Welcome to the 2 Minute Medicine Podcast, summarizing the latest medical studies, curated and written by practicing physicians. On this podcast, twice a month, we cover the latest in healthcare news and research evidence.
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We begin this episode by discussing our article of the week from the New England Journal of Medicine, entitled ““Increasing Prevalence of Artemisinin-Resistant HRP2-Negative Malaria in Eritrea.”
In the second half of our episode, we begin by taking a closer look at the public heath crisis in Gaza. Next, we discuss a recently published study in JAMA, and examine the possible link between ADHD and Dementia. Last but not least, a short discussion about the significance of October being National Pregnancy and Infant Loss Awareness Month.
We are excited to share that the highly anticipated 2nd edition of our Classics in Medicine book is now available in stores and on Amazon! Buy your copy today at: https://bit.ly/2zZnJt9
[Deepti] Welcome to the 2 Minute Medicine Podcast, summarizing the latest medical studies, curated and written by practicing physicians.
For our full suite of daily medical study summaries and updates written by practicing doctors, please visit our website at 2minutemedicine.com to start reading new daily content right now, for free. On this podcast, twice a month, we cover the latest in health care news and research evidence. We are your hosts Deepti and Andrew. On today’s episode, we’ll start off by discussing our two articles of the week. In the second half of the episode, we will look at health issues that have arisen in popular media.
[Andrew] Our article of the week comes from The New England Journal of Medicine and is entitled “Increasing Prevalence of Artemisinin-Resistant HRP2-Negative Malaria in Eritrea.”
Malaria affects communities worldwide, significantly impacting low- and middle-income regions. Artemisinin-based combination therapies are first-line for uncomplicated P. falciparum infections. However, partial artemisinin resistance has emerged in Asia and Africa, resulting in delayed clearance or persistence of parasites following therapy. The fundamental mechanisms of resistance involve mutations in the Pfkelch13 gene. The current study reported results of efficacy studies from 2016 to 2019 at five sites in Eritrea to measure day-three positivity after completing artemisinin-based therapy for uncomplicated P. falciparum malaria. The current study analyzed the results from three open-label, single-group clinical drug efficacy studies to evaluate the partial resistance of P. falciparum to artemisinin in Eritrea. Partial resistance was defined as day-three positivity after artesunate-amodiaquine or artemether-lumefantrine therapy completion. Patients six months or older with uncomplicated P. falciparum, measurable parasitemia, and fever were eligible for inclusion. Exclusion criteria included signs of complicated malaria, infection with another Plasmodium species, severe malnutrition, fever due to another cause, and pregnancy. A total of 852 patients were enrolled. It was found that the percentage of patients with day-three positivity increased from 0.4% in 2016 to 1.95% in 2017 and 4.2% in 2019.
The percentage of patients with positive parasitemia on day three increased steadily during this period. R622I substitution in the Pfkelch13 gene was associated with a greater risk of resistance. Additionally, a proportion of parasites carrying Pfkelch13 R622I mutation also had deletions in hrp2 and hrp3 genes, which could potentially render them undetectable by current HRP-2 rapid tests. Overall, these results indicate that partial artemisinin resistance, underpinned by Pfkelch13 R611I mutation, has emerged in P. falciparum parasites in Eritrea. Furthermore, hrp2 and hrp3 deletions in these lineages could affect their detection with existing rapid tests.
[Deepti] We are excited to share with you that the 2nd edition of The Classics by @2minmed has just been released!
This book is a collection of landmark trials that have shaped medical practice in recent decades, summarized and curated by practicing physicians. There is even a dedicated section on #Covid_19! Purchase your copy on Amazon today! bit.ly/2zZnJt9
[Deepti] Now for The Scan. First, lets take a look at the Crisis in Gaza
You may have been following the news covering the dire situation in the Gaza Strip. Equally important, is the severe public health crisis that this population is experiencing. Power is limited and essential supplies, including food, and medicine are hard to come by. Alongside the war, countless lives are being lost each day due to infection, malnutrition, dehydration, and lack of access to medical care. Without access to clean water, people have been forced to drink seawater or contaminated water containing sewage or chemicals, leading to higher chances for outbreaks such as cholera and dysentery. Moreover, hospitals in Gaza have been targeted, such as the Ahli Arab hospital on October 17, which led to 500 deaths. Other hospitals such as the Shifa hospital have had nearly 35,000 people seeking shelter in them, making it a perfect environment for infectious diseases to spread.
[Andrew] Next, lets take a closer look at ADHD and Dementia; is there a link?
A recently published study in JAMA suggests that there could be a link between attention deficient hyperactivity disorder (ADHD) and dementia. Approximately 5% of adults have ADHD, means of the United States alone, this would represent more than 11 million people. Contrary to popular belief, ADHD is not limited to children, there is no cure, and most are unable to outgrow the condition. Briefly, the study followed over 100,000 participants with or without ADHD for up to 17.2 years. The results highlighted that adults with ADHD seemed to have an increased risk of dementia later in life. Some have pointed out that one possibility leading to this outcome could be that ADHD and dementia share similar genetic causes. Others speculate that both may have similar risk factors, such as diabetes, high blood pressure, or lack of physical exercise – which are important both for good systemic health, but also cognitive health. Last but not least, a conversation about abortion, pregnancy and infant loss, and more.
[Deepti] Recently, Britney Spears shared her experience of undergoing an abortion while dating Justin Timberlake. The story is part of her upcoming memoir called “the woman in me”, following her release from a legal conservatorship that lasted more than 13 years. We have covered the topic of abortion in previous issues such as this one from 4-1-2023 and this one from 10-2-2023. According to the world health organization (WHO), every year, nearly 121,000,000 pregnancies are unintended and 60% of these end in induced abortions. Furthermore, October is national pregnancy and infant loss awareness month. You may be surprised to learn that one and four women experience pregnancy and infant loss. This led the NIH to launch an initiative, called the Implementing Maternal Health and Pregnancy Outcomes Vision for Everyone, which aims to improve and reduce health disparities among women. If you know somebody who has been affected by pregnancy or infant loss, this resource as well as march of dimes, can be helpful to reference.
[Andrew] Thank you for joining us today for this episode of the 2 Minute Medicine Podcast. New episodes come out every other week and all of our content has been curated and written by practicing physicians. We’d like to thank Benjamin Lam and Kiera Liblik.
Please head to our website at 2minutemedicine.com to learn more and to access all of our content including medical study summaries, visual abstracts, excerpts from our Classics book series which is available on Amazon, and The Scan, which is our medical newsletter.
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