Use of Parallel Transmit 7T MRI Changes Management for Epilepsy Surgery 27 Mar 2025, 12:00 am

Lesions were better visualized on pTx than circularly polarized MRI in 57 percent of cases and were never better visualized on circularly polarized MRI

By Elana Gotkine HealthDay Reporter

THURSDAY, March 27, 2025 (HealthDay News) — Parallel transmit (pTx) 7 Tesla (T) magnetic resonance imaging (MRI) changes management in more than half of adult candidates for epilepsy surgery, according to a study published online March 20 in Epilepsia.

Krzysztof Klodowski, Ph.D., from the University of Cambridge in the United Kingdom, and colleagues compared pTx and circularly polarized (CP) 7T MRI in adult candidates for epilepsy surgery who had negative or equivocal 3T MRI. Outcomes were reported for the first 31 patients.

The researchers found that 7T revealed previously unseen structural lesions, confirmed 3T-equivocal lesions, and disproved equivocal lesions in nine, four, and four patients, respectively (29, 13, and 13 percent). In 57 percent of cases, lesions were better visualized on pTx than CP and were never better visualized on CP. In 18 cases (58 percent), clinical management was altered by 7T: Nine were offered surgical resection and one laser interstitial thermal therapy; three were removed from the surgical pathway due to bilateral or extensive lesions; and five were offered stereo-electroencephalography with better targeting. Significantly better overall quality of pTx fluid-attenuated inversion recovery images was confirmed in blinded comparison, while magnetization-prepared 2 rapid acquisition gradient echo images were noninferior and had improved temporal lobe coverage and less signal dropout.

“The introduction of pTx-7T MRI to a real-world epilepsy surgery pathway changed clinical management for more than half of the patients scanned, making it highly likely that it will be cost-effective in patients with normal 3T MRI,” the authors write.

Two authors disclosed ties to Siemens and Siemens Healthcare.

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NIH Ends Funding for the Effects of Climate Change on Health 27 Mar 2025, 12:00 am

By I. Edwards HealthDay Reporter

THURSDAY, March 27, 2025 (HealthDay News) — The National Institutes of Health (NIH) will no longer fund new research on how climate change affects people’s health, according to records reviewed by ProPublica.

The new directive was shared internally with staff last week. It follows other action to stop NIH support for studies related to gender identity, LGBTQ+ health, vaccine hesitancy and diversity, equity and inclusion (DEI).

While it’s unclear if current climate-health studies will lose their funding, the guidance appears to block any new research opportunities on the issue.

Dr. Lisa Patel, executive director of The Medical Society Consortium on Climate and Health, called the move “catastrophic” and said its impact on needed research would be “devastating,” according to the ProPublica report.

“This is an administration where industry voices rule and prevail,” Patel said. “This is an agenda item for the fossil fuel industry, and this administration is doing what the fossil fuel industry wants.”

As extreme weather events — from hurricanes and heat waves to wildfires and floods — have become more frequent, the NIH has funded hundreds of projects looking at the effects of climate on health.

The agency launched a Climate Change and Health Initiative in 2021, which received $40 million in funding in both 2023 and 2024. That program and two others focused on climate and health were quietly shuttered last month.

The new guidance halts all future climate-health research funding across NIH, regardless of its link to previous programs.

A spokesperson for the U.S. Department of Health and Human Services (HHS) said the agency is cutting research that doesn’t align with its new priorities.

“At HHS, we are dedicated to restoring our agencies to their tradition of upholding gold-standard, evidence-based science,” the spokesperson said. “As we begin to Make America Healthy Again, it’s important to prioritize research that directly affects the health of Americans. We will leave no stone unturned in identifying the root causes of the chronic disease epidemic as part of our mission to Make America Healthy Again.”

Former NIH scientist Linda Birnbaum said this isn’t the first time politics has shaped science funding.

During Trump’s first term, researchers removed the term “climate change,” referring instead to “climate and health.”

“If NIH doesn’t study the health impacts of climate, we are not going to be able to prevent some of those health impacts, and we aren’t going to be able to find ways to deal with them,” Birnbaum said.

A December NIH report listed ongoing climate-related research on wildfire smoke, heat and fertility, and mosquito-borne diseases like dengue. That report has since been taken offline.

“We can see with our own eyes how extreme heat and extreme weather are harming people’s health,” Veena Singla, an adjunct assistant professor at Columbia University’s Mailman School of Public Health, told ProPublica.

The NIH decision is part of a larger agenda under President Donald Trump to slash federal spending on climate issues and boost fossil fuel production.

His administration is also considering closing the Environmental Protection Agency’s (EPA) scientific research office, which could affect more than 1,000 jobs, according to a report from The New York Times.

HHS Secretary Robert F. Kennedy Jr. has said he believes in climate change. But experts such as Patel said he has not taken action to support that belief.

“What we can readily see, from the things that RFK Jr. is allowing to happen and unwilling to weigh in on, he is not going to be an anti-industry voice,” Patel said. “He is not there to follow the best science.”

More information

The U.S. Environmental Protection Agency has more on climate change and human health.

SOURCE: ProPublica, March 24, 2025

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Sensorized T-Shirt Enables Early Discharge After Oncological Urology Surgery 27 Mar 2025, 12:00 am

90 percent of patients satisfied with remote patient monitoring

By Lori Solomon HealthDay Reporter

THURSDAY, March 27, 2025 (HealthDay News) — A wearable T-shirt monitor can help oncological urology patients return home sooner after robotic-assisted surgery, according to a study presented at the 40th annual European Association of Urology Congress, held from March 21 to 24 in Madrid.

Antonio Pastore, M.D., Ph.D., from the Sapienza University of Rome, and colleagues evaluated early discharge of patients undergoing oncological robotic-assisted urological surgery using remote patient monitoring. The analysis included 70 patients randomly assigned to a wearable, sensorized T-shirt to monitor blood pressure, pulse rate, oxygen saturation, and blood glucose and with discharge 24 to 36 hours earlier, or control.

The researchers reported that mean remote monitoring was 13.5 days and the overall satisfaction rate among patients in the wearable group was 90 percent. Ten percent of patients in the wearable group had trouble understanding the telemedicine-based instructions, while 87 percent found it effective and encouraging. Eight patients in the control group (26 percent) accessed the hospital before their scheduled follow-up versus two patients (6 percent) in the wearable group. In five patients, the T-shirt monitoring detected the onset of cardiological conditions, allowing for early diagnosis and treatment.

“In Italy, where standard discharge time after this type of robotic-assisted urological surgery can be at least 72 hours, being able to allow patients home sooner improves their quality of life as they feel more comfortable in their own environment, and it means we can free up hospital beds, too,” Pastore said in a statement.

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Five Top CDC Leaders Step Down Amid Wave of Departures 27 Mar 2025, 12:00 am

By I. Edwards HealthDay Reporter

THURSDAY, March 27, 2025 (HealthDay News) — The U.S. Centers for Disease Control and Prevention (CDC) is facing major changes, with five senior leaders stepping down Tuesday.

These exits follow three other recent departures, meaning that as many as one-third of the agency’s top leaders have now left.

The departures were announced at a meeting of senior managers but were not announced to the public.

The Associated Press confirmed the departures through two CDC officials who asked to remain anonymous.

The CDC has about two dozen centers and offices. The leaders stepping down include:

• Leslie Ann Dauphin, who led the Public Health Infrastructure Center with more than 500 staff.

• Dr. Karen Remley, who oversaw the National Center on Birth Defects and Developmental Disabilities.

• Sam Posner, who headed the Office of Science, which publishes the Morbidity and Mortality Weekly Report.

• Debra Lubar, head of the Office of Policy, Performance and Evaluation.

• Leandris Liburd, who led the Office of Health Equity, formed in 2020 to help address COVID-19’s impact on minorities.

Other recent departures include the CDC’s top communications officer, its chief operating officer and a former deputy director.

Based in Atlanta, the CDC has a $9 billion budget and more than 13,000 employees, plus a similar number of contract workers.

The agency is responsible for tracking and responding to disease outbreaks and other health threats.

“The challenges for these individuals to do their jobs on a daily basis must be enormous,” said Jason Schwartz, an associate professor at Yale School of Public Health who studies government health agencies. “The future of CDC is under threat, by any measure. It’s understandable why individuals may decide to move on rather than see the agency diminished in its works, and its resources, and its ability to do its job.”

Earlier this week, the White House announced Susan Monarez as its nominee for CDC director. It’s unclear if that decision played a role in the resignations.

A previous nominee, Dr. David Weldon, was pulled from consideration just before a Senate hearing because he lacked votes for confirmation.

Adding to this tension, more than 500 probationary employees were laid off in February.

Although judges later ordered that those workers be reinstated and paid during administrative leave, some say they still haven’t been allowed to return, The Associated Press reported.

“It would be foolhardy to predict what the CDC will look like” in a few months, let alone a couple of years, Schwartz said. But it’s understandable why senior leaders “might not want to sign up for that,” he added.

More information

Learn more about the role of the U.S. Centers for Disease Control and Prevention.

SOURCE: The Associated Press, March 25, 2025

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Pelabresib Plus Ruxolitinib Improves Underlying Myelofibrosis 27 Mar 2025, 12:00 am

In a recent study, significantly more patients receiving the combination therapy met primary end point of reduction in spleen volume of ≥35 percent from baseline

By Elana Gotkine HealthDay Reporter

THURSDAY, March 27, 2025 (HealthDay News) — Pelabresib, a bromodomain and extraterminal domain inhibitor, plus ruxolitinib (a Janus kinase [JAK] inhibitor) improves signs of underlying myelofibrosis in JAK inhibitor-naive patients, according to a study published online March 10 in Nature Medicine.

Raajit K. Rampal, M.D., Ph.D., from the Memorial Sloan Kettering Cancer Center in New York City, and colleagues conducted a phase 3 study (MANIFEST-2) involving JAK inhibitor-naive patients with myelofibrosis who were randomly assigned to receive pelabresib 125 mg once daily for 14 days followed by a seven-day break or to placebo combined with ruxolitinib 10 or 15 mg twice daily (214 and 216 patients, respectively).

The researchers found that the primary end point of reduction in spleen volume of ≥35 percent from baseline at week 24 was met in 65.9 and 35.2 percent of patients randomly assigned to pelabresib-ruxolitinib and placebo-ruxolitinib, respectively. The absolute change in total symptom score (TSS) was –15.99 and –14.05, respectively; a ≥50 percent decrease from baseline in TSS response at week 24 was achieved in 52.3 and 46.3 percent, respectively, for pelabresib-ruxolitinib and placebo-ruxolitinib. The most common treatment-emergent adverse events were thrombocytopenia (occurring in 52.8 and 37.4 percent, respectively) and anemia (44.8 and 55.1 percent, respectively).

“The phase 3 MANIFEST-2 study provides important insights into disease biology and modification, supporting the combination of pelabresib plus ruxolitinib for JAK inhibitor-naive patients with myelofibrosis,” the authors write.

Several authors disclosed ties to pharmaceutical companies, including Novartis; the MANIFEST-2 study was funded by Constellation Pharmaceuticals, a Novartis Company.

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Study Looks at Recovery Potential in Comatose Patients Who Died After Halting Life-Sustaining Therapy 27 Mar 2025, 12:00 am

Most patients who died after withdrawal of life-sustaining therapy were considered to have recovery potential of at least 1 percent

By Elana Gotkine HealthDay Reporter

THURSDAY, March 27, 2025 (HealthDay News) — Most comatose patients resuscitated from cardiac arrest who died after withdrawal of life-sustaining therapy (WLST) were considered by experts to have recovery potential of at least 1 percent, according to a study published online March 25 in JAMA Network Open.

Jonathan Elmer, M.D., from the University of Pittsburgh School of Medicine, and colleagues conducted a prospective cohort study including comatose adult patients treated following resuscitation from cardiac arrest at a single academic medical center between Jan. 1, 2010, and July 31, 2022. Three or more experts independently estimated recovery potential using a 7-point numerical ordinal scale for each patient if life-sustaining treatment had been continued.

A total of 2,391 patients were included; 714 (29.9 percent) survived to discharge. Thirty-eight experts reviewed cases of uncertain outcome (1,431 patients [59.8 percent]) in which WLST preceded death; they rendered 4,381 estimates of recovery potential. The researchers found that all experts believed that recovery potential was less than 1 percent if life-sustaining therapies had been continued in 518 cases (36.2 percent). At least one expert believed that recovery potential was at least 1 percent in the remaining 913 cases (63.8 percent). All experts agreed that recovery potential was at least 1 percent in 227 cases (15.9 percent); expert estimates differed at this threshold in 686 cases (47.9 percent).

“Our results suggest a potential for biased clinical decision-making and research when deaths after WLST are treated as poor outcomes that cannot be ignored,” the authors write.

Several authors disclosed ties to the biopharmaceutical industry.

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ACC: Screening Mammograms + AI May ID Cardiovascular Disease 27 Mar 2025, 12:00 am

Heart attack, stroke, heart failure, and death increase with breast arterial calcification

By Lori Solomon HealthDay Reporter

THURSDAY, March 27, 2025 (HealthDay News) — Automated deep learning-based quantification of breast arterial calcification (BAC) on routine screening mammograms may allow for opportunistic screening for cardiovascular disease events and death in women, according to a study presented at the annual meeting of the American College of Cardiology, held from March 29 to 31 in Chicago.

Theo Dapamede, M.D., Ph.D., from Emory University in Atlanta, and colleagues examined the prognostic value of BAC for adverse cardiovascular disease events and all-cause death in the general population. A deep learning model was built on data from 56,605 women with screening mammograms between 2013 and 2020 and at least five years of follow-up.

The researchers found that event rates for acute myocardial infarction, stroke, heart failure, or all-cause death significantly increased with BAC level in patients aged younger than 60 years and 60 to 80 years. Compared with patients with BAC <10 mm², patients with BAC >40 mm² had lower average five-year event-free survival (acute myocardial infarction: 96.8 versus 91.0 percent; stroke: 93.1 versus 83.7 percent; heart failure: 95.7 versus 84.7 percent; death: 95.3 versus 86.4 percent).

“Advances in deep learning and artificial intelligence have made it much more feasible to extract and use more information from images to inform opportunistic screening,” Dapamede said in a statement.

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ACC: Colorectal Cancer Tied to Higher Risk for Cardiovascular Death 27 Mar 2025, 12:00 am

Risk highest in the two years following colorectal cancer diagnosis

By Lori Solomon HealthDay Reporter

THURSDAY, March 27, 2025 (HealthDay News) — Colorectal cancer (CRC) is tied to an increased risk for cardiovascular mortality, especially in individuals younger than 50 years, according to a study presented at the annual meeting of the American College of Cardiology, held from March 29 to 31 in Chicago.

Manahil Khan and Ahsan Ayaz, M.D., from Montefiore St. Luke’s Cornwall Hospital in Newburgh, New York, quantified cardiovascular mortality in patients with CRC. The analysis included 631,699 patients identified from the Surveillance, Epidemiology, and End Results database (2000 to 2021).

The researchers found that in the overall population, there was a significant increase in cardiovascular mortality (standardized mortality ratio [SMR], 1.16) with the highest risk within two years of CRC diagnosis (SMR, 1.45). This short-term cardiovascular mortality risk was greatest among younger adults (younger than 50 years; SMR, 2.40), men (SMR, 1.55), and non-Hispanic Black patients (SMR, 1.74).

“Based on our findings, the two-year period after a colorectal cancer diagnosis is a critical period when patients need aggressive care to improve cardiovascular outcomes,” Ayaz said in a statement. “For example, there should be an aggressive approach to control cardiovascular risk factors and comorbidities like diabetes and hypertension. There is also a need for coordination between oncology teams and primary care teams, because most of those risk factors are managed by primary care providers.”

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Chinese Woman Is Third Person to Get a Gene-Edited Pig Kidney 27 Mar 2025, 12:00 am

By I. Edwards HealthDay Reporter

THURSDAY, March 27, 2025 (HealthDay News) — A Chinese woman is the third person in the world living with a gene-edited pig kidney, and nearly three weeks after surgery, doctors say she’s doing well.

The woman, reportedly 69 years old, had kidney failure for eight years before receiving the pig kidney.

The operation took place at Xijing Hospital of the Fourth Military Medical University in Xi’an. Lin Wang, part of the transplant team, said the kidney is working well and the patient is still being monitored in the hospital, a report from NBC News says.

This surgery is part of a growing effort to use genetically altered pig organs to help deal with a shortage of human organs for transplant.

So far, four people have received pig kidneys and two received a pig heart. Some of those early surgeries had poor outcomes, but two other recent kidney recipients — one woman in Alabama and a man in New Hampshire — are both doing well, NBC News reported.

Wang and his team are also testing pig livers. In a study published March 26 in the journal Nature, they reported implanting a pig liver into a brain-dead person. The liver survived for 10 days and showed early signs of working.

What’s more, it made bile and albumin, which are important for liver function, although in smaller amounts that an actual human liver. In theory, Wang said, that could still help support someone with liver failure.

U.S. scientists have tested a similar idea by hooking up a pig liver outside the body to help filter blood, much like a dialysis machine.

“It’s hopefully a first step but it’s still, a lot like any good research, more questions than answers,” said Dr. Parsia Vagefi, a liver transplant surgeon at UT Southwestern Medical Center who wasn’t involved with the work.

Wang said his team has also tried replacing a human liver completely with a pig liver in another brain-dead person and is now studying the results.

More information

The U.S. Food and Drug Administration has more on xenotransplantation.

SOURCE: NBC News, March 26, 2025

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Longer PSA Monitoring in Patients With Persistent PSA May Reduce Overtreatment 27 Mar 2025, 12:00 am

Authors say PSA level should be assessed for at least three months after radical prostatectomy for prostate cancer to accurately document persistent PSA

By Elana Gotkine HealthDay Reporter

THURSDAY, March 27, 2025 (HealthDay News) — Assessment of prostate-specific antigen (PSA) level for three months after radical prostatectomy (RP) for prostate cancer may minimize overtreatment, according to a study published online March 13 in JAMA Oncology.

Derya Tilki, M.D., from University Hospital Hamburg Eppendorf in Germany, and colleagues examined the time necessary to accurately document a persistent PSA level after RP in a cohort study. The study included patients with T1N0M0 to T3N0M0 prostate cancer treated with RP between 1992 and 2020 at two academic centers. The discovery cohort included 30,461 patients, and the validation cohort included 12,837 patients.

The researchers found that for patients with persistent versus undetectable PSA, a pre-RP PSA level >20 ng/mL versus ≤20 ng/mL was significantly associated with reduced all-cause mortality (ACM) risk and prostate cancer-specific mortality (PCSM) risk (adjusted hazard ratios, 0.69 and 0.41, respectively). These findings persisted after adjustment for prostate volume and were confirmed in the validation cohort for PCSM risk. In patients with a pre-RP PSA >20 ng/mL versus ≤20 ng/mL, there was more frequent and a shorter median time to post-RP radiation therapy plus androgen deprivation therapy (ADT) or ADT use (54.7 percent at a median of 2.68 months versus 34.8 percent at a median of 3.30 months). These treatment times were shorter than those to an undetectable PSA in observed patients (median, 2.96 versus 3.37 months). There was an association seen for increasing persistent PSA level with increased ACM and PSCM risks (adjusted hazard ratios, 1.14 and 1.27, respectively).

“The clinical significance of these findings is that they highlight the need to monitor PSA after RP for longer than the commonly practiced 1.5-month to 2.0-month interval before concluding a persistent PSA exists and initiating post-RP therapy to minimize the risk of overtreatment,” the authors write.

One author disclosed ties to the biopharmaceutical industry.

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