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Fellowship
By stlukeorg

Pre-pregnancy potato consumption and risk of gestational diabetes mellitus: prospective cohort study.

Abstract

STUDY QUESTION:

What is the association between potato consumption before pregnancy and the risk of gestational diabetes mellitus (GDM)?

METHODS:

This prospective cohort study included 15?632 women from the Nurses’ Health Study II (1991-2001). They had no previous GDM or chronic diseases before pregnancy. Consumption of potatoes and other foods was assessed every four years. Incident first time GDM was ascertained from self reports of a physician diagnosis of GDM, which was previously validated by medical records.

STUDY ANSWER AND LIMITATIONS:

Over the 10 year follow-up there were 854 incident cases of GDM among 21?693 singleton pregnancies. After adjustment for age, parity, and dietary and non-dietary factors, women who consumed more potatoes before pregnancy had higher rates of developing GDM. Substitution of two servings a week of total potatoes with other vegetables, legumes, and whole grain foods was significantly associated with a 9-12% lower risk of GDM. Consumption and diabetes were self reported, and severity of diabetes was unknown. More than 90% of women were white. A causal association cannot be assumed.

WHAT THIS PAPER ADDS:

Higher levels of potato consumption before pregnancy are associated with greater risk of GDM, and substitution of potatoes with other vegetables, legumes, or whole grain foods might lower the risk.
FUNDING, COMPETING INTERESTS, DATA SHARING:
Funding was received from the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institutes of Health, and the American Diabetes Association (No 7-12-MN-34). The authors have no competing interests or additional data to share.

Published by the BMJ Publishing Group Limited.
by pubmed

Frontiers
By stlukeorg

Spinal stenosis

Spinal stenosis is an abnormal narrowing (stenosis) of the spinal canal that may occur in any of the regions of the spine. This narrowing causes a restriction to the spinal canal, resulting in a neurological deficit. Symptoms include pain, numbness, paraesthesia, and loss of motor control. The location of the stenosis determines which area of the body is affected. With spinal stenosis, the spinal canal is narrowed at the vertebral canal, which is a foramen between the vertebrae where the spinal cord (in the cervical or thoracic spine) or nerve roots (in the lumbar spine) pass through. There are several types of spinal stenosis, with lumbar stenosis and cervical stenosis being the most frequent. While lumbar spinal stenosis is more common, cervical spinal stenosis is more dangerous because it involves compression of the spinal cord whereas the lumbar spinal stenosis involves compression of the cauda equina.

by Wikipedia

Outreaches
By stlukeorg

Triple Lung Cancer Therapy With Experimental Drugs And Radiation Targets Most Resistant Cancers

The four most common gene mutations that occur in lung cancer include KRAS, TP53, STK11, and EGFR, These are often what make those cancers treatment-resistant. As a result, it’s far more difficult to choose the right therapy for lung cancers with genetic mutations.

One new study out of Thomas Jefferson University in Philadelphia, however, has been experimenting with a triple therapy that has proved effective for KRAS gene mutations in mice. The triple therapy involves two experimental drugs in combination with radiation therapy.

“Currently, there is a clinical trial underway to evaluate the combination of two cancer drugs, trametinib and palbociclib, made by two pharma companies for patients with solid tumors and melanoma,” said Dr. Bo Lu, professor of radiation oncology at Thomas Jefferson University and an author of the study, in the press release. “Although further research in human subjects is needed to confirm the finding, our study suggests that we may be able to identify non-small cell lung cancer patients who are likely to benefit most from this combination of therapies.”

Past research has focused on EGFR mutation treatments, but not much has been developed to target the KRAS mutation. Lung cancers, in general, have about a 54 percent survival rate of five years? but only if the cancer is detected early when it’s localized in the lungs. According to the new research, only about 2 percent of lung cancer survivors live past the five-year mark.

For the study, the researchers examined non-small cell lung cancer (NSCLC) cells and applied a KRAS-targeting drug to them. They found that some cells were more resistant to the drug than others and that a certain other mutation called p16 contributed to their resistance. In addition, after reviewing lung-cancer patient genotypes, the authors found that people who had the p16 mutation were less likely to survive, compared to those without the mutation.

This is what helped the researchers decide to use a double drug: The first one targets the KRAS mutation, while the second one unravels the p16 mutation resistance. This would weaken the cancer cells enough to make them fall prey to radiation. Though the treatment proved effective in mice, the researchers will need to repeat the experiment in a clinical trial before moving forward.

“If you hit one target another can take over,” Lu said. “If you hit two, it becomes a lethal bullet.”

Source: Lu B, et al. Clinical Cancer Research, 2015.

By Lecia Bushak / Medical Daily

Featured News
By stlukeorg

Only 6 in Every 100,000 Abortions in England Performed to Save Life of the Mother

Just 6 in every 100,000 abortions being performed in England and Wales were undertaken to save the mother from a life-threatening situation, a new report has found. That means in 99.994 percent of abortions the baby was terminated even though the mother’s life was not immediately at risk.
The new report issued by the British government highlights the alarming number of legal abortions conducted over recent decades with only a tiny fraction being conducted to save the life of the mother.

According to the figures, which were produced in response to a Parliamentary Question by Lord Alton of Liverpool, there were 6.4 million abortions performed on residents of England and Wales between 1968 and 2011.
The alarming statistics reveal that less than 150 of the 6.4 million abortions conducted since abortion was made legal in England were performed to save the life of the mother.

Just 143 or 0.006 percent of the entire number of terminated pregnancies were performed to save the life of the mother or to prevent serious or permanent injury to the physical or mental health of the mother.

Even when the number is increased to include abortions conducted where a continued pregnancy would pose just a heightened risk to the health of the mother, the number still does not reach even half a percent.

Abortions that fell into this wider category attributed to just 0.37 percent, or 23,778 abortions over the 43 year period. That is just over 500 abortions annually on average, compared to the almost 150,000 abortions that have taken place each year on average since 1968.

“When the case for allowing legal abortion was first placed before the [British] Parliament it was argued that the law needed to be changed to deal with extremely serious situations,” according to a report by the Christian Institute in Britain.

“More than 6 million abortions later the figures reveal that in 99.5% of cases where an unborn child’s life is ended there is no risk to the health of the mother…other figures reveal that 3 teenage girls have had 24 abortions between them and that some women have had more than eight legal abortions,” the CI report added.

Under the current abortion law in England, two doctors must sign a referral form before a woman can be allowed an abortion.
But a recent investigation by the Care Quality Commission uncovered that hospitals were using pre-signed forms or forms that had signatures photocopied on them, which allowed the second doctor to circumvent the need to consult another physician.

Last year 189,931 abortions were performed in England and Wales.

Source: By Myles Collier , Christian Post Contributor

Project
By stlukeorg

Hospice care increasing for nursing home patients with dementia

A new study of nursing home records shows more residents with dementia are seeking a hospice benefit and using it longer. The study also estimates that 40 percent of nursing home residents die with some degree of dementia. Researchers hope the new data will help policymakers preserve the hospice benefit even as they seek to control Medicare costs.

In newly published research analyzing data on more than 3.8 million deceased nursing home residents, researchers at Brown University and Hebrew SeniorLife/Deaconess Medical Center in Boston found the proportion of residents with dementia who benefited from Medicare hospice care nearly tripled — and the duration of care more than doubled — between 1999 and 2006.

Because hospice care provides important medical benefits to patients with dementia, including more attentive assistance with feeding and medication, the increased use of the benefit is good news, said Brown University gerontologist Susan Miller, the study’s lead author. But the data need to be considered carefully by policymakers, hospice administrators, physicians, and families in the context of efforts to control Medicare costs, she said.

“Families and caregivers don’t always recognize it as a terminal illness, but people die of dementia,” said Miller, research associate professor of community health in the Warren Alpert Medical School of Brown University. “Ideally the higher the proportion of people with dementia who are in hospice care the better because many studies have shown a benefit. But the issue is the cost and the length of stay.”

The paper published online Dec. 7 in the American Journal of Alzheimer’s Disease and Other Dementias, is the first to estimate the proportion of people who die in nursing homes with mild to moderately severe or an advanced degree of dementia, an important indicator of the prevalence of the condition in nursing homes. It puts the figure at 40.6 percent nationwide in 2006, although that varies widely by state.

Length of stay

Miller also found wide state-by-state variations in the length of stay in hospice care. That is a key finding because Medicare requires patients to have a terminal prognosis of six months or less before they can be enrolled for the hospice benefit. Because the prognosis of someone with dementia is hard to determine so precisely, some patients with dementia have remained in hospice care for much longer than six months, Miller said, and that concerns Medicare officials who must manage costs.

While the national average length of stay for nursing home patients with advanced dementia increased from 46 days in 1999 to 118 days in 2006 — still within the six-month time frame — in eight states more than a quarter of such patients retained hospice care for more than six months. Oklahoma had the largest proportion of long-staying patients with 46.6 percent, followed by Alabama, New Mexico, Wyoming, South Carolina, Mississippi, Arizona, and North Dakota.

The variations revealed in the state-by-state data suggest that very long stays are not just a product of a general uncertainty about prognosis but also of very different practices in different parts of the country.

As Medicare officials consider the cost of the rising use of the hospice benefit, especially with regard to patients with dementia, Miller said she hopes they will not create “perverse financial incentives” that make it harder for patients to get the care they really need. For example, physicians should not be discouraged from referring dementia patients for hospice care even though determining an exact prognosis is difficult. They should retain the latitude to act in good faith, Miller said. Meanwhile, reimbursement should be configured in such a way that it does not unduly favor short hospice stays.

“Initiatives focusing on reducing long hospice stays could disproportionately and adversely affect the timing of hospice referral for persons with dementia,” she wrote in the paper along with co-authors Julie Lima of Brown and Susan Mitchell of Hebrew SeniorLife and Deaconess. “It is critical that the creation of any new policy explicitly consider the challenges inherent in the timing of hospice referral for nursing home residents dying with dementia.”

Funding for the study came from the Alzheimer’s Association and the National Institute on Aging.

Source: Provided by Brown University