Articles of Interest - From our Subscriptions
Pappu, A. , Auckley, D. , Cloward, T. , Dominguez, J. , Dupuy-McCauley, K. , Gali, B. , Gay, P. , Hillman, D. , McConville, S. , Nafiu, O. , Won, C. & Singh, M. (2025). Society of Anesthesia and Sleep Medicine Opinion Paper: High-Flow Nasal Oxygen Therapy for Early Postoperative Management of Patients With Sleep-Disordered Breathing. Anesthesia & Analgesia, 141 (4), 740-747. doi: 10.1213/ANE.0000000000007424.
Abstract
"High-flow nasal oxygen (HFNO) therapy, a cornerstone in managing respiratory failure, has garnered attention for its potential uses in postoperative care, particularly for patients with sleep-disordered breathing (SDB). Despite established benefits in critical care settings, its efficacy in improving postoperative outcomes for SDB patients remains under-researched. This Society of Anesthesia and Sleep Medicine (SASM) opinion paper aims to critically evaluate existing literature, highlight the physiological rationale for HFNO’s effectiveness, especially in the early (within 24 hours) postoperative period, and identify research gaps and future directions."
Comparison of an Energy-Reduced Mediterranean Diet and Physical Activity Versus an Ad Libitum Mediterranean Diet in the Prevention of Type 2 Diabetes : A Secondary Analysis of a Randomized Controlled Trial
Ruiz-Canela, M. , Corella, D. , Martínez-González, M. Á. , Babio, N. , Martínez, A. J. , Forga, L. , Alonso-Gómez, Á. M. , Wärnberg, J. , Vioque, J. , Romaguera, D. , López-Miranda, J. , Estruch, R. , Santos-Lozano, J. M. , Serra-Majem, L. , Bueno-Cavanillas, A. , Tur, J. A. , Martín-Sánchez, V. , Riera-Mestre, A. , Delgado-Rodríguez, M. , Matía-Martín, P. , Vidal, J. , Vázquez, C. , Daimiel, L. , Buil-Cosiales, P. , Shyam, S. , Sorlí, J. V. , Castañer, O. , García-Rios, A. , Torres-Collado, L. , Gómez-Gracia, E. , Zulet, Á. M. , Konieczna, J. , Casas, R. , Cano-Ibáñez, N. , Tojal-Sierra, L. , Bernal-López, R. M. , Toledo, E. , García-Gavilán, J. , Fernández-Carrión, R. , Goday, A. , Arenas-Larriva, A. P. , González-Palacios, S. , Schröder, H. , Ros, E. , Fitó, M. , Hu, F. B. , Tinahones, F. J. & Salas-Salvadó, J. (2025). Annals of Internal Medicine, 178 (10), 1378-1389. doi: 10.7326/ANNALS-25-00388.
Abstract
Limited research has been done to evaluate the combined effect of energy reduction, Mediterranean diet (MedDiet), and physical activity on type 2 diabetes incidence.
Objective:
To evaluate whether an energy-reduced MedDiet (erMedDiet) plus physical activity reduces diabetes incidence compared with a standard MedDiet.
Design:
Prespecified secondary outcome analysis in the PREDIMED (Prevención con Dieta Mediterránea)-Plus randomized, single-blinded, controlled trial. (ISRCTN Registry: ISRCTN89898870)
Setting:
23 centers across Spain.
Participants:
4746 adults aged 55 to 75 years with metabolic syndrome and overweight or obesity, without prior cardiovascular disease or diabetes.
Intervention:
Participants were randomly assigned 1:1 to an intervention group receiving an erMedDiet (planned reduction of 600 kcal per day), increased physical activity, and behavioral strategies for reducing weight, or a control group receiving ad libitum MedDiet advice.
Measurements:
Diabetes incidence was based on the American Diabetes Association criteria. Anthropometric measurements were obtained annually. Cox regression models were used to assess the intervention effect.
Results:
The 6-year absolute risk was 12.0% (95% CI, 11.9% to 12.1%) in the control group (349 cases) and 9.5% (CI, 9.4% to 9.5%) in the intervention group (280 cases). Over a median 6-year follow-up, diabetes incidence was 31% (CI, 18% to 41%) relatively lower in the intervention group compared with the control group, with an absolute risk reduction of -2.6 cases (CI, -2.7 to -2.4) per 1000 person-years. The intervention group attained better adherence to the erMedDiet, higher physical activity levels, and greater reductions in body weight and waist circumference.
Limitation:
Secondary outcome, single-blinded design, and self-reported dietary adherence.
Conclusion:
An intensive intervention with the MedDiet adding caloric reduction, physical activity, and modest weight loss was more effective than only an ad libitum MedDiet in reducing diabetes incidence in overweight/obese persons with metabolic syndrome.
Determinants of geographic variation in the incidence of adult nonmalignant meningioma in the United States, 2010–2019
Abstract:
Background
US incidence rates of nonmalignant brain tumors are 3-fold higher in highest versus lowest incidence states. A county-level analysis was conducted to assess whether geographic variation in nonmalignant meningioma (NMM) incidence is related to demographics, cancer registry, health care, and other factors.
Methods
Age-adjusted incidence rates of NMM in US counties during 2010–2019 were modeled with data from the Central Brain Tumor Registry of the United States. Demographic, geographic, cancer registry, environmental, health care, health, lifestyle, and socioeconomic factors at the county level were drawn from numerous data sources. Bayesian index regression models were fit containing spatial random effects.
Results
Three domains were significantly associated with rates of NMM at the county level: cancer registry practices (funding source and % radiographically confirmed), socioeconomic status index (higher levels with percent working in white-collar occupations as an important contributor), and demographics (% Black and % female). No associations were observed for general health or environmental factors. In the fully adjusted model, the number of counties with significantly elevated and lowered spatial random effects decreased by 33% and 28%, respectively, compared to a no-covariate model.
Conclusions
Although general health and environmental factors cannot be ruled out in explaining the geographic variation in NMM incidence rates, results suggest that socioeconomic factors, certain demographic characteristics, and cancer diagnosis and registry practices may all play a significant role in driving such variation. These results may have implications for other tumor types diagnosed primarily radiographically or outside hospital settings, where variation in detection and reporting may affect incidence rates.
OBJECTIVE:
This study aimed to evaluate the impact of a family member’s ICU admission on post-intensive care syndrome family (PICS-F).
DESIGN:
Retrospective, cohort study using a matched-pair, cohort design and a large administrative database reflecting the entire Japanese population.
SETTING:
The data were provided by DeSC Healthcare (Tokyo, Japan); the database comprised administrative claims data of 3.44 million insurance subscribers.
PATIENTS:
The exposure group was defined as family members of ICU patients from April 1, 2014 to November 30, 2022. Then, families of ICU patients were randomly matched to individuals in the non-exposure group with an exposure to non-exposure ratio of 1:4; matching was performed by age (the same month and year of birth), sex, status of medical insurance, and relationship with the householder.
MEASUREMENTS AND MAIN RESULTS:
The primary outcome was the prevalence of psychological disorders associated with a diagnosis of PICS-F that needed medical care at least once within 6 months after the ICU admission date of the matched pair. Multivariable logistic regression analyses and subgroup analyses by relationship to the ICU patient (spouse, parent, or child) were performed.
Of the eligible individuals, 35,652 family members of 27,748 ICU patients were matched with 142,463 individuals in the non-exposure group. The prevalence of psychological disorders associated with PICS-F within 6 months from the index date was significantly higher in the ICU patients’ families than in the matched individuals (15.1% vs. 13.6%; adjusted odds ratio, 1.08; 95% CI, 1.02–1.15). Similar to the main analyses, ICU patients’ spouses had a significantly higher prevalence of psychological disorders associated with PICS-F than matched individuals, but there were no significant differences in ICU patients’ parents and children.
CONCLUSIONS:
Families of ICU patients, especially spouses, were more likely to seek medical care for psychological disorders associated with PICS-F within 6 months than individuals not exposed to a family member’s ICU admission.
Sundermann, A. , Jasper, E. , Kumar, S. , Hartmann, K. & Velez Edwards, D. (2025). Dating Discrepancies on Research Ultrasonography and Risk of Pregnancy Loss in a Prospective Cohort. Obstetrics & Gynecology, 146 (4), 515-523. doi: 10.1097/AOG.0000000000006031.
Abstract:
OBJECTIVE:
To estimate the risk associated with discrepancies between last menstrual period (LMP)–based and ultrasound-based gestational dating and pregnancy loss in a prospective cohort of individuals of normal fertility who underwent standardized early-pregnancy ultrasonography.
METHODS:
Participants in a community-based, prospective pregnancy cohort were recruited preconceptionally or in early pregnancy. Participants underwent standardized research ultrasonography targeted for the sixth week of gestation. We calculated the magnitude of lag between ultrasound-based age and LMP-based age at the research ultrasonogram. Cox proportional-hazards models were used to estimate the association between this difference and pregnancy loss. To assess for effect modification, analyses were stratified by week of research ultrasonogram, developmental features observed on the ultrasonogram, and menstrual regularity.
RESULTS:
Among 4,935 participants, the median difference between LMP-based and ultrasound-based gestational age on the research ultrasonogram was 1 day (interquartile range −1 to 5 days), and 9.3% of pregnancies ended in loss. Risk of pregnancy loss increased exponentially with each additional day ultrasound-based dating lagged LMP-based dating ( P <.001). This association persisted when stratified by week of ultrasonography and was more pronounced among pregnancies with a measurable crown–rump length. Ultrasound-based gestational age lagging LMP-based gestational age by more than 3 days was associated with a fivefold increased risk of pregnancy loss (adjusted hazard ratio [HR] 5.34, 95% CI, 4.37–6.52), and a lag of more than 5 days was associated with a greater than sixfold increased risk (adjusted HR 6.99, 95% CI, 5.78–8.44). These findings persisted when analyses were restricted to individuals with regular cycles and certain LMP dates.
CONCLUSION:
Increasing lag between ultrasound-based dating and LMP-based dating among asymptomatic patients was strongly associated with pregnancy loss risk. This clinically quantifiable measure can inform concern for pregnancy loss before symptom onset among individuals with a certain LMP.
.png-638919983642827586.png)
Use this form to request