Recent studies shed light on diabetes, mask efficacy, COPD treatment and Alzheimer’s disease

Keeping abreast of medical research and advances is an important part of a career in medicine, but it can be challenging to keep up with countless medical journals, new research studies and medical developments. We combed the latest research to find four studies that are relevant to many DOs and the work they do. See below for summaries and links to the original research.

“Daytime eating prevents internal circadian misalignment and glucose intolerance in night work,” Science Advances, Dec. 2021

This study shows that night shift workers are at an increased risk for diabetes. This is due to the central circadian clock being misaligned. Furthermore, behaviors that are typical in night workers can impair glucose tolerance, which is likely due to internal misalignment between central and peripheral circadian rhythms.

This study used a 14-day circadian paradigm and assessed glycemic control during simulated night work with either nighttime or daytime eating. It was shown that nighttime eating led to the misalignment of central and peripheral endogenous circadian rhythms.

Additionally, nighttime eating also led to an impaired glucose tolerance, while eating only during the daytime prevented it. These findings can offer night workers insight into preventing glucose intolerance. It’s particularly relevant to medical professionals, many of whom work nights and erratic shifts.

“Review: In health care settings, effectiveness of N95 respirators vs surgical masks for preventing respiratory viral illness was assessed,” Journal of the American College of Emergency Physicians Open, Oct. 2021

This study aimed to examine the results, level of evidence and methodologic quality of original studies regarding the effectiveness of surgical masks in minimizing viral respiratory illness transmission. In particular, the study examined the performance of N95 respirators versus surgical masks. Across eight studies with 9,164 participants, it was shown that N95 respirators were associated with fewer viral infections among health care workers.

Furthermore, the N95 respirator was most effective in reducing the risk of a viral infection in a hospital setting from the SARS-CoV 1 and 2 viruses compared to other viruses studied. It was concluded that further research into this topic is necessary, especially in front-line health care settings. This study is especially relevant to health care workers now as the U.S. battles high cases of the Omicron variant.

“Personalized Variable vs Fixed-Dose Systemic Corticosteroid Therapy in Hospitalized Patients With Acute Exacerbations of COPD,” CHEST Journal, Nov. 2021

It is known that systemic corticosteroids for the treatment of COPD exacerbations decrease treatment failure and shorten the length of hospitalization. However, the optimal dose is unclear. This study aimed to determine whether personalized doses of corticosteroids were more effective than fixed doses administered to hospitalized patients with COPD with exacerbations.

The study was a prospective, randomized, open-label trial. Hospital patients were randomly assigned at a 1:1 ratio to either the fixed dose group (receiving the equivalent of 40 mg of prednisolone) or the personalized dose group for five days.

A total of 248 patients were included in the study and randomly assigned to a group. The study concludes that personalized dosages of corticosteroids reduce the risk of failure because more patients were provided with a higher initial dose, especially > 60 mg, while 40 mg or less was too low in either group. For medical professionals, this study shows that current practice habits must continue to be evaluated as we seek to improve patient outcomes.

“Endophenotype-based in silico network medicine discovery combined with insurance record data mining identifies sildenafil as a candidate drug for Alzheimer’s disease,” Nature Aging, Dec. 2021

Researchers participating in this study began by identifying genes associated with Alzheimer’s disease and focused on the subset of genes associated with both amyloid plaques and tau tangles (for more information, read the National Institutes of Health’s summary). The researchers constructed a network of drugs and their molecular targets for more than 1,600 FDA-approved drugs and then calculated the relationships between each drug’s target and the Alzheimer’s disease network components.

This study identified 66 drugs with the closest relationship to Alzheimer’s disease-associated genes. The top candidate was sildenafil, also known as Viagra and Revatio. Sildenafil is an FDA-approved drug that treats erectile dysfunction and pulmonary hypertension.

This study found that people (mostly men) who took sildenafil were 69% less likely to develop Alzheimer’s disease over six years than those who did not take the drug. The association held after adjusting for age, sex, race and disease comorbidities.

Researchers noted that the study doesn’t necessarily show that sildenafil prevents Alzheimer’s disease and that other, unidentified factors may be responsible for the association. This highlights the important difference between causation and correlation. Medical research must continue to evaluate associations in hope of identifying unique causal relationships.