Medical Bulletin 14/ January/ 2025
Here are the top medical news for the day:
Updated Guidelines for Standardization of Biochemical Indices for Bone Status
The Joint International Osteoporosis Foundation (IOF) Working Group and the International Federation of Clinical Chemistry (IFCC) Committee on Bone Metabolism have published important updated guidelines for the correct use of biochemical indices of bone status. The guidelines are published in the journal clinical chemistry and laboratory medicine.
The newly proposed term, "Bone Status Indices" (BSIs), offers a comprehensive framework to unify terminology and improve comparability across studies. Unlike previously used terms such as "bone turnover markers" or "metabolic markers of bone turnover," which focus on isolated aspects of bone metabolism, Bone Status Indices provide a holistic representation of bone status and integrate a wider array of factors—including structural elements, metabolic byproducts, enzymes, and regulatory molecules.
Professor Etienne Cavalier, Chair of the Joint IOF Working Group and IFCC Committee on Bone Metabolism, and Vice-Chair of the IOF Committee of Scientific Advisors, emphasized the transformative potential of the new standardized nomenclature:
"By adopting this unified nomenclature, researchers and clinicians can enhance communication, foster collaboration, ensure the accurate interpretation of findings and ensure consistent reporting. This step is vital for achieving a unified and comprehensive approach to bone status evaluation, benefiting patients and advancing the field of bone metabolism."
Reference: Lombardi, G., Jørgensen, N., Harvey, N., McCloskey, E., Åkesson, K., Eastell, R., Garnero, P., Kanis, J., Khashayar, P., Lane, N., McClung, M., Silverman, S., Makris, K., Bhattoa, H., Vasikaran, S., Pikner, R., Cavalier, E. & the Joint IOF Working Group and IFCC Committee on Bone Metabolism (2024). Guidelines for the correct use of the nomenclature of biochemical indices of bone status: a position statement of the Joint IOF Working Group and IFCC Committee on Bone Metabolism. Clinical Chemistry and Laboratory Medicine (CCLM). https://doi.org/10.1515/cclm-2024-1148
Exposure to Red Light Linked to Lower Risk of Blood Clot?
Humans and mice exposed to long-wavelength red light had lower rates of blood clots that can cause heart attacks, lung damage and strokes, according to research published in the Journal of Thrombosis and Haemostasis.
The findings, which need to be verified through clinical trials, have the potential to reduce blood clots in veins and arteries, which are leading causes of preventable death worldwide.
The team exposed mice to 12 hours of either red, blue or white light, followed by 12 hours of darkness, in a 72-hour cycle. They then looked for differences in blood clots between the groups. The mice exposed to red light had nearly five times fewer clots than the mice exposed to blue or white light. Activity, sleep, eating, weight and body temperature remained the same between the groups.
The team also analyzed existing data on more than 10,000 patients who had cataract surgery and received either conventional lenses that transmit the entire visible spectrum of light, or blue light-filtering lenses, which transmit about 50% less blue light. They discovered that cancer patients who received blue light-filtering lenses had lower risk of blood clots compared to their counterparts with conventional lenses. This is especially notable because cancer patients have nine times the risk of blood clots of non-cancer patients.
The recently published study indicates that the optic pathway is key – light wavelength didn’t have any impact on blind mice, and shining light directly on blood also didn’t cause a change in clotting.
The mice exposed to red light also had increased fatty acid production, which reduces platelet activation. Since platelets are essential to forming clots, this naturally leads to less clot formation.
“These results are unraveling a fascinating mystery about how the light to which we’re exposed on a daily basis influences our body’s response to injury,” said senior author Matthew Neal, M.D., professor of surgery, Watson Fund in Surgery Chair and co-director of the Trauma and Transfusion Medicine Research Center at Pitt, and trauma surgeon at UPMC. “Our next steps are to figure out why, biologically, this is happening, and to test if exposing people at high risk for blood clots to more red light lowers that risk. Getting to the bottom of our discovery has the potential to massively reduce the number of deaths and disabilities caused by blood clots worldwide.”
Reference: Alterations in visible light exposure modulate platelet function and regulate thrombus formation, Andraska, Elizabeth A. et al. Journal of Thrombosis and Haemostasis, Volume 23, Issue 1, 123 - 138
Brain Structure Differences May Influence Disordered Eating in Young Adults: Study Finds
More than half of 23-year-olds in a European study show restrictive, emotional or uncontrolled eating behaviours, according to new research led by the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London. Structural brain differences appear to play a role in the development of these eating habits.
The study, published in Nature Mental Health, investigates the links between genetics, brain structure and disordered eating behaviours in young people. Researchers found that the process of ‘brain maturation’, whereby the volume and thickness of the cortex (the outer layer of the brain) decreases during adolescence, is a factor in whether teenagers develop restrictive or emotional/uncontrolled eating behaviours in young adulthood.
The researchers analysed data from 996 adolescents in the IMAGEN longitudinal cohort in England, Ireland, France and Germany. Participants provided genetic data, completed questionnaires about their wellbeing and eating behaviours, and had an MRI scan at ages 14 and 23. At age 23, participants were categorised into three types of eating behaviours: healthy eaters (42 per cent), restrictive eaters (33 per cent) and emotional or uncontrolled eaters (25 per cent).
The study found that the three groups had different patterns of mental health and behaviour over time.
Young people with unhealthy eating behaviours at age 23 had higher levels of both internalising problems (for example, anxiety or depression) and externalising problems (for example, hyperactivity, inattention or conduct problems) at age 14, compared to healthy eaters. Internalising problems significantly increased with age between 14 to 23 among unhealthy eaters. Although externalising problems decreased with age in all groups, overall levels were higher among those with emotional or uncontrolled eating.
Restrictive eaters dieted more throughout adolescence compared to healthy eaters. Emotional/uncontrolled eaters increased their dieting between ages 14 to 16 and binge eating between ages 14 to 19, compared to healthy eaters. Unhealthy eating behaviours were linked with obesity and increased genetic risk for high BMI.
Results also indicated that brain maturation was delayed and less pronounced in unhealthy eaters. In particular, reduced maturation of the cerebellum – a brain region that controls appetite – helped explain the link between genetic risk for high BMI and restrictive eating behaviours at age 23.
Reference: Yu, X., Zhang, Z., Herle, M. et al. Relationships of eating behaviors with psychopathology, brain maturation and genetic risk for obesity in an adolescent cohort study. Nat. Mental Health 3, 58–70 (2025). https://doi.org/10.1038/s44220-024-00354-7
Clinical Trial Shows New Tablet Safe and More Effective for Elimination of Intestinal Worms
A new tablet combining albendazole and ivermectin is safe and more effective than albendazole alone in treating Trichuris trichiura and other soil-transmitted helminths (STH), according to a clinical trial conducted by the STOP consortium. The findings, published in The Lancet Infectious Diseases, open opportunities to improve the control of these neglected tropical infections, which affect around 1.5 billion people worldwide.
“This fixed-dose co-formulation (FDC) has several advantages. It is easy to administer, as it is one single pill and does not require dose adjustments based on the child’s weight,” explains project leader Jose Muñoz, ISGlobal researcher and Head of the International Health Service at Hospital Clinic Barcelona. “Also, we hope that combining two drugs with different mechanisms of action will reduce the risk of the parasites becoming drug-resistant,” he adds.
The ALIVE clinical trial tested the safety and efficacy of the FDC in school-aged children infected with T. trichiura, hookworms, S. stercoralis or a combination. The children were randomly divided into three treatment groups: group 1 received a single dose of albendazole; group 2 received one dose of the FDC (FDCx1); and group 3 received three doses of the FDC (FDCx3) over three consecutive days.
Phase 2 of the trial focused on safety. A small number of participants were recruited and treated sequentially according to weight, to monitor any adverse effects caused by higher-than-usual doses of ivermectin (above 200 µg/ml). No serious adverse effects were observed, and side effects were similar to those in the albendazole group. This allowed the trial to proceed to phase 3, where efficacy was assessed in a much larger number of participants, alongside continued safety monitoring. Treatment efficacy was assessed based on cure rates (absence of eggs in stool samples post-treatment) and reduction in the number of eggs in stool compared to before the treatment. Although most infections were classified as light, both FDC regimens achieved higher egg reduction rates than albendazole alone.
Reference: Albendazole–ivermectin co-formulation for the treatment of Trichuris trichiura and other soil-transmitted helminths: a randomised phase 2/3 trial, Krolewiecki, AlejandroKrolewiecki, Alejandro et al. The Lancet Infectious Diseases, Volume 0, Issue 0
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