Cardiology Articles Pertaining to Lifestyle and Nutrition Receive Most Media Attention

Posted on November 26, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Patel

Ravi B. Patel, MD
Division of Cardiology, Department of Medicine
Northwestern University Feinberg School of Medicine
Chicago, Illinois

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The digital attention of scientific articles can be readily quantified using the Altmetric score. The Altmetric score is a weighted measure, incorporating a variety of media platforms.

We aimed to characterize the Top 10% of articles by Altmetric score among 4 major cardiovascular journals (Circulation, European Heart Journal, Journal of the American College of Cardiology, and JAMA Cardiology) in 2017.

Our primary findings were:

1) nearly half of the most disseminated articles were not original research investigations,

2) the most common article topic was nutrition/lifestyle, and

3) there was a weak but significant correlation between Altmetric scores and citation number. Continue reading →

Asthma in Children Can Worsen From Allergy to Secondhand Marijuana

Posted on November 18, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Bryce Hoffman, MD
Allergy & Immunology Fellow
National Jewish Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Secondhand marijuana exposure is expected to increase as personal cannabis use becomes legalized in more states and countries. Cannabis allergy from firsthand use has been reported in adults but allergy in young children exposed to secondhand smoke has not been previously reported. We present a case of a young child with difficult-to-control asthma who was found to have cannabis allergy after being exposed to secondhand marijuana smoke in his household. This child’s asthma improved after cannabis was removed from the environment.

MedicalResearch.com: What should readers take away from your report?

Response: Children exposed to secondhand marijuana smoke can become allergic to cannabis, which in turn may significantly worsen their asthma or allergy symptoms. This is particularly concerning as the cannabis may not be suspected as a cause. Parents and physicians should consider the possibility of cannabis allergy in any child with uncontrolled asthma who is being exposed to secondhand marijuana smoke. This includes any use of marijuana in the household where the patient lives. These children should be referred to an allergist for further work-up.

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

Response: Further studies are needed to replicate these results with more patients in the future, and to optimize methods of testing for cannabis allergy. We need to better understand how secondhand allergy develops – is it from particles in the smoke, or plant particles left over in the environment? We also need to better characterize cannabis allergy and in particular its cross-reactivity with other plant foods and pollens.

I have no disclosures.

Citation:Abstract MEETING American College of Allergy, Asthma and Immunology 2018 Annual Scientific Meeting

Abstract Title: Cannabis allergy in a young child with severe asthma exposed to secondhand marijuana smoke

Author: Bryce Hoffman, MD

Nov 18, 2018 @ 12:20 pm

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Not All Pharmacies Have Naloxone for Opioid Overdose in Stock

Posted on November 14, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Puzantian

Talia Puzantian, PharmD, BCPP
Associate Professor of Clinical Sciences,
School of Pharmacy and Health Sciences
Keck Graduate Institute

MedicalResearch.com: What is the background for this study?

Response: Naloxone has been used in hospitals and emergency rooms since the early 1970s. Distribution to laypersons began in the mid-1990s with harm reduction programs such as clean needle exchange programs providing it, along with education, to mostly heroin users. In the years between 1996-2014, 152,000 naloxone kits were distributed in this way with more than 26,000 overdoses reversed (https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6423a2.htm).

We have data showing that counties in which there was greater naloxone distribution among laypeople, there were lower opioid death rates (Walley AY et al BMJ 2013). However, not all opioid users at risk for overdose will interface with harm reduction programs, particularly prescription opioid users, hence more recent efforts to increase access to laypersons through pharmacists. Naloxone access laws have been enacted in all 50 states but very little has been published about how they’ve been adopted by pharmacists thus far. One small study (264 pharmacies) from Indiana (Meyerson BE et al Drug Alcohol Depend 2018) showed that 58.1% of pharmacies stocked naloxone, only 23.6% provided it without prescription, and that large chain pharmacies were more likely to do so.

Continue reading →

Advanced Prostate Cancer: Androgen-Receptor Testing May Guide Selection of Treatment

Posted on November 14, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

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Prostate cancer that has metastasized to the bone: Wikipedia Image

Vincenza Conteduca, MD, PhD
Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) Srl – IRCCS
Meldola , Italy

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In our previous publications, we showed that the study of plasma cell-free DNA holds promise for improving treatment choice in metastatic castration-resistant prostate cancer (mCRPC). Specifically, we demonstrated that the detection in plasma of aberrations (copy number alterations and/or point somatic mutations) of androgen receptor (AR), using an easy and robust multiplex droplet digital PCR method, predicted an adverse outcome in mCRPC patients treated with second-generation AR-directed therapies (abiraterone or enzalutamide) in both settings: chemotherapy-naïve and post-docetaxel.

This current multi-institution work builds on our previous discoveries. We investigated the association of androgen receptor status and survival in men treated with docetaxel. Moreover, we performed an exploratory analysis in patients treated with docetaxel or AR-directed therapies as first-line therapy.

Interestingly, we observed that plasma AR-gained patients do not have a worse outcome compared to AR-normal patients when treated with docetaxel as first-line therapy. This introduces the opportunity to use plasma to select for docetaxel in preference to androgen receptor-directed therapies in AR gained mCRPC patients.

Continue reading →

Pilates Enabled Patients with Musculo-Skeletal Symptoms to Function Better

Posted on November 13, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Ms Lynne Gaskell MSc
University of Salford
Manchester UK

MedicalResearch.com: What is the background for this study?

Response: Musculoskeletal Pain as a result of common problems affecting the back, neck, shoulder, knee and multi-site pain is an increasing cause of reduced function and quality of life, and ever increasing demands on healthcare, Prognosis is often poor with many people reporting persistent symptoms after consulting their primary care practitioner. The likelihood of persistent and recurrent clinical symptoms may accentuate the physical, psychological, and social impacts of musculoskeletal pain particularly with the middle aged and elderly populations. Pilates is an exercise approach that has become increasingly popular in recent years and includes over fifty different exercises to improve flexibility, balance, core strength, core stability. It can therefore can be individualised for people with different needs, preferences, musculoskeletal conditions, ages and abilities. Aligning exercise to patient’s functional needs has been linked to long-term exercise adherence. Many physiotherapists such as sydney physio solutions have started to specialise in this as a form of treatment, click here for more info on pilates and the many benefits they can have on your physical health.

This study investigated the personal experiences and perceptions of the impact of Pilates on the day-to-day lives of adults with a myriad of chronic MSK conditions following a 12 week Pilates Exercise Programme.The results were organised into five main themes: 1. Physical Improvements strength, core stability, flexibility and balance. 2. Pilates Promotes an Active Lifestyle and improved performance at work and / or hobbies. 3. Psychosocial benefits and improved confidence, 4. Increased Autonomy in Managing their own Musculoskeletal Condition and 5. Motivation to continue with exercise.

Continue reading →

Electronic Decision Support Facilitates Home Discharge of Some PE Patients From ER

Posted on November 13, 2018 by Marie Benz MD FAAD

Dr. Vinson

MedicalResearch.com Interview with:
David R. Vinson, MD
Department of Emergency Medicine
Kaiser Permanente Sacramento Medical Center Sacramento, CA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: At least one-third of emergency department (ED) patients with acute blood clots in the lung, or pulmonary embolism (PE), are eligible for expedited discharged to home, either directly from the ED or after a short (<24 hour) period of observation. Yet in in most hospitals in the U.S. and around the world nearly all ED patients with acute PE are hospitalized. These unnecessary hospitalizations are a poor use of health care resources, tie up inpatient beds, and expose patients to the cost, inconvenience, and risk of inpatient care. The better-performing medical centers have two characteristics in common: they help their physicians identify which PE patients are candidates for outpatient care and they facilitate timely post-discharge follow-up. At Kaiser Permanente Northern California (KPNC), we have had the follow-up system in place for some time, but didn’t have a way to help our physicians sort out which patients with acute PE would benefit from home management.

To correct this, we designed a secure, web-based clinical decision support system that was integrated with the electronic health record. When activated, it presented to the emergency physician the validated PE Severity Index, which uses patient demographics, vital signs, examination findings, and past medical history to classify patients into different risk strata, correlated with eligibility for home care. To make use of the PE Severity Index easier and more streamlined for the physician, the tool drew in information from the patient’s comprehensive medical records to accurately auto-populate the PE Severity Index. The tool then calculated for the physician the patient’s risk score and estimated 30-day mortality, and also offered a site-of-care recommendation, for example, “outpatient management is often possible.” The tool also reminded the physician of relative contraindications to outpatient management. At the time, only 10 EDs in KPNC had an on-site physician researcher, who for this study served as physician educator, study promotor, and enrollment auditor to provide physician-specific feedback. These 10 EDs functioned as the intervention sites, while the other 11 EDs within KPNC served as concurrent controls. Our primary outcome was the percentage of eligible ED patients with acute PE who had an expedited discharge to home, as defined above.

During the 16-month study period (8-month pre-intervention and 8-months post-intervention), we cared for 1,703 eligible ED patients with acute PE. Adjusted home discharge increased at intervention sites from 17% to 28%, a greater than 60% relative increase. There were no changes in home discharge observed at the control sites (about 15% throughout the 16-month study). The increase in home discharge was not associated with an increase in short-term return visits or major complications. Continue reading →

Estrogen Receptors More Versatile and Widespread Than Previously Recognized

Posted on November 10, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Prof. Cathrin Brisken MD, PhD
ISREC, School of Life Sciences
Ecole Polytechnique Fédérale (EPFL)
CH-1015 Lausanne, Switzerland

MedicalResearch.com: What is the background for this study?

Response: Estrogen receptor signaling has been well characterized in various in vitro models, like breast cancer cell lines. Understanding estrogen receptor action in complex in vivo context is much more challenging.

We obtained elegant mouse models in which either all estrogen receptor function or specifically either the hormone dependent (AF-2) or the hormone independent (AF-1) function were ablated. Using the mammary glands from these mice we performed tissue recombination studies to discern the role of the different aspects of estrogen receptor signaling in the mouse mammary epithelium and its different cell populations.

Continue reading →

Daily Drinking is Dangerous

Posted on November 8, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Sarah Hartz, MD PhD
Assistant Professor
Department of Psychiatry
Washington University School of Medicine in St. Louis

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This study is the first to show that daily drinking is dangerous. Specifically, drinking four or more times weekly, even if it’s only 1-2 drinks at a time, increases risk of mortality. This is in line with recent studies published in the Lancet, but we were able to break down their lowest drinking categories (up to 12.5 drinks weekly in one and up to 5.6 drinks weekly in the other) and found that the frequency is important, not just the average number of drinks per week. It looks like the increased mortality is predominantly due to cancer-related deaths.

Continue reading →

Medical Record Doesn’t Always Reflect Medications Patient Actually Taking

Posted on November 6, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Timothy Ryan PhD
This work was performed while Dr. Ryan was at
Precera Biosciences, 393 Nichol Mill Lane
Frankluin, Tennessee

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The study design is quite simple. We measured medication concentrations in patients, then compared empirically detected medications with prescribed medications in each patient’s medical record. We used this information to estimate how many prescribed medications patients had actually taken and how often they took medications that were not in their medical record. The later comparison is a particularly novel measure of the number and types of medications taken by patients unbeknownst to healthcare providers who use the medical record as a guide to patient care.

Further, the test was performed in blood and not urine, so we could obtain an estimate of how often patients were in range for medications that they did take – at least for medications where the therapeutic range for blood concentrations are well established.

In sum, we found that patients do not take all of their medications, the medical records are not an accurate indicator of the medications that patients ingest, and that even when taken as prescribed, medications are often out of therapeutic range. The majority of out-of-range medications were present at subtherapeutic levels. Continue reading →

Benefits of Treating Mild Hypertension Not Clear Cut

Posted on November 1, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Sheppard

James Sheppard PhD
Population Health Scientist
Nuffield Department of Primary Care Health Sciences

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The best quality evidence for making clinical decisions comes from clinical trials. Unfortunately there are occasions where trials have not been done, or are not possible and so we rely of ‘expert opinion’ from clinical guidelines. Treatment for low risk mild hypertension is an example of this.

In our study, we looked at the medical records of more than 38,000 patients over a period of 15 years. The patients we studied were aged between 18 and 74, had mild hypertension and had not received any previous treatment. We compared patients who went on to be treated to those who were not, and found no evidence of benefit (in terms of reduced risk of heart attack or stroke), but there was an increased risk of adverse events (such as hypotension [low blood pressure], fainting or kidney damage) over the follow-up period of 5-6 years.

MedicalResearch.com: What should readers take away from your report?

Response: The benefits of treating patients with low risk mild hypertension are not clear cut. It is possible that some patients may suffer more harm than good, so doctors should be cautious when considering treatment in this population.

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

Response: It is likely that some patients with low risk mild hypertension would benefit from treatment, whilst others would not. Future research should focus on understanding which patients have the most to gain, using the wealth of information we now collect about our patients every single day.

MedicalResearch.com: Is there anything else you would like to add?

Response: This study was not a clinical trial and therefore the results must be interpreted with caution. Observational studies such as this can sometimes give biased or unreliable results.

This work was funded by the Medical Research Council in the UK. I have no conflicts of interest to declare.

Citation:

Shepard, J. P., Stevens, S., Stevens, R., Martin, U., Mant, J. W., Hobbs, R., & McManus, R. J. Benefits and harms of antihypertensive treatment for low risk mild hypertension: a real world, matched cohort study of over 38,000 adults. JAMA Internal Medicine https://doi.org/10.17863/CAM.27445

Nov 1, 2018 @ 12:27 pm

Critical Illness: Haloperidol and Ziprasidone for Treatment of Delirium

Posted on October 31, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Truman Pun

Brenda Truman Pun, DNP, RN
Program Clinical Manager
Vanderbilt University Medical Center

MedicalResearch.com: What is the background for this study?

Response: Delirium is a serious problem in Intensive Care Units around the world. Approximately 80% of mechanically ventilated patients develop delirium, acute confusion, while in the ICU. Once thought to be a benign side effect of the ICU environment, research now shows that delirium is linked to a myriad of negative outcomes for patients which include longer ICU and Hospital stays, prolonged time on the ventilator, increased cost, long-term cognitive impairment and even mortality. For a half a century clinicians have been using haloperidol, an typical antipsychotic, to treat delirium in the ICU. However, there has never been evidence to support the use of haloperidol or its pharmacologic cousins, the atypical antipsychotics, to treat delirium. These drugs have serious side effects that include heart arrhythmias, muscle spasms, restlessness and are associated with increased mortality when given for prolonged periods in the outpatient settings leading to a black box warning for their use in this setting.

The MIND-USA study was a double blind placebo controlled trial which evaluated the efficacy and safety of antipsychotics (i.e., haloperidol and ziprasidone) in the treatment delirium in adult ICU patients. Continue reading →

Atrial Fibrillation after Percutaneous Foramen Ovale Closure

Posted on October 31, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Elgendy

Akram Elgendy MD
Division of Cardiovascular Medicine
University of Florida

MedicalResearch.com: What is the background for this study?

Response: Recent clinical trials have demonstrated that percutaneous patent foramen ovale closure is associated with lower risk of stroke recurrence in cryptogenic stroke patients. However, new-onset atrial fibrillation (AF) has been reported as a safety concern. To better understand the risk of new-onset AF, we performed a meta-analysis of PFO closure trials in patients with cryptogenic stroke and migraine.

Continue reading →

Serum Neurofilament Biomarker Helps Determine if Brain Function Will Recover After Cardiac Arrest

Posted on October 31, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Moseby-Knappe

Marion Moseby-Knappe, MD
Neurologist and Researcher
Center for Cardiac Arrest at Lund University and
Skane University Hospital
Lund, Sweden

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our research focuses on improving methods for examining unconscious patients treated on intensive care units after cardiac arrest. If a patient does not wake up within the first days after cardiac arrest, physicians need to evaluate how likely it is that the patient will awaken at all and to which extent there is brain injury.

According to European and American guidelines, decisions on further medical treatment of cardiac arrest patients should always be based on a combination of examinations and not only one single method. Various methods are combined when assessing the patient such as examining different neurologic reflexes, head scans (computed tomography or magnetic resonance imaging), other specialist examinations (electroencephalogram or somatosensory evoked potentials) or blood markers.

Our research focuses on patients included in the largest cardiac arrest trial to date, the Targeted Temperature Management after Out-of-Hospital Cardiac Arrest (TTM) Trial.

Continue reading →

Phase 3 Study of Novel, Once-Daily, Antipsychotic Drug Candidate for Schizophrenia

Posted on October 31, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Kunovac

Jelena Kunovac, M.D., M.S.
Founder and Chief Executive
Chief Medical Officer
Altea Research
Las Vegas, Nevada

MedicalResearch.com: What is the background for this study?

Response: We conducted the study to confirm that the addition of samidorphan to olanzapine does not have an effect on the antipsychotic efficacy of olanzapine in subjects with an acute exacerbation of schizophrenia.

Continue reading →

Should You Get a Ticket For Driving Stoned?

Posted on October 28, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Prof. Kleiman

Prof. Mark A. R. Kleiman PhD
Affiliated Faculty, NYU Wagner; Professor of Public Policy
NYU Marron Institute of Urban Management

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: As state after state legalizes the sale of cannabis, the question of cannabis-impaired driving is getting more attention. There is evidence that the practice has become more common, both because cannabis use – and especially heavy, frequent use – has increased and because a distressingly large fraction of cannabis users believe, falsely, that stoned driving is safe.

The natural response to the problem is to treat cannabis on a par with alcohol: fairly severe criminal penalties for impaired driving, with impairment defined by a specific level of the drug in the body. The paper argues that this would be a mistake, for four independent reasons:

– While cannabis makes driving riskier, it does so by about a factor of two, with no strongly observed dependency on dosage. Alcohol, by contrast, has a steep dose-effect curve. At the legal limit of 0.08% blood alcohol content by weight, the relative risk of drunk driving is at least eight; at 0.15%, which is fairly common, the relative risk has been estimated at 30-50. So there is no justification for punishing stoned driving as severely as we punish drunk driving.

– The lack of evidence of a strong dose-effect relationship suggests that a legal standard based on the content of cannabinoids in blood may not be appropriate.

– Even if a blood standard were valid, the lack of a breath test would make enforcing that standard nearly impossible as a practical matter.

– The long and unpredictable course of cannabis metabolism means that frequent users will be at risk of failing a drug test even when they are neither subjectively intoxicated nor objectively impaired. Worse, they would have no way of judging in advance whether or not driving would be legal. The result would be a re-criminalization of cannabis use through the back door. Continue reading →

Why Aren’t More Teens Vaccinated Against Cancer Causing HPV?

Posted on October 27, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Beavis

Anna Beavis, MD, MPH
Assistant Professor
The Kelly Gynecologic Oncology Service
Department of Gynecology and Obstetrics
Johns Hopkins Medicine
Baltimore, MD 21287-128

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We wanted to look at reasons parents don’t vaccinate their children against HPV, including how those reasons have changed over time from 2010-2016 and how those reasons are different between boys and girls in the most recent data from 2016. We used a nationwide dataset which is publically available from the CDC (Centers for Disease Control) – the National Immunization Survey-Teen, or NIS-Teen – which surveys parents of teens ages 13-17 years old every year to determine rates of all recommended vaccinations. In parents who report that they don’t intend to vaccinate their child against HPV , the survey asks parents why.

We found that from 2010 to 2016, the percentage of parents reporting concerns about their child not being sexually active yet went down significantly for both boys and girls. Also, in boys specifically, parents reported male gender as a less common reason for not vaccinating. For both boys and girls, we found that concerns about safety and side effects, necessity, and lack of knowledge about the vaccine were common reasons for not planning to vaccinate. Also, 10% of parents of girls vs. 20% of parents of boys reporting never having a provider recommendation for the vaccine as their primary reason for not vaccinating.

These results may reflect the growing public understanding of the HPV vaccine as a vaccine which is best given before exposure, so before initiation of sexual activity between the ages of 11 and 12, and that it is recommended for both boys and girls. Also, over 80% of people will have an HPV infection in their lifetime, so everyone should get vaccinated regardless of anticipated sexual activity.

Additionally, providers should focus their counseling and recommendation on improving knowledge about the HPV vaccine, including its decade-long track record of safety and necessity. Continue reading →

Nationwide Children’s: Multiyear Study of Head Impact During Football Seasons Launched

Posted on October 26, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Sean C. Rose, MD
Pediatric sports neurologist and co-director
Complex Concussion Clinic
Nationwide Children’s Hospital
Assistant professor of Pediatrics
The Ohio State University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The link between sub-concussive head impacts and declines in neurocognitive function has been reported by some studies, yet refuted by others. There is very little evidence that has been collected in children as they are sustaining these head impacts.

We initiated a multi-year study of youth football players to provide a more in-depth look at the question. We measured head impacts using helmet sensors during the 2016 football season. 112 players age 9-18 completed a battery of neurocognitive tests before and after the football season.

We found that neither the total burden of head impacts nor the intensity of individual impacts were associated with changes in testing performance from pre to post-season.

Continue reading →

The US Opioid Crisis is Expanding and Worse Among Young People

Posted on October 26, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Joshua Barocas, MD
Assistant Professor of Medicine
Section of Infectious Diseases
Boston Medical Center / Boston University School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Massachusetts has been particularly hard hit by the opioid epidemic despite lower opioid prescribing rates, near universal health insurance, and availability of opioid treatment. That said, it is difficult to estimate the population with or at-risk for opioid use disorder. It is generally a highly stigmatized disease and typical methods to estimate of opioid use disorder relay on contact with the healthcare system and/or patient reporting.

We used a unique and powerful methodology coupled with a first-in-the-nation linked database in Massachusetts to obtain both an accurate count of people with opioid use disorder who are known to the healthcare system and estimate the number who are out there but not yet known to the system.

We found that more than 275,000 people – or 4.6 percent of people over the age of 11 in Massachusetts– have opioid use disorder, a figure nearly four times higher than previous estimates based on national data. In 2011 and 2012, the prevalence of opioid use disorder in Massachusetts for those over the age of 11 was 2.72 percent and 2.87 percent, respectively. That increased to 3.87 percent in 2013, and even more, to 4.6 percent in 2015. Those between the ages of 11 and 25 experienced the greatest increase in prevalence of all age groups. The number of “known” persons increased throughout the study period – from 63,989 in 2011 to 75,431 in 2012, and 93,878 in 2013 to 119,160 in 2015. Continue reading →

Maternal Smoking Linked to Early Puberty in Offspring

Posted on October 24, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Nis Brix M.D., PhD Student
Department of Public Health
Department of Epidemiology
Aarhus University Hospital

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Several studies have indicated a secular trend towards earlier puberty. This is a potential concern as early puberty has been linked to an increased risk of a number of diseases, such as obesity, diabetes, cardiovascular diseases and certain types of cancer. For this reason, our research team are interested in identifying potential modifiable causes of early puberty.

Smoking during pregnancy may be such a modifiable cause of early puberty in the children. Former studies have already linked smoking during pregnancy to earlier age at the daughters’ first menstrual period, a relatively late marker of pubertal development, but other markers of puberty are less studied, especially in the sons.

We studied 15,819 sons and daughters. The mothers gave detailed information on smoking during their pregnancies, and the children gave information on a number of pubertal milestones half-yearly from the age of 11 years. The milestones for the sons were age at voice break, first ejaculation of semen, pubic hair and testicular growth, armpit hair growth and onset of acne. For the daughters the milestones were age at their first menstrual period, pubic hair growth, breast development, armpit hair growth and onset of acne.

Our results suggested that the more cigarettes the mother smoked during her pregnancy the earlier her children, both sons and daughters, went through puberty. If the mother smoked more than ten cigarettes a day during pregnancy, the children appeared to go through puberty, on average, three to six months earlier than the children of non-smoking mothers. Continue reading →

Can an Organic Diet Reduce Cancer Risk?

Posted on October 23, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Julia Baudry &
Emmanuelle Kesse-Guyot PhD
Centre de Recherche Epidémiologie et Statistique Sorbonne Paris Cité, Institut National de la Santé et de la Recherche Médicale (INSERM) U1153, Institut National de la Recherche

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Among the environmental risk factors for cancer, there are concerns about exposure to different classes of pesticides, notably through occupational exposure. Organic foods are less likely to contain pesticide residues than conventional foods, and studies have showed that an organic diet reduces exposure to certain pesticides (Baudry et al 2018, Oates et al 2014, Curl et al 2015). In the general population, the primary route of exposure is diet, especially intake of conventionally grown fruits and vegetables. However, few studies have examined the association of organic food consumption with cancer risk.

In a population of 68 946 French adults from the NutriNet-Santé study, we found a reduction of 25% of cancer risk among consumers with a high frequency of organic foods compared to consumers with a low frequency, after accounting for many factors (such as lifestyle, diet and sociodemographic factors). Specifically a 34% and 76% decrease in risk was observed for post-menopausal breast cancer and all lymphomas, respectively, among frequent organic food consumers compared to consumers with a low organic food consumption frequency.

Continue reading →

Brain Change in Addiction as Learning, Not Disease

Posted on October 23, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Prof. Lewis

Marc Lewis, Ph.D.
Klingelbeekseweg Arnhem
The Netherlands

MedicalResearch.com: What is the background for this study?

Response: According to the brain disease model, addiction is a chronic disease brought about by changes in brain systems that mediate the experience and anticipation of reward and higher-order systems underlying judgment and cognitive control. Its proponents propose that these changes are driven by exposure to drugs of abuse or alcohol. The brain disease model is the most prevalent model of addiction in the Western world.

The disease model’s narrow focus on the neurobiological substrates of addiction has diverted attention (and funding) from alternative models. Alternatives to the brain disease model highlight the social-environmental factors that contribute to addiction and the learning processes that translate these factors into negative outcomes. Learning models propose that addiction, though obviously disadvantageous, is a natural, context-sensitive response to challenging environmental contingencies, not a disease.

In this review I examine addiction within a learning framework that incorporates the brain changes seen in addiction without reference to pathology or disease. Continue reading →

Is Pregnancy a “Stress Test” for Future Dementia Risk?

Posted on October 23, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Heather Boyd, Ph.D.
Senior researcher
Department of Epidemiology Research
Copenhagen Denmark

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We have known for a while that women who have had preeclampsia report different types of cognitive impairment (difficulties with short-term memory, attention deficits) in the years and decades after their pregnancies, and there are a few imaging studies suggesting that these women may have more white matter lesions in the brain and more signs of brain atrophy than women with uncomplicated pregnancies. We also know that women who have had preeclampsia are at increased risk of cardiovascular disease in the years and decades after delivery. Taken together, it was not a great leap to hypothesize that women with a history of preeclampsia might also be at increased risk of dementia later in life. However, the existing epidemiological data were unconvincing, possibly because it takes a great deal of power (a very large study population) to study links between two conditions that often occur decades apart.

Continue reading →

Program Can Help Parents Manage Kids’ Pain from Vaccines

Posted on October 22, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Taddio

Dr. Anna Taddio BScPhm PhD
Professor at the Leslie Dan Faculty of Pharmacy
University of Toronto and Senior Associate Scientis
The Hospital for Sick Children

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In our prior research, parents have reported they are not educated about how to soothe their infants during painful procedures like vaccinations and that they want to know how they can help. Parents also reported that concerns about their infant’s pain affects their decision-making around vaccination. We therefore set out to target parents for education about how to soothe their infants.

We picked the hospital setting because almost all parents are in the hospital for some period of time following the birth of an infant and already routinely receive education about healthy baby topics. Providing information about pain management was easy to add. We found that about 1 out of 10 parents that were given this information acted on it.

MedicalResearch.com: What should readers take away from your report?

Response: No parent wants to see their child in pain and a parents’ desire to reduce pain is supported when we provide them with evidence-based strategies to use. These strategies are easy to use, and not only decrease unnecessary infant suffering, they also help parents. Parents are less anxious about their children getting vaccinations. Attending to infant distress is also important for healthy infant development. Targeting parents at the time of birth also ensures that parents will use and advocate for better pain care for their children across different medical settings and throughout the lifespan.

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

Response: We need to find ways to reach more parents so that they can use this information to help their children. We also need to follow parents over time and teach them about the strategies that are helpful for children of different ages. Finally, we need to study how better pain management practices impacts on vaccination rates.

Citation:

Effectiveness of a hospital-based postnatal parent education intervention about pain management during infant vaccination: a randomized controlled trial Anna Taddio BScPhm PhD, Vibhuti Shah MD, Lucie Bucci MA, Noni E. MacDonald MD, Horace Wong MSc, Derek Stephens MSc

CMAJ 2018 October 22;190:E1245-52. doi: 10.1503/cmaj.180175

Oct 22, 2018 @ 9:53 pm

Cannabis Improved Symptoms, but Not Inflammation of Crohn’s Disease

Posted on October 22, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Timna Naftali MD
Specialist in Gastroenterology
Meir Hospital and Kupat Holim Clinic,
Tel Aviv University, Israel

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In previous studies we could see that Crohn’s patients improve symptoms when taking cannabis but we did not have good data about actual inflammation.

So, in this study we added a colonoscopy to see if we can detect any change in inflammation. We also wanted to find a better mode of consuming cannabis, other than smoking.

MedicalResearch.com: What should readers take away from your report?

Response: The take home massage would be that cannabis may help the patients feel better, but is not a replacement of conventional medical therapy. It should be used as an adjuvant to other treatments in appropriate cases.

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

Response: Regarding future research, there are many points that should be addressed:

Cannabis in laboratory trials does have an anti-inflammatory effect. We have to find a way of translating this effect to clinical treatment
What is the best way of administering cannabis? (We certainly do not want to recommend smoking)
What is the best dose/combination?
What are the long term effects?
Which patients, if any, will benefit most?

Citation:

UEG 2018 abstract:
https://live.ueg.eu/week/
Cannabis induces clinical response but no endoscopic response in Crohn’s disease patients

Oct 22, 2018 @ 9:18 pm

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