Author Interviews, OBGYNE, Sexual Health / 25.08.2022
Study Evaluates Sexual Health After Caesarean Vs Vaginal Delivery
MedicalResearch.com Interview with:
Florence Z. Martin
MRC Integrative Epidemiology Unit
Population Health Sciences
Bristol Medical School
University of Bristol, Bristol, UK
MedicalResearch.com: What is the background for this study?
Response: Globally, rates of caesarean section are on the rise. Many things are contributing to this, including increasing maternal age, more women who have had prior caesareans, and changes in maternal preference. One reason that women have been cited to choose a caesarean in an uncomplicated pregnancy is the maintenance of sexual wellbeing postpartum (in other words, after their baby is born). The protection of sexual wellbeing following caesarean section is thought to be via the maintenance of vaginal tone and reduced risk of vaginal tearing.
However, few studies have shown this to be true. Some studies investigating sexual outcomes in the year after birth found no difference between women who gave birth vaginally and those who delivered via caesarean section. Longer term evidence is sparse, with only one study looking up to 16 years postpartum and finding that women who give birth to all their children via caesarean section are at higher risk of experiencing sex-related pain.
To contribute to previous studies and provide the first piece of evidence looking at sexual wellbeing as a whole several years after delivery, we used data from the Children of the 90s study (also known as the Avon Longitudinal Study of Parents and Children or ALSPAC). We aimed to compare sexual enjoyment, sexual frequency, and sex-related pain between women who delivered via caesarean section and those who delivered vaginally up to 18 years postpartum.
Dr. Bailey[/caption]
Michael Bailey Ph.D.
Senior Principal Engineer, Applied Physics Laboratory
Associate Professor. Mechanical Engineering
Adjunct Associate Professor Urology
MedicalResearch.com: What is the background for this study?
Response: Small (< 6 mm) kidney stones are common and often are asymptomatic. Do you do surgery or wait for them to cause a problem? Or specifically here if you are getting surgery already for other stones that are causing a problem do you take the time and possibly extra risk of cleaning out the small stone in the kidney or in the other kidney?
Dr. Wall[/caption]
Dr Emma Wall
Senior Clinical Research Fellow, UCLH-Crick Legacy study
Consultant Infectious Diseases UCLH
MedicalResearch.com: What is the background for this study?
Response: Since April 2022, both the UK and US have changed their COVID-19 isolation and testing policies. The impact these changes in the guidance and vaccination on community-acquired COVID-19 caused by recent SARS-CoV-2 variants of concern (VOC) has not been fully tested, including infections with BA.2. We aimed to characterise both symptoms and viral loads over the course of COVID-19 infection in otherwise-healthy, vaccinated, non-hospitalised adults, to assess whether current guidance remains justified. All participants were included in the UCLH-Crick Legacy study, a prospective, observational cohort study of otherwise healthy adults who have been taking part in regular workplace testing for SARS-CoV-2 in London
We sent swabs by same-day courier every other day to all adults who reported a positive PCR or lateral flow test to the study team up to day 10 after the start of each infection. We confirmed which variant caused the infection by PCR and sequencing. All participants completed linked symptom diaries.
We compared symptoms and changes in the amount of virus detected in the nose and throat during infection between study participants reporting COVID-19 caused by VOCs Delta and Omicron BA.1 and BA.2. We then analysed how many of our participants would meet current UK/US isolation guidelines.
Dr. Giebultowicz[/caption]
Dr. Jaga Giebultowicz
Professor Emeritus,
Department of Integrative Biology
Oregon State University
Corvallis, OR 97331
MedicalResearch.com: What is the background for this study? Where is blue light commonly found?
Response: Our study in short-lived model organism Drosophila revealed that cumulative, long-term exposure to blue light impacts brain function, accelerates the aging process and significantly shortens lifespan compared to flies maintained in constant darkness or in white light with blue wavelengths blocked.
Blue light is predominantly produced by the light-emitting diodes (LEDs); it appears white due to the addition of yellow fluorescent powder which is activated by blue light. LEDs has become a main source of display screens (phones, laptops, desktops, TV), and ambient lights. Indeed, humans have become awash in LEDs for most of their waking hours.
Clare Jensen[/caption]
Clare Jensen
O’Haire Research Team
Center for the Human-Animal Bond
Purdue University College of Veterinary Medicine
MedicalResearch.com: What is the background for this study?
Response: Service dogs for PTSD are becoming more common and the evidence shows they can help improve mental health and quality of life for many veterans with PTSD. However, some veterans benefit more than others. Our research goal was to ask for the very first time: Why?
Dr. LeBoff[/caption]
Meryl S. LeBoff, MD
Dr. Manson[/caption]
JoAnn E. Manson, MD, DrPH
Professor, Epidemiology, Harvard T.H. Chan School Of Public Health
Michael and Lee Bell Professor of Women's Health, Medicine, Harvard Medical School
Chief, Preventive Medicine, Brigham And Women's Hospital
Co-Director, Womens Health, Brigham And Women's Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Osteoporosis is a major public health problem. Although supplemental vitamin D has been widely used to reduce the risk of fractures in the general population, studies of the effects of vitamin D on fractures, the most important bone health outcome, have been conflicting.
Randomized controlled trials, the highest quality studies, from around the world have shown benefit, no effect, or even harm of supplemental vitamin D on risk of fractures. Some of the trials used bolus dosing, had small samples sizes or short study duration, and co-administered calcium. No large RCTS of this scale tested whether daily supplemental vitamin D (without co-administration with calcium) prevented fractures in the US population.
To fill these knowledge gaps, we tested the hypothesis in this ancillary study to VITAL, whether daily supplemental vitamin D3 reduced the risk of incident total, non-spine and hip fractures in women and men in the US.
Joanna Jiang, PhD
Agency for Healthcare Research and Quality
Rockville, Maryland
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Over the last decade we have seen two trends occurring to rural hospitals – closures and mergers. A hospital in financial distress could likely face closure. But if the hospital affiliates with a multihospital system, it may have access to resources from the system that help shelter the hospital from closure.
That is exactly what we found in this study. System affiliation was associated with a lower risk of closure for financially distressed hospitals. However, among hospitals that were financially stable, system affiliation was associated with a higher risk of closure. This is somewhat puzzling and needs further study to better understand the reason for closure.
Dr. Midya[/caption]
Dania Valvi, MD MPH PhD
Assistant Professor
Department of Environmental Medicine and Public Health
Co-Director, MS in Epidemiology
Icahn School of Medicine at Mount Sinai
Email: dania.valvi@mssm.edu
MedicalResearch.com: What is the background for this study?
Response: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in children in the U.S., Europe and other world regions, currently affecting 1 in every 10 children, and 1 in every 3 children with obesity in the U.S. The rate of pediatric NAFLD has more than doubled in recent decades following the epidemic rates also noted for childhood obesity. There is increasing interest in the role that environmental chemical exposures may play in NAFLD etiology, since several animal studies have shown that prenatal exposures to endocrine-disrupting chemicals (EDCs) cause liver injury and damage; but, until now, the potential effects of prenatal EDC mixture exposures in pediatric NAFLD had not been studied.
SooYoung VanDeMar[/caption]
SooYoung VanDeMark, MBS
Geisinger Commonwealth School of Medicine
Scranton, Pennsylvania
MedicalResearch.com: What is the background for this study?
Response: Health care providers utilize subscription-based, point-of-care databases such as DynaMed and UpToDate to provide clinical care guidance and remain current on the latest evidence-based findings. Both of these websites maintain this content through a cadre of physician contributors who write and edit articles for these sites. These physician contributors are required to self-report any conflicts of interest (COI) as outlined by the respective policies on each website. However, prior COI research into similarly self-regulated areas, such as medical and pharmacology textbooks, and clinical practice guidelines, has found both appreciable potential COI and inconsistencies between self-reported and industry mandated disclosures (1-3).
This study (4) explored the accuracy of physician contributors to DynaMed and UpToDate by comparing their self-reported disclosure status with the financial remunerations they received from the healthcare industry (e.g., pharmaceutical companies) as reported to the U.S. Centers for Medicare and Medicaid Services’ Open Payments database. Physician contributors who reported “nothing to disclose” on their respective article topic but had an entry on Open Payments for having received money from industry, were classified as discordant and, thus, as having the potential for a COI. Additionally, total remuneration, gender, and payment category were investigated more in depth for each database.
Dr. Soriano[/caption]
Victoria Soriano PhD
Research Assistant/Officer, Population Allergy
University of Melbourne
MedicalResearch.com: What is the background for this study?
Response: Peanut allergy is one of the most common childhood food allergies, and children rarely grow out of it. The only proven way to prevent peanut allergy is to give infants age-appropriate peanut products in the first year of life.
We previously showed there was a dramatic increase in peanut introduction from 2007-11 to 2018-19, following changes to infant feeding guidelines. We wanted to know if earlier peanut introduction would reduce peanut allergy in the general population (in Melbourne, Australia).
Dr. Altan-Bonnet[/caption]
Nihal Altan-Bonnet, Ph.D.
Chief of the Laboratory of Host-Pathogen Dynamics
NHLBI
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Enteric viruses such as norovirus, rotavirus and astrovirus are responsible for nearly 1.5 billion global infections per year resulting in gastrointestinal illnesses and sometimes leading to death in the very young, in the elderly and in the immunocompromised. These viruses have been thought to traditionally infect and replicate only in the intestines, then shed into feces and transmit to others via the oral-fecal route (e.g. through ingestion of fecal contaminated food items).
Our findings reported in Nature, using animal models of norovirus, rotavirus and astrovirus infection, challenge this traditional view and reveal that these viruses can also replicate robustly in salivary glands, be shed into saliva in large quantities and transmit through saliva to other animals.
In particular we also show infected infants can transmit these viruses to their mothers mammary glands via suckling and this leads to both an infection in their mothers mammary glands but also a rapid immune response by the mother resulting in a surge in her milk antibodies. These milk antibodies may play a role in fighting the infection in their infants .
