There is evidence that gout and heart disease are mechanistically linked by inflammation and patients with gout are at elevated risk for cardiovascular (CV) disease. But do gout flares, on their own, affect short-term risk for CV events? A new analysis based on records from British medical practices suggests that might be the case. Risk for myocardial infarction (MI) or stroke climbed in the weeks after individual gout flare-ups in the study's more than 60,000 patients with a recent gout diagnosis. The jump in risk, significant but small in absolute terms, held for about 4 months in the case–control study before going away.

@kakali Dietary supplements are a big market in the United States — about 52% of Americans consume them, according to data quoted in the article. Despite their popularity, supplements are subject to very little safety regulation. The Dietary Supplement Health and Education Act (DSHEA) of 1994 prohibits the FDA from screening supplements for safety and efficacy. As a result, the FDA relies on an honor system that defers to manufacturers to ensure the safety of dietary supplements.

The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) released joint guidelines for the safe prevention of primary cesarean delivery. These include the following :

Prolonged latent (early)-phase labor should be permitted

The start of active-phase labor can be defined as cervical dilation of 6 cm, rather than 4 cm

In the active phase, more time should be permitted for labor to progress

Multiparous women should be allowed to push for 2 or more hours and primiparous women for 3 or more hours; pushing may be allowed to continue for even longer periods in some cases, as when epidural anesthesia is administered

Techniques to aid vaginal delivery, such as the use of forceps, should be employed

@lalima The paper made recommendations for atypical findings in several of the soft-tissue masses to perform contrast-enhanced MRI as an additional imaging step. A challenge in further diagnosis with atypical findings is that contrast-enhanced MRI may not be part of standard practice in imaging departments at many healthcare facilities compared with noncontrast MRI

The grim legacy of a child's death may include a heightened risk for death among the child's siblings, the authors of a new study warn. The increased risk was greatest among same-sex siblings or those closest in age to the deceased child, and it persisted throughout the 37-year follow-up period of the study, Yongfu Yu, PhD, and coauthors write in JAMA Pediatrics, published online April 24. They urge healthcare professionals to "be aware of children's vulnerability after experiencing sibling death, especially for same-sex sibling pairs and sibling pairs with close age." The authors of an accompanying editorial similarly draw attention to the issue, noting that the devastating impact of a sibling's death is not surprising "when one considers that the sibling relationship is often the longest-lasting interpersonal relationship that a person will have."

@koushin Ivermectin, which is typically used as an antiparasitic agent, has been much in the news recently, and one of the reasons is that the repurposing of existing medicines that are widely available and reasonably safe has assumed greater importance with the emergence of COVID-19. Ivermectin inhibits the chloride channels of helminthic parasites and has been shown to have clinical efficacy for the treatment of onchocerciasis, strongyloidiasis, and ectoparasitic infections such as scabies. Ivermectin has also been studied in vitro for its potential antiviral properties in many viruses, including severe acute respiratory syndrome coronavirus 1 (SARS-1), HIV, dengue, Zika, yellow fever, West Nile, Hendra, chikungunya, Semliki Forest, Sindbis, and avian influenza viruses.

@lalima Vegetarian diets and other dietary patterns emphasizing plant foods have previously been linked to a lower risk of incident stroke, the investigators note. On the other hand, many vegetarians have a low intake of vitamin B12, which might be responsible for raising homocysteine, an amino acid in the blood, thereby increasing the risk of stroke. In addition, some studies suggest animal protein may be beneficial for the prevention of hemorrhagic stroke.

@shutanu Results from the NutriNet-Santé cohort (n = 102,865) suggest that artificial sweeteners found in many food and beverage brands worldwide may be associated with increased cancer risk, in line with several experimental in vivo/in vitro studies. These findings provide novel information for the re-evaluation of these food additives by health agencies

A healthy, diverse gut microbiome is associated with better cognitive function in middle age, new research suggests. Investigators conducted cognitive testing and analyzed stool samples in close to 600 adults and found that beta-diversity, which is a between-person measure of gut microbial community composition, was significantly associated with cognitive scores. Three specific bacterial genera showed a positive association with performance on at least one cognitive test, while one showed a negative association.

@shutanu Using a mask has become imperative when it comes to restricting intake of toxic air. With pollution levels reaching hazardous levels in different parts of the country, a wide variety of pollution masks are available in the market. From single-use mask to a reusable and washable mask to one with carbon filter there are a lot of options to choose from. A nutritious diet can act as a shield of protection from the adverse impact of pollution. Clinical nutritionist Lovneet Batra recommends inculcating Vitamin A, C, E, seeds, nuts and loads of fruits and vegetables in the diet. Vitamin A, C, and E help in repairing the body, and fighting inflammation that is caused by pollution or any kind of toxin. Keeping in mind the vegetables and fruits available in the current season, Ms Batra suggest consumption of carrot, sweet potato, raddish, spinach, fenugreek (methi) and pumpkin for Vitamin A. While lemon, Amla and oranges are rich in Vitamin C, rice bran oil and almonds will provide Vitamin E.