Emotional Problems in Adolescents: Very Common, Most Brief

Dr. George Patton Department of Paediatrics, University of Melbourne Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, AustraliaMedicalResearch.com Interview with:
Dr. George Patton
Department of Paediatrics, University of Melbourne
Centre for Adolescent Health, Murdoch Children’s Research Institute,
Royal Children’s Hospital, Parkville, VIC, Australia
MedicalResearch.com: What are the main findings of the study?

Dr. Patton: Although there has been wide acceptance that the teens are a time when emotional problems are common, views have been polarized about their significance. Some have viewed these problems are usual for this phase of life with little significance for later life mental health; others have argued that early psychiatric intervention was essential given the risks of ongoing disorders.

In this sample almost two thirds of girls and a third of boys had an episode of emotional troubles (anxiety and depression) at a level that would concern a family physician. For those where the episode were brief lasting weeks to months, recovery without further later life episodes was common. In contrast those with persistent (longer than 6 months) or recurrent emotional problems during the teens had a high likelihood of similar problems with depression and anxiety in their twenties. In general these emotional problems persisted more in females than in males.

Continue reading

Bipolar Disorder: Biological Pathways Becoming Clearer

John I. Nurnberger, Jr., M.D., Ph.D. Professor of Psychiatry Joyce and Iver Small Professor of PsychiatryMedicalResearch.com Interview with:
John I. Nurnberger, Jr., M.D., Ph.D.
Professor of Psychiatry
Joyce and Iver Small Professor of Psychiatry
Indiana University School of Medicine

 

MedicalResearch.com: What are the main findings of this study?

Dr. Nurnberger: The main findings of the study are the biological pathways identified to be associated with bipolar disorder, including those involved in hormonal regulation, calcium channels, second messenger systems, and glutamate signaling. Gene expression studies implicated neuronal development pathways as well.

These findings highlight the role of certain neurobiological processes that have been considered in prior hypotheses of bipolar disorder. They underline a role for calcium signaling, which has only been clearly implicated in the genetics of bipolar disorder in recent years. They also feature hormonal processes such as the hypothalamic-pituitary-adrenal axis, which has been known to be involved in stress responses, but has not been prominent in many recent theories of the pathogenesis of bipolar disorder.
Continue reading

Overuse Sports Injuries More Common In Children From High Income Families

MedicalResearch.com Interview with: Neeru Jayanthi, MD Associate Professor Medical Director, Primary Care Sports Medicine Loyola University Medical Center study MedicalResearch.com: What are the main findings of the study? Dr. Jayanthi: We surveyed a cohort of 1,190 athletes ages 7 to 18, including 1,121 for whom insurance status could be determined. Our main findings were: 1. The rate of serious overuse injuries in athletes who come from families that can afford private insurance is 68 percent higher than the rate in lower-income athletes who are on public insurance (Medicaid). 2. Privately insured young athletes are twice as likely as publicly insured athletes to be highly specialized in one sport.  MedicalResearch.com: Were any of the findings unexpected? Dr. Jayanthi: The findings confirmed our hypothesis that higher-income students would be more likely to specialize in one sport, and also more likely to suffer serious overuse injuries. MedicalResearch.com: What should clinicians and patients take away from your report?   Dr. Jayanthi: Specializing in one sport at an early age increases the risk of serious overuse injuries. Here are evidence-based tips to reduce the risk of overuse injuries: •	Increase the amount of unstructured free play, while limiting the amount of time spent in organized sports and specialized training. Do not spend more than twice as much time playing organized sports as you spend in unstructured play. •	Do not spend more hours per week than your age playing sports. For example, a 10-year-old should not spend more than 10 hours per week playing sports. •	Do not specialize in one sport before late adolescence. •	Do not play sports competitively year round. Take a break from competition for one to three months each year (not necessarily consecutively). •	Take at least one day off per week from sports training. MedicalResearch.com: What recommendations do you have for future research as a result of this study? Dr. Jayanthi: We are doing a pilot study this summer comparing parent/child dyads of high competitive young athletes and recreationally active children with parent dyad to see differences based on sports participation of child and adult, as well as based on socioeconomic status. This may lead to a much larger study.  Citation: Abstract presented at the American Medical Society for Sports Medicine Annual Meeting in New Orleans, LA.MedicalResearch.com Interview with:
Neeru Jayanthi, MD
Associate Professor
Medical Director, Primary Care Sports Medicine
Loyola University Medical Center study


MedicalResearch.com: What are the main findings of the study?

Dr. Jayanthi: We surveyed a cohort of 1,190 athletes ages 7 to 18, including 1,121 for whom insurance status could be determined. Our main findings were:

1. The rate of serious overuse injuries in athletes who come from families that can afford private insurance is 68 percent higher than the rate in lower-income athletes who are on public insurance (Medicaid).

2. Privately insured young athletes are twice as likely as publicly insured athletes to be highly specialized in one sport.
Continue reading

Prostate Cancer: Aggressive Disease Associated with Chronic Inflammation

Angelo M. De Marzo MD PhD Professor of Pathology Johns Hopkins School of Medicine Baltimore, MD 21231MedicalResearch.com Interview with:
Angelo M. De Marzo MD PhD
Professor of Pathology
Johns Hopkins School of Medicine
Baltimore, MD 21231

MedicalResearch.com: What are the main findings of the study?

Dr. De Marzo: Working as a team with Dr. Elizabeth Platz and a group of other investigators we found that men with chronic inflammation in their benign areas of their prostate biopsies had a higher chance of prostate cancer,  and especially higher grade cancers, which are associated with disease aggressiveness. A key unique aspect of the study is that the samples were taken from man who were enrolled in the Prostate Cancer Prevention Trial (PCPT), a trial in which all men entering the study had a relatively low PSA, and, all men at the end of study who did not already have a diagnosis of prostate cancer were offered a prostate biopsy regardless of their PSA. This study design, unlike a standard association study, allowed us to minimize the potential bias whereby inflammation is associated itself with elevations in PSA. In this standard design approach, when cancer is detected it could artifactually appear that inflammation is associated with cancer because the inflammation was in part driving the PSA elevation, which prompted the biopsy in which cancer was detected.

Continue reading

Cancer: Financial Strain and Modifiable Risk Factors in African Americans

Dr. Lorraine R. Reitzel Ph.D Associate Professor in the Health Program of the Department of Educational Psychology College of Education, University of Houston in Houston, Texas.MedicalResearch.com Interview with:
Dr. Lorraine R. Reitzel Ph.D
Associate Professor in the Health Program of the Department of Educational Psychology
College of Education, University of Houston in Houston, Texas.
MedicalResearch.com: Please tell us about your study.

Dr. Reitzel: The current study represented a secondary analysis of data that were collected by Dr. Lorna McNeill and colleagues at The University of Texas MD Anderson Cancer Center. The parent study was focused on better understanding factors associated with cancer risk among African American adults, and several faculty members including myself contributed ideas about the variables we thought might play a role. The current study represents one of several studies emerging from these data. The current study was led by Ms. Pragati S. Advani, a graduate student on my research team, who was interested in better understanding the associations between financial strain and modifiable behavioral risk factors for cancer among African American adults. Financial strain represents an unfavorable income to needs ratio and was assessed using a questionnaire that tapped into current difficulty affording things that represent pretty basic components of life, including suitable food, clothing, and housing for the respondent and their family. The modifiable behavioral risk factors for cancer examined included smoking cigarettes, at-risk alcohol use, being overweight/obese, getting insufficient physical activity, and having inadequate fruit and vegetable intake. We also included a tally of the total number of these factors (0 to 5) as an outcome variable of interest.
Continue reading

Severe Obesity Linked to Vitamin D Deficiency

MedicalResearch.com Interview with:
Tomás Ahern MB, BCh, BAO
St Columcille’s Hospital and St Vincent’s University Hospital
Dublin, Ireland

MedicalResearch.com: What are the main findings of the study?

Answer: More than 40% of severely obese people, who make up 6.5% of American adults, are at risk of vitamin D deficiency.

Severely obese people with low vitamin D levels are less active and have worse physical function than those with healthy vitamin D levels. Other investigators have found that poor physical function predicts premature death – whether this is the case in people with severe obesity remains to be determined.

MedicalResearch.com: Were any of the findings unexpected?

Answer: Yes. Other studies, of people without severe obesity, have shown that people with low vitamin D levels have higher blood sugar levels and are more likely to have diabetes. We did not find such a relationship in this study of people with severe obesity.

MedicalResearch.com: What should clinicians and patients take away from your report?

Answer: Determining serum 25-hydroxyvitamin D levels in severely obese people is appropriate because low levels are common and associated with poor physical activity and poor physical function.

The finding of a low 25-hydroxyvitamin D level should be a portal to interventions that improve physical function and should lead to consideration of vitamin D supplementation. Vitamin D supplementation can take the form of spending more time outdoors or chewing calcium and vitamin D tablets daily.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Ahern: We feel that this study generates the imperative to determine the effects of vitamin D supplementation in severely obese people at risk of vitamin D deficiency. We feel it likely that vitamin D supplementation in this group will result in improvement in physical function and possibly improvement in other markers of increased mortality.

Citation:

Association between Vitamin D Status and Physical Function in the Severely Obese

T. Ahern, A. Khattak, E. O’Malley, C. Dunlevy, M. Kilbane, C. Woods, M. J. McKenna, D. O’Shea. Association Between Vitamin D Status and Physical Function in the Severely Obese. The Journal of Clinical Endocrinology & Metabolism, 2014; jc.2014-1704 DOI: 10.1210/jc.2014-1704

 

About Half of Adults Use Dietary Supplements On A Regular Basis

Dr. Annette Dickinson PhD Consultant to the Council for Responsible Nutrition.MedicalResearch.com Interview with:
Dr. Annette Dickinson PhD
Consultant to the Council for Responsible Nutrition.

 
MedicalResearch.com: What are the main findings of the study?  

Dr. Dickinson: “A five-year series of consumer surveys (2007 to 2011) consistently found that about half of adult consumers use dietary supplements on a regular basis, and a higher percentage (about 2/3) report using dietary supplements when occasional as well as regular use is taken into account.  Over the five years, there was a shift in the pattern of supplement use, with the percentage of respondents who said they regularly used mostly a multivitamin declining, and the percentage who said they regularly used a variety of products increasing.  The top 7 products used were:  multivitamins, omega-3 fatty acids, calcium, vitamin D, vitamin C, B vitamins, and vitamin E.  The main reasons given for supplement use were for overall health and wellness (58% of users) and to fill nutrient gaps in the diet (42%).  Supplement users were more likely than nonusers to say they try to eat a balanced diet, visit their doctor regularly, get a good night’s sleep, exercise regularly, and maintain a healthy weight.  This indicates that supplement use is part of an overall approach to seeking a healthy lifestyle.” Continue reading

Obesity in Early Childhood Linked to Weight Gain in Pregnancy

MedicalResearch.com Interview with:
Sneha Sridhar, MPH
Kaiser Permanente, Division of Research
2000 Broadway, 3rd Floor
Oakland, CA  94612

MedicalResearch.com: What are the main findings of the study?
 
Answer: We found that women whose weight gain during pregnancy exceeded the current Institute of Medicine (IOM) recommendations were 46% more likely to have an overweight or obese child at ages 2-5, compared to women who met the recommendations. The association was stronger among women who were of normal weight before pregnancy. These normal weight women were more likely to have an overweight or obese child if they gained either below or above the IOM recommendations.
Continue reading

Graves’ and Hashimoto’s Thyroid Disease: Race and Ethnic Relationships

MedicalResearch.com Interview with:
Donald S. A. McLeod, FRACP, MPH
Department of Population Health,
QIMR Berghofer Medical Research Institute, Herston,
Queensland, Australia

MedicalResearch.com: What are the main findings of the study?

Dr. McLeod: We examined the incidence of Graves’ disease and Hashimoto’s thyroiditis by race/ethnicity among U.S. active duty service personnel aged 20-54 years over a 15-year period (more than 20,000,000 person years follow-up). Cases were identified by International Classification of Diseases, Ninth Revision, Clinical Modification codes.

In women, we found that Graves’ disease was almost twice as common among non-Hispanic black and Asian-Pacific Islander personnel compared with non-Hispanic white personnel.  While in men, non-Hispanic black and Asian-Pacific Islander personnel had over two-and-a-half times higher incidence compared with non-Hispanic white personnel. The opposite pattern existed for Hashimoto’s thyroiditis, with non-Hispanic white personnel having the highest incidence, and non-Hispanic black and Asian-Pacific Islander personnel the lowest incidence. Hispanic personnel did not have significantly different incidence compared to white personnel for either disorder.

Continue reading

Medical Diagnostic Errors Occur In About 5% of US Adults

Dr Hardeep Singh MD MPH  Chief of the health policy, quality & informatics program at the Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety, based at the Michael E. DeBakey VA Medical Center in Houston, Texas Associate professor at Baylor College of Medicine in HoustonMedicalResearch.com Interview with:
Dr Hardeep Singh MD MPH 
Chief of the health policy, quality & informatics program at the Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety, based at the Michael E. DeBakey VA Medical Center in Houston, Texas
Associate professor at Baylor College of Medicine in Houston

MedicalResearch.com: What are the main findings of the study?

Dr Singh: We built estimates of diagnostic error by compiling and analyzing data from three previous studies. These studies evaluated situations such as unexpected return visits and lack of timely follow up and provided researchers with an estimated frequency of diagnostic error. This frequency was then applied to the general adult population. Diagnostic errors, which we defined as missed opportunities to make a correct or timely diagnosis based on available evidence—occur in about 5 percent of adults in the United States.

Continue reading