Staying #Up2Date 🚨

1. Breast density and breast cancer (BCa) 

In this retrospective cohort study of 1.7 million women aged 40+, 5 breast density groups were identified: fatty breast tissue (group 1), fatty breast tissue increasing in breast density over time (group 2), and dense breast tissue with slight decrease in density over time (groups 3-5). Women in groups 2-5 had increased risk of BCa compared to group 1; group 2 had a 1.6-fold increased risk of BCa and adjusted hazard ratios (HRs) for group 3-5 were 1.86, 2.49, and 2.07, respectively, suggesting that breast density changes may be important for breast cancer risk stratification.

2. Palliative care in the emergency department (ED)

In this RCT of ~100K older adults with serious, life-limiting illness, a multicomponent palliative care intervention was implemented in the ED. It consisted of evidence-based multidisciplinary education, simulation-based workshops on serious illness communication, clinical decision support, and audit/feedback for ED clinical staff. However, the results did not yield statistically significant differences in hospital nor ICU admission, ED revisits, hospice use, home health care, hospital readmissions, or short-term mortality. 

3. Air pollution and venous thromboembolism (VTE)

This longitudinal study of 6,651 participants, aged 45-84, found that higher chronic exposure to fine particulate matter (PM2.5), nitrogen dioxide (NO2), and nitrogen oxides (NOx) was associated with an increased risk of developing VTE. For each 3.6 µg/m³ increase in PM2.5, the HR for VTE was 1.39; for each 13.3 ppb increase in NO2, the HR was 2.74; and for each 30 ppb increase in NOx, the HR was 2.21. No significant association was found with ozone (O3).

Move Aside, BMI 𐄷

Is BMI testing a thing of the past? Experts weigh in.

What happened: 58 international experts and folks living with clinical obesity recently proposed a new definition and diagnostic criteria for the condition. 

Why it’s interesting: For years, obesity has been categorized by BMI – a weight-to-height ratio that doesn’t distinguish between fat and lean mass, which has led to widespread misdiagnoses. The report redefines clinical obesity as a chronic disease linked with reduced organ function. The new criteria includes individuals who have a hard time bathing, dressing, or using the bathroom.

With an estimated 1 billion people worldwide living with obesity, experts hope the new definition will reduce weight-based stigma. They hope to improve care, too, endorsing treatments aligned with diet, exercise, and obesity medications. Under the new criteria, about 20% of people previously considered obese now aren’t, while another 20% with serious health conditions but low BMI now qualify. 

Yes, but: physicians haven't aligned around a standardized method of measuring excess adiposity, and variations could cause people to also fall through the cracks.

We're also not sure that the goal of reducing stigma is possible just by redefining obesity, as one nutrition expert points out. Lastly, there’s also a risk that framing obesity as a medical problem might shift focus from personal responsibility and lifestyle choices.

Bottom line: Obesity is a complex condition. Critics raise valid concerns, but authors of the report are optimistic their redefinition will give public health practices better tools to support patients dealing with obesity. 

Hot Off The Press

1: 🐓 All poultry activities have been put to a halt in Georgia after bird flu was found in a commercial poultry operation. The poultry business is Georgia’s number one industry and agriculture officials say they are working hard to limit the spread of the disease, and hope to return to normal as quickly as possible.

2: 💨 The FDA have given the green light to 10 nicotine pouch flavors. The company, Zyn, is the first one regulators have approved as the demand for the pouches grows. The product works like any other smoking alternative by releasing low levels of nicotine that are absorbed into the gums to help reduce cravings. Officials note that while Zyn isn’t the safest option when choosing to quit, but they are less harmful than older alternatives.

3: 😷 COVID disrupted more than just our hospital wards — it also set back our battle against antimicrobial resistance. A new report finds AMR-related infections and deaths spiked during the pandemic — a 15% rise in drug-resistant infections in just the first year — thanks to overuse of antibiotics and overwhelmed healthcare systems. A reminder that AMR is a priority, especially in times of crisis.

4: 💊 And… speaking of antibiotics — Here’s a twist on the usual antibiotic prescription advice... A recent study shows: longer courses of antibiotics don’t offer any added benefit — or harm. Researchers found no difference in outcomes between short (3-7 days) and long (8-14 days) regimens, reinforcing that shorter durations remain the optimal choice for infection treatment.

Notable Numbers 🔢

4318: the number of study participants who confirmed what many of us suspected: late-night video watching boosts the risk of hypertension in younger adults. The higher the hours, the higher the risk. Using a tested risk model, we can predict hypertension risk more precisely, factoring in screen habits and other lifestyle issues that need addressing. Thankfully, we’ve got a reliable nomogram to predict hypertension risk more accurately — taking into account other critical lifestyle contributors needing intervention.

$537 billion: the projected global cost of mental disorders due to climate, pollution, and environment-related causes. Extreme weather is intensifying, and so is PTSD, anxiety, and depression — especially in vulnerable regions. Only 3% of countries mention mental health in their climate action plans. And, as research on the “planetary health–mental health nexus” shows, ignoring one exacerbates the other.

74: the number of studies pulled for a new meta-analysis in JAMA Pediatrics that suggests fluoride might lower IQ in kids… but the findings are murky. 52 of those 74 were rated as high-risk for bias, so it’s hard to take the results at face value — especially with political figures like RFK Jr. taking a strong stance against fluoridation.

Postcall Picks

💗 Attend: the HerHealth Oncology Conference from March 1st-2nd in Florida! Join hundreds of researchers and health care professionals as they discuss the challenges of cancer care in women.

🤑 Save: still sticking to those New Years resolutions? Asics’ got you covered with 30% athletic footwear

🤣 Laugh: at how often things come up in adult life vs. how often you expect them to (source: xkcd).

Relax

First Question: A false belief or symptoms of pregnancy (without being pregnant).

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