Medical Bulletin 1/June/2023

Here are the top medical news for the day:

Extended lymph node removal not beneficial for patients with clinically localized muscle-invasive bladder cancer

An extended lymphadenectomy removal of additional lymph nodes beyond the extent of the standard procedure - in patients undergoing radical cystectomy (removal of bladder and nearby tissues) because of clinically localized muscle-invasive bladder cancer provides no patient benefit as measured by disease-free survival or overall survival times. It does, however, increase the risk of adverse events (side effects) and post-surgical death.

Once cancer invades the muscle of the bladder, it can also get into the blood and lymphatic system and can lodge in the lymph nodes. In about one-quarter of patients with muscle-invasive bladder cancer, the disease has already spread to regional lymph nodes. For this reason, after removing the bladder in these patients, surgeons will also remove all of the lymph nodes in the primary landing zone from around the bladder. Removing those lymph nodes - known as a lymphadenectomy - significantly reduces the chances of the cancer returning within the pelvis.

Reference:

SWOG CANCER RESEARCH NETWORK,MEETING American Society of Clinical Oncology Annual Meeting

Lung infection could be less transmissible than thought

Recent research found that various strains of the bacterium, Mycobacterium abscessus, were genetically similar, stoking fears that it was spreading from person to person.

But a new study by Harvard Medical School researchers published May 22 in PNAS, calls those findings into question, offering an alternative explanation behind the genetic similarity of clinical clusters. This suggests that the pathogen may not be that prone to person-to-person transmission after all. The team set out to investigate a hypothesis that the samples appeared genetically similar because the pathogen was evolving at a very slow rate.

Reference:

Mutation rates and adaptive variation among the clinically dominant clusters of Mycobacterium abscessus,Proceedings of the National Academy of Sciences,DOI 10.1073/pnas.2302033120

Ketamine nasal spray for refractory migraine may prove safe and effective

Ketamine taken in the form of a nasal spray may prove a safe and effective treatment for refractory chronic migraine, suggests a single centre study, published in the open access journal Regional Anesthesia & Pain Medicine.

The researchers retrospectively reviewed the outcomes and experiences of people given nasal ketamine spray for chronic refractory migraine between January and February 2020 at one single specialist headache centre.

Reference:

Real-world study of intranasal ketamine for use in patients with refractory chronic migraine: a retrospective analysis,Regional Anesthesia and Pain Medicine,DOI: 10.1136/rapm-2022-104223