Examining the Complex Relationship Between Tuberculosis and Other Infectious Diseases in Children

Mortality Lower With Lung Volume Reduction Surgery In Emphysema

HealthDay News — For patients with advanced emphysema, endobronchial valve placement (EBV) is associated with higher mortality and morbidity compared with lung volume reduction surgery (LVRS), according to a study presented at the annual meeting of The Society of Thoracic Surgeons, held from Jan. 24 to 26 in Los Angeles.

J.W. Awori Hayanga, M.D., M.P.H., from West Virginia University in Morgantown, and colleagues examined data from the U.S. Centers for Medicare and Medicaid Services inpatient claims database for all beneficiaries with severe emphysema undergoing either LVRS or EBV between Jan. 1, 2019, and Dec. 31, 2022, to compare outcomes.

Overall, 3,219 patients underwent lung volume reduction therapy: LVRS in 2,378 and EBV in 841. The researchers found that compared with those who underwent LVRS, EBV patients had lower Elixhauser comorbidity scores, shorter length of stay, and lower hospital charges prior to risk adjustment. Most of the LVRS procedures were minimally invasive (1,897 video-assisted thoracoscopic/robotic surgeries versus 481 open surgeries). EBV was associated with higher 30-day mortality, 30-day readmission rate, reintervention rate, and 30-day readmission with pneumothorax, higher supplementary oxygen requirement, and higher all-cause mortality at one year compared with LVRS after doubly robust risk adjustment including frailty (adjusted odds ratios, 2.68, 1.4, 17.2, 2.09, 3.49, and 1.75, respectively).

"Patients undergoing EBV placement have higher occurrences of various complications over time, often need a greater number of interventions, and even suffer higher mortality compared to those undergoing LVRS in contemporary surgical practice, where techniques have become much less invasive than they were 20 years ago when surgical options were first evaluated," Hayanga said in a statement.

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Scientists Find A Major Cause Of Multiple Sclerosis

Multiple sclerosis (MS) is a disease that affects the brain and spinal cord. It happens when the body's immune system mistakenly attacks the protective covering around nerves, called myelin. Over time, this damage makes it harder for the brain to send signals to the rest of the body.

This can lead to problems with movement, balance, and even thinking. Some people with MS eventually lose the ability to walk, while others may have milder symptoms. There is no cure for MS, and doctors still don't fully understand what causes it.

MS is a relatively rare disease, but it affects about 2.8 million people worldwide. Scientists have long suspected that certain viruses might trigger the disease, but proving this has been difficult. Now, a large study from Harvard University has found strong evidence that a virus called Epstein-Barr virus (EBV) is the main cause of MS.

EBV is a very common virus. Most people get infected with it at some point in their lives, often in childhood. It can cause a mild illness or, in some cases, mononucleosis (also called "mono" or the "kissing disease"), which makes people feel very tired for weeks or even months.

Once a person is infected, EBV stays in the body forever, usually without causing any problems. Since almost everyone carries the virus but only a small number of people develop MS, it has been hard to prove that EBV is directly responsible for the disease.

To better understand the connection, researchers studied over 10 million young adults serving in the U.S. Military. They focused on 955 people who were diagnosed with MS while in service. Because the military regularly collects blood samples from its members, scientists were able to check whether these individuals had been infected with EBV before they developed MS.

Their findings were striking. Almost every person who developed MS had been infected with EBV before their diagnosis. In fact, the risk of developing MS increased 32 times after someone got infected with EBV. Other viruses did not have the same effect.

The researchers also found that a key marker of nerve damage, called neurofilament light chain, only increased after EBV infection. This suggests that the virus plays a major role in triggering MS.

The delay between EBV infection and the first symptoms of MS—often about 10 years—may explain why the connection was not obvious before. Scientists believe that in the early stages, MS develops slowly and silently, making it hard to detect. It is also possible that the immune system's response to EBV changes over time, leading to MS in some people but not others.

Currently, there is no way to prevent EBV infection, and there is no treatment to remove the virus from the body. However, this study raises hope that an EBV vaccine or antiviral drugs targeting the virus could one day prevent or even cure MS. Scientists are now working to develop these treatments.

This study, published in the journal Science, provides the strongest evidence yet that EBV is the leading cause of MS. If future research confirms these findings, it could change the way MS is treated and bring new hope to millions of people living with the disease.

If you care about cancer risk, please read studies that exercise may stop cancer in its tracks, and vitamin D can cut cancer death risk.

For more information about cancer, please see recent studies that yogurt and high-fiber diet may cut lung cancer risk, and results showing that new cancer treatment may reawaken the immune system.

Copyright © 2025 Knowridge Science Report. All rights reserved.

Adults Who Receive Epstein–Barr Donor Kidneys Face Risk Of Post-transplant Complications

January 28, 2025

2 min read

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All-cause graft failure risk was higher for recipients of Epstein–Barr virus D-positive/R-negative kidneys.

The Epstein–Barr virus D-positive/R-negative group had up to a 10-fold higher cumulative incidence of post-transplant lymphoproliferative disorder.

Patients who receive kidney transplants from Epstein–Barr virus D-positive/R-negative donors face a higher risk for post-transplant lymphoproliferative disorder, data show.

"Post-transplant lymphoproliferative [PTLDs] disorders are associated with high morbidity and mortality," Vishnu S. Potluri, MD, MPH, assistant professor of medicine at the Hospital of the University of Pennsylvania, wrote with colleagues. "Most [Epstein–Barr virus] EBV-associated PTLDs occur after donor-to-recipient EBV transmission at the time of transplantation. … Limited information about the timing and magnitude of posttransplant EBV DNAemia and its relationship to PTLD has hindered the development of evidence-based strategies to mitigate these complications."

All-cause graft failure risk was higher in Epstein–Barr virus D-positive/R-negative transplant recipients. Image: Adobe Stock.

Researchers conducted a retrospective cohort study with 104 EBVD-positive/R-negative kidney transplant recipients matched to 312 EBV R-negative recipients.

Adults who had a transplant between 2010 and 2022 were recruited from the Hospital of the University of Pennsylvania in Philadelphia and the University of Pittsburgh Medical Center in Pittsburgh as part of the study. Mean patient age was 42 years, 59% had living donor transplants and 95% had thymoglobulin induction.

The study aimed to determine whether a mismatch in the EBV status of the donor and recipient impacts PTLD outcomes, as well as graft and patient survival among adults with a kidney transplant.

In the EBV D-positive/R-negative transplant group, 48.1% developed EBV DNAemia, according to the findings, with a median onset of 198 days post-transplantation. In addition, 22.1% of patients in this group were diagnosed with PTLD at a median 202 days after transplantation.

The risk for all-cause graft failure was also higher for EBV  D-positive/R-negative transplant recipients (HR = 2.21; 95% CI, 1.06-4.63) compared with patients with tranplants without EBV.

Overall, EBV D-positive/R-negative transplant recipients had a fivefold to 10-fold higher cumulative incidence of with PTLD vs. Controls.

"Our study highlights the need to urgently standardize care and develop additional tools to reduce the risk for PTLD for [EBV D-positive/R-negative] recipients," Potluri and colleagues wrote. "Post-transplant cancer is a leading concern of patients, clinicians and caregivers involved in kidney transplantation. During pretransplant care, the risks and benefits of waiting for an EBV-seronegative donor kidney should be explored and discussed with transplant candidates."

Sources/DisclosuresCollapse Source: Potluri V, et al. Ann Intern Med. 2024;doi.Org/10.7326/ANNALS-24-00165.

Disclosures: Potluri reports receiving award support from the National Institute of Diabetes. The research was supported by the NIH. Please see the study for all other authors' relevant financial disclosures.

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