Categories : Cardiovascular Disease ExerciseTags : Leave a comment

Swimming Beats Running for Strengthening the Heart, Study Finds

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Photo by Kampus Production

By Maria Fernanda Ziegler  |  Agência FAPESP – A study conducted on an animal model by researchers at the Federal University of São Paulo (UNIFESP) in Brazil demonstrated that swimming is more effective than running in promoting healthy heart growth and improving the strength with which the heart muscle (myocardium) contracts.

“Swimming and running are two excellent ways to improve cardiorespiratory health and protect the heart muscle, but we wanted to know if one could be even more beneficial than the other. We found that, although both increase respiratory capacity, swimming goes a step further by combining functional and molecular adaptations that make the heart stronger and more efficient,” says Andrey Jorge Serra, a professor at UNIFESP and coordinator of the study supported by FAPESP. 

The study, published in the journal Scientific Reports, demonstrates that swimming promotes greater modulation of microRNAs that control various heart adaptations, such as cardiac cell growth, the formation of new blood vessels (angiogenesis), protection against cell death, and the regulation of contractility and responses to oxidative stress, compared to running training.

MicroRNAs are molecules that regulate the expression of messenger RNAs, which are responsible for protein synthesis.

“Although several studies had already examined the expression of microRNAs regulated by aerobic training in general, little was known about expression patterns when swimming and running were compared in the same experimental setting. Therefore, this study reveals that there’s a distinction in cardiovascular effects between these two modalities,” says Serra.

In the study, the mice underwent an eight-week training protocol consisting of daily 60-minute sessions five days a week. The rats were divided into three groups: one that did not train, one that only ran, and one that only swam. Since running and swimming are very different forms of exercise, the comparison between the training regimens was not based on the speed the animals reached but rather on the relative intensity of the effort, as measured by maximum oxygen consumption (VO₂ max) – an indicator that assesses the body’s ability to capture, transport, and utilize oxygen during physical activity.

According to the results, running and swimming improved physical fitness similarly: between the first and last training sessions, VO₂ max increased by more than 5%. However, only swimming promoted significant structural changes in the heart, such as increases in cardiac and left ventricular mass. Running did not show relevant differences compared to the sedentary animals.

“People’s choice of sport depends largely on personal preference, aptitude, and enjoyment. But our results show that swimming may have a special impact in situations involving myocardial recovery, cardiac rehabilitation, and above all, scientific research. This is also relevant because studies on aerobic exercise often use running and swimming interchangeably, and we now know that the effects aren’t the same,” Serra explains.

Before and after the training period, the researchers administered a series of tests to evaluate various aspects of cardiac health, including cardiorespiratory capacity, fitness, and the structure and function of the heart and myocardium.

The study also analyzed the gene expression and protein pathways involved in physiological cardiac hypertrophy and the mechanisms involved in identifying regulatory microRNAs.

“Although we don’t yet know why this change occurs at the molecular level, of the microRNA, we were able to delve deeply into and investigate the molecular pathways that control physiological hypertrophy,” the researcher adds.

The article “Swimming is superior to running in inducing physiological cardiac hypertrophy and enhancing myocardial performance” can be read at nature.com/articles/s41598-026-36818-2.

Source: FAPESP

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‘Yo-yo’ Fluctuations in Weight, Blood Pressure Linked to Kidney Disease in Type 1 Diabetes

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Photo by I Yunmai on Unsplash

Fluctuations – known as the ‘yo-yo’ effect – in body mass index (BMI) and blood pressure are associated with the progression of diabetic kidney disease in people with type 1 diabetes, new papers have revealed.

The findings, shown in two studies from Dr Murat Ozdede, Visiting Research Fellow, and Janaka Karalliedde, Professor of Diabetes, both from King’s College London, indicate that only having good average blood pressure and weight may not be enough to prevent progression of the disease. Instead, keeping fluctuations under control may be a better way to keep the kidneys healthy.  

Variability – also known as ‘yo-yo-ing’ – in weight and blood pressure has been shown to be harmful in people with type 2 diabetes with regard risk heart and kidney disease. Our work is the first demonstration of this potential risk in people with type 1 diabetes, many of whom had normal weight, BMI and blood pressure. Future studies will need to explore if reducing variability with treatments can reduce the risk of kidney disease.”

Janaka Karalliedde, Professor of Diabetes, King’s College London

Diabetic Kidney Disease (DKD) affects up to 40% of people with diabetes and is one of the leading causes of kidney failure in the UK and many countries around the world. Individuals with kidney failure require kidney replacement therapy. Doctors already know that DKD is linked to higher blood glucose, higher blood pressure and protein in the urine. However, these biological functions change over time. Therefore, the researchers were interested in exploring whether variation of these risk factors may affect the body in ways that stress the kidneys and contribute to progression of kidney disease.

The first study looked at changes in systolic blood pressure (max pressure) and diastolic blood pressure (when the heart rests in between beats). The researchers measured variation in visit-to-visit changes, taken from test results of 3,079 adults with type 1 diabetes between 2004 and 2018.

They used estimated glomerular filtration rate (eGFR) test results to understand how well the kidneys were filtering the blood. A 50% fall of eGFR, or a final eGFR below 30 – indicating serious kidney damage – were the primary endpoints.

They found that both a higher systolic blood pressure and diastolic blood pressure variability was linked to substantially higher risk of kidney decline. This was independent of average blood pressure, meaning two people could have the same average systolic blood pressure, but the one who has higher variability may be at greater risk of kidney harm.

The second study explored whether BMI fluctuation – also known as metabolic cycling – could add additional stress to the kidneys and lead to the progression of the disease.

The researchers studied 3,270 adults over roughly 9.6 years, taking at least six BMI measurements during that time. They used four different ways of measuring variability to confirm their analyses.

They found that one of the key factors contributing to worsening of the disease was higher BMI variability, even after adjusting for other risk factors. After 12 years, cumulative incidence of the kidney endpoint was 11.9% in the highest variability group, compared with just 2.1% in the most stable group.

Baseline BMI itself was fairly similar between the different groups, suggesting that simply ‘being heavier’ was less of a risk factor than BMI that changed over time.

These findings are of particular importance considering recent trends in weight loss diets and medication, that can cause sudden weight loss caused by weight gain – a phenomenon known as the ‘yo-yo’ effect.

Rapid fluctuations in weight or blood pressure can cause damage to the blood vessels in the kidney. People with diabetes are more susceptible to blood vessel damage and it’s vital to prevent further aggravating factors. Avoiding fluctuations in weight, blood pressure, and blood sugar levels may help reduce to risk of kidney damage.”

Janaka Karalliedde, Professor of Diabetes, King’s College London

Source: King’s College London

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Cannabis and Tobacco Co-use Increases Psychosis Chances in High-risk Cohorts

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Results highlight concern about co-use, a growing trend that has been understudied until now

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A new multisite study published May 12 in Nature Mental Health found that using cannabis and tobacco together increases the risk of developing psychotic disorders like schizophrenia among those considered high risk.  

Researchers led by Heather Ward, MD, assistant professor of Psychiatry and Behavioral Sciences and director of Neuromodulation Research at Vanderbilt Health, analysed data from more than 1,000 participants in the North American Prodrome Longitudinal Study, which tracks individuals at “clinical high risk” for psychosis. These individuals often experience mild or early symptoms but have not yet developed a full psychotic disorder.  

“The prevalence of cannabis and tobacco use, known as ‘co-use,’ has been rising in the general population for the past several decades, while exclusive tobacco use has declined and exclusive cannabis use has been on the rise,” Ward said. “However, little is known about cannabis and tobacco co-use in adolescents at risk for psychosis.”  

Substance use patterns – tobacco only, cannabis only, co-use, other substances and no substance use – were assessed over a two-year period in 734 individuals at clinical high risk for psychosis and 278 healthy controls.   

“People with psychosis are much more likely to use cannabis and tobacco than the general population. Because of their heavy cannabis and tobacco use, people with psychosis are also disproportionately affected by the negative consequences of cannabis and tobacco use,” said Ward, who recently presented study findings at the Society of Biological Psychiatry Annual Meeting in an oral session titled, “High Stakes: Consequences of Cannabis Use in Vulnerable Populations.”  

According to Ward, in people with psychosis, tobacco use is associated with a 20-year decreased life expectancy compared to the general population, that is attributable to the medical consequences of tobacco use, such as cardiovascular disease, heart attack, stroke and lung cancer.  

“In people in their first episode of psychosis, it is estimated that 25%–50% use cannabis. Cannabis use is associated with more severe psychosis symptoms, poor response to treatment and psychiatric hospitalisations. There is even evidence that cannabis use may cause psychosis in people who are already at risk,” Ward said.  

“Tobacco and cannabis use in isolation have devastating consequences for people with psychosis, so we wanted to see if people who co-use cannabis and tobacco had more severe psychiatric symptoms and if they were at greater risk for developing psychosis in the first place.”  

The study found that regular use of either cannabis or tobacco was linked to anxiety, depression and early psychotic experiences. However, people who used cannabis and tobacco together did not show worse short-term symptoms than those using just one.  

However, the biggest difference appeared over time. Those who used cannabis heavily and tobacco lightly were almost three times more likely to develop psychosis compared to those who used neither substance.  

The results highlight concern about co-use, a growing trend that has been understudied until now. Researchers defined co-use in the study as “using substances at the same time, on the same occasion, or within a defined time frame where their effects may overlap.”  

“We found that cannabis and tobacco co-use was associated with a nearly threefold increased risk of developing psychosis in people who were already at risk,” Ward said. “There is evidence to suggest that using tobacco and cannabis together may have synergistic effects on the brain.  

“Smoking tobacco and cannabis together increases absorption of THC, the psychoactive component of cannabis. It is possible that co-use itself is contributing to the development of psychosis. However, it is also possible that the people who are going to develop psychosis anyway have an underlying predisposition to using both cannabis and tobacco.”  

Ward said it is important for both patients and clinicians to know that cannabis and tobacco co-use is a risk factor for psychosis. Stopping use of cannabis and tobacco may improve mental health symptoms, and it is possible that stopping cannabis and tobacco co-use could reduce risk of developing psychosis in the first place.  

The next step is to replicate this finding in other groups of people at risk for psychosis, and “we need to test if stopping cannabis and tobacco use reduces risk of developing a psychotic disorder,” Ward said.  

Source: Vanderbilt University Medical Center

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Global Health Progress at Risk Without Stronger Systems, Warns WHO

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Organisations working to strengthen health systems in Africa, including COHSASA, are likely to find renewed urgency in the latest report from the World Health Organization, which warns that gains in global health are under threat.

The World Health Statistics 2026 report released yesterday highlights uneven progress, slowing gains and, in some areas, reversals – leaving the world off track to achieve the health-related Sustainable Development Goals (SDGs) by 2030. WHO points to the need for stronger health systems and improved data to sustain progress and close persistent gaps.

There have been notable advances over the past decade. New HIV infections fell by 40% between 2010 and 2024, while the number of people needing interventions for neglected tropical diseases dropped by 36%.

In the WHO African Region, progress in reducing HIV (down 70%) and tuberculosis (down 28%) has outpaced global averages.

However, these gains are fragile. Malaria incidence has increased by 8.5% since 2015, and progress towards universal health coverage has slowed sharply. One quarter of the global population faces financial hardship due to healthcare costs, and an estimated 1.6 billion people were pushed into or further into poverty due to out-of-pocket spending in 2022.

The report also underscores critical weaknesses in health information systems. As of the end of 2025, only 18% of countries were reporting mortality data within one year, and just one third met WHO standards for high-quality mortality data. These gaps limit the ability to monitor trends, target interventions and ensure accountability.

WHO Director-General Tedros Adhanom Ghebreyesus said the findings reflect “both progress and persistent inequality,” emphasising the need for stronger, more equitable health systems supported by resilient data systems.

For organisations such as COHSASA, the findings reinforce the importance of systematic approaches to improving the quality and safety of care. While the WHO report does not prescribe specific mechanisms, it points to challenges – such as uneven performance, gaps in measurement and preventable harm – that that are directly addressed through structured quality improvement and accreditation processes.

By applying measurable standards, supporting continuous improvement and strengthening the use of data at facility level, accreditation programmes provide a practical means of translating system-wide priorities into day-to-day clinical practice. The report sends a clear message: global health progress is real, but fragile. Strengthening health systems – supported by better data and sustained, measurable improvement – will be essential to regain momentum towards the 2030 health goals.

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Tranexamic Acid Prevents Severe Bleeding in Caesarean Births

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New trial adds high quality evidence on benefits of tranexamic acid for high-risk women

Photo by Jonathan Borba on Unsplash

Giving tranexamic acid to women with placenta praevia (when the placenta covers the cervical opening) undergoing caesarean birth leads to a significant yet modest reduction in severe bleeding after delivery with no evidence of an increase in serious adverse events, finds a trial from China published by The BMJ today.

Tranexamic acid is widely used to prevent or reduce heavy bleeding usually after surgery or trauma. It works by inhibiting blood clot breakdown and is recommended for the treatment of severe bleeding after childbirth (postpartum haemorrhage).

But high quality evidence on its prophylactic use to prevent postpartum haemorrhage in high risk women remains scarce.

To address this gap, researchers in China set out to examine the effect of tranexamic acid in women with placenta praevia, a group at high risk of severe bleeding.

The trial included 1694 pregnant women with placenta praevia who were scheduled for caesarean delivery at 24 maternity units across China between July 2023 and March 2025.

Participants received prophylactic oxytocin – standard treatment to reduce blood loss after delivery – and were randomly assigned to receive either intravenous tranexamic acid (845 women) or placebo (849 women) over 10 minutes, starting within five minutes of umbilical cord clamping.

The main outcome measure was postpartum haemorrhage, defined as blood loss of at least 1000 mL or red blood cell transfusion within two days after delivery. Serious adverse events including blood clots, seizures, acute kidney or liver injury, and maternal death, were also recorded.

The results show that prophylactic tranexamic acid reduced the rate of postpartum haemorrhage by 15%, from 35.1% to 29.7% compared with placebo. This means that for every 19 women receiving prophylactic tranexamic acid, one case of postpartum haemorrhage would be prevented.

Rates of serious adverse effects were similar between the two groups.

The researchers acknowledge various limitations including that the findings are specific to women with placenta praevia receiving prophylactic oxytocin and therefore may not apply to other obstetric populations. However, this was a well-designed trial and results were consistent after further analyses, suggesting that the findings are robust.

As such, they conclude: “In a high risk population – specifically, women with placenta praevia undergoing caesarean delivery – prophylactic tranexamic acid leads to a statistically significant but modest reduction in the incidence of postpartum haemorrhage.”

“Future studies in diverse international settings are warranted to validate these results and to identify specific patient subgroups most likely to benefit from prophylactic use of tranexamic acid,” they add.

In a linked editorial, UK researchers point out that this modest reduction in bleeding understates the impact, particularly in women at high risk of harm from bleeding, for whom even modest relative risk reductions translate into worthwhile benefits.

The focus should now shift from whether tranexamic acid reduces bleeding to how it is used to maximise patient benefit, they say, noting that in non-obstetric surgery, tranexamic acid is given before incision, but in caesarean section trials it is delayed until after cord clamping to avoid placental transfer.

They recommend evaluating pre-incision administration for caesarean section, while carefully monitoring maternal and neonatal outcomes.

Source: The BMJ Group

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New Drug Doubles One-year Survival in Pancreatic Cancer Trial

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Phase 2 randomised trial shows 38% reduction in risk of death with the drug when combined with chemotherapy

Kaplan–Meier estimates of OS in the mITT and ITT populations. Nature Medicine, 2026.

Pancreatic cancer is one of the deadliest cancers and among the hardest to treat, with most patients surviving less than a year after diagnosis. But a new drug developed at Northwestern University may soon help patients live longer.

In a randomised phase 2 clinical trial, patients who received the experimental drug elraglusib, alongside standard chemotherapy, were twice as likely to be alive after one year of treatment, compared to those receiving chemotherapy alone. The drug also reduced the risk of death by 38%.

The study is one of only a few successful randomised trials in the last decade to show a survival benefit that would be applicable to a broad population of pancreatic cancer patients, according to the authors.

The study, which was led by Northwestern Medicine, was published in Nature Medicine.

“Pancreatic cancer remains one of the most challenging solid tumours to treat, but these findings provide cautious optimism for patients,” said study lead author Dr Devalingam Mahalingam, professor of medicine in the division of Hematology and Oncology at Northwestern University Feinberg School of Medicine.

“While these results will need to be confirmed in phase 3 trials, observing survival benefit in such a difficult-to-treat cancer is encouraging. Given the novel mechanism of this drug, these findings raise the possibility that it could have broader application across other tumour types,” added Mahalingam, who also is the associate director of clinical research at Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

How the trial was conducted

The phase 2 trial enrolled 233 patients with metastatic pancreatic cancer across 60 sites in six countries in North America and Europe. Patients were randomly assigned to receive either standard chemotherapy or the same chemotherapy combined with elraglusib.

Those who received elraglusib lived a median of 10.1 months, compared to 7.2 months for those who only received chemotherapy. While that three-month difference may appear modest, it’s partly because the trial included patients whose cancer progressed too quickly to benefit from treatment.

Among patients who benefited from the drug, the impact was pronounced. Twice as many patients who received elraglusib were alive at one year (44% vs 22%) and about 13% of patients in the drug group were alive at two years, compared to none in the chemotherapy group.

Side effects were generally consistent with chemotherapy but slightly more common in the elraglusib group. The most frequent included low white blood cell counts, fatigue and temporary vision changes, which were reversible. Overall, the safety profile of the drug was considered manageable, the authors said in the study.

How elraglusib works

Elraglusib was developed nearly 15 years ago inside Northwestern University labs. It targets a protein known as GSK-3 beta, which plays a role in tumour growth and suppression of the immune system.

Unlike traditional chemotherapy, which aims to kill cancer cells, elraglusib seems to act on the tumour microenvironment – the mix of cancer cells, immune cells and surrounding tissue that can either support or weaken tumours.

Pancreatic tumours are hard to treat in part because of their microenvironment, which is particularly adept at suppressing immune response. In the study, patients who received elraglusib showed increases in cancer-fighting cells within their tumours, offering early evidence that the drug may help re-engage the immune system.

In addition, certain immune-related markers in the blood at the start of the trial were associated with longer survival among patients who received the drug. While these findings are preliminary, they suggest that elraglusib may be particularly effective in certain patients whose immune systems are already primed to respond.

Mahalingam and his colleagues are exploring a larger confirmatory phase 3 trial as funding and partnership allow. They are also interested in studying the drug in combination with other novel therapies to determine if broader clinical benefit can be achieved.

Source: Northwestern University

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Don’t Blame the Iodine For Reactions to Contrast Scans

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Patients may often be worried about reactions to the contrast agents used in their scans.

What is a contrast scan?

‘A contrast scan is a medical imaging test, such as a CT scan or MRI,’ says Dr Jean de Villiers, a radiologist and director of SCP Radiology, ‘that uses a special dye called a ‘contrast agent’ to make certain areas of the body easier to see. The contrast helps highlight blood vessels, organs or abnormal tissues, providing clearer and more detailed images. Dr de Villiers talks about the dye, what it is used for and debunks the myth that it is the iodine that causes allergic reactions in some people.

For MRI scans, a different type of contrast is used, which is gadolinium-based and, while allergic reactions are possible, they are extremely rare.

Why is it used?

The contrast agent shows the blood flow through arteries and veins, blockages, bleeding or abnormal growths and detailed organ structure (such as the brain, liver or kidneys).

In short, contrast helps to highlight differences between normal and abnormal tissue, improving diagnosis and treatment planning.

How is the dye administered?

The contrast agent is usually injected into a vein but, in some cases it can be swallowed or given as a rectal enema, depending on the area being examined. It temporarily changes the way radiation or magnetic fields interact with the body’s internal structures.

Is there an iodine allergy risk in a contrast scan?

This is a common concern, but it’s a bit misunderstood.

People often believe they are allergic to iodine because they may have reacted to contrast dye in the past or to shellfish, which contain iodine. However, iodine itself is not an allergen. According to radiologists and allergists, the body doesn’t mount an allergic immune response to iodine as it’s a basic element, essential to human health, particularly for thyroid function.

What causes allergic reactions in contrast scans?

The culprits are usually one of the other compounds, not iodine. Most contrast agents used in CT scans are iodinated contrast agents however, reactions tend to be linked to the chemical structure of the compound, not its iodine content.

Reactions may range from mild (nausea, itching, flushing) to more serious (difficulty breathing or anaphylactoid reactions), which mimic allergies but do not involve the immune system in the same way.

These reactions are typically caused by:

  • Concentration of the contrast agent
  • Molecular structure (ionic vs non-ionic)
  • Patient-specific factors such as history of allergies, asthma or previous reaction to contrast

Advancements in the type of contrast agent used have significantly reduced the rate of reactions in patients.

To confirm: It’s not the iodine, it’s the other compounds attached to the iodine in the dye and the body’s unique response to them. That is why patients are always asked about any previous contrast reactions, asthma or other allergies before being given the contrast injection.

‘Whether you are asked or not,’ says Dr de Villiers, it’s always best to inform the radiology team if you have had any previous allergic contrast reactions.’

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Digoxin Benefits Heart Failure Patients, Study Shows

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Right side heart failure. Credit: Scientific Animations CC4.0

Analyses supporting the use of digitalis glycosides in patients with heart failure were presented in a Late-Breaking Science session at Heart Failure 2026, [1–3] the annual congress of the Heart Failure Association of the European Society of Cardiology.

Investigations from researchers at University Medical Center Groningen, Netherlands, evaluated the effects of the digitalis glycosides, digoxin and digitoxin, in patients with heart failure (HF) and reduced or mildly reduced left ventricular ejection fraction (HF(m)rEF). 

“Digoxin is the oldest drug in cardiovascular medicine, but there has been uncertainty about its value in HF(m)rEF management,” explained Principal Investigator, Professor Dirk van Veldhuisen. “In the DIG trial, published in 1997, digoxin had a neutral effect on the primary endpoint of mortality, but a 28% reduction in heart failure hospitalisations (a secondary endpoint) was observed. Later analyses from DIG showed that lower serum digoxin levels were associated with a favourable effect, while higher digoxin levels worsened prognosis. [4] We conducted the DECISION trial to investigate whether low-dose digoxin has positive effects on cardiovascular outcomes in patients with HF(m)rEF receiving contemporary guideline-recommended treatments.”[1]

The double-blind DECISION trial was conducted at 43 sites in the Netherlands (NCT03783429). Patients with symptomatic mild-to-moderate HF(m)rEF (left ventricular ejection fraction <50%). were randomised to low-dose digoxin or placebo, with a target serum digoxin concentration of 0.5–0.9 ng/mL.  Both patients with sinus rhythm and atrial fibrillation were enrolled. The primary outcome was a composite of total worsening HF events (defined as total hospitalisations or total urgent hospital visits for worsening HF) and cardiovascular mortality. A total of 1001 patients were randomised. The mean age of the participants was 73 years, 28% were women, and 29% had atrial fibrillation.

Low-dose digoxin did not significantly reduce the primary outcome. Over a median follow-up of 36.5 months, 238 primary-outcome events occurred in 131 of 500 patients in the digoxin group, while 291 primary-outcome events occurred in 152 of 501 patients in the placebo group (rate ratio [RR] 0.81; 95% confidence interval [CI] 0.61 to 1.07; p=0.133). Although not statistically significant, the total number of worsening HF events was lower in the digoxin group than in the placebo group (RR 0.76; 95% CI 0.54 to 1.05). Cardiovascular mortality was similar with digoxin and placebo (hazard ratio [HR] 0.93; 95% CI 0.69 to 1.26). Low-dose digoxin was generally well tolerated and safe.

Last year, results were published from the DIGIT-HF trial, which studied another digitalis glycoside, digitoxin, in patients with advanced HF and reduced ejection fraction. [5] Treatment with digitoxin led to a lower risk of death from any cause or hospital admission for worsening HF.

A second presentation at Heart Failure 2026, by Associate Professor Kevin Damman, demonstrated positive overall benefits with digoxin/digitoxin in a meta-analysis of the DECISION, DIGIT-HF and DIG trials. [2] Across 9,013 patients, digitalis glycoside treatment reduced the risk of the primary endpoint of time to cardiovascular death or first worsening HF event compared with placebo (HR 0.85; 95% CI 0.80 to 0.90; p<0.001). This reduction was mostly attributable to the effect on time to the first worsening HF event (HR 0.75; 95% CI 0.69 to 0.81; p<0.001). There was no statistically significant heterogeneity by trial, treatment period or type of digitalis glycoside. In addition, the effect was not attenuated in patients who were already receiving full guideline-directed HF treatment. 

A third presentation, by Professor Peter van der Meer, found that digoxin withdrawal was associated with clinical deterioration. [3] This was a prespecified blinded analysis that followed patients who stopped taking study medication at the end of the DECISION trial, and were subsequently followed for another 6 weeks. Across 587 patients, there were more cardiovascular deaths and HF events in patients after withdrawal of digoxin than after placebo withdrawal (RR 7.37; 95% CI 1.56 to 34.88; p=0.012). 

Summing up the evidence, Professor van Veldhuisen concluded, “In patients with HF(m)rEF, low-dose digitalis glycosides seem to be an effective additional medical treatment option, which are cheap, safe and easy to use. The totality of the evidence supports the role of low-dose digoxin in the contemporary management of HF, with caution warranted when it is stopped.”

References

[1] ‘Low-dose digoxin in heart failure’ presented during the Hottest trials (2) session on 10 May at 13:15 to 14:15 in Room 3, with simultaneous publication in Nature Medicine: https://doi.org/10.1038/s41591-026-04406-6.


[2] ‘DECISION/DIGIT-HF/DIG study level meta analysis’ presented during the Hottest trials (2) session on 10 May at 13:15 to 14:15 in Room 3.


[3] ‘Blinded withdrawal of digoxin or placebo’ presented during the Hottest trials (2) session on 10 May at 13:15 to 14:15 in Room 3. 


[4] Digitalis Investigation Group. The effect of digoxin on mortality and morbidity in patients with heart failure. N Engl J Med. 1997;336:525−533.


[5] Bavendiek U, Großhennig A, Schwab J, et al. Digitoxin in patients with heart failure and reduced ejection fraction. N Engl J Med. 2025;393:1155–1165.

Source: European Society of Cardiology

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Cipla Secures Vaccine Tender Across Key Immunisation Categories

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Photo by Mufid Majnun on Unsplash

Cipla has been awarded a public sector vaccine tender, reaffirming the company’s commitment to strengthening South Africa’s immunisation program through the equitable supply of high‑quality, affordable vaccines.

Cipla submitted bids across several critical paediatric and childhood immunisation categories, including Pneumococcal Conjugate Vaccine (PCV‑10), Rotavirus vaccine, Hepatitis B (Paediatric formulation). These vaccines play a vital role in preventing life‑threatening childhood illnesses and reducing the burden on healthcare systems.

CEO of Cipla Africa, Paul Miller, said: “This tender award marks an important milestone for Cipla as we continue to expand our vaccine footprint in support of national immunisation priorities. We can meaningfully contribute to comprehensive immunisation programmes and long‑term disease prevention efforts.

“Our participation across multiple vaccine categories demonstrates our commitment to addressing critical public health needs and strengthening health outcomes for children and communities.”

Cipla’s vaccine portfolio is underpinned by stringent quality standards and a focus on ensuring continuity of supply reliability. Cipla has a long history of partnering with the Department of Health to support equitable access to quality healthcare, including the supply of antiretrovirals and various vaccines.

Cipla South Africa focus will be ensuring reliability of supply, consistency, and responsible partnership with the public health sector, particularly in communities where access to healthcare remains uneven. CEO of Cipla Africa, Paul Miller, said: “This tender reaffirms our ongoing partnership with the state, as part of Cipla’s mission of ensuring access to quality, affordable healthcare.”

As part of our ethos of “Caring for Life”, we strongly believe in the importance of robust routine immunisation programmes that save lives, reduces inequality and delivery lasting benefits for society as a whole. In public health, progress often comes down to getting the basics right – ensuring vaccines are available, delivered on time, and reach every child who needs them.”

Participation in the Expanded Programme on Immunisation (EPI) aligns with Cipla’s broader mandate to support preventative healthcare and long‑term public health sustainability, said Miller.

Cipla South Africa continues to work closely with healthcare partners and has invested in initiatives to strengthen vaccines knowledge and reduce vaccine hesitancy. For more information about vaccines, visit https://medinformer.co.za/?s=vaccines

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Is Depression Being Overdiagnosed in Ovarian Cancer Patients?

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Study finds that physical symptoms may disproportionately inflate depression scores in patients. 

Photo by Tima Miroshnichenko on Pexels

In addition to causing mental symptoms such as sadness and despair, depression can cause physical sensations including fatigue, headaches, back pain, gastrointestinal issues, and sleep problems.

New research indicates that individuals with ovarian cancer report more of these physical issues at lower levels of depression than people in the general population. Published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings may reflect misattribution of cancer-related symptoms to depression in patients with ovarian cancer.

 Research indicates that more than one-quarter of patients with ovarian cancer develop depressive symptoms. Diagnosis is complicated because physical symptoms of depression overlap with those that can arise from cancer-related causes. Investigators examined how physical symptoms of depression are reported relative to other depression symptoms in patients with ovarian cancer at the time of diagnosis and one-year postdiagnosis, comparing the results with those from people without cancer. 

The team found that at diagnosis, patients reported physical symptoms more frequently than people without cancer and at a lower severity of depression (based on cognitive or emotional symptoms). These differences disappeared at the one-year follow-up, when disease processes no longer drove physical sympto “We intend these findings to help guide assessments of depressive symptoms to discriminate between physical symptoms that are related to cancer and cognitive or affective symptoms that may respond to more traditional interventions for depression,” said lead author Rachel Telles, MA, of the University of Iowa. “We hope that more tailored care will improve outcomes for these patients.”

Source: Wiley