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Fulltext Therapeutic radionuclides in nuclear medicine: current and future prospects

Yeong CH, Cheng MH, Ng KH

J Zhejiang Univ Sci B, 2014 Oct;15(10):845-63.
PMID: 25294374 DOI: 10.1631/jzus.B1400131

The potential use of radionuclides in therapy has been recognized for many decades. A number of radionuclides, such as iodine-131 ((131)I), phosphorous-32 ((32)P), strontium-90 ((90)Sr), and yttrium-90 ((90)Y), have been used successfully for the treatment of many benign and malignant disorders. Recently, the rapid growth of this branch of nuclear medicine has been stimulated by the introduction of a number of new radionuclides and radiopharmaceuticals for the treatment of metastatic bone pain and neuroendocrine and other malignant or non-malignant tumours. Today, the field of radionuclide therapy is enjoying an exciting phase and is poised for greater growth and development in the coming years. For example, in Asia, the high prevalence of thyroid and liver diseases has prompted many novel developments and clinical trials using targeted radionuclide therapy. This paper reviews the characteristics and clinical applications of the commonly available therapeutic radionuclides, as well as the problems and issues involved in translating novel radionuclides into clinical therapies.
Fulltext The effect of ertugliflozin in patients with nonalcoholic fatty liver disease associated with type 2 diabetes mellitus: A randomized controlled trial

Khaliq A, Badshah H, Shah Y, Rehman IU, Khan KU, Ming LC, et al.

Medicine (Baltimore), 2024 Nov 08;103(45):e40356.
PMID: 39533572 DOI: 10.1097/MD.0000000000040356

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease associated with liver inflammation, fibrosis, and cirrhosis and is associated with a greater risk of hepatocarcinoma. Nonalcoholic steatohepatitis (NASH) is a persistent and progressive form of NAFLD. Recent evidence suggested that ertugliflozin, a sodium-glucose cotransporter 2 inhibitor (SGLT2), suppresses NAFLD development in patients with type 2 diabetes mellitus (T2DM). The objective of this study was to determine the impact of ertugliflozin on improving NAFLD in patients with T2DM and the function of liver enzymes.
METHODS: This prospective, randomized, double-blind, placebo-controlled, interventional study aimed to determine the effectiveness of 15 mg of ertugliflozin versus 30 mg of the standard therapy pioglitazone versus placebo in NAFLD patients with T2DM. The study was established based on patient randomization in three groups: ertugliflozin, pioglitazone, and a placebo. This study was registered under the Australian New Zealand Clinical Trial Registry (Trial ID: ACTRN12624000032550).
RESULTS: The impact of therapy was determined in the treatment groups by utilizing liver ultrasonography and biochemical parameters. After 24 weeks of clinical study, the results revealed significant improvement in the grades of fatty liver, especially in the ertugliflozin group. The number of patients with hepatic steatosis significantly decreased among the respective groups classified according to fatty liver grade. Among patients in the ertugliflozin and pioglitazone groups, 45% to 23.4% and 41.7% to 26.6%, respectively, decreased in the Grade 2 group. The aspartate aminotransferase and alanine aminotransferase levels were significantly lower in all the study groups, especially in the ertugliflozin group (P ≤ .001).
CONCLUSION: The present study revealed that the concomitant use of ertugliflozin has favorable effects on liver enzymes, as it decreases liver fat intake and reduces complications in patients with NAFLD-associated T2DM. However, more in-depth studies will be required to observe every aspect of ertugliflozin.
Ethnic differences in knowledge, attitudes, and practices related to dietary salt intake and association with hypertension in Malaysia: a multi-centre cross-sectional study

Chia YC, Ching SM, Chew MT, Devaraj NK, Oui JEK, Lim HM, et al.

Hypertens Res, 2025 Jan;48(1):131-147.
PMID: 39223391 DOI: 10.1038/s41440-024-01851-z

The association between high salt intake and elevated blood pressure levels has been well-documented. However, studies on how effectively this knowledge translates into actionable practices, particularly across different ethnic groups, remain limited. This study aimed to evaluate the knowledge, attitudes, and practices (KAP) towards dietary salt intake across ethnicities and determine its association with hypertension. 5128 Malaysian adults recruited from a national blood pressure screening study completed questionnaires on demographics, and KAP related to dietary salt intake. There were 57.4% Malay, 23.5% Chinese, 10.4% Indian, and 8.7% individuals of other ethnic groups. Overall, more than 90% of the participants knew that a high salt intake causes serious health problems, but only around one-third knew the relationship between high salt intake and strokes and heart failure. Participants of different ethnic groups displayed significant differences in the KAP domains, where Indians generally exhibited better knowledge, attitudes, and reported better practices such as reading salt labels and using spices. Those who were unaware of the difference between salt and sodium and who reported not reading salt labels had higher odds of having elevated blood pressure. These findings demonstrate that while there is a suboptimal translation of salt knowledge into practice in Malaysia, with significant differences in KAP observed between ethnic groups, the potential of improving health outcomes by improving the clarity and awareness of salt labels is substantial. Tailored education promoting salt-label reading, minimizing processed foods intake and discretionary salt use should be ethnic-specific to better curb this escalating hypertension epidemic.
Assessing food vendor receptiveness to healthier options: a study of knowledge, attitudes, practices, and perceived barriers regarding salt, sugar, and oil reduction in cafeteria food vendors

Chia WX, Chung FF, Chia YC, Ng JY, Lee KH, Gunawan K, et al.

BMC Nutr, 2025 Mar 14;11(1):54.
PMID: 40087710 DOI: 10.1186/s40795-025-01037-x

BACKGROUND: Prioritizing policies that address major non-communicable disease (NCD) risk factors, such as poor diet, is a cost-effective way to improve health outcomes. While education can enhance knowledge and practices in the short term, recent trends show that structural and policy-based initiatives, such as setting mandatory salt, sugar, and oil (SOS) targets are effective means of changing dietary behaviours and reducing NCD risk factors. However, few studies have surveyed the KAP of food vendors in workplaces and educational institutions and assessed their receptiveness to serving low-SOS dishes. This study aimed to evaluate the knowledge, attitudes, and practices (KAP) regarding salt, oil, and sugar (SOS) consumption and use, as well as the barriers, and enablers of these practices amongst food operators within Malaysia's out-of-home sector.
METHODS: This study employed a cross-sectional, descriptive survey design to assess knowledge, attitudes, and practices (KAP) related to the consumption of salt, oil, and sugar and their use in food preparation amongst campus canteen staff at two Malaysian higher education institutions. Data were collected anonymously from 38 participants, which included representatives from all independent canteen operators on the premises. The study also explored the barriers and enablers vendors encounter in reducing salt and sugar usage.
RESULTS: The study found that most participants were aware of the health risks associated with high salt, oil, and sugar (SOS) consumption and had positive attitudes towards reducing dietary SOS intake in general, though these attitudes did not extend to their own food preparations. However, their knowledge of recommended dietary guidelines was poor, and actual practices related to SOS reduction were inadequate. Barriers to reducing SOS included concerns about taste and customer acceptance, as well as the lack of standardized guidelines and tools for measuring SOS in food preparation.
CONCLUSIONS: This study identifies gaps in knowledge and practices related to SOS reduction among the surveyed food vendors. While vendors acknowledge the health risks of high SOS consumption, there is a lack of awareness of dietary guidelines and practical low-SOS cooking methods, highlighting the need for regular monitoring, vendor education, and support in promoting healthier food options.
Role of dietary potassium and salt substitution in the prevention and management of hypertension

Chia YC, He FJ, Cheng MH, Shin J, Cheng HM, Sukonthasarn A, et al.

Hypertens Res, 2025 Jan;48(1):301-313.
PMID: 39472546 DOI: 10.1038/s41440-024-01862-w

Cardiovascular diseases (CVD) continue to be the leading cause of deaths and disability worldwide and the major contributor is hypertension. Despite all the improvements in detecting hypertension together with technological advances and affordable, efficacious and relatively free of adverse effects anti-hypertensive agents, we continue to struggle to prevent the onset of hypertension and to control blood pressure (BP) to acceptable targets. The poor control of hypertension is commonly due to non-adherence to medications. Another reason is the failure to adopt diet and lifestyle changes. Reduction of dietary salt intake is important for lowering BP but the role of potassium intake is also important. Globally the intake of sodium is double that of the recommended 2 gm per day (equivalent to 5 gm of sodium chloride/salt) and half that of the daily recommended intake of potassium of 3500 mg/day, giving a sodium-to-potassium ratio of >1, when ideally it should be <1. Many studies have shown that a higher potassium intake is associated with lower BPs, particularly when coupled concurrently with a lower sodium intake giving a lower sodium to potassium ratio. Most hypertension guidelines, while recommending reduction of salt intake to a set target, do not specifically recommend a target for potassium intake nor potassium supplementation. Here we review the role of potassium and salt substitution with potassium in the management of hypertension. Hence, the focus of dietary changes to lower BP and improve BP control should not be on reduction of salt intake alone but more importantly should include an increase in potassium intake.