Migrant children face fear and lack safety crossing Mexico |
REUTERS/Jose Luis Gonzalez |
Migrant children crossing Mexico in hopes of reaching the United States, fleeing danger at home, face alarming levels of violence, exclusion and uncertainty before, during and after their journey, according to Save the Children and Plan International. | |
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Electrical pulses to duodenum improve type 2 diabetes |
High-voltage electrical pulses to the upper region of the small intestine in a minimally invasive procedure can significantly improve type 2 diabetes, researchers reported at the Digestive Disease Week meeting. The magnitude of improvement is comparable to the diabetes benefits seen with gastric bypass weight loss surgery, particularly in patients who receive the highest-dose electrical pulses, the researchers said. "This first-of-its-kind study demonstrates that non-thermal pulsed electric field energy treatment of the duodenum can significantly and durably improve... insulin resistance and beta cell function," the main body processes involved in type 2 diabetes, Dr. Richard Pratley of the AdventHealth Diabetes Institute in Orlando, Florida, who worked on the study, said in a statement. As nutrients move from the stomach into the small intestine, the cells of the duodenum play a crucial role in glucose regulation. Typically in type 2 diabetes, the duodenum is inflamed and dysfunctional. Delivery of the electric pulses triggers the body to regenerate healthy cells that can help control blood sugar levels. The 51 mostly overweight or obese patients with type 2 diabetes who participated in the trial of the Endogenex Pulsed Electric Field System known as ReCET, showed significant improvements in insulin sensitivity and pancreas beta cell function at 12 weeks, with improvements persisting at 48 weeks, the researchers reported. Patients also had significant improvements in blood sugar control and body weight. The researchers are now testing the procedure in a pivotal trial in overweight individuals with type 2 diabetes inadequately controlled by non-insulin glucose-lowering medications. While the current studies are looking at blood sugar control and weight loss, study leader Dr. Barham Abu Dayyeh of Cedars-Sinai in Los Angeles said the treatment is likely to also work for type 2 diabetes in patients who are not overweight. "We believe any patient who has type 2 diabetes, is struggling to maintain control of their disease, and is progressing toward (needing multiple diabetes medications) or insulin will be target candidates," he said. |
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Procedure for preventing pancreatitis doesn't work |
A common surgery done to prevent pancreatitis does not actually work, a new study has found. About one in 10 people are born with a condition called pancreas divisum, in which pancreas ducts fail to fuse properly. While often asymptomatic, it can sometimes be a factor in recurrent pancreatitis, a serious and painful condition. Retrospective studies have suggested that a minimally invasive surgery called endoscopic retrograde cholangiopancreatography (ERCP) with minor papilla endoscopic sphincterotomy (miES) eases acute pancreatitis in 50% to 70% of such patients. However, ERCP itself can cause acute pancreatitis in 10%-20% of patients and may instigate other issues later, such as scarring of the pancreas opening, which may lead to other symptoms, study leader Dr. Gregory Cote of Oregon Health & Science University said in a statement. Despite the known risks of the procedure, until now there have been no trials comparing miES to a sham procedure. At the Digestive Disease Week meeting, his team reported on 148 patients with pancreas divisum and an average of three previous episodes of pancreatitis who were randomly assigned to undergo miES or a sham procedure. During a median follow-up of 33.5 months, there was no statistically significant difference in the number of patients who had another bout of acute pancreatitis. There were also no differences in numbers of patients who reported pancreas-related pain more than a month after the procedure or who developed chronic pancreatitis, diabetes, or inadequate production of digestive enzymes by the pancreas. The findings are "actually quite extraordinary when you consider that many doctors have advocated for this procedure for decades," Cote said. "Guidelines currently recommend/acknowledge pancreas divisum as a risk factor for pancreatitis, and suggest ERCP as a treatment. These guidelines are likely to change based on this study," he said. He added that some patients with conditions such as a narrowing or blockages of the pancreatic duct might still benefit from ERCP. Patients with those conditions were not included in this study. |
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Vasectomy rarely fails, but check semen to be sure |
Vasectomy failure is very rare but happens more often than previously believed, researchers reported at the American Urology Association annual meeting in Las Vegas. They said a post-vasectomy semen analysis to ensure that sperm is not present should become routine. Reviewing nearly half a million vasectomies performed between 2007 and 2021, they found a post-vasectomy pregnancy rate of 2.26 for every 1,000 patients observed for one year after the procedure. Historically, the pregnancy rate had been roughly 1 in every 2,000 patients observed for a year. Vasectomy failure rates were highest during the first four months after the procedure, at 4.7 pregnancies per 1,000 per year. Pregnancy rates were lower in patients with older partners and when procedures had been performed more recently. After taking patients' risk factors into account, the researchers saw an increased risk of failure when the doctor performing the vasectomy was not a urologist, when the procedure was done in a doctor's office, or when a semen analysis was not performed after the procedure. |
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This newsletter was edited by Bill Berkrot; additional reporting by Shawana Alleyne-Morris. |
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