conducted on 18,925 adults, totaling 38,638 observations, employing weighted-incidence estimates and generalized estimating equation models to assess both unadjusted and adjusted associations.
Findings revealed that the weighted incidence proportion (WIP) of nocturnal dry cough was significantly higher among current (WIP: 16.6%) and former fruit-flavored ECIG users (WIP: 16.6%) compared to non-ECIG users (WIP: 11.1%). Current users of fruit-flavored ECIGs had a 40% higher risk of reporting nocturnal dry cough compared to non-users (aRR: 1.40). Former ECIG users of multiple flavors and other flavors had a markedly increased risk of cough, with 300% and 66% higher risks, respectively (aRR: 3.33 and aRR: 1.66).
The significant association between fruit-flavored ECIG use and increased risk of nocturnal dry cough highlights a potential early indicator of respiratory inflammation and disease risk, raising concerns about the respiratory health impact of flavored ECIGs. Further studies are needed to assess the long-term implications of these findings on respiratory health.
 

Efficacy, safety, and feasibility of roxadustat as part of a dialysis organization, Docvidya, Medshorts, Dialysis, Roxadustat, Erythropoiesis-stimulating agents (ESAs), Hemoglobin (Hb)

Efficacy, safety, and feasibility of roxadustat as part of a dialysis organization

Recent research demonstrated that roxadustat successfully achieved and maintained average hemoglobin levels of 10.0 g/dL or higher in patients who are on dialysis. The incorporation of oral roxadustat within dialysis organizations demonstrated a significant degree of adherence to dosing protocols, with no new safety issues identified. The results of this study were published in the journal Hemodialysis International.

Eligible individuals were treated with open-label roxadustat, administered three times weekly for a total of twenty-four weeks, with the possibility of extension of  ≤ 1 year. The initial dosing regimen depended on the dosage of erythropoiesis-stimulating agents (ESAs) at the time of screening for patients who had been on ESAs for six weeks or longer, while it was based on body weight for those who had been on ESAs for less than six weeks. This study's primary efficacy endpoints were the percentage of patients with a mean hemoglobin (Hb) level of at least 10.0 g/dL, averaged throughout the time period from weeks sixteen to twenty-four, as well as the mean change in hemoglobin from the baseline to the average observed from sixteen to twenty-four weeks. Additionally, treatment-emergent serious adverse events (TESAEs) and treatment-emergent adverse events (TEAEs) were evaluated.

Among the 281 patients screened, 203 underwent treatment, and 201 were incorporated into the complete analysis set. In total, 166 patients completed the twenty-four week treatment duration, with 126 proceeding into the extension period. The mean baseline hemoglobin level was 10.4 g/dL, and 82.6% of the participants underwent in-center hemodialysis. From weeks sixteen to twenty-four, a mean hemoglobin level of 10.0 g/dL or higher was achieved by 84.6% of the patients. The mean change in Hb from baseline during this timeframe was 0.5 (1.0) g/dL. Adherence to the dosing regimen was recorded at 94%. Additionally, 3.0% of patients received a red blood cell transfusion at up to week twenty-four. TESAEs and TEAEs were reported by 25.6% and 71.4% of patients, respectively. The most commonly reported TESAEs included COVID-19 (n = 5; 2.5%), as well as pneumonia, acute myocardial infarction, and sepsis (each n = 4; 2.0%).

Thus, it can be concluded that roxadustat was able to effectively reach and uphold mean hemoglobin levels of ≥10.0 g/dL in patients on dialysis. The successful incorporation of oral roxadustat into dialysis protocols has been shown, signifying compliance with the recommended dosing schedule.

Stent on a string: a potential new gold standard for postureteroscopy ureteral drainage, Docvidya, Medshorts, Stent on string (SOS), Postureteroscopy ureteral drainage, Gold standard, Systematic review

Stent on a string: a potential new gold standard for postureteroscopy ureteral drainage

A recent study indicated that stent on string (SOS) is a great alternative following ureteroscope (URS), particularly for patients without intraoperative complications, and they are typically inserted as a routine based on surgeon preference. These stents decrease pain, cost, dwell time, risks, and the suffering associated with prolonged stenting, and most patients are satisfied to remove them at home. While their use is currently limited in endourology practices, they are expected to become the standard for routine URS in the future. The findings of this study were published in the Journal of Endourology.

An extensive systematic review was carried out across several databases, utilizing the preferred reporting items for systematic reviews and meta-analyses (PRISMA) methodology. This review targeted studies published in English that involved patients of all age groups with SOS after undergoing ureteroscopy (URS) for the management of stone disease. A total of 22 studies (20 involving adults and 2 involving pediatric patients) were included from the 1210 records identified, including 8382 patients. Among these patients, 3427 (40.9%) had stent on string inserted and 434 (11%) were in the pediatric age group.

Study results showed that SOS presents several advantages, and when compared with stents without strings (SWOSs), they were implanted for a shorter period, with no significant differences in complications such as urinary tract infection or urinary symptoms. Moreover, SOS showed notable cost savings, decreased pain upon removal, and a high incidence of successful home removal, with more than 90% of patients indicating their readiness to remove their SOSs at home. However, it is important to consider the minor risk of stent dislodgment when deciding on SOS placement post-URS.

The above study demonstrated that SOS is an excellent option after URS, especially for patients who do not experience intraoperative complications. Surgeons typically insert these stents based on their preference as part of routine practice. The use of these stents reduces cost, pain dwell time, risks, and the discomfort associated with prolonged stenting. Many patients are happy to have them removed at home. The use of SOS is currently limited in endourology, it is anticipated that they will become the gold standard for routine ureteroscope in the future.

The correlation between chronic sinonasal inflammation and nasopharyngeal carcinoma, Docvidya, Medshorts, Allergic Rhinitis, Chronic rhinosinusitis, Sinonasal inflammation, Meta-analysis, Nasopharyngeal cancer,

The correlation between chronic sinonasal inflammation and nasopharyngeal carcinoma

In a recent systematic review and meta-analysis, the presence of chronic sinonasal inflammation shows a significant correlation with nasopharyngeal carcinoma. Findings of this study were documented in the American Journal of Otolaryngology.

This meta-analysis involved a comprehensive search of four international databases from 1^st January 1973 to 28^th March 2022 for studies addressing sinonasal inflammation and NPC in adults (greater than 18 years old). Case-control, cohort, or cross-sectional studies were included that explored the association between a prior history of sinonasal inflammation and the risk of developing NPC. The incidence of nasopharyngeal carcinoma (NPC) in patients with prior sinonasal inflammation is the outcome.

A total of eight studies, comprising 8,245 individuals diagnosed with NPC and 1,036,087 individuals without NPC, were examined. The overall odds ratio for developing NPC following sinonasal inflammation was found to be 1.81 (95% confidence interval 1.73-1.89). Chronic rhinosinusitis (CRS) exhibited a stronger association with an increased risk of NPC, with an odds ratio of 1.78 (95% confidence interval: 1.68-1.90), in comparison to allergic rhinitis (AR) (odds ratio of 1.60; 95% confidence interval: 1.52-1.68).

Thus, it can be concluded that chronic sinonasal inflammation is strongly linked to nasopharyngeal carcinoma. It is important to thoroughly examine the cause-and-effect relationship and the potential effects of targeted screening using large-scale prospective studies.

Analgesic onset of FA-acetaminophen in a postoperative dental impaction pain model, Docvidya, Medshorts, Dental, fast-acting acetaminophen (FA-acetaminophen), commercial acetaminophen caplets (ES-acetaminophen), commercial ibuprofen liquid-filled gelatin capsules (LG-Ibuprofen), impacted third molars, perceptible pain relief (TCPR), meaningful pain relief (TMPR).

Analgesic onset of FA-acetaminophen in a postoperative dental impaction pain model

A recent study has shown that fast-acting acetaminophen (FA-acetaminophen) had a quicker onset of action than both commercial acetaminophen caplets (ES-acetaminophen) and commercial ibuprofen liquid-filled gelatin capsules (LG-Ibuprofen). This study findings were published in the journal, Current Medical Research and Opinion.

Two single-center, randomized, inpatient, placebo-controlled, double-blind design clinical trials were carried out utilizing the postoperative dental impaction pain model. Study 1 included 240 subjects, whereas study 2 had 420 subjects. The individuals involved in this study were between the ages of 17 and 50 and were suffering from moderate to severe pain after undergoing the surgical extraction of a minimum of three impacted third molars. The two studies evaluated four different treatment groups: 1,000 mg of FA-acetaminophen, 400 mg of LG-ibuprofen, 1,000 mg of ES-acetaminophen, and a placebo. The double-stopwatch method was used to determine the times to confirm perceptible pain relief (TCPR) and meaningful pain relief (TMPR). Pain intensity and relief were assessed using a 0-10 numerical rating scale for a duration of 6 hours after administering the drug.

The efficacy results demonstrated that all active treatments were statistically superior to the placebo. Within study 1, TCPR was significantly shorter for FA-acetaminophen in comparison to ES-acetaminophen and LG-ibuprofen. Additionally, FA-acetaminophen 1,000 mg showed a significantly shorter TMPR compared to LG-ibuprofen. In both studies 1 and 2, at the 15-minute mark post-administration of the study drug, PID and PAR scores were higher for FA-acetaminophen than LG-ibuprofen.

It can be concluded that FA-acetaminophen demonstrated a faster onset of action in comparison to both ES-acetaminophen and LG-Ibuprofen.

Insights from the RHINESSA Study suggest Chronic Cough to be Heritable Across Generations, Docvidya, Medshorts, Chronic Cough, Productive cough, Non-productive cough, Asthma, Body Mass Index, Rhinitis

Insights from the RHINESSA Study suggest Chronic Cough to be Heritable Across Generations

This study investigated the heritability of chronic cough, examining whether individuals with chronic cough are more likely to have offspring who also develop cough, and whether this association varies by cough type (productive vs. nonproductive).

The RHINESSA Generation Study included 7,155 parents aged 30-54 who completed detailed questionnaires in 2000 and 2010, and 8,176 offspring aged ≥20 who completed similar questionnaires between 2012-2019. Chronic cough was classified as either productive or nonproductive. Mixed-effects logistic regression analyses were conducted to assess the associations between parental and offspring cough, adjusting for multiple factors including offspring age, sex, body mass index, smoking history, asthma, rhinitis, gastroesophageal reflux, and parental smoking.

Results indicated that offspring of parents with nonproductive cough had a higher prevalence of nonproductive cough (11%) compared to those with parents without nonproductive cough (7%), with an adjusted odds ratio (aOR) of 1.59 (95% CI: 1.20-2.10). Similarly, offspring of parents with productive cough had a higher prevalence of productive cough (14%) compared to those with non-productive cough parents (11%), with an aOR of 1.34 (95% CI: 1.07-1.67). No significant associations were found between mismatched cough types.

These findings suggest that chronic cough, independent of asthma, may be a distinct heritable trait with type-specific transmission patterns.

Combination of tamsulosin and Pentoxifylline vs. tamsulosin alone in the treatment of lower urinary tract symptoms caused by benign prostate hyperplasia, Docvidya, Medshorts, Tamsulosin, Pentoxifylline, Lower urinary tract symptoms, Benign prostate hyperplasia (BPH), Quality of life (QoL)

Combination of tamsulosin and Pentoxifylline vs. tamsulosin alone in the treatment of lower urinary tract symptoms caused by benign prostate hyperplasia

According to a recent study, the addition of Pentoxifylline to tamsulosin has shown promising results in alleviating the lower urinary symptoms experienced by patients with benign prostatic hyperplasia (BPH). This combination therapy is well-tolerated and has demonstrated superior treatment outcomes compared to tamsulosin alone. The findings of this study were published in the journal, Lower Urinary Tract Symptoms.

A total of 60 patients diagnosed with BPH were included in this randomized clinical trial. The participants were divided into two groups: intervention (Pentoxifylline + tamsulosin) and control (placebo + tamsulosin). Throughout the study, the patients were assessed for international prostate symptom score (IPSS), maximum urinary flow rate (Q_max) using uroflowmetry, quality of life (QoL), and post-void residual volume (PVR) through abdominal sonography at the beginning of the trial and after 12 weeks.

Patients who were administered the combination therapy exhibited significantly improved results in terms of prostate symptoms and improvement of quality of life (IPSS: -36.6%; QoL:       -45.3%) when compared to patients who solely received tamsulosin (IPSS: -21.2%; QoL: -27.7%). Additionally, the combination therapy yielded a significantly higher improvement in maximum urinary flow rate and residual volume (Q_max: +42.5%; PVR: -42.6%) compared to monotherapy (Q_max: +25.1%; PVR: -26.1%).

It can be concluded that the addition of Pentoxifylline to tamsulosin is effective in reducing the lower urinary symptoms in patients with BPH.

The effect of ziltivekimab on hemoglobin levels in individuals with CKD stage 3-5, Docvidya, Medshorts, Renal Anemia, Anemia, Stage 3-5 chronic kidney disease, Ziltivekimab, Anti-inflammatory therapy, Nephrology, Haematology, Internal medicine, Nephrologist, Haematologist, General Practitioner

The effect of ziltivekimab on hemoglobin levels in individuals with CKD stage 3-5

A recent study has shown that the use of ziltivekimab as an anti-inflammatory treatment led to improvements in anemia markers and iron regulation in individuals with stage 3-5 chronic kidney disease (CKD) and systemic inflammation, indicating a potential role in managing anemia. The Journal of the American Society of Nephrology published the study's findings.

This study analyzed exploratory end points from the RESCUE trial, involving 264 adults with CKD stage 3-5 and high-sensitivity C-reactive protein ≥2 mg/L. The subjects were administered with either a placebo or subcutaneous ziltivekimab (7.5 mg, 15 mg, or 30 mg) in a 1:1:1:1 ratio at four-week intervals for a duration of up to twenty-four weeks. The end points included the biomarkers of iron homeostasis and changes in hemoglobin (Hb) from baseline to twelfth week.

The levels of hemoglobin significantly increased from the starting point to week 12 when administered with ziltivekimab at 7.5 mg, 15 mg, and 30 mg doses. The differences in treatment compared to the placebo were +0.57 g/dl [95% CI, 0.27 to 0.86], +1.05 g/dl [0.76 to 1.33], and +0.99 g/dl [0.70 to 1.28], respectively, all with a P value < 0.001. Ziltivekimab also resulted in significant elevations in total iron-binding capacity, serum iron levels, and transferrin saturation from the baseline to week 12 (P value < 0.05 vs. placebo for all doses and comparisons). Instances of sustained neutropenia, sustained thrombocytopenia, anemia, and iron deficiency anemia were uncommon and similar across all cohorts.

The above study showed that treatment with ziltivekimab, an anti-inflammatory therapy, led to improvements in anemia markers and iron homeostasis in patients with stage 3-5 CKD and systemic inflammation. This indicates a possible role in the treatment of anemia.