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In individuals with rheumatoid arthritis, who are at an increased risk for the illness, medicines often administered to patients to reduce joint inflammation may also reduce the risk of cardiovascular disease.

The study, titled, ‘Reducing cardiovascular risk with immunomodulators: a randomised active comparator trial among patients with rheumatoid arthritis’, was published in the journal Annals of Rheumatic Diseases. “The reassuring message is that as your joints are improving with RA treatments, so too is your risk for cardiovascular disease,” says Joan Bathon, MD, a co-leader of the study and professor of medicine and director of the division of rheumatology at Columbia University Vagelos College of Physicians and Surgeons.

Immunomodulators, or anti-inflammatory medications, have been demonstrated in recent clinical studies to considerably lower heart attacks, strokes, and other cardiovascular events in persons with cardiovascular disease. However, it remained unclear if these medications, which increase heart disease risk by 50% compared to the general population in adults with rheumatoid arthritis, have a similar impact on these patients.

Rheumatoid arthritis is a chronic autoimmune and inflammatory disease that causes painful joint swelling and affects more than 1.3 million individuals in the United States. Inflammation is known to cause atherosclerosis and contribute to heart disease, which may account for the higher prevalence of heart disease in rheumatoid arthritis sufferers.

Patients with moderate to severe rheumatoid arthritis should first consider methotrexate, although most RA patients eventually start on a tumour necrosis factor inhibitor (TNFi) or triple therapy (methotrexate plus sulfasalazine and hydroxychloroquine).

In a recent study, conducted by Brigham and Women’s Hospital and Columbia University researchers, 115 adults with moderate to severe rheumatoid arthritis who had not responded to methotrexate treatment were randomised to triple therapy or to add a TNFi, either adalimumab (Humira) or etanercept (Enbrel).
Both groups saw comparable reductions in arterial inflammation, a risk factor for heart disease, and RA disease activity after six months.

“We were surprised to see that both of these powerful anti-inflammatory treatment strategies reduced heart disease risk in patients with rheumatoid arthritis,” Bathon says. “Doctors still need to pay attention to the usual heart disease risk factors, such as high cholesterol, high blood pressure, and obesity. But since inflammation–a key feature of RA–elevates cardiovascular risk even further, reducing inflammation by treating the arthritis is a novel mechanism to reduce heart disease risk in these patients.”

Patients with moderate to severe atopic dermatitis who participated in a clinical trial of the novel, patient-tailored monoclonal antibody therapy rocatinlimab showed encouraging results both while taking the medication and for up to 20 weeks after it was stopped, according to Mount Sinai researchers who published their findings in The Lancet.

The researchers’ findings indicate that rocatinlimab may have the power to permanently modify a person’s atopic dermatitis genetics and may even help maintain long-lasting benefits in the absence of continued therapy. Rocatinlimab inhibits the immunological molecule OX40, which is essential for the onset of atopic dermatitis and other inflammatory diseases and is involved in activating inflammatory cells.

“Atopic dermatitis, the most common type of eczema, is a debilitating chronic inflammatory skin disease that affects 1 in 10 Americans and millions of people worldwide,” said Emma Guttman, MD, PhD, Waldman Professor and System Chair, The Kimberly and Eric J. Waldman Department of Dermatology; Director, Center of Excellence in Eczema; and Director, Laboratory of Inflammatory Skin Diseases, at the Icahn School of Medicine at Mount Sinai. “It often develops at a very young age, causing the skin to become inflamed, red, extremely itchy, painful, and very dry–all symptoms that greatly affect a patient’s quality of life. We are very optimistic about the results of this trial and the potential for disease modification and long-lasting effects to improve patients’ quality of life.”

In this phase 2b multicenter, double-blind, placebo-controlled research, 274 patients were enrolled, and (rocatinlimab: n=217; placebo: n=57) randomly allocated 1:1:1:1:1 to subcutaneous placebo up to week 18, with an extension of active therapy for a further 18 weeks, and 20 weeks of follow-up.

65 locations in the United States, Canada, Japan, and Germany participated in this experiment. The main objective was calculated as the percent change from baseline in the Eczema Area and Severity Index (EASI) score at week 16, and all active rocatinlimab dosages (-48 to -61%) achieved significance vs placebo (-15 per cent). After week 16, all active dosage groups kept getting better, and the majority of patients kept their response for at least 20 weeks of therapy.

The findings demonstrate the effectiveness and safety of rocatinlimab as a therapy for mild to moderate atopic dermatitis, with the potential for long-term efficacy and disease modification. The documented adverse effects between rocatinlimab groups were essentially comparable.

During the double-blind period, fever, chills, headaches, aphthous ulcers (canker sores), and nausea were frequent side effects. “At week 36, all participants had been on the treatment for at least 18 weeks,” added Dr Guttman, senior author of the study. “By this time, we saw that while the drug achieved the primary endpoints in all doses versus the placebo, it’s also a drug that improves over time, which is really unusual and unique among currently available treatment options.”

This examination will be continued in a phase 3 programme in 2023, according to the researchers. Future studies will also examine combination treatment and include a bigger research population with longer follow-ups (such as rocatinlimab plus topical corticosteroids).

According to recent studies, foetuses of pregnant women who work in hot, humid areas may exhibit indications of stress before their mothers. The study is the first to assess the effects of heat stress on the foetuses of manual labourers, and it involved 92 pregnant subsistence farmers in The Gambia. According to the results, there was a 17% increase in foetal strain for every degree Celsius in heat stress exposure, as seen by elevated foetal heart rate and slower blood flow through the umbilical cord.

Overall, the team, which was led by scientists from the Medical Research Council (MRC) Unit The Gambia at the London School of Hygiene & Tropical Medicine (LSHTM) and LSHTM, discovered that even a small increase in body temperature from performing manual labour in intense heat resulted in physiological strain in both the mother and foetus. The Lancet Planetary Health published the study.

Dr Ana Bonell, Wellcome Trust Global Health Clinical PhD Fellow at LSHTM and lead author, said: “Climate change has led to increasingly extreme temperatures worldwide and Sub-Saharan Africa is particularly vulnerable to climate impacts. Our study found that pregnant subsistence farmers in The Gambia commonly experience levels of extreme heat above recommended outdoor working limits, and that this can have significant effects on their health and the health of their babies. The results suggest we have to find effective interventions to protect these women and reduce adverse birth outcomes.”

Study author Jainaba Badjie from MRC The Gambia at LSHTM said: “Despite the growing scientific evidence linking maternal heat exposure to adverse birth outcomes, including premature birth, low birth weight, and still birth, up until now there has been little research into the physiological mechanisms responsible for these outcomes. We urgently need to understand these mechanisms so that we can find better ways to support mothers and babies in these conditions.”

Participants in West Kiang, The Gambia, were given wearable devices to track their maternal heart rate, skin temperature, and projected energy expenditure during field visits while being encouraged to go about their normal daily activities.

Fetal heart rate and umbilical artery blood flow were measured using portable ultrasound equipment at the beginning of each visit (which served as the baseline), midway through the worker’s shift, and finally at the end of the shift.
Additionally, data on maternal signs of heat sickness was gathered. Over half of the women said they had at least one of the following symptoms during field visits: nausea, vomiting, headache, dizziness, weakness, muscular aching, exhaustion, and dry mouth.

Data analysis revealed significant correlations between maternal heat strain, which was also connected to foetal strain, and exposure to heat stress. Even after correcting for maternal heat stress, foetal strain was still substantially correlated with maternal heat stress, indicating that other biological considerations are necessary.

The researchers propose that the redirection of blood from the placenta to the skin, which appears to occur at lower core temperatures than emphasised by other studies, is an essential physiological component to take into account in future study. The results also emphasise the need for more research to uncover and assess treatments that can assist Sub-Saharan African pregnant agricultural workers in becoming used to working in intense heat.

A team at the University of Queensland has developed a rapid, needle-free testing method for malaria that could potentially save hundreds of thousands of lives annually. The study has been released in PNAS Nexus. However, scientists have created a device that for five to ten seconds shines a beam of safe infrared light on a person’s finger or ear. This technique gathers an infrared signature, which a computer system then analyses. The technique, according to Dr. Maggy Lord, the international team leader from the School of Biological Sciences at UQ, will fundamentally change how malaria is combated on a worldwide basis.

But using this instrument, we can immediately determine whether a whole village or town is infected with malaria or has it. The method uses infrared light to detect malaria via the skin without the need of chemicals or needles; all it takes is a quick flash on the patient’s skin to complete the procedure.” Results are obtained in real-time since the gadget may be handled by a smartphone “Technology, according to the researchers, is the first step towards eradicating malaria.

“According to the World Health Organisation malaria report, in 2020 there were an estimated 241 million cases worldwide and more than 600,000 died from malaria,” Dr Lord said.

The majority of instances are in sub-Saharan Africa, where 90% of fatalities are children under the age of five. The existence of asymptomatic individuals in a population who serve as a reservoir for mosquito-borne illness transmission presents the largest obstacle to disease eradication. The World Health Organization has suggested widespread surveillance in endemic areas, and this quick, inexpensive, and non-invasive instrument provides a means of doing so. Other ailments could be treated with the use of the technology.

“We’ve successfully used this technology on mosquitoes to non-invasively detect infections such as malaria, Zika and dengue,” Dr Lord said. “It could be used to better combat diseases as people move around the world in our post-COVID world. “We expect that the technology will be used at entrance points to check travellers, minimising the reintroduction of illnesses and lowering worldwide epidemics.” “Although it is very early, this proof-of-concept is intriguing.”

According to a new RAND Corporation study, the prevalence of dementia among adults over the age of 65 is declining in the United States, dropping 3.7 percentage points between 2000 and 2016.
The age-adjusted prevalence of dementia fell from 12.2% of individuals over the age of 65 in 2000 to 8.5% of people over the age of 65 in 2016 – a nearly one-third reduction from the 2000 figure. Dementia prevalence fell throughout the study period, but the pace of reduction was faster between 2000 and 2004.

The gap in dementia prevalence between Black men and white men has shrunk, with the prevalence of dementia reducing by 7.3 percentage points among Black men and 2.7 percentage points among white men.
The findings were published in the journal Proceedings of the National Academy of Sciences in the most recent issue.
“The causes for the drop in dementia frequency are unknown, but this trend is excellent news for older Americans and the institutions that serve them,” said Peter Hudomiet, principal author of the study and an economist at RAND, a nonprofit research group. “As the American population ages, this drop may help alleviate the load on families, nursing homes, and other support services.”

The study’s co-authors are RAND’s Michael D. Hurd and Susann Rohwedder.
Throughout the study period, women had a greater frequency of dementia than males, however the gap narrowed between 2000 and 2016. The frequency of dementia in men fell by 3.2 percentage points, from 10.2% to 7.0%. Women had a bigger drop, dropping 3.9 percentage points from 13.6% to 9.7%.
In 2021, around 6.2 million persons 65 and older in the United States will have dementia. Because age is the most important risk factor for dementia, rising life expectancy is expected to raise the global incidence of Alzheimer’s disease and associated dementias from 50 million to 150 million by 2050.

However, there is mounting evidence that age-adjusted dementia incidence is dropping in industrialised nations, probably as a result of more education, a decrease in smoking, and improved treatment of significant cardiovascular risk factors such as high blood pressure.
Any change in these age-specific rates has significant consequences for expected prevalence and related expenditures, such as household, insurance, and government payments for nursing care.
The new RAND study applies an unique model to assess cognitive health based on a wide range of cognitive measures elicited from more than 21,000 adults who take part in the national Health and Retirement Study, a large population-representative survey that has been conducted for more than two decades.

By utilising the longitudinal dimension of the data, the model improves the precision of dementia classification. Importantly for the study of inequality, the model is built to guarantee that the dementia categorization is calibrated among population subgroups, and therefore it can generate reliable estimates of dementia prevalence by age, gender, education, race and ethnicity, and a measure of lifetime wages.
According to the RAND research, education was a major factor that contributed statistically to the reduction in dementia prevalence, accounting for approximately 40% of the reduction in dementia prevalence among men and 20% of the reduction in dementia prevalence among women.

The study’s proportion of college-educated men climbed from 21.5% in 2000 to 33.7% in 2016, while the proportion of college-educated women increased from 12.3% to 23% during the same period.
Education trends fluctuate between demographic groupings, which may impact dementia inequities in the future. For example, while women have traditionally had lower levels of education than males, women are becoming more educated among younger generations. While racial and ethnic minority groups continue to have lower education levels than non-Hispanic White people, the disparities between racial and ethnic groupings have narrowed.

“Closing the education gap across racial and ethnic groups might be a significant instrument for reducing health inequities in general, and dementia inequalities in particular,” Hudomiet added.
The age-adjusted prevalence of dementia was greater among racial and ethnic minority people, both men and women. However, the gap in frequency between non-Hispanic Black and White adults declined among males while remaining steady among women. The prevalence of dementia among non-Hispanic White males fell from 9.3% to 6.6%. The percentage declined from 17.2% to 9.9% among non-Hispanic Black men.

A grant from the National Institute on Aging provided funding for the study, titled “Trends in Inequalities in the Prevalence of Dementia in the United States.”
The RAND Social and Economic Well-Being division strives to actively enhance the health, social, and economic well-being of populations and communities worldwide.

According to recent research, ultra-processed foods (UPFs), which are ready-to-eat or heat commercial formulations manufactured using chemicals derived from foods or synthesised in labs, are gradually replacing traditional foods and meals made from fresh and minimally processed components.
Although Brazilians consume far fewer of these products than citizens of high-income countries, the study published in Elsevier’s American Journal of Preventive Medicine found that increased consumption of these foods was linked to more than 10% of all-cause premature, preventable deaths in Brazil in 2019.

“Previous modelling studies have estimated the health and economic burden of critical ingredients such as sodium, sugar, and trans fats, as well as specific foods or drinks such as sugar-sweetened beverages,” said lead investigator Eduardo A.F. Nilson, ScD, of the University of Sao Paulo and the Oswaldo Cruz Foundation in Brazil. “To far, no study has quantified the possible impact of UPFs on premature mortality. Knowing the number of fatalities caused by these items and modelling how changes in dietary patterns might promote more effective food policy may help to avoid disease and premature mortality.”

Dr. Nilson and his colleagues used data from nationally representative dietary surveys as the foundation for their modelling to calculate the baseline intakes of UPFs by gender and age group. Using 2019 data, statistical analyses were conducted to assess the percentage of total fatalities attributable to the usage of UPFs and the impacts of lowering UPF consumption by 10%, 20%, and 50% within those age categories.

Throughout the research period, UPF consumption in Brazil ranged from 13% to 21% of total dietary intake across all age groups and sexes. In 2019, there were 541,260 premature deaths among people aged 30 to 69, with avoidable, noncommunicable illnesses accounting for 261,061 of these.

The model revealed that the use of UPFs was responsible for about 57,000 deaths that year, accounting for 10.5% of all premature deaths and 21.8 percent of all deaths from preventable noncommunicable illnesses in those aged 30 to 69.
The researchers hypothesised that the projected impact would be much bigger in high-income countries such as the United States, Canada, the United Kingdom, and Australia, where UPFs account for more than 50% of total calorie consumption.
Dr. Nilson found that traditional whole meals such as rice and beans were steadily declining in Brazil over time.

To reduce UPF consumption and promote healthier food options, a variety of interventions and public health measures, such as fiscal and regulatory policies, changing the food environment, accelerating the implementation of food-based dietary guidelines, and improving consumer knowledge, attitudes, and behaviour, may be required.
Reduced UPF consumption by 10% to 50% in Brazil might potentially avoid 5,900 to 29,300 early deaths per year.

“Consumption of UPFs is associated with many disease outcomes, such as obesity, cardiovascular disease, diabetes, some cancers, and other diseases, and it represents a significant cause of preventable and premature deaths among Brazilian adults,” said Dr Nilson.

“Even decreasing UPF consumption to levels seen just a decade ago would cut linked early deaths by 21%. Policies that discourage the use of UPFs are desperately required.” Having a technique to quantify the mortality attributed to UPF consumption can contribute in the creation of more effective food policy alternatives to foster healthier food environments. This method can also help governments estimate the cost of dietary changes caused by industrial food processing. UPFs can be found in prepackaged sauces, frozen pizza, prepared meals, hot dogs, sausages, sodas, ice cream, and store-bought cookies, cakes, candies, and doughnuts.

According to a recent study, young pigs’ gut microbes were shifted toward a more desirable profile following two weeks of eating a tomato-rich diet.

The findings were reported in the journal Microbiology Spectrum. Following the observation of these results with a short-term intervention, the research team intends to conduct similar studies in humans, looking for health-related links between tomato consumption and changes in the human gut microbiome – the community of microorganisms living in the gastrointestinal tract.

“It’s possible that tomatoes impart benefits through their modulation of the gut microbiome,” said senior author Jessica Cooperstone, assistant professor of horticulture and crop science and food science and technology at The Ohio State University.

“Overall dietary patterns have been associated with differences in microbiome composition, but food-specific effects haven’t been studied very much,” Cooperstone said. “Ultimately we’d like to identify in humans what the role is of these particular microorganisms and how they might be contributing to potential health outcomes.”

The tomatoes used in the study were developed by Ohio State plant breeder, tomato geneticist, and co-author David Francis, and are the type typically found in canned tomato products.

“It’s possible that tomatoes impart benefits through their modulation of the gut microbiome,” said senior author Jessica Cooperstone, assistant professor of horticulture and crop science and food science and technology at The Ohio State University.

“Overall dietary patterns have been associated with differences in microbiome composition, but food-specific effects haven’t been studied very much,” Cooperstone said. “Ultimately we’d like to identify in humans what the role is of these particular microorganisms and how they might be contributing to potential health outcomes.”

The tomatoes used in the study were developed by Ohio State plant breeder, tomato geneticist, and co-author David Francis, and are the type typically found in canned tomato products.

Ten newly weaned control pigs were fed a conventional diet, and ten pigs were fed the usual diet with 10% of the meal made up of a freeze-dried tomato powder.

Both diets included the same amount of fibre, sugar, protein, fat, and calories. The control and study pig populations were kept separate, and the researchers who ran the study spent as little time as possible with the pigs – a series of precautions designed to ensure that any microbiome changes observed with the study diet could be attributed to chemical compounds in the tomatoes.

Microbial communities in the pigs’ stomachs were found in faecal samples collected before the trial began, as well as seven and fourteen days after the food was introduced.

The team used a technique called shotgun metagenomics to sequence all microbial DNA present in the samples. Results showed two main changes in the microbiomes of pigs fed the tomato-heavy diet – the diversity of microbe species in their guts increased, and the concentrations of two types of bacteria common in the mammal microbiome shifted to a more favorable profile.

This higher ratio of the phyla Bacteroidota (formerly known as Bacteriodetes) compared to Bacillota (formerly known as Firmicutes) present in the microbiome has been found to be linked with positive health outcomes, while other studies have linked this ratio in reverse, of higher Bacillota compared to Bacteroidota, to obesity.

Tomatoes account for about 22 per cent of vegetable intake in Western diets, and previous research has associated consumption of tomatoes with reduced risk for the development of various conditions that include cardiovascular disease and some cancers.

But tomatoes’ impact on the gut microbiome is still a mystery, and Cooperstone said these findings in pigs – whose gastrointestinal tract is more similar than rodents’ to the human GI system – suggest it’s an avenue worth exploring.

“This was our first investigation as to how tomato consumption might affect the microbiome, and we’ve characterized which microbes are present, and how their relative abundance has changed with this tomato intervention,” she said.

“To really understand the mechanisms, we need to do more of this kind of work in the long term in humans. We also want to understand the complex interplay – how does consuming these foods change the composition of what microbes are present, and functionally, what does that do?

“A better understanding could lead to more evidence-based dietary recommendations for long-term health.”

According to a Rutgers study of obese persons with nonalcoholic fatty liver disease (NAFLD) and morbid obesity (body mass index > 40), those who had bariatric surgery had considerably fewer serious cardiovascular events in the years that followed.
The findings were published in JAMA Network Open, and the Rutgers team revealed that obese individuals receiving bariatric surgery were roughly 50% less likely to experience adverse cardiovascular events such as heart attacks, angina, or strokes.

“The findings provide evidence in support of bariatric surgery as an effective therapeutic tool to lower elevated risk of cardiovascular disease for select individuals with obesity and NAFLD,” said Vinod K. Rustgi, Distinguished Professor of Medicine, clinical director of Hepatology and director of the Center for Liver Diseases and Liver Masses at Rutgers Robert Wood Johnson Medical School.

“These findings are extremely significant for a variety of reasons.” Heart disease is the top cause of mortality for both men and women in the United States, regardless of race or ethnicity. According to the Centers for Disease Control and Prevention, around 697,000 persons in the United States died from heart disease in 2020. NAFLD and its more advanced variant, NASH, are both fast rising forms of liver disease that can affect persons who use little to no alcohol. The illness is more frequent in persons with obesity and type 2 diabetes because too much fat is deposited in liver cells, causing an inflammatory state.

Researchers used the MarketScan Commercial Claims and Encounters medical insurance database to assess outcomes data from 2007 to 2017. Of the 230 million people covered, 86,964 persons aged 18 to 64 with obesity and NAFLD were found. The research group included of 68 percent females, 35 percent underwent bariatric surgery, and 65 percent got nonsurgical therapy.

Patients who underwent bariatric surgery had a 49 percent lower chance of experiencing serious cardiovascular events such as heart attacks, heart failure, or ischemic strokes. They were also considerably less likely to suffer from angina, atherosclerosis, or arterial blood clots.

According to the researchers, the relationship between bariatric surgery and lower risk of developing cardiovascular disease has never been investigated in such depth. There is mounting evidence that bariatric surgery, due to the weight loss it induces in patients, has significant health advantages. A study done by Rustgi and colleagues, which was published in the journal Gastroenterology in March 2021, found that bariatric surgery can considerably lower the incidence of cancer, particularly obesity-related malignancies, in obese persons with NAFLD. Colorectal, pancreatic, endometrial, thyroid, multiple myeloma, and hepatocellular carcinoma were among the malignancies studied.

“Although bariatric surgery is a more aggressive approach than lifestyle modifications, it may be associated with other benefits, such as improved quality of life and decreased long-term health care burden,” Rustgi said.