Medical Bulletin 06/ February/ 2025
Here are the top medical news for the day:
CMAJ Study Reveals Alcohol Related Deaths Jump 18% During Pandemic
Alcohol-related deaths increased 18% during the pandemic, as did hospitalizations related to alcohol use, according to new research in Canadian Medical Association Journal
To understand the effect of changing patterns of alcohol use during the pandemic, researchers looked at deaths and hospitalizations between 2016 and 2022, comparing a prepandemic period and a pandemic period. They found that deaths from alcohol use increased about 18% over the 3-year period, with higher increases mainly in 2020 and 2021 (about 24%), resulting in 1600 more deaths than expected. Alcohol-related hospitalizations also increased 8% over the pandemic period studied, with higher increases (about 14%) in 2020/21.
There were regional variations, with the highest increases in deaths in the Prairie provinces (28%) and in British Columbia (24%), excess rates 3 times higher than in Ontario and the Atlantic provinces, and 6–7 times higher than in Quebec. Hospitalizations were also higher in the Prairies and especially in the territories. Younger adults had the highest increases in both excess deaths (age 25–44 yr) and hospitalizations (age 15–44 yr).
Deaths and hospitalizations were largely due to alcoholic liver disease (ALD) and alcohol use disorder (AUD). As increases in hospitalizations were 3 times higher in females, the authors suggest this could be an early warning of future liver-related disease in this group.
Increased alcohol consumption may have been driven by stress, boredom, deteriorating mental health, and other factors, including easier access to alcohol.
“Our findings highlight the importance of timely interventions to prevent high-risk drinking from developing into alcohol use disorder or alcoholic liver disease. A comprehensive approach to preventing and managing high-risk drinking, alcohol use disorder, and alcoholic liver disease in the aftermath of the pandemic should comprise both public health and clinical management interventions,” the authors conclude.
Reference: Mortality and hospitalizations fully attributable to alcohol use before versus during the COVID-19 pandemic in Canada, Yipu Shi, Kathryn Macrae, Margaret de Groh, Wendy Thompson, Tim Stockwell, CMAJ Feb 2025, 197 (4) E87-E95; DOI: 10.1503/cmaj.241146
Air Pollution Linked to Increased Hospital Admissions for Lower Respiratory Infections: Study Finds
A new research showed that long-term exposure to PM2.5, PM10, NO2 and ozone (O3) air pollution is associated with more hospital admissions for lower respiratory tract infections in adults. The associations were stronger in men, people over 65 years of age and those diagnosed with hypertension. The results have been published in the journal Environment International.
Researchers from the Barcelona Institute for Global Health assessed the effect of air pollution on hospital admissions for lower respiratory infections in adults, and investigated the existence of subgroups that are particularly vulnerable to these infections.
The study involved 3,800,000 adults from the COVAIR-CAT cohort. The research team used exposure models to estimate annual average concentrations of PM2.5, PM10, NO2 and ozone during the warm season (May-September) between 2018 and 2020 at the participants' residences. Information on hospital admissions, mortality and comorbidities was obtained from various administrative databases. The study included hospital admissions for all lower respiratory infections and, separately, the subgroup of hospital admissions for influenza and pneumonia. A statistical model was then used to assess the association between air pollution and hospital admissions.
Specifically, elevated levels of air pollution were associated with approximately three times higher rates of hospital admissions for lower respiratory infections among people aged 65 years and older compared with younger people.
In addition, exposure to elevated levels of NO2, PM2.5 or PM10 (but not O3) was associated with about a 50% increase in hospital admissions in men, while the association was about 3% higher in women.
“The association between air pollution and hospital admissions for lower respiratory tract infections was observed even at pollution levels below current EU air quality standards,” says Anna Alari, ISGlobal researcher and first author of the study. “It is crucial to adopt stricter air quality standards, as more ambitious measures to reduce air pollution would decrease hospital admissions and protect vulnerable populations,” she adds.
Reference: Anna Alari, A., Ranzani, O., Milà, C., Olmos, S., Basagaña, X., Dadvand, P., Duarte-Salles, T., Nieuwenhuijsen, M., Tonne, C. Long-term exposure to air pollution and lower respiratory infections in a large population-based adult cohort in Catalonia. Environment International, 2025. Doi: https://doi.org/10.1016/j.envint.2024.109230
Clinical Trial Shows Benefits of High Precision Radiation Therapy for Metastatic Cancer
A new Phase I clinical trial from London Health Sciences Centre Research Institute (LHSCRI) has found high-precision radiation therapy is safe for use in patients with cancer that has spread to more than 10 spots in the body. Published in the International Journal of Radiation Oncology, Biology, Physics, the ARREST trial highlights the potential of this therapy for patients with limited treatment options.
Past research from LHSCRI has shown that targeted radiation, called stereotactic ablative radiotherapy (SABR), may be beneficial for those with cancers that have spread or metastasized to fewer than 10 spots by showing it can lengthen the time until new cancer spots appear and, in some patients, lengthen their lifespan. This study aimed to assess the safety and feasibility of using stereotactic ablative radiotherapy in cancer patients with polymetastatic disease – where the cancer has spread to more than 10 spots in multiple organs throughout the body – who have very few drug treatment options available to them.
Thirteen patients were treated at LHSC’s Verspeeten Family Cancer Centre with five doses of radiation using stereotactic ablative radiotherapy. It was found to be safe in treating 10 or more lesions of cancer throughout the body. All results were within acceptable toxicity levels.
In addition, researchers found that although creating radiation plans for the patients was more complex and resource-intensive in terms of targeting multiple lesions while protecting normal organs and tissues, it was feasible in all but one study participant.
A larger Phase II clinical trial is now underway to look beyond the safety of the treatment to the benefits for the patient. This trial will involve patients who are not planning to receive drug therapy for the next three months – whether due to patient preference, a desired break from side effects, or no additional drug treatments being available.
“The Phase I trial was successful in demonstrating the safety and feasibility of this approach,” says Dr. Timothy Nguyen, a Radiation Oncologist at LHSC and the study’s lead author. “With this next, larger trial, ARREST-2, we are examining whether treating as many spots of cancer as safely possible can improve survival and give patients more time.”
Reference: Ablative Radiation Therapy to Restrain Everything Safely Treatable (ARREST): A Phase 1 Study of Stereotactic Ablative Radiation Therapy for Polymetastatic Disease, Nguyen, Timothy K. et al. International Journal of Radiation Oncology, Biology, Physics, Volume 120, Issue 5, 1231 - 1238alcohol,death,pandemic,canadian medical association journal,CMAJ,ALD
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