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Lucas Franki is an associate editor for MDedge News, and has been with the company since 2014. He has a BA in English from Penn State University and is an Eagle Scout.
Poppy-seeking parrots, harmonious mice, and feline-fueled hospital bills
Polly want another hit?
Once again, the animals are getting high.
Parrots in India are giving opium farmers a huge and expensive headache. The birds have become addicted to the poppy crop and are taking a huge bite out of the seasonal yields. According to an opium specialist, the birds get a jolt of instant energy from the poppy flower, similar to drinking a cup of coffee. No wonder the birds keep coming back for more.
This roving (flying?) gang of parrot menaces are feeding 30-40 times a day on the plants. Farmers have tried in vain to use firecrackers to scare off the birds, but nothing will stop Polly from getting her next fix. Opium dens might be long gone, but opium nests might be the next big thing.
Sing your little mouse heart out
In addition to being a big star on American Idol: Rodent Edition, the Alston’s singing mouse could also be a key player in understanding how mammalian brains control conversations.
These musical mice, native to Central America, do something unique: They take turns singing, rather than all belting it out at once. Researchers at New York University are using these mouse powerhouses as a model to study how conversation is regulated.
Unsurprisingly, this superstar is reportedly the mouse version of Mariah Carey, requiring a very specific environment: a palatial terrarium, a highly specialized diet, a microphone-shaped swimming pool, no brown M&Ms … you get the picture.
Researchers believe the demands are worth it, however. They’ve discovered that the mice time their songs very precisely to avoid any overlap with a singing neighbor. This could lead to insight on how humans delay conversation in order to not talk over one another (except for that one annoying coworker – you know who you are).
Reason No. 48,512 to hate cats
It really is true that no good deed goes unpunished. Jeannette Parker was nice to a cat, and she ended up with a hospital bill of $48,512.
We will elaborate. Ms. Parker, a wildlife biologist in Florida, offered a stray kitten some tuna and got bitten in the process. (Reason No. 48,513: Cats will bite the hand that feeds them.) There had been rabies warnings recently and the bite did break the skin, so she decided to go to the emergency department at Mariners Hospital in Tavernier, Fla., according to Kaiser Health News. She was there 2 hours and never spoke with a physician, but she did get the first in a series of rabies shots and 12 mL of rabies immune globulin.
The next thing she received from the hospital was a bill for – you guessed it – $48,512, of which $46,422 was for the immune globulin. “My funeral would have been cheaper,” she told Kaiser.
Her husband’s insurance covered most of the bill, but Ms. Parker ended up paying the rest of her deductible and 10% of the charges accepted by her insurer, almost $4,200.
All because she tried to help a cat. Way to go, cat.
And the best doctor award goes to ...
Normally, it requires a lot of time and money to become a respected physician. Medical school, residencies – it’s tough just becoming a doctor, let alone reaching the top of your field.
However, if you’re a reporter at ProPublica who specializes in health care, you can receive the prestigious Top Doctor award for just $289 – or only $99 if you act right now. For your money, you get a customized plaque made of either cherry wood with gold trim or black with chrome trim. That’s an offer too good to pass up.
A reasonable question to ask at this point would probably be, Why is a reporter receiving an award presumably meant for an actual doctor? Well, according to the company selling the award, the reporter’s peers had nominated him and his patients had given him stellar reviews. He was without a doubt one of America’s Top Doctors. His lack of medical degree was absolutely not a problem.
Okay, the award is probably a scam. But we’re also health care reporters here at Livin’ on the MDedge, so if the Top Doctor people are reading, we’ll have the cherry wood with gold trim.
Polly want another hit?
Once again, the animals are getting high.
Parrots in India are giving opium farmers a huge and expensive headache. The birds have become addicted to the poppy crop and are taking a huge bite out of the seasonal yields. According to an opium specialist, the birds get a jolt of instant energy from the poppy flower, similar to drinking a cup of coffee. No wonder the birds keep coming back for more.
This roving (flying?) gang of parrot menaces are feeding 30-40 times a day on the plants. Farmers have tried in vain to use firecrackers to scare off the birds, but nothing will stop Polly from getting her next fix. Opium dens might be long gone, but opium nests might be the next big thing.
Sing your little mouse heart out
In addition to being a big star on American Idol: Rodent Edition, the Alston’s singing mouse could also be a key player in understanding how mammalian brains control conversations.
These musical mice, native to Central America, do something unique: They take turns singing, rather than all belting it out at once. Researchers at New York University are using these mouse powerhouses as a model to study how conversation is regulated.
Unsurprisingly, this superstar is reportedly the mouse version of Mariah Carey, requiring a very specific environment: a palatial terrarium, a highly specialized diet, a microphone-shaped swimming pool, no brown M&Ms … you get the picture.
Researchers believe the demands are worth it, however. They’ve discovered that the mice time their songs very precisely to avoid any overlap with a singing neighbor. This could lead to insight on how humans delay conversation in order to not talk over one another (except for that one annoying coworker – you know who you are).
Reason No. 48,512 to hate cats
It really is true that no good deed goes unpunished. Jeannette Parker was nice to a cat, and she ended up with a hospital bill of $48,512.
We will elaborate. Ms. Parker, a wildlife biologist in Florida, offered a stray kitten some tuna and got bitten in the process. (Reason No. 48,513: Cats will bite the hand that feeds them.) There had been rabies warnings recently and the bite did break the skin, so she decided to go to the emergency department at Mariners Hospital in Tavernier, Fla., according to Kaiser Health News. She was there 2 hours and never spoke with a physician, but she did get the first in a series of rabies shots and 12 mL of rabies immune globulin.
The next thing she received from the hospital was a bill for – you guessed it – $48,512, of which $46,422 was for the immune globulin. “My funeral would have been cheaper,” she told Kaiser.
Her husband’s insurance covered most of the bill, but Ms. Parker ended up paying the rest of her deductible and 10% of the charges accepted by her insurer, almost $4,200.
All because she tried to help a cat. Way to go, cat.
And the best doctor award goes to ...
Normally, it requires a lot of time and money to become a respected physician. Medical school, residencies – it’s tough just becoming a doctor, let alone reaching the top of your field.
However, if you’re a reporter at ProPublica who specializes in health care, you can receive the prestigious Top Doctor award for just $289 – or only $99 if you act right now. For your money, you get a customized plaque made of either cherry wood with gold trim or black with chrome trim. That’s an offer too good to pass up.
A reasonable question to ask at this point would probably be, Why is a reporter receiving an award presumably meant for an actual doctor? Well, according to the company selling the award, the reporter’s peers had nominated him and his patients had given him stellar reviews. He was without a doubt one of America’s Top Doctors. His lack of medical degree was absolutely not a problem.
Okay, the award is probably a scam. But we’re also health care reporters here at Livin’ on the MDedge, so if the Top Doctor people are reading, we’ll have the cherry wood with gold trim.
Polly want another hit?
Once again, the animals are getting high.
Parrots in India are giving opium farmers a huge and expensive headache. The birds have become addicted to the poppy crop and are taking a huge bite out of the seasonal yields. According to an opium specialist, the birds get a jolt of instant energy from the poppy flower, similar to drinking a cup of coffee. No wonder the birds keep coming back for more.
This roving (flying?) gang of parrot menaces are feeding 30-40 times a day on the plants. Farmers have tried in vain to use firecrackers to scare off the birds, but nothing will stop Polly from getting her next fix. Opium dens might be long gone, but opium nests might be the next big thing.
Sing your little mouse heart out
In addition to being a big star on American Idol: Rodent Edition, the Alston’s singing mouse could also be a key player in understanding how mammalian brains control conversations.
These musical mice, native to Central America, do something unique: They take turns singing, rather than all belting it out at once. Researchers at New York University are using these mouse powerhouses as a model to study how conversation is regulated.
Unsurprisingly, this superstar is reportedly the mouse version of Mariah Carey, requiring a very specific environment: a palatial terrarium, a highly specialized diet, a microphone-shaped swimming pool, no brown M&Ms … you get the picture.
Researchers believe the demands are worth it, however. They’ve discovered that the mice time their songs very precisely to avoid any overlap with a singing neighbor. This could lead to insight on how humans delay conversation in order to not talk over one another (except for that one annoying coworker – you know who you are).
Reason No. 48,512 to hate cats
It really is true that no good deed goes unpunished. Jeannette Parker was nice to a cat, and she ended up with a hospital bill of $48,512.
We will elaborate. Ms. Parker, a wildlife biologist in Florida, offered a stray kitten some tuna and got bitten in the process. (Reason No. 48,513: Cats will bite the hand that feeds them.) There had been rabies warnings recently and the bite did break the skin, so she decided to go to the emergency department at Mariners Hospital in Tavernier, Fla., according to Kaiser Health News. She was there 2 hours and never spoke with a physician, but she did get the first in a series of rabies shots and 12 mL of rabies immune globulin.
The next thing she received from the hospital was a bill for – you guessed it – $48,512, of which $46,422 was for the immune globulin. “My funeral would have been cheaper,” she told Kaiser.
Her husband’s insurance covered most of the bill, but Ms. Parker ended up paying the rest of her deductible and 10% of the charges accepted by her insurer, almost $4,200.
All because she tried to help a cat. Way to go, cat.
And the best doctor award goes to ...
Normally, it requires a lot of time and money to become a respected physician. Medical school, residencies – it’s tough just becoming a doctor, let alone reaching the top of your field.
However, if you’re a reporter at ProPublica who specializes in health care, you can receive the prestigious Top Doctor award for just $289 – or only $99 if you act right now. For your money, you get a customized plaque made of either cherry wood with gold trim or black with chrome trim. That’s an offer too good to pass up.
A reasonable question to ask at this point would probably be, Why is a reporter receiving an award presumably meant for an actual doctor? Well, according to the company selling the award, the reporter’s peers had nominated him and his patients had given him stellar reviews. He was without a doubt one of America’s Top Doctors. His lack of medical degree was absolutely not a problem.
Okay, the award is probably a scam. But we’re also health care reporters here at Livin’ on the MDedge, so if the Top Doctor people are reading, we’ll have the cherry wood with gold trim.
Comorbid skin conditions common in children with lichen nitidus
as is generalized disease, according to Selcen Kundak, MD, and Yasemin Çakır, MD, of Dr. Behcet Uz Children’s Research and Training Hospital in Izmir, Turkey.
In a retrospective study 10-year study of 17 children with biopsy-confirmed lichen nitidus (LN) who were diagnosed with the disease at a single tertiary care health center between January 2007 and March 2017, the mean age of onset was 9 years and 15 of 17 (88%) were male. The mean skin lesion duration period was 13 months (range 1-48 months).
The generalized form of LN was common in the study population, occurring in 7 of 17 (41%) patients, 2 of whom had severe pruritus. Comorbid skin conditions also occurred in seven (41%) patients; these conditions included lichen planus in one patient, lichen striatus in one patient, nail psoriasis in one patients, and cutaneous features of atopic skin in four patients. In addition, 11 of 17 (65%) patients had multinucleated giant cells.
“Seven of 17 had comorbid skin conditions. Lichen planus, lichen striatus, psoriasis, and atopy are also chronic inflammatory skin conditions, and possibly, there are common triggers for these and LN; however, this is speculative, not proven,” the investigators concluded in Pediatric Dermatology.
Mild to moderate corticosteroids were give to 16 patients; all showed some clinical improvement within 3 weeks. One patient was treated with systemic corticosteroids.
The study authors reported no relevant financial disclosures.
SOURCE: Kundak S et al. Pediatr Dermatol. 2019 Feb 11. doi: 10.1111/pde.13749.
as is generalized disease, according to Selcen Kundak, MD, and Yasemin Çakır, MD, of Dr. Behcet Uz Children’s Research and Training Hospital in Izmir, Turkey.
In a retrospective study 10-year study of 17 children with biopsy-confirmed lichen nitidus (LN) who were diagnosed with the disease at a single tertiary care health center between January 2007 and March 2017, the mean age of onset was 9 years and 15 of 17 (88%) were male. The mean skin lesion duration period was 13 months (range 1-48 months).
The generalized form of LN was common in the study population, occurring in 7 of 17 (41%) patients, 2 of whom had severe pruritus. Comorbid skin conditions also occurred in seven (41%) patients; these conditions included lichen planus in one patient, lichen striatus in one patient, nail psoriasis in one patients, and cutaneous features of atopic skin in four patients. In addition, 11 of 17 (65%) patients had multinucleated giant cells.
“Seven of 17 had comorbid skin conditions. Lichen planus, lichen striatus, psoriasis, and atopy are also chronic inflammatory skin conditions, and possibly, there are common triggers for these and LN; however, this is speculative, not proven,” the investigators concluded in Pediatric Dermatology.
Mild to moderate corticosteroids were give to 16 patients; all showed some clinical improvement within 3 weeks. One patient was treated with systemic corticosteroids.
The study authors reported no relevant financial disclosures.
SOURCE: Kundak S et al. Pediatr Dermatol. 2019 Feb 11. doi: 10.1111/pde.13749.
as is generalized disease, according to Selcen Kundak, MD, and Yasemin Çakır, MD, of Dr. Behcet Uz Children’s Research and Training Hospital in Izmir, Turkey.
In a retrospective study 10-year study of 17 children with biopsy-confirmed lichen nitidus (LN) who were diagnosed with the disease at a single tertiary care health center between January 2007 and March 2017, the mean age of onset was 9 years and 15 of 17 (88%) were male. The mean skin lesion duration period was 13 months (range 1-48 months).
The generalized form of LN was common in the study population, occurring in 7 of 17 (41%) patients, 2 of whom had severe pruritus. Comorbid skin conditions also occurred in seven (41%) patients; these conditions included lichen planus in one patient, lichen striatus in one patient, nail psoriasis in one patients, and cutaneous features of atopic skin in four patients. In addition, 11 of 17 (65%) patients had multinucleated giant cells.
“Seven of 17 had comorbid skin conditions. Lichen planus, lichen striatus, psoriasis, and atopy are also chronic inflammatory skin conditions, and possibly, there are common triggers for these and LN; however, this is speculative, not proven,” the investigators concluded in Pediatric Dermatology.
Mild to moderate corticosteroids were give to 16 patients; all showed some clinical improvement within 3 weeks. One patient was treated with systemic corticosteroids.
The study authors reported no relevant financial disclosures.
SOURCE: Kundak S et al. Pediatr Dermatol. 2019 Feb 11. doi: 10.1111/pde.13749.
FROM PEDIATRIC DERMATOLOGY
New IPF diagnosis test now covered by Medicare
The Envisia Genomic Classifier, produced by Veracyte, has received final Medicare local coverage determination for the diagnosis of idiopathic pulmonary fibrosis (IPF).
Envisia is a complement to high-resolution CT that can help differentiate IPF from other interstitial lung diseases, as more than half of patients with IPF/interstitial lung disease report being misdiagnosed at least once. The test analyzes samples obtained through transbronchial biopsy, a nonsurgical procedure commonly used in lung evaluation. Envisia has been shown to detect usual interstitial pneumonia, a signature of IPF, with high accuracy.
The new policy was issued through the Palmetto GBA MolDx program and will go into effect on April 1, 2019, making Envisia the first commercially available test of its kind, available to the 55 million people who are currently enrolled in Medicare.
“We are pleased that the evidence supporting the Envisia classifier met the MolDx program’s high standards for coverage. This important milestone will enable us to begin making the Envisia Classifier more widely available to patients with suspected IPF so that they can obtain an accurate, timely diagnosis and, in turn, appropriate treatment,” Bonnie Anderson, chairman and chief executive officer of Veracyte, said in a press release.
Find the full press release on the Veracyte website.
The Envisia Genomic Classifier, produced by Veracyte, has received final Medicare local coverage determination for the diagnosis of idiopathic pulmonary fibrosis (IPF).
Envisia is a complement to high-resolution CT that can help differentiate IPF from other interstitial lung diseases, as more than half of patients with IPF/interstitial lung disease report being misdiagnosed at least once. The test analyzes samples obtained through transbronchial biopsy, a nonsurgical procedure commonly used in lung evaluation. Envisia has been shown to detect usual interstitial pneumonia, a signature of IPF, with high accuracy.
The new policy was issued through the Palmetto GBA MolDx program and will go into effect on April 1, 2019, making Envisia the first commercially available test of its kind, available to the 55 million people who are currently enrolled in Medicare.
“We are pleased that the evidence supporting the Envisia classifier met the MolDx program’s high standards for coverage. This important milestone will enable us to begin making the Envisia Classifier more widely available to patients with suspected IPF so that they can obtain an accurate, timely diagnosis and, in turn, appropriate treatment,” Bonnie Anderson, chairman and chief executive officer of Veracyte, said in a press release.
Find the full press release on the Veracyte website.
The Envisia Genomic Classifier, produced by Veracyte, has received final Medicare local coverage determination for the diagnosis of idiopathic pulmonary fibrosis (IPF).
Envisia is a complement to high-resolution CT that can help differentiate IPF from other interstitial lung diseases, as more than half of patients with IPF/interstitial lung disease report being misdiagnosed at least once. The test analyzes samples obtained through transbronchial biopsy, a nonsurgical procedure commonly used in lung evaluation. Envisia has been shown to detect usual interstitial pneumonia, a signature of IPF, with high accuracy.
The new policy was issued through the Palmetto GBA MolDx program and will go into effect on April 1, 2019, making Envisia the first commercially available test of its kind, available to the 55 million people who are currently enrolled in Medicare.
“We are pleased that the evidence supporting the Envisia classifier met the MolDx program’s high standards for coverage. This important milestone will enable us to begin making the Envisia Classifier more widely available to patients with suspected IPF so that they can obtain an accurate, timely diagnosis and, in turn, appropriate treatment,” Bonnie Anderson, chairman and chief executive officer of Veracyte, said in a press release.
Find the full press release on the Veracyte website.
ASCO issues guideline for early detection, management of colorectal cancer
The American Society of Clinical Oncology has issued a new guideline on the early detection and management of colorectal cancer in people at average risk for colorectal cancer, which was written by Gilberto Lopes, MD, of the University of Miami and his associates on an ASCO expert panel.
The panel assembled by ASCO to write the guideline consisted of medical oncology, surgical oncology, surgery, gastroenterology, health technology assessment, cancer epidemiology, pathology, radiology, radiation oncology, and patient advocacy experts. Guidelines from eight different developers were examined, and recommendations from those guidelines were adapted to form the new ASCO guideline. The guideline was published in the Journal of Global Oncology.
In people who are asymptomatic, are aged 50-75 years, have no family history of colorectal cancer, are at average risk, and are in settings with high incidences of colorectal cancer, the expert panel recommends guaiac fecal occult blood test or fecal immunochemical testing every 1-2 years, flexible sigmoidoscopy every 5 years, a combination of flexible sigmoidoscopy every 10 years and annual stool-based testing, or colonoscopy every 10 years, depending on available resources. The testing strategy for those with positive stool-based testing or flxible sigmoidoscopy is colonoscopy or a double-contrast barium enema if colonoscopy is unavailable.
For patients who have polyps, polypectomy at the time of colonoscopy is recommended, with the option of referral for surgical resection if not suitable for endoscopic resection. When symptoms (iron-deficiency anemia, bleeding abdominal pain and/or change in bowel habits) are present, a colonoscopy should be performed if available. If colonoscopy is contraindicated, a double-contrast barium enema can be performed; if endoscopy is contraindicated, CT colonography can be performed.
More information, including a data supplement with additional evidence tables, a methodology supplement with information about evidence quality and strength of recommendations, slide sets, and clinical tools and resources is available at www.asco.org/resource-stratified-guidelines, the guideline noted.
Several members of the expert panel reported conflicts of interest.
Review AGA and U.S. Multi-society Task Force on Colorectal Cancer guidelines and recommendations on colorectal cancer screening, evaluation of Lynch Syndrome, colonoscopy and bowel cleansing at https://www.gastro.org/guidelines/colorectal-cancer.
SOURCE: Lopes G et al. J Glob Oncol. 2019 Feb 25. doi: 10.1200/JGO.18.00213.
The American Society of Clinical Oncology has issued a new guideline on the early detection and management of colorectal cancer in people at average risk for colorectal cancer, which was written by Gilberto Lopes, MD, of the University of Miami and his associates on an ASCO expert panel.
The panel assembled by ASCO to write the guideline consisted of medical oncology, surgical oncology, surgery, gastroenterology, health technology assessment, cancer epidemiology, pathology, radiology, radiation oncology, and patient advocacy experts. Guidelines from eight different developers were examined, and recommendations from those guidelines were adapted to form the new ASCO guideline. The guideline was published in the Journal of Global Oncology.
In people who are asymptomatic, are aged 50-75 years, have no family history of colorectal cancer, are at average risk, and are in settings with high incidences of colorectal cancer, the expert panel recommends guaiac fecal occult blood test or fecal immunochemical testing every 1-2 years, flexible sigmoidoscopy every 5 years, a combination of flexible sigmoidoscopy every 10 years and annual stool-based testing, or colonoscopy every 10 years, depending on available resources. The testing strategy for those with positive stool-based testing or flxible sigmoidoscopy is colonoscopy or a double-contrast barium enema if colonoscopy is unavailable.
For patients who have polyps, polypectomy at the time of colonoscopy is recommended, with the option of referral for surgical resection if not suitable for endoscopic resection. When symptoms (iron-deficiency anemia, bleeding abdominal pain and/or change in bowel habits) are present, a colonoscopy should be performed if available. If colonoscopy is contraindicated, a double-contrast barium enema can be performed; if endoscopy is contraindicated, CT colonography can be performed.
More information, including a data supplement with additional evidence tables, a methodology supplement with information about evidence quality and strength of recommendations, slide sets, and clinical tools and resources is available at www.asco.org/resource-stratified-guidelines, the guideline noted.
Several members of the expert panel reported conflicts of interest.
Review AGA and U.S. Multi-society Task Force on Colorectal Cancer guidelines and recommendations on colorectal cancer screening, evaluation of Lynch Syndrome, colonoscopy and bowel cleansing at https://www.gastro.org/guidelines/colorectal-cancer.
SOURCE: Lopes G et al. J Glob Oncol. 2019 Feb 25. doi: 10.1200/JGO.18.00213.
The American Society of Clinical Oncology has issued a new guideline on the early detection and management of colorectal cancer in people at average risk for colorectal cancer, which was written by Gilberto Lopes, MD, of the University of Miami and his associates on an ASCO expert panel.
The panel assembled by ASCO to write the guideline consisted of medical oncology, surgical oncology, surgery, gastroenterology, health technology assessment, cancer epidemiology, pathology, radiology, radiation oncology, and patient advocacy experts. Guidelines from eight different developers were examined, and recommendations from those guidelines were adapted to form the new ASCO guideline. The guideline was published in the Journal of Global Oncology.
In people who are asymptomatic, are aged 50-75 years, have no family history of colorectal cancer, are at average risk, and are in settings with high incidences of colorectal cancer, the expert panel recommends guaiac fecal occult blood test or fecal immunochemical testing every 1-2 years, flexible sigmoidoscopy every 5 years, a combination of flexible sigmoidoscopy every 10 years and annual stool-based testing, or colonoscopy every 10 years, depending on available resources. The testing strategy for those with positive stool-based testing or flxible sigmoidoscopy is colonoscopy or a double-contrast barium enema if colonoscopy is unavailable.
For patients who have polyps, polypectomy at the time of colonoscopy is recommended, with the option of referral for surgical resection if not suitable for endoscopic resection. When symptoms (iron-deficiency anemia, bleeding abdominal pain and/or change in bowel habits) are present, a colonoscopy should be performed if available. If colonoscopy is contraindicated, a double-contrast barium enema can be performed; if endoscopy is contraindicated, CT colonography can be performed.
More information, including a data supplement with additional evidence tables, a methodology supplement with information about evidence quality and strength of recommendations, slide sets, and clinical tools and resources is available at www.asco.org/resource-stratified-guidelines, the guideline noted.
Several members of the expert panel reported conflicts of interest.
Review AGA and U.S. Multi-society Task Force on Colorectal Cancer guidelines and recommendations on colorectal cancer screening, evaluation of Lynch Syndrome, colonoscopy and bowel cleansing at https://www.gastro.org/guidelines/colorectal-cancer.
SOURCE: Lopes G et al. J Glob Oncol. 2019 Feb 25. doi: 10.1200/JGO.18.00213.
FROM THE JOURNAL OF GLOBAL ONCOLOGY
ASCO publishes new guideline for treatment, follow-up of early-stage colorectal cancer
An expert panel appointed by the American Society of Clinical Oncology has issued a new guideline for the treatment and follow-up of patients with early-stage colorectal cancer.
The multidisciplinary, multinational panel identified and reviewed previous guidelines from 12 different developers to create the new ASCO guideline; of these, recommendations from six guidelines were adapted into the evidence base. All recommendations have a consensus rate of at least 75%.
For patients with basic, nonobstructing stage I-IIA colon cancer, open resection is recommended; those with enhanced disease should receive laparoscopic or minimally invasive surgery. For nonobstructing stage IIB-IIC colon cancer, recommended treatment for basic disease is open resection; emergency surgical resection is recommended in enhanced disease.
Treatment for basic, obstructing IIB-IIC disease is resection and/or diversion and is emergency surgical resection in enhanced disease. In left-sided, stage IIB-IIC disease, colonic stent placement is recommended. In high-risk, obstructing stage II disease or in T4N0/T3N0 disease with high-risk features, adjuvant chemotherapy is recommended.
In cT1N0 and cT2n0 rectal cancer, total mesorectal excision is recommended; for cT3n0, total mesorectal excision is recommended in basic and limited cases, with diversion recommended in other cases. For resectable cT3N0 rectal cancer, patients should receive base neoadjuvant chemotherapy.
For follow-up, patients should receive a combination of medical history, physical examination, carcinoembryonic antigen testing, imaging, and endoscopy, with the frequency depending on patient setting.
More information, including a data supplement with additional evidence tables, a methodology supplement with information about evidence quality and strength of recommendations, slide sets, and clinical tools and resources is available at www.asco.org/resource-stratified-guidelines, according to the guideline.
Several members of the expert panel reported conflicts of interest.
Help your patients better understand colorectal cancer risk factors and screening by sharing AGA patient education materials written by specialists, for patients at http://ow.ly/s7XS30nVPI4.
SOURCE: Costas-Chavarri A et al. J Glob Oncol. 2019 Feb 25. doi: 10.1200/JGO.18.00214.
An expert panel appointed by the American Society of Clinical Oncology has issued a new guideline for the treatment and follow-up of patients with early-stage colorectal cancer.
The multidisciplinary, multinational panel identified and reviewed previous guidelines from 12 different developers to create the new ASCO guideline; of these, recommendations from six guidelines were adapted into the evidence base. All recommendations have a consensus rate of at least 75%.
For patients with basic, nonobstructing stage I-IIA colon cancer, open resection is recommended; those with enhanced disease should receive laparoscopic or minimally invasive surgery. For nonobstructing stage IIB-IIC colon cancer, recommended treatment for basic disease is open resection; emergency surgical resection is recommended in enhanced disease.
Treatment for basic, obstructing IIB-IIC disease is resection and/or diversion and is emergency surgical resection in enhanced disease. In left-sided, stage IIB-IIC disease, colonic stent placement is recommended. In high-risk, obstructing stage II disease or in T4N0/T3N0 disease with high-risk features, adjuvant chemotherapy is recommended.
In cT1N0 and cT2n0 rectal cancer, total mesorectal excision is recommended; for cT3n0, total mesorectal excision is recommended in basic and limited cases, with diversion recommended in other cases. For resectable cT3N0 rectal cancer, patients should receive base neoadjuvant chemotherapy.
For follow-up, patients should receive a combination of medical history, physical examination, carcinoembryonic antigen testing, imaging, and endoscopy, with the frequency depending on patient setting.
More information, including a data supplement with additional evidence tables, a methodology supplement with information about evidence quality and strength of recommendations, slide sets, and clinical tools and resources is available at www.asco.org/resource-stratified-guidelines, according to the guideline.
Several members of the expert panel reported conflicts of interest.
Help your patients better understand colorectal cancer risk factors and screening by sharing AGA patient education materials written by specialists, for patients at http://ow.ly/s7XS30nVPI4.
SOURCE: Costas-Chavarri A et al. J Glob Oncol. 2019 Feb 25. doi: 10.1200/JGO.18.00214.
An expert panel appointed by the American Society of Clinical Oncology has issued a new guideline for the treatment and follow-up of patients with early-stage colorectal cancer.
The multidisciplinary, multinational panel identified and reviewed previous guidelines from 12 different developers to create the new ASCO guideline; of these, recommendations from six guidelines were adapted into the evidence base. All recommendations have a consensus rate of at least 75%.
For patients with basic, nonobstructing stage I-IIA colon cancer, open resection is recommended; those with enhanced disease should receive laparoscopic or minimally invasive surgery. For nonobstructing stage IIB-IIC colon cancer, recommended treatment for basic disease is open resection; emergency surgical resection is recommended in enhanced disease.
Treatment for basic, obstructing IIB-IIC disease is resection and/or diversion and is emergency surgical resection in enhanced disease. In left-sided, stage IIB-IIC disease, colonic stent placement is recommended. In high-risk, obstructing stage II disease or in T4N0/T3N0 disease with high-risk features, adjuvant chemotherapy is recommended.
In cT1N0 and cT2n0 rectal cancer, total mesorectal excision is recommended; for cT3n0, total mesorectal excision is recommended in basic and limited cases, with diversion recommended in other cases. For resectable cT3N0 rectal cancer, patients should receive base neoadjuvant chemotherapy.
For follow-up, patients should receive a combination of medical history, physical examination, carcinoembryonic antigen testing, imaging, and endoscopy, with the frequency depending on patient setting.
More information, including a data supplement with additional evidence tables, a methodology supplement with information about evidence quality and strength of recommendations, slide sets, and clinical tools and resources is available at www.asco.org/resource-stratified-guidelines, according to the guideline.
Several members of the expert panel reported conflicts of interest.
Help your patients better understand colorectal cancer risk factors and screening by sharing AGA patient education materials written by specialists, for patients at http://ow.ly/s7XS30nVPI4.
SOURCE: Costas-Chavarri A et al. J Glob Oncol. 2019 Feb 25. doi: 10.1200/JGO.18.00214.
FROM THE JOURNAL OF GLOBAL ONCOLOGY
ASCO issues guideline for early detection, management of colorectal cancer
The American Society of Clinical Oncology has issued a new guideline on the early detection and management of colorectal cancer in people at average risk for colorectal cancer, which was written by Gilberto Lopes, MD, of the University of Miami and his associates on an ASCO expert panel.
The panel assembled by ASCO to write the guideline consisted of medical oncology, surgical oncology, surgery, gastroenterology, health technology assessment, cancer epidemiology, pathology, radiology, radiation oncology, and patient advocacy experts. Guidelines from eight different developers were examined, and recommendations from those guidelines were adapted to form the new ASCO guideline. The guideline was published in the Journal of Global Oncology.
In people who are asymptomatic, are aged 50-75 years, have no family history of colorectal cancer, are at average risk, and are in settings with high incidences of colorectal cancer, the expert panel recommends guaiac fecal occult blood test or fecal immunochemical testing every 1-2 years, flexible sigmoidoscopy every 5 years, a combination of flexible sigmoidoscopy every 10 years and annual stool-based testing, or colonoscopy every 10 years, depending on available resources. The testing strategy for those with positive stool-based testing or flexible sigmoidoscopy is colonoscopy or a double-contrast barium enema if colonoscopy is unavailable.
For patients who have polyps, polypectomy at the time of colonoscopy is recommended, with the option of referral for surgical resection if not suitable for endoscopic resection. When symptoms (iron-deficiency anemia, bleeding, abdominal pain, and/or change in bowel habits) are present, a colonoscopy should be performed if available. If colonoscopy is contraindicated, a double-contrast barium enema can be performed; if endoscopy is contraindicated, CT colonography can be performed.
More information, including a data supplement with additional evidence tables, a methodology supplement with information about evidence quality and strength of recommendations, slide sets, and clinical tools and resources is available at www.asco.org/resource-stratified-guidelines, the guideline noted.
Several members of the expert panel reported conflicts of interest.
SOURCE: Lopes G et al. J Glob Oncol. 2019 Feb 25. doi: 10.1200/JGO.18.00213.
This story was updated on March 4, 2019.
The American Society of Clinical Oncology has issued a new guideline on the early detection and management of colorectal cancer in people at average risk for colorectal cancer, which was written by Gilberto Lopes, MD, of the University of Miami and his associates on an ASCO expert panel.
The panel assembled by ASCO to write the guideline consisted of medical oncology, surgical oncology, surgery, gastroenterology, health technology assessment, cancer epidemiology, pathology, radiology, radiation oncology, and patient advocacy experts. Guidelines from eight different developers were examined, and recommendations from those guidelines were adapted to form the new ASCO guideline. The guideline was published in the Journal of Global Oncology.
In people who are asymptomatic, are aged 50-75 years, have no family history of colorectal cancer, are at average risk, and are in settings with high incidences of colorectal cancer, the expert panel recommends guaiac fecal occult blood test or fecal immunochemical testing every 1-2 years, flexible sigmoidoscopy every 5 years, a combination of flexible sigmoidoscopy every 10 years and annual stool-based testing, or colonoscopy every 10 years, depending on available resources. The testing strategy for those with positive stool-based testing or flexible sigmoidoscopy is colonoscopy or a double-contrast barium enema if colonoscopy is unavailable.
For patients who have polyps, polypectomy at the time of colonoscopy is recommended, with the option of referral for surgical resection if not suitable for endoscopic resection. When symptoms (iron-deficiency anemia, bleeding, abdominal pain, and/or change in bowel habits) are present, a colonoscopy should be performed if available. If colonoscopy is contraindicated, a double-contrast barium enema can be performed; if endoscopy is contraindicated, CT colonography can be performed.
More information, including a data supplement with additional evidence tables, a methodology supplement with information about evidence quality and strength of recommendations, slide sets, and clinical tools and resources is available at www.asco.org/resource-stratified-guidelines, the guideline noted.
Several members of the expert panel reported conflicts of interest.
SOURCE: Lopes G et al. J Glob Oncol. 2019 Feb 25. doi: 10.1200/JGO.18.00213.
This story was updated on March 4, 2019.
The American Society of Clinical Oncology has issued a new guideline on the early detection and management of colorectal cancer in people at average risk for colorectal cancer, which was written by Gilberto Lopes, MD, of the University of Miami and his associates on an ASCO expert panel.
The panel assembled by ASCO to write the guideline consisted of medical oncology, surgical oncology, surgery, gastroenterology, health technology assessment, cancer epidemiology, pathology, radiology, radiation oncology, and patient advocacy experts. Guidelines from eight different developers were examined, and recommendations from those guidelines were adapted to form the new ASCO guideline. The guideline was published in the Journal of Global Oncology.
In people who are asymptomatic, are aged 50-75 years, have no family history of colorectal cancer, are at average risk, and are in settings with high incidences of colorectal cancer, the expert panel recommends guaiac fecal occult blood test or fecal immunochemical testing every 1-2 years, flexible sigmoidoscopy every 5 years, a combination of flexible sigmoidoscopy every 10 years and annual stool-based testing, or colonoscopy every 10 years, depending on available resources. The testing strategy for those with positive stool-based testing or flexible sigmoidoscopy is colonoscopy or a double-contrast barium enema if colonoscopy is unavailable.
For patients who have polyps, polypectomy at the time of colonoscopy is recommended, with the option of referral for surgical resection if not suitable for endoscopic resection. When symptoms (iron-deficiency anemia, bleeding, abdominal pain, and/or change in bowel habits) are present, a colonoscopy should be performed if available. If colonoscopy is contraindicated, a double-contrast barium enema can be performed; if endoscopy is contraindicated, CT colonography can be performed.
More information, including a data supplement with additional evidence tables, a methodology supplement with information about evidence quality and strength of recommendations, slide sets, and clinical tools and resources is available at www.asco.org/resource-stratified-guidelines, the guideline noted.
Several members of the expert panel reported conflicts of interest.
SOURCE: Lopes G et al. J Glob Oncol. 2019 Feb 25. doi: 10.1200/JGO.18.00213.
This story was updated on March 4, 2019.
FROM THE JOURNAL OF GLOBAL ONCOLOGY
ASCO publishes new guideline for treatment, follow-up of early-stage colorectal cancer
An expert panel appointed by the American Society of Clinical Oncology has issued a new guideline for the treatment and follow-up of patients with early-stage colorectal cancer.
The multidisciplinary, multinational panel identified and reviewed previous guidelines from 12 different developers to create the new ASCO guideline; of these, recommendations from six guidelines were adapted into the evidence base. All recommendations have a consensus rate of at least 75%.
For patients with basic, nonobstructing stage I-IIA colon cancer, open resection is recommended; those with enhanced disease should receive laparoscopic or minimally invasive surgery. For nonobstructing stage IIB-IIC colon cancer, recommended treatment for basic disease is open resection; emergency surgical resection is recommended in enhanced disease.
Treatment for basic, obstructing IIB-IIC disease is resection and/or diversion and is emergency surgical resection in enhanced disease. In left-sided, stage IIB-IIC disease, colonic stent placement is recommended. In high-risk, obstructing stage II disease or in T4N0/T3N0 disease with high-risk features, adjuvant chemotherapy is recommended.
In cT1N0 and cT2n0 rectal cancer, total mesorectal excision is recommended; for cT3n0, total mesorectal excision is recommended in basic and limited cases, with diversion recommended in other cases. For resectable cT3N0 rectal cancer, patients should receive base neoadjuvant chemotherapy.
For follow-up, patients should receive a combination of medical history, physical examination, carcinoembryonic antigen testing, imaging, and endoscopy, with the frequency depending on patient setting.
More information, including a data supplement with additional evidence tables, a methodology supplement with information about evidence quality and strength of recommendations, slide sets, and clinical tools and resources is available at www.asco.org/resource-stratified-guidelines, according to the guideline.
Several members of the expert panel reported conflicts of interest.
SOURCE: Costas-Chavarri A et al. J Glob Oncol. 2019 Feb 25. doi: 10.1200/JGO.18.00214.
An expert panel appointed by the American Society of Clinical Oncology has issued a new guideline for the treatment and follow-up of patients with early-stage colorectal cancer.
The multidisciplinary, multinational panel identified and reviewed previous guidelines from 12 different developers to create the new ASCO guideline; of these, recommendations from six guidelines were adapted into the evidence base. All recommendations have a consensus rate of at least 75%.
For patients with basic, nonobstructing stage I-IIA colon cancer, open resection is recommended; those with enhanced disease should receive laparoscopic or minimally invasive surgery. For nonobstructing stage IIB-IIC colon cancer, recommended treatment for basic disease is open resection; emergency surgical resection is recommended in enhanced disease.
Treatment for basic, obstructing IIB-IIC disease is resection and/or diversion and is emergency surgical resection in enhanced disease. In left-sided, stage IIB-IIC disease, colonic stent placement is recommended. In high-risk, obstructing stage II disease or in T4N0/T3N0 disease with high-risk features, adjuvant chemotherapy is recommended.
In cT1N0 and cT2n0 rectal cancer, total mesorectal excision is recommended; for cT3n0, total mesorectal excision is recommended in basic and limited cases, with diversion recommended in other cases. For resectable cT3N0 rectal cancer, patients should receive base neoadjuvant chemotherapy.
For follow-up, patients should receive a combination of medical history, physical examination, carcinoembryonic antigen testing, imaging, and endoscopy, with the frequency depending on patient setting.
More information, including a data supplement with additional evidence tables, a methodology supplement with information about evidence quality and strength of recommendations, slide sets, and clinical tools and resources is available at www.asco.org/resource-stratified-guidelines, according to the guideline.
Several members of the expert panel reported conflicts of interest.
SOURCE: Costas-Chavarri A et al. J Glob Oncol. 2019 Feb 25. doi: 10.1200/JGO.18.00214.
An expert panel appointed by the American Society of Clinical Oncology has issued a new guideline for the treatment and follow-up of patients with early-stage colorectal cancer.
The multidisciplinary, multinational panel identified and reviewed previous guidelines from 12 different developers to create the new ASCO guideline; of these, recommendations from six guidelines were adapted into the evidence base. All recommendations have a consensus rate of at least 75%.
For patients with basic, nonobstructing stage I-IIA colon cancer, open resection is recommended; those with enhanced disease should receive laparoscopic or minimally invasive surgery. For nonobstructing stage IIB-IIC colon cancer, recommended treatment for basic disease is open resection; emergency surgical resection is recommended in enhanced disease.
Treatment for basic, obstructing IIB-IIC disease is resection and/or diversion and is emergency surgical resection in enhanced disease. In left-sided, stage IIB-IIC disease, colonic stent placement is recommended. In high-risk, obstructing stage II disease or in T4N0/T3N0 disease with high-risk features, adjuvant chemotherapy is recommended.
In cT1N0 and cT2n0 rectal cancer, total mesorectal excision is recommended; for cT3n0, total mesorectal excision is recommended in basic and limited cases, with diversion recommended in other cases. For resectable cT3N0 rectal cancer, patients should receive base neoadjuvant chemotherapy.
For follow-up, patients should receive a combination of medical history, physical examination, carcinoembryonic antigen testing, imaging, and endoscopy, with the frequency depending on patient setting.
More information, including a data supplement with additional evidence tables, a methodology supplement with information about evidence quality and strength of recommendations, slide sets, and clinical tools and resources is available at www.asco.org/resource-stratified-guidelines, according to the guideline.
Several members of the expert panel reported conflicts of interest.
SOURCE: Costas-Chavarri A et al. J Glob Oncol. 2019 Feb 25. doi: 10.1200/JGO.18.00214.
FROM THE JOURNAL OF GLOBAL ONCOLOGY
Watch for depression symptom trajectory in high-risk young adults
Severity, variability of symptoms may be only predictor of suicide attempts.
Among the trajectories of clinical predictors of suicide attempt, depression symptoms were the only ones linked with an increased risk of suicide attempt in young adults whose parents have mood disorders, according to a longitudinal study.
Psychiatric diagnoses are well established as predictors of suicidal behavior; however, symptoms and risk can vary over the course of illness, and it is important to identify symptoms that can change over time, wrote Nadine M. Melhem, PhD, associate professor of psychiatry at the University of Pittsburgh, and her associates. The report is in JAMA Psychiatry.
Between July 15, 1997, and Sept. 6, 2005, 663 adolescents and young adults (mean age, 23.8 years) whose parents have mood disorders were recruited and followed until Jan. 21, 2014. All participants were assessed at baseline and every year for up to 12 years (median follow-up, 8.1 years) for lifetime and current psychiatric disorders as well as suicidal ideation. In addition, participants were assessed at baseline and at each follow-up for the trajectory of depression symptoms, hopelessness, impulsivity, aggression, impulsive aggression, and irritability.
After the study period, participants were analyzed for all trajectories and separated into classes based on mean scores and variability. All trajectories except for depression had two classes, in which participants in class 2 had higher mean scores and variability; for depression, patients were separated into three classes, in which class 3 had the highest mean score and variability.
Over the study period, 71 of the 663 patients attempted suicide (10.7%), with 51 patients attempting suicide for the first time. The mean number of attempts was 1.2, and the median time from the last assessment to the attempt was 45 weeks.
(22.9% with vs. 27 without), class 2 impulsivity (38.8% vs. 21.7%), class 2 aggression (29.0% vs. 15.6%), class 2 impulsive aggression (76.5% vs. 52.2%), and class 2 irritability (39.4% vs. 22.7%). However, after adjustment for demographics, parental suicide attempts, and additional clinical characteristics, only class 3 depression remained associated with suicide attempts (odds ratio, 4.72; 95% confidence interval, 1.47-15.21; P = .01).
Other significant predictors of suicide attempts were younger age (OR, 0.82; 95% CI, 0.74-0.90; P less than .001), lifetime history of unipolar disorder (OR, 4.71; 95% CI, 1.63-13.58; P = .004), lifetime history of bipolar disorder (OR, 3.4; 95% CI, 0.96-12.04; P = .06), history of childhood abuse (OR, 2.98; 95% CI, 1.40-6.38; P = .01), and parental suicide attempt (OR, 2.24; 95% CI, 1.06-4.75; P = .04).
The investigators concluded that clinicians should “pay particular attention to the severity of both current and past depression and the variability in these symptoms, and monitor and treat depression symptoms over time to reduce symptom severity and fluctuation, and thus the likelihood for suicide attempt, in high-risk young adults.”
Dr. Melhem reported receiving research support from the National Institute of Mental Health, the Brain and Behavior Research Foundation, and the American Foundation for Suicide Prevention. Several other coauthors also reported conflicts of interest.
SOURCE: Melhem NM et al. JAMA Psychiatry. 2019 Feb 27. doi: 10.1001/jamapsychiatry.2018.4513.
Severity, variability of symptoms may be only predictor of suicide attempts.
Severity, variability of symptoms may be only predictor of suicide attempts.
Among the trajectories of clinical predictors of suicide attempt, depression symptoms were the only ones linked with an increased risk of suicide attempt in young adults whose parents have mood disorders, according to a longitudinal study.
Psychiatric diagnoses are well established as predictors of suicidal behavior; however, symptoms and risk can vary over the course of illness, and it is important to identify symptoms that can change over time, wrote Nadine M. Melhem, PhD, associate professor of psychiatry at the University of Pittsburgh, and her associates. The report is in JAMA Psychiatry.
Between July 15, 1997, and Sept. 6, 2005, 663 adolescents and young adults (mean age, 23.8 years) whose parents have mood disorders were recruited and followed until Jan. 21, 2014. All participants were assessed at baseline and every year for up to 12 years (median follow-up, 8.1 years) for lifetime and current psychiatric disorders as well as suicidal ideation. In addition, participants were assessed at baseline and at each follow-up for the trajectory of depression symptoms, hopelessness, impulsivity, aggression, impulsive aggression, and irritability.
After the study period, participants were analyzed for all trajectories and separated into classes based on mean scores and variability. All trajectories except for depression had two classes, in which participants in class 2 had higher mean scores and variability; for depression, patients were separated into three classes, in which class 3 had the highest mean score and variability.
Over the study period, 71 of the 663 patients attempted suicide (10.7%), with 51 patients attempting suicide for the first time. The mean number of attempts was 1.2, and the median time from the last assessment to the attempt was 45 weeks.
(22.9% with vs. 27 without), class 2 impulsivity (38.8% vs. 21.7%), class 2 aggression (29.0% vs. 15.6%), class 2 impulsive aggression (76.5% vs. 52.2%), and class 2 irritability (39.4% vs. 22.7%). However, after adjustment for demographics, parental suicide attempts, and additional clinical characteristics, only class 3 depression remained associated with suicide attempts (odds ratio, 4.72; 95% confidence interval, 1.47-15.21; P = .01).
Other significant predictors of suicide attempts were younger age (OR, 0.82; 95% CI, 0.74-0.90; P less than .001), lifetime history of unipolar disorder (OR, 4.71; 95% CI, 1.63-13.58; P = .004), lifetime history of bipolar disorder (OR, 3.4; 95% CI, 0.96-12.04; P = .06), history of childhood abuse (OR, 2.98; 95% CI, 1.40-6.38; P = .01), and parental suicide attempt (OR, 2.24; 95% CI, 1.06-4.75; P = .04).
The investigators concluded that clinicians should “pay particular attention to the severity of both current and past depression and the variability in these symptoms, and monitor and treat depression symptoms over time to reduce symptom severity and fluctuation, and thus the likelihood for suicide attempt, in high-risk young adults.”
Dr. Melhem reported receiving research support from the National Institute of Mental Health, the Brain and Behavior Research Foundation, and the American Foundation for Suicide Prevention. Several other coauthors also reported conflicts of interest.
SOURCE: Melhem NM et al. JAMA Psychiatry. 2019 Feb 27. doi: 10.1001/jamapsychiatry.2018.4513.
Among the trajectories of clinical predictors of suicide attempt, depression symptoms were the only ones linked with an increased risk of suicide attempt in young adults whose parents have mood disorders, according to a longitudinal study.
Psychiatric diagnoses are well established as predictors of suicidal behavior; however, symptoms and risk can vary over the course of illness, and it is important to identify symptoms that can change over time, wrote Nadine M. Melhem, PhD, associate professor of psychiatry at the University of Pittsburgh, and her associates. The report is in JAMA Psychiatry.
Between July 15, 1997, and Sept. 6, 2005, 663 adolescents and young adults (mean age, 23.8 years) whose parents have mood disorders were recruited and followed until Jan. 21, 2014. All participants were assessed at baseline and every year for up to 12 years (median follow-up, 8.1 years) for lifetime and current psychiatric disorders as well as suicidal ideation. In addition, participants were assessed at baseline and at each follow-up for the trajectory of depression symptoms, hopelessness, impulsivity, aggression, impulsive aggression, and irritability.
After the study period, participants were analyzed for all trajectories and separated into classes based on mean scores and variability. All trajectories except for depression had two classes, in which participants in class 2 had higher mean scores and variability; for depression, patients were separated into three classes, in which class 3 had the highest mean score and variability.
Over the study period, 71 of the 663 patients attempted suicide (10.7%), with 51 patients attempting suicide for the first time. The mean number of attempts was 1.2, and the median time from the last assessment to the attempt was 45 weeks.
(22.9% with vs. 27 without), class 2 impulsivity (38.8% vs. 21.7%), class 2 aggression (29.0% vs. 15.6%), class 2 impulsive aggression (76.5% vs. 52.2%), and class 2 irritability (39.4% vs. 22.7%). However, after adjustment for demographics, parental suicide attempts, and additional clinical characteristics, only class 3 depression remained associated with suicide attempts (odds ratio, 4.72; 95% confidence interval, 1.47-15.21; P = .01).
Other significant predictors of suicide attempts were younger age (OR, 0.82; 95% CI, 0.74-0.90; P less than .001), lifetime history of unipolar disorder (OR, 4.71; 95% CI, 1.63-13.58; P = .004), lifetime history of bipolar disorder (OR, 3.4; 95% CI, 0.96-12.04; P = .06), history of childhood abuse (OR, 2.98; 95% CI, 1.40-6.38; P = .01), and parental suicide attempt (OR, 2.24; 95% CI, 1.06-4.75; P = .04).
The investigators concluded that clinicians should “pay particular attention to the severity of both current and past depression and the variability in these symptoms, and monitor and treat depression symptoms over time to reduce symptom severity and fluctuation, and thus the likelihood for suicide attempt, in high-risk young adults.”
Dr. Melhem reported receiving research support from the National Institute of Mental Health, the Brain and Behavior Research Foundation, and the American Foundation for Suicide Prevention. Several other coauthors also reported conflicts of interest.
SOURCE: Melhem NM et al. JAMA Psychiatry. 2019 Feb 27. doi: 10.1001/jamapsychiatry.2018.4513.
FROM JAMA PSYCHIATRY
Key clinical point: Only depression symptoms were associated with a higher suicide attempt risk in young adults whose parents have mood disorders.
Major finding: The depression symptom trajectory with the highest mean scores and variability over time was the only measured trajectory that predicted suicide attempts (odds ratio, 4.72; 95% confidence interval, 1.47-15.21; P = .01).
Study details: A longitudinal study of 663 adolescents and younger adults whose parents have mood disorders.
Disclosures: Dr. Melhem reported receiving research support from the National Institute of Mental Health, the Brain and Behavior Research Foundation, and the American Foundation for Suicide Prevention. Several other coauthors also reported conflicts of interest.
Source: Melhem NM et al. JAMA Psychiatry. 2019 Feb 27. doi: 10.1001/jamapsychiatry.2018.4513.
Cancer-battling breath, Zombie Bambi, and hops as health food
Does my breath smell like reduced cancer risk?
Cancer prevention just got a whole lot more ... fragrant. Allium vegetables – garlic, onions, leeks, chives, and shallots – have been found to decrease the risk of colorectal cancer (CRC), according to a Chinese study published last year. Very good news for Italians, but it looks like the risk of CRC in the vampire population might continue to rise.
The study authors reported that high allium intake correlated with lower CRC risk in both men and women, in the northeast Chinese population sampled. Bioactive compounds in these vegetables have anticarcinogenic properties, and researchers found that eating at least 35 pounds of allium vegetables per year could reduce cancer risk.
Unclear if this study was secretly funded by Big Onion, but as fans of delicious and anticancer flavor, we here at LOTME support these findings. However, we strongly advise against going the Tony Abbott route of chomping into whole onions.
An IPA a day keeps the doctor away
After you’re finished eating your annual 35 pounds of garlic and onions (sure, do it all in 1 day if you want), you might be a little thirsty. And we’ve got good news for you – have a brewski, it’s good for ya! Turns out, hops might have some health benefits, so drink up.
Hops contain a class of compound called isohumulones, which gives them that bitter taste. There have been multiple studies showing the metabolic effects of isohumulones, including cell inflammation suppression, reduced weight gain, reduced hyperglycemia, and increased glucose tolerance.
These isohumulones (try typing that 10 times in a row) interact with the bitter taste receptors in the gut, and researchers are hopeful that this could lead to isohumulone-esque drugs to treat metabolic disorders. In the meantime, maybe just chug a few IPAs a day.
My kingdom for a helmet
Most people like to root for the underdog. You know, the whole David vs. Goliath thing, the little guy who goes against overwhelming odds to take on some form of the Big Establishment.
But what if the little guy happens to be a fairly normal-sized lacrosse player with a very large head?
Alex Chu, a freshman at Division III Wheaton College in Norton, Mass., is just such a guy. “My head is wide,” he told WJAR TV. He wants to play goalie for the school’s lacrosse team, but he can’t because no current helmet will fit on the 25-inch-circumference head that sits atop his 6-foot-tall, 265-pound body.
He’s up against Big Sports Equipment in the form of Cascade-Maverik and Warrior, the two major manufacturers of lacrosse helmets, which won’t build him a custom helmet. It would be too expensive, they say – but the Boston Globe reported that there is a lacrosse player at a Division I school who wears a very large helmet “that was produced after [his] coaches and Cascade ‘huddled up.’ ”
We wish Mr. Chu well, and perhaps one day he will be mentioned with such large-skulled high achievers as Jay Leno, LeBron James, Jennifer Garner, Tyrannosaurus rex, Rihanna, Napoleon Bonaparte, SpongeBob SquarePants, and Simon Cowell.
We’ll just have the salad
Zombies, beware: You might want to eat us, but now, we can eat you.
Okay, “zombie” deer aren’t actually zombies, but they are infected with something almost as terrifying. Chronic wasting disease is a prion disorder similar to bovine spongiform encephalopathy, or mad cow disease, and has been found in deer across 24 U.S. states as of January 2019.
While venison is less commonly eaten than beef, if mad cow disease can make the jump to humans, can people who eat meat infected with chronic wasting disease also become infected?
Thanks to an Oneida County, N.Y., fire company and a 2005 Sportsmen’s feast we’re sure someone’s never heard the end of, we know the answer to be “no.”
The fire company accidentally served meat from a deer that was infected with chronic wasting disease, and more than 200 people were exposed. A group of about 80 of these individuals have been monitored since then by a research team from the Oneida County Health Department and the State University of New York at Binghamton. At the most recent follow-up, no individual had developed the disease.
Experts do caution that it’s entirely possible chronic wasting disease will make the jump to humans eventually, despite the species gap. But for now, you can enjoy without fear your sweet ironic revenge on those zombies.
Does my breath smell like reduced cancer risk?
Cancer prevention just got a whole lot more ... fragrant. Allium vegetables – garlic, onions, leeks, chives, and shallots – have been found to decrease the risk of colorectal cancer (CRC), according to a Chinese study published last year. Very good news for Italians, but it looks like the risk of CRC in the vampire population might continue to rise.
The study authors reported that high allium intake correlated with lower CRC risk in both men and women, in the northeast Chinese population sampled. Bioactive compounds in these vegetables have anticarcinogenic properties, and researchers found that eating at least 35 pounds of allium vegetables per year could reduce cancer risk.
Unclear if this study was secretly funded by Big Onion, but as fans of delicious and anticancer flavor, we here at LOTME support these findings. However, we strongly advise against going the Tony Abbott route of chomping into whole onions.
An IPA a day keeps the doctor away
After you’re finished eating your annual 35 pounds of garlic and onions (sure, do it all in 1 day if you want), you might be a little thirsty. And we’ve got good news for you – have a brewski, it’s good for ya! Turns out, hops might have some health benefits, so drink up.
Hops contain a class of compound called isohumulones, which gives them that bitter taste. There have been multiple studies showing the metabolic effects of isohumulones, including cell inflammation suppression, reduced weight gain, reduced hyperglycemia, and increased glucose tolerance.
These isohumulones (try typing that 10 times in a row) interact with the bitter taste receptors in the gut, and researchers are hopeful that this could lead to isohumulone-esque drugs to treat metabolic disorders. In the meantime, maybe just chug a few IPAs a day.
My kingdom for a helmet
Most people like to root for the underdog. You know, the whole David vs. Goliath thing, the little guy who goes against overwhelming odds to take on some form of the Big Establishment.
But what if the little guy happens to be a fairly normal-sized lacrosse player with a very large head?
Alex Chu, a freshman at Division III Wheaton College in Norton, Mass., is just such a guy. “My head is wide,” he told WJAR TV. He wants to play goalie for the school’s lacrosse team, but he can’t because no current helmet will fit on the 25-inch-circumference head that sits atop his 6-foot-tall, 265-pound body.
He’s up against Big Sports Equipment in the form of Cascade-Maverik and Warrior, the two major manufacturers of lacrosse helmets, which won’t build him a custom helmet. It would be too expensive, they say – but the Boston Globe reported that there is a lacrosse player at a Division I school who wears a very large helmet “that was produced after [his] coaches and Cascade ‘huddled up.’ ”
We wish Mr. Chu well, and perhaps one day he will be mentioned with such large-skulled high achievers as Jay Leno, LeBron James, Jennifer Garner, Tyrannosaurus rex, Rihanna, Napoleon Bonaparte, SpongeBob SquarePants, and Simon Cowell.
We’ll just have the salad
Zombies, beware: You might want to eat us, but now, we can eat you.
Okay, “zombie” deer aren’t actually zombies, but they are infected with something almost as terrifying. Chronic wasting disease is a prion disorder similar to bovine spongiform encephalopathy, or mad cow disease, and has been found in deer across 24 U.S. states as of January 2019.
While venison is less commonly eaten than beef, if mad cow disease can make the jump to humans, can people who eat meat infected with chronic wasting disease also become infected?
Thanks to an Oneida County, N.Y., fire company and a 2005 Sportsmen’s feast we’re sure someone’s never heard the end of, we know the answer to be “no.”
The fire company accidentally served meat from a deer that was infected with chronic wasting disease, and more than 200 people were exposed. A group of about 80 of these individuals have been monitored since then by a research team from the Oneida County Health Department and the State University of New York at Binghamton. At the most recent follow-up, no individual had developed the disease.
Experts do caution that it’s entirely possible chronic wasting disease will make the jump to humans eventually, despite the species gap. But for now, you can enjoy without fear your sweet ironic revenge on those zombies.
Does my breath smell like reduced cancer risk?
Cancer prevention just got a whole lot more ... fragrant. Allium vegetables – garlic, onions, leeks, chives, and shallots – have been found to decrease the risk of colorectal cancer (CRC), according to a Chinese study published last year. Very good news for Italians, but it looks like the risk of CRC in the vampire population might continue to rise.
The study authors reported that high allium intake correlated with lower CRC risk in both men and women, in the northeast Chinese population sampled. Bioactive compounds in these vegetables have anticarcinogenic properties, and researchers found that eating at least 35 pounds of allium vegetables per year could reduce cancer risk.
Unclear if this study was secretly funded by Big Onion, but as fans of delicious and anticancer flavor, we here at LOTME support these findings. However, we strongly advise against going the Tony Abbott route of chomping into whole onions.
An IPA a day keeps the doctor away
After you’re finished eating your annual 35 pounds of garlic and onions (sure, do it all in 1 day if you want), you might be a little thirsty. And we’ve got good news for you – have a brewski, it’s good for ya! Turns out, hops might have some health benefits, so drink up.
Hops contain a class of compound called isohumulones, which gives them that bitter taste. There have been multiple studies showing the metabolic effects of isohumulones, including cell inflammation suppression, reduced weight gain, reduced hyperglycemia, and increased glucose tolerance.
These isohumulones (try typing that 10 times in a row) interact with the bitter taste receptors in the gut, and researchers are hopeful that this could lead to isohumulone-esque drugs to treat metabolic disorders. In the meantime, maybe just chug a few IPAs a day.
My kingdom for a helmet
Most people like to root for the underdog. You know, the whole David vs. Goliath thing, the little guy who goes against overwhelming odds to take on some form of the Big Establishment.
But what if the little guy happens to be a fairly normal-sized lacrosse player with a very large head?
Alex Chu, a freshman at Division III Wheaton College in Norton, Mass., is just such a guy. “My head is wide,” he told WJAR TV. He wants to play goalie for the school’s lacrosse team, but he can’t because no current helmet will fit on the 25-inch-circumference head that sits atop his 6-foot-tall, 265-pound body.
He’s up against Big Sports Equipment in the form of Cascade-Maverik and Warrior, the two major manufacturers of lacrosse helmets, which won’t build him a custom helmet. It would be too expensive, they say – but the Boston Globe reported that there is a lacrosse player at a Division I school who wears a very large helmet “that was produced after [his] coaches and Cascade ‘huddled up.’ ”
We wish Mr. Chu well, and perhaps one day he will be mentioned with such large-skulled high achievers as Jay Leno, LeBron James, Jennifer Garner, Tyrannosaurus rex, Rihanna, Napoleon Bonaparte, SpongeBob SquarePants, and Simon Cowell.
We’ll just have the salad
Zombies, beware: You might want to eat us, but now, we can eat you.
Okay, “zombie” deer aren’t actually zombies, but they are infected with something almost as terrifying. Chronic wasting disease is a prion disorder similar to bovine spongiform encephalopathy, or mad cow disease, and has been found in deer across 24 U.S. states as of January 2019.
While venison is less commonly eaten than beef, if mad cow disease can make the jump to humans, can people who eat meat infected with chronic wasting disease also become infected?
Thanks to an Oneida County, N.Y., fire company and a 2005 Sportsmen’s feast we’re sure someone’s never heard the end of, we know the answer to be “no.”
The fire company accidentally served meat from a deer that was infected with chronic wasting disease, and more than 200 people were exposed. A group of about 80 of these individuals have been monitored since then by a research team from the Oneida County Health Department and the State University of New York at Binghamton. At the most recent follow-up, no individual had developed the disease.
Experts do caution that it’s entirely possible chronic wasting disease will make the jump to humans eventually, despite the species gap. But for now, you can enjoy without fear your sweet ironic revenge on those zombies.
FDA approves label extension for dapagliflozin
The Food and Drug Administration has approved a label extension for Farxiga (dapagliflozin) and Xigduo XR (extended-release dapagliflozin and metformin HCl) for use in patients with type 2 diabetes and moderate renal impairment, lowering the estimated glomerular filtration rate (eGFR) threshold to 45 mL/min per 1.73 m2 from the current60 mL/min per 1.73 m2.
The update is based on results from DERIVE, a phase 3 study in patients with inadequately controlled diabetes and an eGFR of 45-59 mL/min per 1.73 m2 who received either dapagliflozin 10 mg or placebo during a 24-week period. After that time, patients who received dapagliflozin had significant reductions in glycosylated hemoglobin, compared with placebo. The safety profile was similar to that in other studies with dapagliflozin.
The most common adverse events associated with Farxiga are female genital mycotic infections, nasopharyngitis, and urinary tract infections. For Xigduo XR, the most common adverse events are female genital mycotic infection, nasopharyngitis, urinary tract infection, diarrhea, and headache.
“The DERIVE study, which further confirmed the well-established efficacy and safety profile for Farxiga and Xigduo XR, has resulted in important label changes for patients with type 2 diabetes that enable a broader population with impaired renal function to potentially benefit from these important treatment options,” Jim McDermott, PhD, vice president, U.S. medical affairs, diabetes, at AstraZeneca, said in the press release.
Find the full press release on the AstraZeneca website.
The Food and Drug Administration has approved a label extension for Farxiga (dapagliflozin) and Xigduo XR (extended-release dapagliflozin and metformin HCl) for use in patients with type 2 diabetes and moderate renal impairment, lowering the estimated glomerular filtration rate (eGFR) threshold to 45 mL/min per 1.73 m2 from the current60 mL/min per 1.73 m2.
The update is based on results from DERIVE, a phase 3 study in patients with inadequately controlled diabetes and an eGFR of 45-59 mL/min per 1.73 m2 who received either dapagliflozin 10 mg or placebo during a 24-week period. After that time, patients who received dapagliflozin had significant reductions in glycosylated hemoglobin, compared with placebo. The safety profile was similar to that in other studies with dapagliflozin.
The most common adverse events associated with Farxiga are female genital mycotic infections, nasopharyngitis, and urinary tract infections. For Xigduo XR, the most common adverse events are female genital mycotic infection, nasopharyngitis, urinary tract infection, diarrhea, and headache.
“The DERIVE study, which further confirmed the well-established efficacy and safety profile for Farxiga and Xigduo XR, has resulted in important label changes for patients with type 2 diabetes that enable a broader population with impaired renal function to potentially benefit from these important treatment options,” Jim McDermott, PhD, vice president, U.S. medical affairs, diabetes, at AstraZeneca, said in the press release.
Find the full press release on the AstraZeneca website.
The Food and Drug Administration has approved a label extension for Farxiga (dapagliflozin) and Xigduo XR (extended-release dapagliflozin and metformin HCl) for use in patients with type 2 diabetes and moderate renal impairment, lowering the estimated glomerular filtration rate (eGFR) threshold to 45 mL/min per 1.73 m2 from the current60 mL/min per 1.73 m2.
The update is based on results from DERIVE, a phase 3 study in patients with inadequately controlled diabetes and an eGFR of 45-59 mL/min per 1.73 m2 who received either dapagliflozin 10 mg or placebo during a 24-week period. After that time, patients who received dapagliflozin had significant reductions in glycosylated hemoglobin, compared with placebo. The safety profile was similar to that in other studies with dapagliflozin.
The most common adverse events associated with Farxiga are female genital mycotic infections, nasopharyngitis, and urinary tract infections. For Xigduo XR, the most common adverse events are female genital mycotic infection, nasopharyngitis, urinary tract infection, diarrhea, and headache.
“The DERIVE study, which further confirmed the well-established efficacy and safety profile for Farxiga and Xigduo XR, has resulted in important label changes for patients with type 2 diabetes that enable a broader population with impaired renal function to potentially benefit from these important treatment options,” Jim McDermott, PhD, vice president, U.S. medical affairs, diabetes, at AstraZeneca, said in the press release.
Find the full press release on the AstraZeneca website.