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spondyloarthritis (SpA), Diclofenac and Myocardial Infarction

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NEW YORK (Reuters Health) - Risk of myocardial infarction (MI) is increased in patients with spondyloarthritis (SpA) who use the nonsteroidal anti-inflammatory drug (NSAID) diclofenac but not in those who take naproxen, researchers say.

Dr. Maureen Dubreuil of Boston University School of Medicine and colleagues analyzed 20 years of medical records from the UK's Health Improvement Network for adults ages 18 to 89 with incident ankylosing spondylitis (AS) or psoriatic arthritis (PsA), two forms of SpA. Controls had incident osteoarthritis (OA).

Within each cohort, the team then matched each MI case to four controls without MI.

NSAID use was categorized as (a) current (prescription within 180 days prior to index date); (b) recent (181-365 days) or (c) remote (>365 days).

The daily dosage of diclofenac was 100 mg or more in 92% of individuals with OA, 95% of those with AS, and 92% of those with PsA. The most common daily dosage of naproxen was 1,000 mg (55%); the dose was 1,000…

Inflamation and Alzheimer disease

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A new study shows that microglia, which are the immune cells of the central nervous system, can "remember" inflammation. This "memory" influences how the cells react to new stimuli and deal with toxic plaque in the brain, a marker of Alzheimer's disease.

The brain's immune cells remember previous inflammation. Microglia, sometimes referred to as "scavenger" cells, "are the primary immune cells of the central nervous system."
As the key player in the brain's immunity, microglia are dispatched to the site of infection or injury, where they fight toxic agents or pathogens and get rid of useless cells.
However, these cells are also known to play a negative role in neurodegenerative disorders such as Alzheimer's disease, Parkinson's disease, ischemic stroke, and traumatic brain injuries.
For instance, a recent study showed that when microglia are overactive, they devour toxic plaques along with synapses, which presumably leads…

Once-Daily 'Male Pill' Shows Promise in Early Study

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CHICAGO, Illinois — An investigational oral synthetic androgen shows promise as a possible male contraceptive pill in a new month-long study.

Dose-finding and safety results of the trial in 82 healthy men were presented March 18 here ENDO 2018: The Endocrine Society Annual Meeting by Arthi Thirumalai, MBBS, acting assistant professor, University of Washington, Seattle.

"It only needs to be dosed once a day, and we didn't see any significant side effects, but it needs to be tested much longer. This is a very early phase," Study coauthor Stephanie Page, MD, PhD, professor of medicine at the university, told Medscape Medical News.

The agent, dimethandrolone undecanoate (DMAU), is a prodrug that is converted to dimethandrolone (DMA), which binds to both androgen and progesterone receptors. The long-chain fatty acid component undecanoate slows the drug's clearance, enabling the once-daily dosing.

During a press briefing, Page showed data from a multinational survey i…

The Council of the European Union has decided that the European Medicines Agency (EMA) will be relocated to the City of Amsterdam.

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The Council of the European Union has decided that the European Medicines Agency (EMA) will be relocated to the City of Amsterdam. The Dutch government proudly welcomes the Agency, its staff and their families to the Netherlands.

We are dedicated to safeguard the continuity of EMA’s important work for all European patients during and after its relocation. Our key objective is to ensure that the Agency can continue to function throughout the relocation process without disruption.

The Dutch government and the Amsterdam Metropolitan Area will begin to initiate the proposed transition activities immediately after the decision on relocation, in close cooperation with EMA.

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Inflammatory Bowel Disease an Independent Risk Factor for MI

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Patients with inflammatory bowel disease (IBD) are at significantly higher risk for myocardial infarction (MI), particularly younger patients and women, compared with the general population, new research suggests.

The study emphasizes the need for closer monitoring and aggressive attention to cardiovascular risk factors, say the researchers.

"Patients with IBD who present with any cardiovascular complaints, including chest pain or shortness of breath, should be thoroughly evaluated by their physicians for a potential heart condition," lead investigators, Muhammad Panhwar, MD, and Mahazarin Ginwalla, MD, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Ohio, advised in an email to theheart.org | Medscape Cardiology.

"Our hope is that this study prompts clinicians who care for IBD patients to start thinking about IBD as an additional risk factor for heart disease and to also screen them and treat their risk factors aggressively,&q…

Early-Onset Diabetes Increases Mortality Risk

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People who develop type 2 diabetes before the age of 40 are significantly more likely to die early than those diagnosed after 60, according to a new analysis.
The study adds weight to previous research that suggests early-onset diabetes may be a more aggressive form of the condition, say scientists. However, these findings have only included small groups of people.
The latest research drew on data from 2,706,820 people in England aged 20 and older diagnosed with type 2 diabetes after 2008 and included in the National Diabetes Audit. These individuals were cross-referenced with death register entries up to December 2015.

Risk Factors
Results showed that, after taking account of people's age and sex, individuals diagnosed with type 2 diabetes before the age of 40 were almost two-and-a-half times more likely to die early than those diagnosed after the age of 60.

They also showed that:
· People diagnosed before the age of 40 had higher body mass index (BMI) (33.5 compared with 2…

FDA Approves AliveCor Personal ECG Monitor for Apple Watch

The Food and Drug Administration has approved a wrist-worn version of the groundbreaking KardiaMobile from AliveCor, the company has announced. It's the next step in AliveCor's bid to do for the Apple Watch what it did for the iPhone: turn it into a single-channel ECG monitor.

The new AliveCor product, KardiaBand, is a wristband for the Apple Watch equipped with a sensor the user presses with a thumb. Via the company's Kardia mobile app, the ECG and heart rate are soon displayed on the watch's screen.

"This is a paradigm shift for cardiac care as well as an important advance in healthcare," Dr Ronald P Karlsberg (David Geffen School of Medicine, University of California, Los Angeles) is quoted as saying in the company announcement. "With an [ECG] device on the wrist, afib can be detected wherever the patient is, 24 hours a day." Users must subscribe to a $99/year service to use the KardiaBand system, the company notes in its announcement. That all…