Medical Bulletin 21/February/2024

Here are the top medical news highlights for the day:

Remission of Cushing's disease increases the risk of autoimmune disease

A cohort study of more than 250 patients undergoing surgical therapy for Cushing’s disease (CD) or nonfunctioning pituitary adenomas (NFPAs) revealed that patients who achieved remission of CD were more likely to develop new-onset autoimmune disease within 3 years after remission, than those with surgically treated NFPAs. The study is published in Annals of Internal Medicine.

Cushing's disease occurs when a tumor in the pituitary gland produces excess ACTH hormone, leading to high levels of cortisol in the body. Surgery to remove the tumor, called transsphenoidal surgery, is usually the first treatment. After surgery, when the tumor is gone, the body might not make enough cortisol, causing adrenal insufficiency. While the symptoms of excessive cortisol usually get better over time, some people may experience withdrawal symptoms when Cushing's disease goes into remission.

Reference: David A. Savitz, PhD; Lauren A. Wise, MSc, ScD; Julia C. Bond, MPH; Elizabeth E. Hatch, MS, PhD; Collette N. Ncube, DrPH, MPH, MS; Amelia K. Wesselink, PhD; Mary D. Willis, PhD, MPH; Jennifer J. Yland, PhD; Kenneth J. Rothman, DrPH DOI: 10.7326/M23-2024

Exploring the connection between sleep, body clock and mental health

According to a new research, problems with our sleep and internal body clock can trigger or worsen a range of psychiatric disorders.

The review, published on 19 February 2024 in Proceedings of the National Academy of Sciences (PNAS), suggests gaining a better understanding of the relationship between sleep, circadian rhythms and mental health could unlock new holistic treatments to alleviate mental health problems.

“Sleep-circadian disturbances are the rule, rather than the exception, across every category of psychiatric disorders,” says Dr Sarah L. Chellappa from the University of Southampton and senior author of the review. “Sleep disturbances, such as insomnia, are well understood in the development and maintenance of psychiatric disorders, but our understanding of circadian disturbances lags behind.”

Reference: DOI: 10.1073/pnas.2214756121

FDA approves first-ever medication for severe frostbite treatment

The U.S. Food and Drug Administration (FDA) has approved Aurlumyn (iloprost) injection for treating severe frostbite in adults, aiming to decrease the risk of finger or toe amputation.

Frostbite can occur in several stages, ranging from mild frostbite that does not require medical intervention and does not cause permanent skin damage, to severe frostbite when both the skin and underlying tissue are frozen and blood flow is stopped, sometimes requiring amputation.

Iloprost, the active ingredient in Aurlumyn, is a vasodilator (a drug that opens blood vessels) and prevents blood from clotting implying that it is beneficial in reducing blood pressure and improving blood flow to frozen fingers and toes. It a synthetic analogue of prostacyclin and was first developed by researchers seeking a treatment for vascular disorders and was initially investigated for its vasodilatory properties and potential therapeutic benefits in conditions such as pulmonary hypertension and peripheral vascular disease.