- Since 2006, the VA has been systematically using teleretinal screening of patients with diabetes to screen for retinopathy in the Primary Care Clinics. Under this program, 90% of veterans with diabetes are evaluated on a regular basis. A number of patients who are screened have findings that warrant a face-to-face ophthalmic exam. No information exists on the effect of such a program on medical center resources.
- 1,935 patients underwent teleretinal screening through the Atlanta VA over a 6 month period. We reviewed the charts of the 465 (24%) of the patients who were referred for a face to face exam in the Eye Clinic.
- Data was collected for these patients to determine the reasons for referral, the accuracy of the teleretinal interpretation, the resources needed in the Eye Clinic of the Medical Center to evaluate and care for the referred patients over a two year period and possible barriers to patient care.
- Of the 465 patients referred for an exam, 260 (55.9%) actually came in for an exam. Community notes were available for an additional 66 patients. Information was available for 326 (70.1%) of the referred patients.
- The most common referring diagnoses were nonmacular diabetic retinopathy (43.2% of referrals), nerve related issues (30.8%), lens or media opacity (19.1%), age-related macular degeneration (12.9%) and diabetic macular edema (5.6%).
- 16.9% of the referred patients had 2 or more concurrent problems that put them at high risk for visual loss.
- The percentage agreement between teleretinal screening and the ophthalmic exam was high: 90.4%. Overall sensitivity was 73.6%. The detection of diabetic macular edema had the lowest sensitivity.
- A visually significant condition was detected for the first time through teleretinal screening for 142 of the patients examined (43.6%).
- The resource burden to care for referred patients was substantial.
- 36% of patients required 3 or more visits over the ensuing 2 year period.
- The treatment of diabetic macular edema had the highest resource use involving on average 5 clinic visits, 6 diagnostic procedures and 2 surgical procedures
- The most common non-refractive diagnostic procedures were visual fields and optical coherence tomography.
- The average cost to care for the referred patients (in Medicare dollars) in work RVUs alone was approximately $1,000 per patient. The cost to care for a patient with diabetic macular edema was $2673.36.
Author Interviews, JAMA, Ophthalmology, Telemedicine / 11.09.2014
MedicalResearch.com Interview with: Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia Medical Research: What are the main findings of the study? Dr. Lynch:
Author Interviews, Dermatology, JAMA, NIH, Transplantation / 11.09.2014
MedicalResearch.com Interview with: Rena Zuo, BA MD Candidate at Duke University School of Medicine and Edward W. Cowen, MD, MHSc Senior Clinician Head, Dermatology Consultation Service Dermatology Branch Center for Cancer Research National Cancer Institute National Institutes of Health MedicalResearch: What are the main findings of the study? Answer: Chronic graft-vs-host disease (cGVHD) is a debilitating multisystem disease that occurs in patients receiving allogeneic hematopoietic stem cell transplantations as treatment for hematologic disorders. Although the diverse clinical presentations of cGVHD frequently mimic other autoimmune diseases such as Sjögren syndrome and systemic sclerosis, and low-titer antibodies are commonly found in patients with cGVHD, the exact pathogenesis and role of autoimmunity in cGVHD are incompletely understood. Our study is the first to characterize and identify risk factors associated with the development of two uncommon autoimmune phenomena, specifically alopecia areata and vitiligo, in the setting of cGVHD. Laboratory markers, including 11 antibodies, transplant-related factors, and other cGVHD systemic manifestations were analyzed. Several particularly interesting results were found:
- Among 282 patients with cGVHD, 15 demonstrated vitiligo (14 of 282; 4.9%) and/or alopecia areata (2 of 282; 0.7%).
- Female donor and female donor to male recipient sex mismatch, in particular, are significantly associated with the development of vitiligo and/or alopecia areata.
- Positive anti-cardiolipin (ACA) IgG was also significantly associated with development of vitiligo and/or alopecia areata.
Author Interviews, Dermatology, Gastrointestinal Disease, JAMA, Mayo Clinic / 11.09.2014
MedicalResearch.com Interview with: Shadi Rashtak, MD Department of Dermatology Mayo Clinic College of Medicine Rochester, Minnesota Medical Research: What are the main findings of the study? Dr. Rashtak: We found that among a population of mainly acne patients those who received isotretinoin had a lower risk of inflammatory bowel disease as compared to those who did not take this medication. We carefully reviewed the medical records of patients to ensure that this finding was not simply because the drug was avoided in patients with a previous personal or family history of IBD. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA / 10.09.2014
MedicalResearch.com Interview with: Hayley Gershengorn MD Assistant Professor, Department of Medicine (Critical Care) Assistant Professor, The Saul R. Korey Department of Neurology Albert Einstein College of Medicine Bronx, NY 10461 Medical Research: What are the main findings of the study? Dr. Gershengorn: Using a large national database, we found there to be no association between the use of arterial catheters and mortality in mechanically ventilated medical intensive care unit patients. Similarly, we found no beneficial association between arterial catheters and mortality in any of the eight other critically ill subgroups evaluated. (more…)
Author Interviews, Cost of Health Care, JAMA / 09.09.2014
MedicalResearch.com Interview with: Michael Johansen, MD MS Assistant Professor Dept of Family Medicine Ohio State University Medical Research: What are the main findings of the study? Dr. Johansen: Between 2007-2011, the United States spent $63.4 billion on high-cost proton pump inhibitors of which $47.1 billion was in excess of using generic omeprazole. (more…)
MedicalResearch.com Interview with: Louis R. Pasquale, MD Channing Division of Network Medicine Department of Ophthalmology Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, Massachusetts Medical Research: What are the main findings of the study? Dr. Pasquale: We found that more time spent outdoors in summer was associated with increased risk of exfoliation syndrome. (more…)
Author Interviews, JAMA, Mental Health Research, Schizophrenia / 06.09.2014
MedicalResearch.com Interview with: Sandra M. Meier, PhD The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, National Centre for Register-Based Research Aarhus University, Aarhus, Denmark Medical Research: What are the main findings of the study? Dr. Meier: People with an obsessive-compulsive disorder are at a 6 to 7 times higher risk of developing schizophrenia than people without an obsessive-compulsive disorder. If the parents are diagnosed with an obsessive-compulsive disorder, their offspring experience a 3 to 4 times higher chance to develop schizophrenia. (more…)
Author Interviews, JAMA, Multiple Sclerosis / 05.09.2014
MedicalResearch.com Interview with: Jeffrey Cohen MD Department of Neurology Cleveland Clinic Medical Research: What are the main findings of the study? Dr. Cohen: This study assessed the relationship between walking speed, as measured by the Timed 25-foot Walk test, and patient-reported quality of life, as measured by the Physical Component Summary score of the 36-Item Short Form Health Survey (SF-36), in a pooled dataset from the AFFIRM, SENTINEL, and IMPACT multiple sclerosis Phase 3 trials. It showed that slowed walking speed is associated with decreased quality of life. It also showed that 20-25% slowing of walking speed is a clinically meaningful change. (more…)
Author Interviews, JAMA, Nutrition / 03.09.2014
MedicalResearch.com Interview with: Dong D. Wang, MD, MSc Department of Nutrition Harvard School of Public Health Boston, Massachusetts Medical Research: What are the main findings of the study? Dr. Wang:
- The quality of the US diet improved modestly from 1999 to 2010, but the dietary quality of US population remains far from optimal and huge room exists for further improvements.
- More than half of the improvement in diet quality was due to a large reduction in consumption of trans fat.
- he improvement in dietary quality was greater among persons with higher socioeconomic status and healthier body weight, thus disparities that existed in 1999 increased over the next decade.
Author Interviews, Breast Cancer, JAMA / 03.09.2014
MedicalResearch.com Interview with: Dr. Gudrun Jonasdottir...
Author Interviews, JAMA, Weight Research / 03.09.2014
MedicalResearch.com Interview with: Bradley Johnston, PhD Scientist | Child Health Evaluative Sciences Hospital for Sick Children Research Institute Assistant Professor | Department of Clinical Epidemiology & Biostatistics McMaster University Toronto, Ontario, Canada Medical Research: What are the main findings of the study? Dr. Johnston:
- Our findings represent the first meta-analysis using advanced epidemiological methods to summarize popular branded diets for weight loss, trials having been investigated using randomized trial methodology.
- Among the 48 original RCTs included in our NMA, low to moderate quality evidence showed that both low-carbohydrate and low-fat diets were associated with an approximate 8 kg weight loss at 6 months when compared to no diet. Approximately 1-2 kg of this effect was lost by 12-months.
- Although statistical differences existed among several of the diet macronutrient classes, the differences were small and unlikely to be important to those seeking to lose weight.
- Similarly, our results showed that although there are statistically significant differences between some of the brand named diets, these differences are small and not likely patient important.
- In terms of potential effect modifiers, behavioural support was significant at 6-months (enhancing weight-loss by 3.23 kg) and exercise was significant at 12-months (enhancing weight loss by 2.13 kg)
- Regarding our sensitivity analyses, Differences in weight loss were not clinically important based on risk of bias, missing data, baseline weight, gender, and those with and without specific health conditions
- Overall, our findings suggest that patients may choose, among those associated with the largest weight loss, the diet that gives them the least challenges with adherence.
Author Interviews, Heart Disease, JAMA / 31.08.2014
MedicalResearch.com Interview with: Massimo Imazio on behalf of the COPPS-2 Investigators Massimo Imazio. MD, FESC Dipartimento di Cardiologia/Cardiology Department Maria Vittoria Hospital and University of Torino Torino, Italia Medical Research: What is the background for this investigation? Dr. Imazio: Post-pericardiotomy syndrome, post-operative atrial fibrillation (AF), and post-operative effusions may be responsible for increased morbidity and healthcare costs after cardiac surgery. Postoperative use of colchicine prevented these complications in a single trial (the COPPS trial published on EHJ in 2010). Here all events occurred within 3 months and colchicine was given after cardiac surgery starting from postoperative day 3 for 1 month. However most postoperative AF events are reported in the first 3 days and thus pre-treatment with colchicine may give better outcomes. Thus we performed the COPPS-2 giving colchicine 48 to 72 hours before surgery for 1 month without a loading dose and weight adjusted doses (i.e. 0.5 mg twice daily for patients >70kg or 0.5 mg once for patients <70Kg) in order to improve patients compliance.The Colchicine for Prevention of the Post-pericardiotomy Syndrome and post-operative atrial fibrillation (COPPS-2 trial) is an investigator-initiated, double-blind, placebo-controlled, randomized clinical trial. A total of 360 consecutive candidates for cardiac surgery, 180 for each arm, were enrolled in 11 Italian centers between March 2012 and March 2014. Main exclusion criteria were absence of sinus rhythm at enrollment, cardiac transplantation, and contraindications to colchicine. (more…)
Author Interviews, Dermatology, JAMA, UC Davis / 28.08.2014
MedicalResearch.com Interview with: Gayatri Patel, MD, MPH Division of General Medicine UC Davis Medical Center Medical Research: What are the main findings of the study? Dr. Patel: In this systematic review and meta-analysis, we sought to determine the effectiveness of photodynamic therapy (PDT) for the treatment of actinic keratoses relative to other common treatments. We included only randomized controlled trials and preformed a meta-analysis on homogenous studies. The primary finding of the study was that PDT has a better chance of removing actinic keratoses on the face or scalp than treatment with cryotherapy. (more…)
Author Interviews, Hospital Acquired, JAMA, Surgical Research / 28.08.2014
MedicalResearch.com Interview with: Christopher Mantyh, M.D. Associate Professor of Surgery Chief of Colorectal Surgery NSQIP Surgical Champion Duke University Medical Center Medical Research: What are the main findings of the study? Dr. Mantyh: Specific perioperative bundles can drastically reduce surgical site infections in colorectal surgery patients. (more…)
Author Interviews, Cancer Research, JAMA, Outcomes & Safety / 28.08.2014
MedicalResearch.com Interview with: Elizabeth Goodman BA Division of Oncology The Children’s Hospital of Philadelphia Philadelphia, Pennsylvania Medical Research: What are the main findings of the study? Answer: Weekend hospital admission for pediatric patients newly diagnosed with leukemia was associated with a longer length of stay, slightly longer wait to start chemotherapy and higher risk for respiratory failure; however, weekend admissions were not linked to an increased risk for death. (more…)
Author Interviews, Bipolar Disorder, JAMA, Stanford / 27.08.2014
MedicalResearch.com Interview with: Manpreet K. Singh, MD MS Assistant Professor of Psychiatry and Behavioral Sciences Akiko Yamazaki and Jerry Yang Faculty Scholar in Pediatric Translational Medicine Stanford University School of Medicine Medical Research: What are the main findings of the study? Dr. Singh: Our research team used a monetary incentive delay paradigm to measure fronto-limbic activity and connectivity associated with anticipation and receipt of reward and loss in healthy offspring of parents with bipolar I disorder. We found that compared to youth offspring without any family history of psychopathology, high-risk offspring had aberrant prefrontal and cingulate activations and connectivity during reward processing. Further, greater striatal, amygdalar, and insula activations while anticipating and receiving rewards and losses were associated with greater novelty-seeking and impulsivity traits in high-risk youth. (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease, JAMA / 27.08.2014
MedicalResearch.com Interview with Prof Richard McManus MA PhD FRCGP NIHR School for Primary Care Research, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire United Kingdom Medical Research: What are the main findings of the study? Prof. McManus: The TASMIN-SR clinical trial followed 552 patients with an average age of 70 and high blood pressure with pre-existing cardiovascular disease, diabetes or chronic kidney disease. After training in how to self-monitor blood pressuring using a readily available device, patients took readings twice each morning for the first week of each month, and following an individualised management plan were able to request additional medication from their general practitioner without the need for consultation. At the end of the study, patients who self-managed had significantly lower blood pressure (by 9.2 / 3.4 mmHg) than those who were visiting their GP for blood pressure monitoring, which would be expected to lower stroke risk by around 30% if sustained. (more…)
Author Interviews, Infections, JAMA, Pediatrics / 27.08.2014
MedicalResearch.com Interview with: Dr. Ralph Joseph Diclemente PhD Behavoral Sciences & Health School Of Public Health Emory University Atlanta Georgia Medical Research: What are the main findings of the study? Dr. DiClemente: In our study of 701 African American girls we observed significant and durable reductions in laboratory-confirmed sexually transmitted infections (50% reduction in chlamydial infections and a 60% reduction in gonorrhea) among girls in our intervention group relative to the comparison condition over a 36-month follow-up period. In addition, we observed significant increases in condom use during sex and reductions in sex while using drugs or alcohol. The key finding is the durability of the results - 3 years in the life of an adolescent is a long period. (more…)
Author Interviews, Heart Disease, JACC, JAMA / 26.08.2014
MedicalResearch.com Interview with: Dr. Peter Godsk Jørgensen Copenhagen City Heart Study Frederiksberg Hospital, Frederiksberg, Denmark Medical Research: What are the main findings of your study? Dr. Jørgensen: In the coming decades, a larger and larger proportion of the population will be aged 65 years or above. At present, no risk prediction models have been developed specifically for estimation of risk in this population. ECG changes are easily recognized and identify subclinical signs of end-organ disease. Our data reveal that not only are ECG changes a very frequent finding that independently predicts cardiovascular disease, they significantly improve risk prediction when added to the most used European and US risk models. Thus, our data demonstrate that adding ECG changes will correctly reclassify more than one third of the persons aged 65 years and above without cardiovascular disease. (more…)
Author Interviews, General Medicine, Heart Disease, JAMA / 26.08.2014
MedicalResearch.com Interview with Steven M. Bradley, MD, MPH Veterans Affairs, Eastern Colorado Health CareSystem Denver, Colorado Medical Research: What are the main findings of the study? Dr. Bradley: In 539 hospitals participating in the CathPCI Registry that performed elective coronary angiography on more than 500,000 patients, 22% of patients were asymptomatic at the time of coronary angiography. We observed marked variation in the hospital rate of angiography performed in asymptomatic patients, ranging from 0.2% to 66.5%, suggesting broad variation in the quality of patient selection for coronary angiography across hospitals. Additionally, hospitals with higher rates of asymptomatic patients at diagnostic angiography also had higher rates of inappropriate PCI, due to greater use of PCI in asymptomatic patients. These findings suggest that patient selection for diagnostic angiography is associated with the quality of patient selection for PCI as determined by Appropriate Use Criteria. By addressing patient selection upstream of the catheterization laboratory, we may improve on the optimal use of both angiography and PCI. (more…)
Author Interviews, Heart Disease, JAMA / 26.08.2014
MedicalResearch Interview with: Michael B. Rothberg, MD, MPH Department of Internal Medicine Medicine Institute, Vice Chair for Research Cleveland Clinic, Cleveland, Ohio Medical Research: What are the main findings of the study? Dr. Rothberg: In this randomized study we found that when people are presented with no information about the benefits of elective PCI, most assumed that it would prevent a heart attack. Unfortunately, this is incorrect, so people may choose to have the procedure based on false information. We also found that simply telling them that PCI would not prevent a heart attack successfully dispelled this belief for most, but not all, participants. Explaining why PCI does not prevent heart attacks in this circumstance was the most effective way to change people's beliefs. We also found that most people were willing to take medications, but when they were told that PCI does not prevent heart attacks, they were more likely to agree to medication. (more…)
Author Interviews, Frailty, Geriatrics, JAMA / 22.08.2014
MedicalResearch.com Interview with Dr. Bellal Joseph MD FACS Associate Professor of Surgery Medical Director, Southern Arizona Telemedicine and Telepresence (SATT) Program Program Director, International Research Fellowship Liaison, Multi-Specialty Surgery Clinic at UAMC Medical Research: What are the main findings of the study? Dr. Joseph: Chronologic age is frequently used as the determinant of outcomes when treating elderly and treatments are tailored accordingly. However, the findings of our study challenge this dogma and suggest that it’s not the chronologic age rather frailty status of the individual that determines outcomes. We found frailty Index (quantitative measure of frailty) as a better predictor of in-hospital complications and discharge disposition in elderly compared to the chronologic age. (more…)
Author Interviews, JAMA, Johns Hopkins, Outcomes & Safety / 20.08.2014
MedicalResearch.com Interview with: Sosena Kebede, MD, MPH Assistant Professor of Medicine, Department of Medicine Associate Faculty, the Armstrong Institute for Patient Safety and Quality, Johns Hopkins School of Medicine Faculty, Department of Health Policy and Management and Baltimore, MD 21287 Medical Research: What are the main findings of the study? Dr. Kebede: There were 3 main findings in this study: 1. Patients’ understanding of aspects of their hospital care is suboptimal on the domains of knowledge of diagnoses, indications for the medications they take and the types of procedures/tests they get. Some forms of poor shared understanding could have potentially serious implications for their health and for future care such as identifying a prescribed antidepressant as a blood thinner or mistaking an echocardiogram a left heart catheterization or thinking a liver cyst is a liver cancer. Other forms of poor shared understanding such as not accurately identifying why a procedure is done or what the results of the procedure show (a finding not discussed in the research letter) may seem less consequential but raise the issue of informed consent, patient empowerment and may alsoraise questions about patient and physician behavior towards appropriate use of in-patient procedures. Some of the questions we could ask here include: would patients demand more or less procedures if they had better understanding of what the procedures entail, and why they are beingordered? Conversely, would physicians recommend more or less of in-patient procedures, when they encounter patients whose understanding of procedure indications are optimal? (more…)
Author Interviews, JAMA, Karolinski Institute, Surgical Research / 20.08.2014
MedicalResearch.com Interview with: Mats Möller MD Department of Surgery, Ersta Hospital Department of Clinical Sciences Karolinska Institutet Danderyds Hospital, Stockholm, Sweden Medical Research: What are the main findings of the study? Dr. Möller: The natural course of common bile duct stones seem not as favorable as previous studies have suggested. Leaving stones with no measures taken has in our study a less favorable outcome compared to removing the stones. (more…)
Author Interviews, JAMA, Pediatrics, Pulmonary Disease / 19.08.2014
MedicalResearch.com Interview with: Suzanne Schuh, MD, FRCP(C), FAAP, ABPEM Staff Paediatrician, Division of Paediatric Emergency Medicine Senior Associate Scientist, Research Institute, Hospital for Sick Children Professor of Paediatrics, University of Toronto Medical Research: What are the main findings of this study? Dr. Schuh: Our study shows that in previously healthy infants presenting to the Emergency Department with mild to moderate bronchiolitis (a viral lower respiratory tract disease producing breathing distress) who had their oxygen saturation measurements artificially elevated by a physiologically small amount experienced significantly reduced rate of hospitalizations within 72 hours compared to infants with unaltered oximetry readings. (more…)
Author Interviews, Diabetes, JAMA, Macular Degeneration, Race/Ethnic Diversity / 19.08.2014
MedicalResearch.com Interview with: Rohit Varma, MD, MPH Grace and Emery Beardsley Professor and Chair USC Department of Ophthalmology Director, USC Eye Institute Associate Dean for Strategic Planning and Network Development Keck School of Medicine of USC Medical Research: What are the main findings of the study? Dr. Varma: Our research demonstrates African-Americans bear a heavier burden of diabetic macular edema (DME), one of the leading causes of blindness in diabetic patients in the United States, compared to Non-Hispanic whites. The study points to a need for improved screening and greater attention to vision loss by clinicians and patients particularly those who are at high risk of developing diabetic macular edema. (more…)
Author Interviews, Cancer Research, Erasmus, JAMA / 19.08.2014
MedicalResearch.com Interview with: Frank van Hees MSc Erasmus University Medical Center Rotterdam, the Netherlands Medical Research: What are the main findings of the study? Answer: Many U.S. elderly are screened for colorectal cancer more frequently than recommended: One in every five elderly with a negative screening colonoscopy result undergoes another screening colonoscopy within 5 years’ time instead of after the recommended 10 years. Moreover, one in every four elderly with a negative screening colonoscopy result at age 75 or older receives yet another screening colonoscopy at an even more advanced age. Our study shows that, in average risk individuals, these practices are not only a waste of scarce health care resources: often they are also associated with a balance among benefits, burden, and harms that is unfavorable for those being screened. (more…)
MedicalResearch.com Interview with: Agnes Dechartres, MD, PhD Centre de Recherche Epidémiologie et Statistique Centre d’Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France Medical Research: What are the main findings of the study? Dr. Dechartres: In this study, we aimed to compare treatment effect estimates obtained from the meta-analysis including all trials to several alternative strategies for analysis. These alternative strategies are:
- 1) the single most precise trial;
- 2) a meta-analysis including only the largest trials;
- 3) a “limit meta-analysis” that is a type of meta-analysis model recently developed to take into account small-study-effect and
- 4) a meta-analysis restricted to trials at low risk of biases.
Author Interviews, Colon Cancer, JAMA, Transplantation / 15.08.2014
MedicalResearch.com Interview with: Øyvind Holme, MD Department of Medicine, Sorlandet Hospital Kristiansand, Kristiansand, Norway Institute of Health and Society, University of Oslo, Oslo, Norway Departments of Epidemiology and Biostatistics, Harvard School of Public Health, Harvard-MIT Division of Health Sciences and Technology Boston, Massachusetts Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway Medical Research: What are the main findings of the study? Dr. Holme: In this population-based trial, we found that once-only flexible sigmoidoscopy screening in asymptomatic 50-64 year old individuals reduces colorectal cancer mortality by 27% and colorectal cancer incidence by 20% after 11 years of follow-up. We found that the incidence reduction is as great in 50-54 year old individuals as in 55-64 old individuals. Addition of a once-only fecal occult blood test to flexible sigmoidoscopy did not lead to a larger reduction in colorectal cancer incidence or mortality compared to flexible sigmoidoscopy screening alone. (more…)
Author Interviews, JAMA, Mental Health Research / 13.08.2014
MedicalResearch.com Interview with Dr Golam Khandaker Clinical Lecturer, Department of Psychiatry University of Cambridge Medical Research: What are the main findings of the study? Dr. Khandaker: The study shows low grade systemic inflammation may have a role in the pathogenesis of depression and psychotic disorders. Low grade systemic inflammation may also be a common cause for chronic physical and psychiatric illnesses. The study shows that higher serum levels of the circulating inflammatory marker, interleukin 6 (IL-6), in childhood is associated with nearly two-fold increased risk of developing depression and psychotic disorder in young adulthood. This association persisted after taking into account effects of age, sex, social class, ethnicity, body mass index, maternal depression, and past psychological and behavioural problem in the participant. We studied a sample of 4,500 individuals from the Avon Longitudinal Study of Parents and Children birth cohort, taking blood samples at age 9 and following up at age 18, to see if they had experienced episodes of depression or psychosis. We excluded children with an infection at the time of blood test at age 9 years. (more…)