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Alcohol Abstinence in Cirrhosis: New Research Proves It’s Never Too Late Written By: Dr. Janhvi Ajmera Think abstinence is futile once cirrhosis sets in? Think again. New research studies reveals that alcohol abstinence significantly reduces hepatic decompensation and mortality risks, even in advanced stages of portal hypertension. This study shifts the clinical conversation from “if” to “when” abstinence begins. The Research in Focus A comprehensive observational study of 320 patients with alcohol-related cirrhosis, published in Clinical Gastroenterology and Hepatology, has delivered one of the clearest clinical messages to date: Abstinence works, no matter the stage of portal hypertension. From moderate (HVPG 10–19 mm Hg) to high-risk portal hypertension (HVPG ≥20 mm Hg), sustained alcohol abstinence was consistently linked to improved survival and fewer hepatic complications, regardless of baseline severity. Source:  DOI: 10.1016/j.cgh.2022.11.033 Key Findings that Shift Clinical Practice 75.3% of the group maintained abstinence. Abstinence reduced the risk of: Hepatic decompensation by 60% Liver-related mortality by 57% All-cause mortality by 55% These benefits remained strong even in patients with prior decompensation and a hepatic venous pressure gradient (HVPG) of ≥20 mmHg. Why This Matters for Clinicians and Researchers Many clinicians encounter a common yet dangerous patient belief: “It’s too late. Stopping won’t help now.” This study refuse that notion, showing that abstinence remains the most powerful intervention even in decompensated cirrhosis. Moreover, the HVPG measurement proved useful not only for staging disease but also for refining prognosis, independent of alcohol intake. Clinical Applications: Counsel proactively: Emphasize that abstinence yields measurable gains at any stage. Monitor HVPG to stratify patients and tailor surveillance strategies. Integrate abstinence goals into multidisciplinary care in patients listed for transplant. Beyond the Liver: Systemic Inflammation and Recovery Abstinent patients demonstrated reduced levels of: CRP AST Liver stiffness These point towards reduced systemic inflammation and even early signs of disease regression, bringing in the gut-liver axis theory and the impact of alcohol on intestinal permeability. What About HCC? Interestingly, the incidence of hepatocellular carcinoma (HCC) was not significantly affected by abstinence (6.6% vs 3.8%). However, abstinence didn’t increase HCC risk, and in the context of overall survival benefits, this finding does not take away from the clinical urgency of achieving abstinence. Final Word: Abstinence Is the Intervention This study adds to a growing body of evidence urging physicians, hepatologists, and transplant teams to prioritize alcohol cessation counseling- regardless of disease stage. In fact, alcohol abstinence outperformed even MELD and HVPG as independent predictors of survival in multivariable analysis. Clinical takeaway:  If your patient with alcohol-related cirrhosis is still drinking, it’s not a lost cause— it’s a critical opportunity. Reference: https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://www.cghjournal.org/article/S1542-3565(22)01113-2/fulltext&ved=2ahUKEwi_ucO78_yNAxVITWwGHf9sIZEQFnoECD4QAQ&usg=AOvVaw0nbaSo30D38MtM0wRWCeYU 🔗 Stay Informed For more clinically relevant research updates, follow us on Instagram, LinkedIn, and visit our website at mdresearch.us. _________________________________________________________________________

The Hidden Heart Risk in Your Sugar-Free Drink? Written By: Dr. Janhvi Ajmera New Research Links Popular Sugar Substitute to Heart Attack and Stroke Risk As medical professionals, we often recommend sugar substitutes like erythritol for patients battling diabetes, obesity, or metabolic syndrome. But what if the very sweetener marketed as “healthy” is quietly increasing cardiovascular risk? A groundbreaking study has raised an urgent red flag: elevated blood levels of erythritol a widely used zero-calorie sweetener are linked to a significantly higher risk of major adverse cardiovascular events (MACE), including heart attack and stroke. What Did the Study Find? Researchers analyzed data from over 4,000 individuals across U.S. and European cohorts. Here’s what they discovered: Erythritol levels were significantly higher in individuals who later experienced MACE. The highest quartile of erythritol in plasma was associated with a 2-4x higher risk of heart attack, stroke, or death. These findings were independent of traditional cardiovascular risk factors, such as diabetes, hypertension, and high cholesterol. And it doesn’t stop at correlation. The researchers went a step further to uncover how erythritol could increase cardiovascular risk and what they found was alarming. How Does Erythritol Affect the Body? When healthy volunteers consumed just 30 grams of erythritol, equivalent to a serving of “keto” ice cream or a sugar-free drink, plasma levels spiked 1000-fold and stayed elevated for over 48 hours. At those levels, platelet reactivity soared. Mechanistic studies in humans and mice showed: Increased platelet aggregation in response to triggers like ADP and thrombin. Enhanced clot formation in microfluidic assays and in vivo thrombosis in animal models. Simply put: erythritol appears to create a pro-thrombotic environment, potentially tipping the balance toward blood clots. Why It Matters to Physicians & Researchers This study urges us to rethink what we label as “safe” in our dietary guidelines. Erythritol is FDA- and EU-approved. But regulatory approval is based on short-term studies and animal data, not long-term cardiovascular outcomes in humans. While it’s easy to focus on glucose control, this data reminds us to look at the whole picture. For vulnerable patients, those already at higher risk of cardiovascular events, the chronic use of erythritol might be doing more harm than good. Clinical Takeaways For clinicians: Reassess routine recommendations for erythritol in diabetic and obese patients with cardiovascular risk. Educate patients on the hidden sources of erythritol in “keto” snacks, sugar-free drinks, protein bars, and gum. For researchers: This study highlights the value of metabolomics in discovering novel biomarkers of cardiovascular risk. Future work must explore erythritol’s interaction with platelet biology, renal clearance, and endothelial function. Big Picture: More Sweeteners, More Questions Artificial sweeteners have long been sold as “guilt-free” alternatives. Yet, as the body of evidence grows; from saccharin and sucralose impairing glycemic control, to erythritol elevating clot risk, we must ask: Are these sweeteners merely replacing calories… or replacing one risk with another? Final Thoughts: A Call for Caution and Further Study Erythritol might still have a role, but its blanket use as a healthy alternative needs reevaluation. Especially for our high-risk patients, long-term safety trials are urgently needed. Reference: https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://pubmed.ncbi.nlm.nih.gov/36638072/&ved=2ahUKEwj95qHg3PWNAxUHTGwGHRl2BDkQFnoECDoQAQ&usg=AOvVaw3P1LXyAOIJDQjGHw2YyJZL   _________________________________________________________________________

Vitamin D: A Simple Supplement With Life-Saving Potential? Written By: Dr. Janhvi Ajmera When we think of vitamin D, we usually picture it helping us absorb calcium and keep our bones strong. But what if we told you that this humble vitamin might also reduce your risk of type 2 diabetes, self-harm, and even melanoma? Recent studies are shedding light on vitamin D’s potential far beyond bone health, and the findings are surprising. Here’s what you need to know (and possibly rethink) about vitamin D. 1. Can Vitamin D Help Prevent Diabetes? A large clinical trial recently looked at people with prediabetes to see if vitamin D could help delay or prevent type 2 diabetes. The result? It worked modestly. Those who took vitamin D had a 3.3% lower risk of developing diabetes compared to those on inactive drugs. While that might sound small, applied to the global prediabetes population, it could delay diabetes in over 10 million people. But to get this benefit, vitamin D blood levels need to reach about 50–60 ng/mL (125–150 nmol/L), which is near the upper safety limit. That means standard doses (400–800 IU/day) might not be enough for everyone. In some cases, higher doses (up to 4000 IU/day) may be needed, especially under medical supervision to avoid risks like high calcium levels or kidney stones. Clinical Tip: If your patient has prediabetes and low vitamin D levels, it’s worth considering supplementation as part of a broader lifestyle plan. 2. A Potential Tool Against Suicide and Self-Harm This one’s hard to ignore. A retrospective study of over 1.3 million U.S. veterans with vitamin D deficiency showed something remarkable: Cholecalciferol (Vitamin D₃) supplementation cut suicide and self-harm rates from 0.36% to 0.20 , a 45% reduction. Ergocalciferol (Vitamin D₂) showed similar results — a 49% reduction. The most dramatic effect? Among Black veterans who received D₃: there’s 64% drop in suicide and self-harm risk. While this doesn’t prove cause and effect (more trials are needed), it’s a signal that correcting vitamin D deficiency might impact mental health. Takeaway for clinicians: In patients with mood disorders and documented vitamin D deficiency, supplementation may be more than just supportive, rather it could be protective. 3. Vitamin D and Melanoma Risk: A Surprising Link In a Finnish study of about 500 people, researchers found that regular vitamin D users were 55% less likely to develop malignant melanoma compared to those who used it occasionally or not at all. Even after adjusting for skin type, sun exposure, and other variables, the link held strong. Is it definitive? Not yet. But vitamin D may play a protective role against certain cancers, particularly skin cancers. Watch this space: More studies are needed, but this opens the door to new discussions about prevention and supplementation. 4. Why Your Weight Might Affect Vitamin D’s Power In the VITAL trial, researchers gave 2000 IU/day of vitamin D to a large group of older adults to see if it could reduce cancer and heart disease. The results? No benefit across the board. But when they looked closer at participants with a BMI under 25, things got interesting: 24% lower cancer incidence 42% lower cancer mortality 22% less chances of autoimmune diseases This suggests that obesity may dull vitamin D’s effects, likely due to the vitamin being stored in fat tissue and not circulating where it’s needed. For clinicians:  Consider adjusting vitamin D dosing based on BMI. What works for a lean adult may not work for someone with higher adiposity. So, What Should Medical Professionals Do With All This? Don’t overlook vitamin D in chronic disease prevention. From diabetes to depression and even cancer, the evidence is growing. Test and tailor. Check levels in at-risk patients (especially those with prediabetes, obesity, or mood disorders) and consider appropriate dosing, sometimes beyond the RDA, but always within safe limits. Rethink “normal.” A level of 30 ng/mL might not be enough for disease prevention. Some benefits emerge closer to 50–60 ng/mL. Make it part of the conversation. Especially in mental health, metabolic health, and preventive care. For USMLE & Research Students If you’re preparing for boards or digging into research, this is a perfect example of how one nutrient intersects with endocrinology, psychiatry, oncology, and public health. Think about how you’d frame this in a clinical description or what research question you could ask based on these findings. What’s Next? Clinical trials to confirm effects on suicide prevention and cancer Deeper understanding of vitamin D’s role in the immune system Personalized dosing based on BMI, race, and genetic factors Final Thoughts Vitamin D isn’t a miracle drug. But it might just be one of the most underestimated tools in your clinical toolkit. Affordable, accessible, and (when used wisely) safe- It’s time we start thinking of it as more than just a bone-builder. Reference: https://www.medpagetoday.com/endocrinology/diabetes/102980?trw=yes&hr=kmd

Can Childhood Nightmares Predict Parkinson’s and Cognitive Decline? New Research Sparks a Wake-Up Call Written By: Dr. Janhvi Ajmera Imagine if something as ordinary and overlooked as your child’s nightmares could signal a risk for serious neurological diseases 40 years down the line. Groundbreaking research from the 1958 British Birth Cohort Study has uncovered a startling association: persistent distressing dreams in childhood may predict a higher risk of developing cognitive impairment or Parkinson’s disease (PD) by age 50. For medical professionals and researchers, this study reframes how we view pediatric sleep disturbances;not just as transient childhood fears, but as potential early neurodevelopmental biomarkers. The Study in a Nutshell This large-scale longitudinal analysis followed 6991 people born in a single week in 1958 in the UK. Researchers tracked participants from birth to age 50, with specific attention to parental reports of “bad dreams or night terrors” at ages 7 and 11. By age 50: 267 participants (3.8%) had developed cognitive impairment or PD. Those with persistent distressing dreams at both time points had an 85% increased risk of these outcomes. The odds of being diagnosed with PD were nearly seven times higher for this group. And these results held up even after adjusting for a wide range of variables, including socioeconomic background, birth weight, childhood anxiety, and early-life infections. From Nightmare to Neuromarker? The strength of this study lies not just in its design, but in the conversation it opens: can recurring bad dreams in childhood act as red flags for neurodegeneration decades later? The researchers propose several potential explanations: 1. Early brain changes:  Although unlikely, some forms of subtle neurodevelopmental alterations may begin far earlier than traditionally believed, affecting REM sleep regulation and emotional processing. 2. Genetic overlap:  Genes linked to nightmare frequency may also intersect with those associated with neurodegenerative diseases like Alzheimer’s and PD. 3. Causal pathways:  Frequent nightmares can disrupt sleep architecture, impeding glymphatic clearance mechanisms that are critical for flushing out neurotoxic proteins like amyloid-beta and alpha-synuclein. Why This Matters for Clinicians and Researchers Traditionally, neurodegenerative diseases have been viewed through the lens of mid-to-late life risk factors. But this study challenges that notion, suggesting that the roots of these conditions may extend into early childhood. This has far-reaching implications: One should not dismiss Pediatric sleep complaints lightly. Screening and early intervention protocols could shift from reactive to preventive. Long-term monitoring of children with persistent nightmares may allow for early detection of vulnerable individuals. Cross-disciplinary collaboration between pediatricians, neurologists, sleep researchers, and psychologists is now more vital than ever. Could Treating Nightmares Prevent Disease? If the association proves to be causal, the implications are revolutionary. Interventions like Imagery Rehearsal Therapy, CBT for insomnia, or even low-dose pharmacotherapy in children may not just improve sleep quality but potentially reduce long-term neurological risks. Preventive neurology might one day include dream therapy as a core component of risk mitigation strategies for dementia and PD. Limitations to Consider The assessment of nightmares relied on maternal report rather than objective sleep measures. The diagnosis of PD was self-reported and not clinically verified. The number of PD cases at age 50 was small, reflecting the earlier age of outcome assessment relative to typical disease onset. That said, the findings remain statistically significant and robust; even after adjusting for confounders and missing data using multiple imputation. The Road Ahead This study doesn’t close the book, it opens a new chapter. Future research should: Replicate findings in diverse global cohorts Investigate neurobiological mechanisms linking childhood dream patterns to adult brain health Evaluate whether treating nightmares in youth alters the trajectory of neurodegeneration Final Thoughts In the world of clinical research, few discoveries are as quietly powerful as this one. By tuning into what our children see in their sleep, we may be peering decades into their neurological future. For now, the message is clear: listen to the nightmares. They may be whispering what science is only just beginning to understand. Reference: https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://pubmed.ncbi.nlm.nih.gov/37064510/&ved=2ahUKEwi9u6aw6-iNAxULwzgGHfWHI1IQFnoECD0QAQ&usg=AOvVaw1iRF9l7jN3mwnzOEWbWW51

Research Experience Supercharges Your Residency Application Written By: Dr. Janhvi Ajmera Every March, Match Day stirs up a whirlwind of emotions, excitement, nerves, relief, and lots of questions. In 2025, the competition was tougher than ever: 52,498 applicants competed for 43,237 positions in the NRMP Main Residency Match—the highest numbers to date. With so many qualified candidates, the big question is: How do you stand out? One powerful answer? Research experience. Why Research Matters More Than Ever Demonstrates Dedication and Curiosity Residency program directors are looking for more than just good grades. They want to see your commitment to medicine and your drive to push the field forward. Research experience proves you’re willing to go beyond the basics, ask important questions, and seek real answers. Builds Skills That Residency Programs Value Research hones critical thinking, data analysis, teamwork, and scientific communication skills that are required for success in any residency. According to NRMP research, applicant characteristics like scholarly activity and research productivity are increasingly influential in how programs rank candidates. Gives Your CV a Competitive Edge At a 94.3% fill rate, every line of your application counts. If you’ve published, presented, or even contributed to a well-run project, you’ve got proof that you’re serious and capable, and for IMGs, that extra edge is even more important. Match rates in 2025 were: 67.8% for U.S. citizen IMGs, 58.0% for non-U.S. IMGs And Research can help bridge that gap. Builds Real Connections Research connects you with mentors, collaborators, and future recommenders. You’re gaining skills and joining a professional network that can support you when you need it.   So, how can you start? Getting involved in research doesn’t have to feel overwhelming. Ask yourself:     What topics in medicine interest me?   Can I start small and build?     Do I know anyone doing research I can talk to? Here are a few ways to begin:     Join an ongoing project – Use platforms like MDResearch.us to learn from the best mentors and do a study of your own.   Propose a new study – Have a question that won’t leave you alone? Pitch it to a faculty member or mentor.   Present and publish – Even a poster presentation at a regional conference adds value and confidence to your CV.  If you’re serious about making your residency application stand out, research experience isn’t optional, it’s essential.  At MDResearch.us, we’re here to help you:   Find projects that match your schedule and interests   Connect with experienced mentors, collaborators, and future recommenders   Gain real-world skills that programs are looking for  Join us now and start building the future you’ve been working toward.    References: National Resident Matching Program®. (2025). 2025 Main Residency Match Results. Retrieved from NRMP.org NRMP. (2025). Main Residency Match Highlights and Data. NRMP. (2025). Key Results from the 2025 Match. NRMP Research and Data Reports. (2025). Applicant Characteristics and Program Director Survey Presentations.

Could Cold Sores Be Linked to Alzheimer’s? A Closer Look at the HSV-1 Connection Written By: Dr. Janhvi Ajmera A Surprising Association When we think about Alzheimer’s disease, our minds usually think about aging, genetics, and maybe even cardiovascular risk factors. But a recent study brings an unexpected player into the picture, herpes simplex virus type 1 (HSV-1), the virus responsible for cold sores.  The idea that a common virus could be linked to a complex neurodegenerative disease like Alzheimer’s might sound surprising. But it’s not entirely new and recent findings are giving it more weight. What the Data Tells Us The study analyzed data from IQVIA PharMetrics Plus, a large U.S. insurance claims database covering over 200 million individuals. Researchers looked at a group of more than 344,000 people diagnosed with Alzheimer’s disease and compared them to a carefully matched group of controls. The goal was to see if there was a difference in the rates of HSV-1 diagnosis between the two groups. The results showed that individuals with Alzheimer’s were nearly twice as likely to have a documented HSV-1 infection compared to the control group. While the absolute numbers were small (under 1% of patients had a recorded diagnosis of HSV-1), the relative difference was significant, an 80% increased odds of developing Alzheimer’s among those with HSV-1. Antiviral Therapy and Risk Reduction Even more interesting was the secondary finding, that patients who had been treated with antiviral medications showed a 17% lower risk of developing Alzheimer’s compared to untreated individuals with HSV- This leads us to further questions. Why would antivirals, commonly used to suppress cold sore outbreaks have any effect on neurodegeneration? Is the virus somehow contributing to the disease process? And if so, could early or chronic suppression change outcomes? The idea is speculative but fascinating. HSV-1 has been found in the brains of some Alzheimer’s patients, and there’s evidence from animal studies that viral reactivation may trigger neuroinflammation and even amyloid plaque formation. While we can’t conclude causality from this data, it points towards a therapeutic possibility that could be explored in future research. Why It’s Hard to Interpret There are some important limitations to consider. First, HSV-1 is extremely common. Most estimates suggest that up to two-thirds of the global population carries the virus, many without ever showing symptoms. The fact that only a tiny percentage of individuals in this study had a documented diagnosis suggests that majority of HSV-1 cases simply go unrecorded in the healthcare system. This underreporting could turn the data in unpredictable ways. It’s possible that only those with more frequent or severe symptoms are getting diagnosed and treated. Which means that the group we’re looking at may not represent the broader HSV-1-positive population. Second, this was a retrospective observational study based on insurance claims data. It shows correlation but no causation. It’s completely possible that other unmeasured variables (such as immune status, socioeconomic factors, or general healthcare access) could influence both HSV-1 diagnosis and Alzheimer’s risk. With these warnings, the signal is strong enough that it shouldn’t be dismissed outright. Making Sense of the Mechanism So how could HSV-1 potentially influence Alzheimer’s disease risk? One leading theory is that repeated reactivation of the virus in the central nervous system could cause chronic low-grade inflammation. Over time, this might promote the kind of cellular stress that leads to tau tangles and beta-amyloid plaque accumulation, the hallmarks of Alzheimer’s pathology. This mechanism has been supported by some lab-based and epidemiologic studies. In mice, HSV-1 infections have been shown to trigger the formation of amyloid plaques. In humans, a Swedish study found that individuals with high HSV antibody levels had twice the risk of developing dementia, even when adjusting for other risk factors. What we’re seeing here is the gradual convergence of multiple lines of evidence,from bench science to big data that points in the same direction. What This Means in Practice As clinicians, we often look for ways to reduce risk in our patients, especially when it comes to diseases like Alzheimer’s, where current treatment options are limited and prevention is key. This study doesn’t change our standard of care right now. We’re not recommending screening all patients for HSV-1, and we’re not prescribing antivirals to prevent dementia. But it does raise important questions, especially for patients who already experience frequent HSV-1 outbreaks. If these individuals are already candidates for antiviral treatment, there may be an added potential benefit in the long run, though we’ll need better evidence from randomized controlled trials to say for sure. Looking Ahead Alzheimer is a multifactorial disease and the more we learn, the more we realize how many systems it touches. From vascular health to infection, immunity to inflammation, it’s likely that multiple pathways feed into the neurodegenerative process. The idea that something as common as a cold sore could play a role is a powerful reminder of how complex the brain really is. Future research will need to dig deeper into the role of chronic viral infections in neurodegeneration and explore whether antiviral strategies can slow or prevent cognitive decline in at-risk populations. For now, this evolving evidence gives us another angle to consider, and perhaps another piece of the puzzle in understanding one of medicine’s most challenging diseases. Reference: https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://pmc.ncbi.nlm.nih.gov/articles/PMC8464096/&ved=2ahUKEwjnkZ-b5deNAxU1xzgGHWnWMs0QFnoECDYQAQ&usg=AOvVaw0StVqCgViP5nSlSP_lEWGK

Genetic Testing in Atrial Fibrillation: A Game Changer in Predicting Heart Failure Risk Written By: Dr Nandini L Why Genetic Testing Matters in Atrial Fibrillation (AF) If you’re seeing a young patient with atrial fibrillation (AF) in your clinic, it may be time to think beyond stroke prevention. New research out of the Netherlands is shining light on how genetic testing could help flag those most at risk for developing cardiomyopathy and heart failure, especially in younger populations. This isn’t just about ticking another diagnostic box. It’s about early detection, proactive care, and, ultimately, saving lives. The Research: Genetic Clues in AF Patients The study, published in JAMA Cardiology, analyzed data from over 44,000 patients with AF using two major longitudinal databases—the All of Us Research Program (U.S.) and the UK Biobank. The key finding? Patients with AF were twice as likely to carry rare, inherited genetic variants associated with cardiomyopathy. In patients with early-onset AF (diagnosed before age 45), this risk jumped to five times higher. What’s more, individuals carrying these gene variants had a 50–70% higher risk of developing incident heart failure or cardiomyopathy after their AF diagnosis, independent of traditional risk factors or polygenic risk scores. “It’s not a benign disease where you only have to treat the ischemic stroke risk,” said Dr. Sean J. Jurgens, co-author and assistant professor at Amsterdam UMC. What This Means for Clinical Practice This study advocates for a shift in how we perceive AF, particularly in young adults. It’s no longer just about symptom control or anticoagulation. Genetic testing can offer powerful prognostic insights. Patients with pathogenic variants are the ones clinicians “really need to look after,” says Dr. Jurgens, because they’re far more likely to develop progressive heart failure. Identifying these patients early could enable closer monitoring, preventive strategies, and potentially targeted therapies in the future. Barriers to Widespread Genetic Testing Despite its promise, genetic testing in cardiology remains a non-routine practice. Cost, lack of insurance coverage, limited access to genetic counselors, and regional disparities—especially in the U.S.—are significant hurdles. But there’s hope. Technological advances are driving costs down, and the study team was able to narrow the gene panel from over 100 to just 26 variants, thereby improving both cost efficiency and clinical applicability. Expert Endorsement: A Call for Wider Integration An editorial by Olivia G. Anderson, MS, CGC, of the University of Pennsylvania, praised the study’s “methodological rigor” and emphasized how it confirms AF as a potential early manifestation of genetic cardiomyopathy. She and her colleagues also highlighted the urgent need for more genetic counselors in cardiology and the creation of specialized cardiovascular genetics clinics. “This work makes a strong case for incorporating genetic testing into the evaluation of patients with AF, especially those under 45.” Final Thoughts The future of cardiology lies at the intersection of genetics and personalized care. For those pursuing research or clinical training in internal medicine, cardiology, or electrophysiology, this study exemplifies how intelligent data and early genetic insights can influence patient outcomes. At MD Research, we’re here to keep you updated on the latest breakthroughs and help you integrate research into your journey to residency success. Keywords: genetic testing, atrial fibrillation, AF, early-onset AF, cardiomyopathy, heart failure, precision medicine, cardiovascular genetics, MD research, USMLE, medical residency, polygenic risk, genomic risk predictionReference: https://www.medscape.com/viewarticle/genetic-tests-patients-atrial-fibrillation-may-flag-those-2025a1000est

How Lifestyle Medicine Can Add Years to Your Life and Health to Your Years Written By: Dr Nandini L Introduction: A Crisis in Health—And a Cure Within Reach. Modern medicine faces a paradox. While we have cutting-edge treatments and the highest healthcare spending, chronic illnesses like cardiovascular disease, cancer, and type 2 diabetes continue to rise. The root cause? A modern lifestyle is filled with poor diet, inactivity, and unmanaged stress. Enter Lifestyle Medicine—an evidence-based approach that addresses the true root of disease. What Is Lifestyle Medicine? Unlike conventional medicine, which often focuses on treating symptoms, Lifestyle Medicine focuses on preventing, managing, and reversing chronic diseases through daily habits. It emphasizes six core pillars: Whole-food, plant-predominant nutrition Regular physical activity Restorative sleep Stress management Avoidance of risky substances Positive social connections Why Are We Getting Sicker? Cardiovascular disease and cancer now account for more than 50% of deaths in the U.S. The Western lifestyle—marked by sedentary behavior, processed foods, and chronic stress—is primarily to blame. Our health is deteriorating despite our wealth and technology. The Preventable Epidemic: Inflammation, Obesity, and Type 2 Diabetes. These three conditions form a vicious cycle, fueling each other and leading to premature death. But they’re not inevitable. Studies show that over 80% of chronic diseases are preventable with proper lifestyle changes. The Cost of Inaction Chronic illnesses are not only devastating to individuals—they’re financially unsustainable. Our current healthcare system is being crushed by diseases that are, in many cases, avoidable. Implementing lifestyle medicine can drastically reduce healthcare costs and improve quality of life. The Science Behind Lifestyle Medicine Numerous studies have shown that adopting a plant-based diet, engaging in regular physical activity, and reducing stress can: Lower blood pressure and cholesterol Reverse type 2 diabetes Improve survival rates in cancer patients Reduce the risk of heart disease The Power of Food as Medicine: A whole-food, plant-based diet fights inflammation, supports the gut microbiome, and reduces the risks of multiple diseases. It’s not just a diet; it’s a prescription for longevity. Mental Health Matters: The Role of Emotional Resilience. Emotional resilience—the ability to bounce back from stress—is closely tied to physical health. Chronic stress, depression, and anxiety can: Shortened telomeres (cell aging markers) Increased risk of heart disease and cancer Weaken immune function Lifestyle interventions like exercise, social support, and stress reduction techniques can strengthen emotional resilience and improve outcomes in chronic illness. The Microbiome Connection: A fiber-rich diet low in processed foods supports a healthy gut microbiome. This reduces inflammation and improves mental well-being, as the gut-brain axis plays a key role in mood and cognitive function. A Call to Action for Healthcare Professionals. The evidence is clear: Lifestyle Medicine must be integrated into standard medical practice. From nutrition education to behavioral support, we must equip doctors and patients with the tools to live healthier lives. How Many Publications Do You Need to Match? 2025 NRMP Data Reveals the Answer 📊 Research Publications: A Key Component in Residency Applications In the competitive landscape of residency applications, research publications play a pivotal role. The National Resident Matching Program (NRMP) provides insights into the average number of research experiences and publications among successful applicants. While the 2025 “Charting Outcomes in the Match” report has not been released yet, historical data offers valuable benchmarks. Epicos +5 NRMP +5 NRMP +5 📈 Average Number of Publications by Specialty Based on the 2020 NRMP data, the average number of research experiences and publications for U.S. MD seniors who matched into various specialties were as follows: foustka.com +6 Op-Med +6 snma.org +6 Neurosurgery: 5.5 research experiences; 18.3 publications Plastic Surgery: 2.43 research experiences; 14.2 publications Dermatology: 2.55 research experiences; 14.7 publications Orthopaedic Surgery: 1.6 research experiences; 8.2 publications Otolaryngology (ENT): 2.76 research experiences; 10.4 publications Op-Med These numbers indicate that applicants to more competitive specialties tend to have higher research involvement. 🧪 Research Trends and Their Impact The emphasis on research varies across specialties. For instance, applicants to surgical specialties often engage in more research activities compared to those applying to primary care fields. This trend underscores the importance of tailoring your research endeavors to align with your desired specialty. Op-Med +2 AAFP +2 PubMed Central +2   🎯 Strategies to Enhance Your Research Profile To bolster your residency application:   Engage Early: Start participating in research projects during medical school.   Seek Mentorship: Collaborate with experienced researchers who can guide your work. Aim for Quality: Focus on producing impactful research that contributes meaningfully to your field. Present Your Work: Submit abstracts to conferences and aim for publications in reputable journals. NRMP +2 pahomepage.com +2 Op-Med +2 🌟 Conclusion While the number of publications is a significant factor in residency applications, it’s essential to focus on the quality and relevance of your research. Engaging in meaningful research not only enhances your application but also contributes to your growth as a medical professional. NRMP +1 pahomepage.com +1

Reimagining US Healthcare Delivery: Addressing Social Needs for a Healthier Future By Aida Feda Vanderpuye, MD, MPH Candidate In 2023, Maureen, a single mother of three residing in Boston, was diagnosed with uncontrolled diabetes after months of untreated symptoms. She carried more than just a medical condition and faced housing instability, job loss, and daily uncertainty. Without reliable transportation, affordable healthy food, or health insurance, her condition deteriorated. Maureen entered Boston Medical Center for her routine medical appointment and enrolled in the THRIVE Social Determinants of Health Screening & Referral Program. Tears welled up as she shared her struggles—revealing to her care team a complex web of unmet social needs that were just as urgent as her medical ones. Her story reflects the experiences of millions of Americans. According to the National Academy of Medicine, up to 80% of an individual’s health shapes social and economic factors beyond medical care. These realities reflect the need for a fundamental shift in healthcare delivery modalities. If the US healthcare system is to improve outcomes and meaningfully serve communities, it must integrate social care, prioritize patient-centered approaches, and proactively address social determinants of health. The US healthcare delivery system is a fragmented network of various public and private entities responsible for providing, financing, and regulating health services. It is not a single unified system, but rather, it reflects a patchwork of models: the Beveridge model seen in the Veterans Affairs (VA) system, where care is government-funded and delivered; the Bismarck model reflects employer-sponsored insurance, financed jointly by employers and employees; traditional Medicare resembles a National Health Insurance model, where the government funds services delivered by private providers, and millions of uninsured Americans fall under an out-of-pocket model, paying directly for care or forgoing it altogether. Core components of the US system include healthcare providers (hospitals, physicians, clinics), payers (private insurers, Medicare, Medicaid), regulators (federal and state agencies), and patients. This complexity creates opportunities and obstacles to achieving equity, access, and quality. Historically, care focused on acute, episodic issues. Employer-sponsored insurance and government programs like Medicare and Medicaid expanded access, but the system remained reactive. The emphasis on care has transitioned to equity and prevention. Despite 21st century policy advances structural and cultural barriers to care persist. The core values of the US healthcare system, particularly autonomy, equity, justice, beneficence, and non-maleficence, generate a moral obligation to fulfill the needs of vulnerable populations. Equity demands a fair distribution of resources and services and the elimination of avoidable disparities. Autonomy entails the right of individuals to make informed decisions about their care, requiring systems that are culturally sensitive, linguistically accessible, and free from coercion. Beneficence compels doing good to promote well-being and address medical needs and social conditions that shape health. Non-maleficence, the duty to not harm, requires removing systemic barriers that cause preventable suffering. A commitment to population health means extending care beyond clinic walls to housing, food access, education, and environmental safety. To effectively attain these goals, healthcare systems must recognize the specific needs of vulnerable populations: racial and ethnic minorities, immigrants, rural residents, low-income individuals, individuals with disabilities, LGBTQ+ individuals, and the elderly. They face health disparities and unjust inequities rooted in structural (social, economic, and political) disadvantage. For example, Black women are three to four times more likely to die from pregnancy-related causes than white women due to clinical and structural racism. Native American communities experience high rates of diabetes and hypertension, which links to limited access to nutritious food and culturally relevant care. Immigrants face language and cultural barriers that reduce their ability to access preventive services or navigate complex systems. These setbacks reflect more than medical needs—they represent fundamental gaps in access to stable housing, nutritious food, transportation, education, safe neighborhoods, and trusted care, all shaped by broader Social Determinants of Health (SDOH). These SDOHs are deciding factors in shaping health outcomes over life trajectories. For example, food deserts fuel obesity and diabetes. Lack of transportation leads to missed appointments, delayed diagnosis, and avoidable hospitalizations. Poor housing quality can trigger or worsen respiratory conditions. Addressing these factors is vital for improving outcomes and reducing disparities. While public policy, defined as the formal rules, regulations, and laws enacted by federal, state, or local governments, can powerfully shape health outcomes in the United States, purposeful transformation does not have to wait for legislative action. Although major reforms like the Affordable Care Act have expanded access and funding, US healthcare delivery systems and public health agencies can take independent, proactive steps to address social needs and reduce disparities today. Across the country, innovative models are already emerging. For instance, hospitals in cities like Boston and Camden have implemented programs that integrate community health workers and trusted members of their populations to help patients navigate care, housing, and food resources. Health centers are increasingly co-locating social services inside clinics, such as housing assistance or legal aid—a practice used by Federally Qualified Health Centers (FQHCs) nationwide. Beyond these examples, US health systems can partner with local nonprofits, schools, and faith-based organizations to amplify their reach and engage patients where they live and work. Hospitals and clinics can implement social prescribing programs, where providers “prescribe” non-medical interventions such as exercise, access to social services, or community engagement activities. Kaiser Permanente and Montefiore Health Systems utilize social risk screening tools to collate demographic and neighborhood-level data, allowing for more targeted and equitable care. Furthermore, US healthcare providers can advance health equity by integrating interdisciplinary team-based care- doctors, social workers, mental health professionals, and community advocates into a cohesive, patient-centered approach. Additionally, training providers to recognize and address bias and discrimination is important. Despite resource limitations, these efforts show that health systems can promote equity without waiting for new policies. Building on these innovations, one of the most potent strategies health systems can adopt—without waiting for significant policy reform is the widespread implementation of patient-centered care (PCC) and the intentional design of patient-built environments. Together, these approaches hold transformative potential in reducing disparities and improving outcomes,

Pediatric Atopic Dermatitis: Insights into Recent Clinical Advances and Treatment Strategies By Dr Swetha Mora M.B.B.S,M.S(Ophthalmology) Introduction Atopic dermatitis (AD), commonly referred to as eczema, is a chronic, relapsing, inflammatory skin condition that primarily affects children. It is characterized by dry, itchy skin and is often associated with other atopic diseases, such as asthma and allergic rhinitis. Understanding the recent trends and advancements in the clinical examination of pediatric AD is crucial for effective diagnosis and management. Recognizing Pediatric Atopic Dermatitis Age of onset (typically <5 years) Common symptoms: Pruritus (itching) Erythema (redness) Dry, scaly skin Flexural involvement Triggers: Soaps, pollen, dust mites, stress Associated conditions: asthma, allergic rhinitis Recent Trends in Pediatric Atopic Dermatitis: Rising Prevalence and Ethnic Disparities: The global burden of pediatric AD has increased, especially in industrialized nations. According to recent epidemiological studies, non-Hispanic Black children are 14.2% more likely to develop AD compared to White children, highlighting significant ethnic disparities in prevalence and access to care. Black children and European American children have higher rates of eczema compared to Hispanic children, according to WebMD. Studies suggest that Black and Hispanic children may also experience more severe cases. Overall, the prevalence of atopic dermatitis in affluent nations is estimated to be 15-20% among children, according to Fortune Journals.  Role of Genetics and Environment  Genetic predispositions, such as mutations in the filaggrin gene, compromise the skin barrier, making it more susceptible to allergens and irritants. Urban living, climate change, and pollution exacerbate the onset and severity of diseases (Elsevier). Influence of the Microbiome  Emerging research highlights the significance of the skin and gut microbiomes in the pathogenesis of atopic dermatitis (AD). Dysbiosis—an imbalance in microbial communities—can drive inflammation and immune dysregulation, a key factor in pediatric atopic dermatitis (AD). The gut and skin microbes are interconnected and influence each other. The gut microbiome produces metabolites that can affect skin health, while the skin microbiome can also impact the gut’s immune function. Understanding the role of the microbiome in Atopic disease (AD) opens up possibilities for novel therapeutic approaches. Modulating the microbiome through probiotics, dietary modifications, or targeted antibiotic therapies may help manage AD symptoms.  Digital Tools and Teledermatology  Smartphone apps and teledermatology platforms now assist in remote monitoring, symptom tracking, and even AI-based assessments, improving care in underserved and rural populations. Advances in Clinical Examination of Atopic Dermatitis (AD) **Updated Diagnostic Criteria**   The Hanifin and Rajka criteria serve as the foundational framework for diagnosing atopic dermatitis (AD). However, in primary care settings, simplified diagnostic versions are frequently utilized. Core features essential for diagnosis include:   – Chronic pruritus (itchiness)   – Distinctive lesion morphology, particularly flexural involvement in older children   – Early onset of symptoms   – A personal or family history of atopy **Severity Scoring Systems**   To facilitate standardized assessments of the disease, several scoring tools have been developed, including:   – **SCORAD (Scoring Atopic Dermatitis)**   – **EASI (Eczema Area and Severity Index)**   – **POEM (Patient-Oriented Eczema Measure)**   These tools are utilized in both clinical practice and research environments. For instance, SCORAD evaluates the extent of lesions, their severity, and subjective experiences such as itch and sleep disturbances. **Non-Invasive Diagnostic Innovations**   Recent advancements have led to the development of non-invasive diagnostic tools, including:   Dermoscopy: which allows for detailed visualization of skin structures   Transepidermal Water Loss (TEWL)devices: used to assess skin barrier functionality   Hyperspectral imaging: which aids in evaluating inflammation and monitoring healing progress   Comorbidity Screening:  Given the frequent coexistence of AD with other allergic conditions, current guidelines emphasize the importance of early screening for associated issues such as asthma, allergic rhinitis, and food allergies, particularly in patients presenting with moderate to severe cases of AD. Advances in Pediatric Atopic Dermatitis Treatment Significant progress has been made in treating pediatric atopic dermatitis (AD), particularly for moderate to severe cases. These new therapies are helping reduce flares, control inflammation, and improve quality of life with greater precision and fewer side effects. Advancements in Treating Pediatric Atopic Dermatitis Recent improvements have enhanced the treatment of pediatric atopic dermatitis (AD), particularly for moderate to severe cases. New options include topical creams, oral medications, and biologics that target specific parts of the immune system. While topical corticosteroids and calcineurin inhibitors are still used, newer non-steroidal treatments offer alternatives with fewer side effects. Systemic treatments provide better options for children who don’t respond to standard therapies. Understanding skin function and immune responses has led to personalized care that reduces flare-ups and improves overall well-being. Many children now experience fewer symptoms and healthier skin, allowing them to enjoy daily activities more fully. Biologic Therapies: Precision in Inflammation Control 🔹 Dupilumab (Dupixent®) Target: IL-4 and IL-13 pathways Approved for: Children ≥6 months Impact: Reduces itch, improves sleep and skin barrier function Note: Now approved irrespective of comorbid conditions like asthma (SpringerLink) 🔹Nemolizumab (Nemluvio®) Target: IL-31 receptor A (primary pruritus mediator) Approved for: Children ≥12 years (FDA 2024) Key Benefit: Rapid and sustained itch relief (Wikipedia) 🔹Ebglyss® (Lebrikizumab) Target: IL-13 Frequency: Monthly dosing Approved for: Adolescents ≥12 years Strength: Option for patients needing less frequent injections (Reuters) 🧴 2. Advanced Topical Therapies: Beyond Steroids 🔹 Roflumilast 0.05% (Zoryve®) Class: PDE4 inhibitor Use: Children 2–5 years Efficacy: Achieves EASI-75 in up to 40% by Week 4 Longevity: Sustained results through 56 weeks (Arcutis) 🔹Tapinarof 1% (Vtama®) Class: AhR agonist Steroid-free alternative with anti-inflammatory and antioxidant effects Approved for: Children ≥2 years (National Eczema Association) 💊 3. Oral JAK Inhibitors: Systemic Precision 🔹Baricitinib (Olumiant®) Mechanism: JAK1/JAK2 inhibitor Use: Understudy for adolescents Benefit: Long-term symptom control with minimal steroid reliance (EMJ Dermatology) 🧴 4. Barrier Repair and Proactive Skincare Ceramide-rich moisturizers: Restore the lipid barrier Proactive maintenance: Long-term control by continuing topical anti-inflammatories during remission Early TCS use in infants: May reduce future flare severity and allergic sensitization .        Emerging Treatment, Future Directions, and Research Frontiers : Personalized Medicine: Genomic and proteomic tools are being developed to tailor treatment based on the individual’s immune profile. Biomarkers: Cytokine profiling (e.g., IL-4, IL-13 levels) may guide the use of targeted therapies. Microbiome Modulation: Research