Latest news with #medicalstudy
CTV News
2 days ago
- Health
- CTV News
Canadians with Down syndrome living longer: study
Winnipeg Watch A new study into the mortality rate of people living with Down syndrome leads MedicalWatch for July 17, 2025.
Medscape
10-07-2025
- Health
- Medscape
Do UTIs Trigger Heart Attacks or Strokes?
TOPLINE: Microbiologically confirmed urinary tract infections (UTIs) raised the risk for cardiovascular events such as heart attack and stroke, with both risks peaking in the first 7 days. The risks for heart attack and stroke rose again from 15 to 28 days and 29 to 90 days after the infection, respectively. METHODOLOGY: Researchers in the UK conducted a self-controlled case series analysis to estimate associations between microbiologically confirmed UTIs and the risk for the first acute myocardial infarction (MI) and stroke. They included Welsh residents aged 30 years or older who experienced a first MI (n = 2320) or stroke (n = 2840) along with microbiologically confirmed UTIs between 2010 and 2020. A UTI counted as new only if at least 7 days passed since a previous episode, and UTIs within 7 days were counted as the same episode. The risks for MI and stroke among individuals with a UTI were assessed during a 7-day prerisk period before diagnosis — to capture infections that began prior to consultation — and at 1-7, 8-14, 15-28, and 29-90 days after the infection. The risks measured in these predefined windows were then compared with each patient's risk for stroke or MI at baseline. TAKEAWAY: The risk for MI was elevated in the first 7 days following a UTI (incidence rate ratio [IRR], 2.49; 95% CI, 1.65-3.77) and again during days 15-28 after the infection (IRR, 1.60; 95% CI, 1.10-2.33). Similarly, the risk for stroke was elevated in the first 7 days (IRR, 2.34; 95% CI, 1.61-3.40) and during days 29-90 (IRR, 1.26; 95% CI, 1.05-1.52) after an UTI. Among individuals with a clinically suspected UTI, the adjusted IRR for MI within the first 7 days was 1.26 (95% CI, 0.52-3.05) in those with mixed bacterial growth on culture, 1.83 (95% CI, 1.54-2.18) in those without a urine culture, and 3.69 (95% CI, 2.28-5.96) in those with no bacterial growth on culture; the risk for stroke was also elevated in all these instances. Compared with infections by other bacteria, Escherichia coli infections carried a lower risk for MI but a higher risk for stroke. IN PRACTICE: "We observed an increased risk of MI and stroke immediately following a UTI," the authors wrote. SOURCE: This study was led by Nicola F. Reeve, Cardiff University, Cardiff, Wales. It was published online on June 30, 2025, in BMJ Open. LIMITATIONS: The precise date of the onset of UTI was unknown, and only the date of diagnosis was recorded. Additionally, the study may have missed UTIs for which people did not seek medical care or those unrecorded in the Welsh Results Reporting Service prior to 2015. The use of routine data also meant that outcome ascertainment relied on accurate coding. DISCLOSURES: This study was supported by a grant from the British Heart Foundation. One author declared being a member of the Statistical Advisory Board for BMJ Open. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
10-07-2025
- Health
- Medscape
Are IV Proton Pump Inhibitors Overused in Upper GI Bleeding?
TOPLINE: Nearly 70% of patients with acute upper gastrointestinal (GI) bleeding and low-risk or no peptic ulcer disease received intravenous (IV) proton pump inhibitors (PPIs) inappropriately, leading to longer hospital stays. METHODOLOGY: Current guidelines recommend transitioning from IV to oral PPIs after esophagogastroduodenoscopy (EGD) if no high-risk stigmata are found and stopping PPIs in patients with upper GI bleeding from causes other than peptic ulcer disease. Researchers conducted a retrospective cohort study of patients hospitalized for acute upper GI bleeding between January 2014 and December 2019. All patients were started on continuous or intermittent IV PPI and underwent EGD that showed a gastric or duodenal ulcer with low-risk signs or lesions unrelated to ulcer disease. Inappropriate use was defined as any continuous IV PPI infusion lasting more than 4 hours after EGD or any intermittent dose administered after the procedure. TAKEAWAY: Researchers analyzed 253 patients (mean age, 62 years; 57% women; 35% White/Caucasian), of whom only 79 (31%) received appropriate PPI therapy, whereas 174 (69%) received it inappropriately (55 on continuous IV PPI infusion and 119 receiving excess intermittent doses). Patients with peptic ulcer disease with low-risk stigmata received an average of five excess IV PPI doses, and those on continuous infusions received an average of 41 additional hours of treatment. Among patients with lesions unrelated to peptic ulcer disease or with no lesions at all, those receiving twice daily IV PPI dosing averaged six extra doses, and those on continuous infusion received an average of 34 additional hours of therapy. At baseline, hemoglobin levels were slightly lower in the inappropriate therapy group than in the appropriate group (7.9 vs 8.7 g/dL). Patients receiving appropriate therapy had a shorter hospital stay than those receiving inappropriate therapy (4 vs 7 days; P = .001). IN PRACTICE: 'We believe that educating practitioners on the appropriate use of PPI therapy in the context of the endoscopic lesion that was believed to have caused bleeding is a critically important next step,' the authors wrote. SOURCE: This study was led by Michael M. Sutton, MD, University of Oklahoma Health Sciences Center, Oklahoma City. It was published online in the Journal of Clinical Gastroenterology. LIMITATIONS: The retrospective design may have introduced biases, such as ascertainment bias, as verbal recommendations for discontinuing IV PPI therapy might not have been documented. The single-center setting limits the generalizability of the findings. DISCLOSURES: This study was supported in part by grants from the National Institutes of Health — the National Institute of Diabetes and Digestive and Kidney Disease, the National Institute of General Medical Sciences, and the National Center for Advancing Translational Sciences. The authors reported having no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
