Medical Bulletin 20/December/2022

A team of researchers from China, Taiwan and Australia aimed to determine whether metformin use was associated with a lower risk of TKR or THR as evidence to date has been sparse and inconclusive. They analyzed data from 69 706 participants who received a diagnosis of type 2 diabetes in Taiwan between 2000 and 2012 and compared the risk of TKR and/or THR between people taking metformin and those not taking metformin. The mean age was 63 years and half were women. About 90% of total joint replacements were related to osteoarthritis.

Osteoarthritis is a common chronic condition that usually causes joint pain and can be severe enough to require knee and hip replacements. In the United States, the number of total knee replacement (TKR) and total hip replacement (THR) surgeries is estimated to reach 572 000 per year by 2030. No medications are currently known to prevent or reverse osteoarthritis.

Reference:

Dr. Changhai Ding et al, Metformin use and associated risk of total joint replacement in patients with type 2 diabetes: a population-based matched cohort study, Canadian Medical Association Journal, DOI 10.1503/cmaj.220952

FDA approval to targeted imaging agent pafolacianine for use in lung cancer surgery

More than 130,000 Americans die of lung cancer each year, making lung cancer the leading cause of cancer mortality in the country. Lung cancer mortality is high largely because it tends to be diagnosed at later stages when the tumor has begun to spread. About 20 percent of cases, or roughly 50,000 per year, are localized enough to be treated surgically, in the hope of a cure. But even with surgery there is a high chance of recurrence, which implies that standard visual and tactile inspection often fails to detect all cancerous tissue.

The U.S. Food and Drug Administration (FDA) has approved the targeted imaging agent Cytalux (pafolacianine) for use in lung cancer surgery. This injectable diagnostic binds to cancerous tissue and glows when stimulated by near-infrared light, making it easier for surgeons to remove tumors completely while sparing healthy tissue.

Reference:

Sunil Singhal et al, UNIVERSITY OF PENNSYLVANIA SCHOOL OF MEDICINE

Higher levels of diet-associated gut microbe-produced metabolite increased heart failure risk: Study

Elevated levels of phenylacetylglutamine (PAG) - a byproduct created when microbes in the gut breakdown dietary protein - can be directly linked to both increased heart failure risk and severity, according to findings published in Circulation: Heart Failure.

New research at Cleveland Clinic expands the link between what we eat and how the gut microbiome impacts our susceptibility to develop different diseases - in this case, how a specific gut microbe-generated byproduct is linked to heart failure risk.

Reference:

Kymberleigh A. Romano el at, Gut microbiota-generated phenylacetylglutamine and heart failure, Circulation: Heart Failure, doi.org/10.1161/CIRCHEARTFAILURE.122.009972