Top Medical Bulletin 27/May/2022

Here are the top medical stories for today:

 Long-term breastfeeding protects against childhood asthma 

A cohort study results published in Annals of Allergy, Asthma & Immunology showed that Longer duration of exclusive breastfeeding have a protective association with child asthma. Postnatal exposures, including breastfeeding, may influence asthma development.

Morbidity of childhood asthma accounts for up to 50% of asthma emergency visits. Although much progress has been made in terms to control asthma, there is still no cure for asthma and little is known about how to prevent it. Over the years, it has become evident that factors in early life, play important role in a child's susceptibility to developing asthma.

The study included 2,021 mother-child dyads and it aimed to investigate the association between breastfeeding duration and child asthma. Authors developed questionnaires asking mothers about durations of exclusive breastfeeding.

It was found that 16% of the children had current wheeze, 12% had asthma and 9% had strict current asthma. There found to be a duration-dependent protective association between exclusive breastfeeding and child asthma outcomes.

The researchers concluded that their findings provide evidence of protective associations between exclusive breastfeeding continued for longer durations and child asthma outcomes.

 Computer assisted colonoscopy More effective than traditional colonoscopy 

Colonoscopies performed with computer-aided detection, or artificial intelligence, (AI) saw an increase in the overall rate of detection of adenoma, or cancerous and precancerous polyps, by 27 percent in average-risk patients. This is in accordance to new data presented at the Digestive Disease Week Annual Meeting.

The results of the prospective, randomized, multicenter study published online in the journal Gastroenterology, found that when artificial intelligence was used during a screening colonoscopy, the adenoma per colonoscopy rate increased significantly by 22%, from .82 to 1.05. The research further suggests that artificial intelligence can be an efficient tool for gastroenterologists and endoscopists to incorporate into their procedures to reduce the number of polyps missed and left behind in the colon, many of which can be precancerous. 

The study used 22 skilled, board-certified gastroenterologists performed colonoscopies on 1,440 patients, who were randomized to receive either a standard colonoscopy or a colonoscopy using computer-aided detection software. All patients included in the study were over the age of 40. A total of 677 patients were randomized to the standard arm and 682 into the computer-aided arm. The number of polyps found using a computer-aided colonoscope was 1.05 compared to 0.82 and there was no decrease in the true histology rate indicating the polyps of concern were all removed.

Researchers concluded that the findings add to the growing amount of literature that shows using computer-aided technology during an endoscopy procedure can improve the quality of exams performed and improve outcomes for patients.

Common diabetes drug effective against early-stage breast cancer?     

according to new findings, a widely used and inexpensive Type 2 diabetes drug, once hoped to hold enormous promise in treating breast cancer, does not prevent or stop the spread of the most common forms of the disease.

The randomized, double-blind trial enrolled patients who were treated with two pills a day of either placebo or the diabetes drug metformin. Overall, researchers found the addition of metformin to standard breast cancer treatments did not improve outcomes in the two most common types of breast cancer, hormone receptor-positive or negative. The findings were published in the Journal of the American Medical Association.

While metformin was found not to be effective in treating the most common forms of breast cancer, the trial found a potentially important result for individuals with a less common but aggressive form of the disease, called HER2-positive breast cancer. For the subtype of breast cancer, researchers found there was evidence that use of metformin for five years might lead to a reduction in deaths. HER2-positive cancer makes up about 20 per cent of all breast cancers.

Metformin is not beneficial for use in most common breast cancers, but in the cases of HER2-positive breast cancer, these findings suggest it may be beneficial.

 Artificial Intelligence Helps predict lung cancer risk     

As per a new study published in the journal Radiology, an artificial intelligence (AI) tool helps doctors predict the cancer risk in lung nodules seen on CT.

Pulmonary nodules appear as small spots on the lungs on chest imaging. They have become a much more common finding as CT has gained favor over X-rays for chest imaging.

In the study, six radiologists and six pulmonologists made estimates of malignancy risk for nodules using CT imaging data alone. They also made management recommendations such as CT surveillance or a diagnostic procedure for each case without and with the artificial intelligence tool. A total of 300 chest CTs of indeterminant pulmonary nodules were used in the study. The researchers defined indeterminant nodules. Analysis showed that use of the AI tool improved estimation of nodule malignancy risk on chest CT.

malignant or benign lesions are usually judged with a reasonable level of accuracy based on imaging itself, but when you combine their clinical interpretation with the artificial intelligence algorithm, the accuracy level improves significantly. The level of improvement suggests that this tool has the potential to change how we judge cancer and hopefully improve how patients can be managed.