Katie Lennon

Mycophenolate mofetil was superior to azathioprine in preventing treatment failure in 227 lupus nephritis patients who initially responded to induction therapy, according to a randomized, double-blind comparison of the drugs’ efficacy during a 36-month maintenance phase of treatment.

The study’s participants were selected from a group of 370 lupus nephritis patients that received induction therapy in the form of mycophenolate mofetil (MMF) or intravenous cyclophosphamide (IVC) for 24 weeks; there was no difference in the efficacy of these two drugs.

All patients entered the study with biopsy-proven class III-V lupus nephritis and laboratory tests consistent with active nephritis, including evidence of an active urine sediment, proteinuria greater than or equal to 1 g/day or elevated serum creatinine (greater than 1.3 mg/dL). Patients with class III or V lupus nephritis were required to have higher levels of proteinuria (greater than or equal to 2 g/day) or serum creatinine greater than 1.3 mg/dL. Only patients who met prespecified criteria for a complete or partial renal response after 24 weeks of induction therapy and were adjudicated as responders by the clinical endpoints committee were advanced into the maintenance phase of the trial. The primary outcome measure in the maintenance phase was the time to treatment failure (TF), defined by any of the following criteria: death, end-stage renal disease, sustained doubling of serum creatinine, or renal flare and requirement for rescue therapy.

Among the patients who participated in the induction phase of the trial, non-Hispanic ethnicity was associated with a higher likelihood of complete remission.

Various characteristics of the study’s participants were associated with greater likelihood of treatment failure. These included: anti–double-stranded DNA (anti-dsDNA) at trial entry, failure to reduce anti-dsDNA within 8 weeks, and failure to reduce urine protein:creatinine ratio (UP/C) by greater than or equal to 25% within 8 weeks (Lupus Sci. Med. 2015 [doi:10.1136/lupus-2015-000089]).

For patients who participated in the maintenance phase, baseline estimated glomerular filtration rate (eGFR) greater than or equal to 90 mL/min/1.73 m², and UP/C greater than or equal to 1 at the end of induction were independently associated with complete remission during the maintenance phase.

Among the study’s other findings for patients who participated in maintenance therapy were that lack of treatment with antimalarials, failure to reduce anti-dsDNA or UP/C within the first 8 weeks of induction therapy, and anti-dsDNA positivity at the end of induction were independently associated with TF.

“Although our findings contribute to the understanding of predictors of renal outcomes in lupus nephritis, we believe that the associations described in this study are not strong enough to directly impact therapeutic decision making in individual patients in the clinic,” noted Dr. Maria Dall’Era of the University of California, San Francisco, and her colleagues. “Better biomarkers are needed to achieve this important goal. Lastly, in future controlled trials of lupus nephritis, studying the factors identified in our present analysis in a prespecified fashion might serve to further elucidate their association with renal response to treatment.”

The researchers declared no conflicts of interest.

[email protected]

Mycophenolate mofetil was superior to azathioprine in preventing treatment failure in 227 lupus nephritis patients who initially responded to induction therapy, according to a randomized, double-blind comparison of the drugs’ efficacy during a 36-month maintenance phase of treatment.

The study’s participants were selected from a group of 370 lupus nephritis patients that received induction therapy in the form of mycophenolate mofetil (MMF) or intravenous cyclophosphamide (IVC) for 24 weeks; there was no difference in the efficacy of these two drugs.

All patients entered the study with biopsy-proven class III-V lupus nephritis and laboratory tests consistent with active nephritis, including evidence of an active urine sediment, proteinuria greater than or equal to 1 g/day or elevated serum creatinine (greater than 1.3 mg/dL). Patients with class III or V lupus nephritis were required to have higher levels of proteinuria (greater than or equal to 2 g/day) or serum creatinine greater than 1.3 mg/dL. Only patients who met prespecified criteria for a complete or partial renal response after 24 weeks of induction therapy and were adjudicated as responders by the clinical endpoints committee were advanced into the maintenance phase of the trial. The primary outcome measure in the maintenance phase was the time to treatment failure (TF), defined by any of the following criteria: death, end-stage renal disease, sustained doubling of serum creatinine, or renal flare and requirement for rescue therapy.

Among the patients who participated in the induction phase of the trial, non-Hispanic ethnicity was associated with a higher likelihood of complete remission.

Various characteristics of the study’s participants were associated with greater likelihood of treatment failure. These included: anti–double-stranded DNA (anti-dsDNA) at trial entry, failure to reduce anti-dsDNA within 8 weeks, and failure to reduce urine protein:creatinine ratio (UP/C) by greater than or equal to 25% within 8 weeks (Lupus Sci. Med. 2015 [doi:10.1136/lupus-2015-000089]).

For patients who participated in the maintenance phase, baseline estimated glomerular filtration rate (eGFR) greater than or equal to 90 mL/min/1.73 m², and UP/C greater than or equal to 1 at the end of induction were independently associated with complete remission during the maintenance phase.

Among the study’s other findings for patients who participated in maintenance therapy were that lack of treatment with antimalarials, failure to reduce anti-dsDNA or UP/C within the first 8 weeks of induction therapy, and anti-dsDNA positivity at the end of induction were independently associated with TF.

“Although our findings contribute to the understanding of predictors of renal outcomes in lupus nephritis, we believe that the associations described in this study are not strong enough to directly impact therapeutic decision making in individual patients in the clinic,” noted Dr. Maria Dall’Era of the University of California, San Francisco, and her colleagues. “Better biomarkers are needed to achieve this important goal. Lastly, in future controlled trials of lupus nephritis, studying the factors identified in our present analysis in a prespecified fashion might serve to further elucidate their association with renal response to treatment.”

The researchers declared no conflicts of interest.

[email protected]

Mycophenolate mofetil was superior to azathioprine in preventing treatment failure in 227 lupus nephritis patients who initially responded to induction therapy, according to a randomized, double-blind comparison of the drugs’ efficacy during a 36-month maintenance phase of treatment.

The study’s participants were selected from a group of 370 lupus nephritis patients that received induction therapy in the form of mycophenolate mofetil (MMF) or intravenous cyclophosphamide (IVC) for 24 weeks; there was no difference in the efficacy of these two drugs.

All patients entered the study with biopsy-proven class III-V lupus nephritis and laboratory tests consistent with active nephritis, including evidence of an active urine sediment, proteinuria greater than or equal to 1 g/day or elevated serum creatinine (greater than 1.3 mg/dL). Patients with class III or V lupus nephritis were required to have higher levels of proteinuria (greater than or equal to 2 g/day) or serum creatinine greater than 1.3 mg/dL. Only patients who met prespecified criteria for a complete or partial renal response after 24 weeks of induction therapy and were adjudicated as responders by the clinical endpoints committee were advanced into the maintenance phase of the trial. The primary outcome measure in the maintenance phase was the time to treatment failure (TF), defined by any of the following criteria: death, end-stage renal disease, sustained doubling of serum creatinine, or renal flare and requirement for rescue therapy.

Among the patients who participated in the induction phase of the trial, non-Hispanic ethnicity was associated with a higher likelihood of complete remission.

Various characteristics of the study’s participants were associated with greater likelihood of treatment failure. These included: anti–double-stranded DNA (anti-dsDNA) at trial entry, failure to reduce anti-dsDNA within 8 weeks, and failure to reduce urine protein:creatinine ratio (UP/C) by greater than or equal to 25% within 8 weeks (Lupus Sci. Med. 2015 [doi:10.1136/lupus-2015-000089]).

For patients who participated in the maintenance phase, baseline estimated glomerular filtration rate (eGFR) greater than or equal to 90 mL/min/1.73 m², and UP/C greater than or equal to 1 at the end of induction were independently associated with complete remission during the maintenance phase.

Among the study’s other findings for patients who participated in maintenance therapy were that lack of treatment with antimalarials, failure to reduce anti-dsDNA or UP/C within the first 8 weeks of induction therapy, and anti-dsDNA positivity at the end of induction were independently associated with TF.

“Although our findings contribute to the understanding of predictors of renal outcomes in lupus nephritis, we believe that the associations described in this study are not strong enough to directly impact therapeutic decision making in individual patients in the clinic,” noted Dr. Maria Dall’Era of the University of California, San Francisco, and her colleagues. “Better biomarkers are needed to achieve this important goal. Lastly, in future controlled trials of lupus nephritis, studying the factors identified in our present analysis in a prespecified fashion might serve to further elucidate their association with renal response to treatment.”

The researchers declared no conflicts of interest.

[email protected]

About one-third of people with bipolar disorder are affected by comorbid migraine, and migraine is significantly more common among bipolar II disorder patients than among those with bipolar I disorder, a meta-analysis shows.

The meta-analysis covered 14 studies of 3,976 patients with some type of bipolar disorder from North America, Europe, and South America. Of the sample, 2,161 had bipolar I disorder and 647 had bipolar II disorder. The type of bipolar disorder the other patients had was either mixed or unknown. On average, each of the studies included 283.69 participants, and the mean age of a participant was 35.5 years. Studies that reported the prevalence of bipolar disorder among people with migraines were excluded.

Fifty-four percent of bipolar II disorder patients had migraines, compared with 32.7% of bipolar I disorder patients. An additional finding of the meta-analysis is that migraine was found significantly more often in studies that used standardized criteria to determine whether a bipolar patient had comorbid migraine than in studies that used nonstandardized criteria, such as self-report.

A meta-regression analysis of data from the studies showed that mean age moderated how frequently migraine occurred among the entire sample.

“The findings of this meta-analysis suggest that the prevalence of comorbid migraine among people with [bipolar disorder] is remarkably high, particularly among people with [bipolar II disorder],” according to Dr. Michele Fornaro and Brendon Stubbs.

The results of this meta-analysis “highlighted the need for further studies focusing on [migraine-bipolar II disorder] comobidity including well-matched control cases with or without rapid cycling features too,” according to the researchers.

Read the full study in Journal of Affective Disorders (doi:http://dx.doi.org/10.1016/j.jad.2015.02.032).

[email protected]

About one-third of people with bipolar disorder are affected by comorbid migraine, and migraine is significantly more common among bipolar II disorder patients than among those with bipolar I disorder, a meta-analysis shows.

The meta-analysis covered 14 studies of 3,976 patients with some type of bipolar disorder from North America, Europe, and South America. Of the sample, 2,161 had bipolar I disorder and 647 had bipolar II disorder. The type of bipolar disorder the other patients had was either mixed or unknown. On average, each of the studies included 283.69 participants, and the mean age of a participant was 35.5 years. Studies that reported the prevalence of bipolar disorder among people with migraines were excluded.

Fifty-four percent of bipolar II disorder patients had migraines, compared with 32.7% of bipolar I disorder patients. An additional finding of the meta-analysis is that migraine was found significantly more often in studies that used standardized criteria to determine whether a bipolar patient had comorbid migraine than in studies that used nonstandardized criteria, such as self-report.

A meta-regression analysis of data from the studies showed that mean age moderated how frequently migraine occurred among the entire sample.

“The findings of this meta-analysis suggest that the prevalence of comorbid migraine among people with [bipolar disorder] is remarkably high, particularly among people with [bipolar II disorder],” according to Dr. Michele Fornaro and Brendon Stubbs.

The results of this meta-analysis “highlighted the need for further studies focusing on [migraine-bipolar II disorder] comobidity including well-matched control cases with or without rapid cycling features too,” according to the researchers.

Read the full study in Journal of Affective Disorders (doi:http://dx.doi.org/10.1016/j.jad.2015.02.032).

[email protected]

About one-third of people with bipolar disorder are affected by comorbid migraine, and migraine is significantly more common among bipolar II disorder patients than among those with bipolar I disorder, a meta-analysis shows.

The meta-analysis covered 14 studies of 3,976 patients with some type of bipolar disorder from North America, Europe, and South America. Of the sample, 2,161 had bipolar I disorder and 647 had bipolar II disorder. The type of bipolar disorder the other patients had was either mixed or unknown. On average, each of the studies included 283.69 participants, and the mean age of a participant was 35.5 years. Studies that reported the prevalence of bipolar disorder among people with migraines were excluded.

Fifty-four percent of bipolar II disorder patients had migraines, compared with 32.7% of bipolar I disorder patients. An additional finding of the meta-analysis is that migraine was found significantly more often in studies that used standardized criteria to determine whether a bipolar patient had comorbid migraine than in studies that used nonstandardized criteria, such as self-report.

A meta-regression analysis of data from the studies showed that mean age moderated how frequently migraine occurred among the entire sample.

“The findings of this meta-analysis suggest that the prevalence of comorbid migraine among people with [bipolar disorder] is remarkably high, particularly among people with [bipolar II disorder],” according to Dr. Michele Fornaro and Brendon Stubbs.

The results of this meta-analysis “highlighted the need for further studies focusing on [migraine-bipolar II disorder] comobidity including well-matched control cases with or without rapid cycling features too,” according to the researchers.

Read the full study in Journal of Affective Disorders (doi:http://dx.doi.org/10.1016/j.jad.2015.02.032).

[email protected]

Psoriasis may play a role in temporomandibular joint disorders, according to an observational study that compared psoriasis patients to individuals without the disorder.

The Italian study, conducted from January 2014 to December 2014, included 112 patients with psoriasis and a 112-person control group. Of the patients with psoriasis, 25 (22%) had psoriatic arthritis (PsA). Patients were examined for temporomandibular disorder (TMD) signs and symptoms based on the standardized Research Diagnostic Criteria for Temporomandibular Disorders. TMD was assessed through a questionnaire and a clinical examination.

Overall, patients with psoriasis experienced TMD symptoms significantly more frequently than did members of the control group, with 69% of the psoriasis group reporting one or more symptoms, compared with 24% of the controls. Most often, the patients with psoriasis reported suffering from tenderness or stiffness in the neck and shoulders, muscle pain on chewing, and the sensation of a stuck or locked jaw. The control group’s major complaint was tenderness or stiffness in the neck and shoulders.

Temporomandibular joint sounds and opening derangement, which are signs of TMD, also were more common in the patients with psoriasis than in the control group.

TMD symptoms and signs were even more common in the subset of patients with PsA, with 80% of these patients reporting symptoms. Additionally, a statistically significant increase in opening derangement, bruxism, and temporomandibular joint sounds occurred in patients with PsA, compared with psoriasis patents without arthritis and controls.

Temporomandibular joint sounds and opening derangement “were found to be more frequent and severe in patients with psoriasis and PsA than in the healthy subjects, this result being highly significant,” wrote Dr. Vito Crincoli and colleagues at the University of Bari (Italy). “Therefore, in addition to dermatological and rheumatological implications, psoriasis seems to play a role in TMJ disorders, causing an increase in orofacial pain and an altered chewing function.”

Read the full study in the International Journal of Medical Sciences (2015;12:341-8 [doi:10.7150/ijms.11288]).

[email protected]

Psoriasis may play a role in temporomandibular joint disorders, according to an observational study that compared psoriasis patients to individuals without the disorder.

The Italian study, conducted from January 2014 to December 2014, included 112 patients with psoriasis and a 112-person control group. Of the patients with psoriasis, 25 (22%) had psoriatic arthritis (PsA). Patients were examined for temporomandibular disorder (TMD) signs and symptoms based on the standardized Research Diagnostic Criteria for Temporomandibular Disorders. TMD was assessed through a questionnaire and a clinical examination.

Overall, patients with psoriasis experienced TMD symptoms significantly more frequently than did members of the control group, with 69% of the psoriasis group reporting one or more symptoms, compared with 24% of the controls. Most often, the patients with psoriasis reported suffering from tenderness or stiffness in the neck and shoulders, muscle pain on chewing, and the sensation of a stuck or locked jaw. The control group’s major complaint was tenderness or stiffness in the neck and shoulders.

Temporomandibular joint sounds and opening derangement, which are signs of TMD, also were more common in the patients with psoriasis than in the control group.

TMD symptoms and signs were even more common in the subset of patients with PsA, with 80% of these patients reporting symptoms. Additionally, a statistically significant increase in opening derangement, bruxism, and temporomandibular joint sounds occurred in patients with PsA, compared with psoriasis patents without arthritis and controls.

Temporomandibular joint sounds and opening derangement “were found to be more frequent and severe in patients with psoriasis and PsA than in the healthy subjects, this result being highly significant,” wrote Dr. Vito Crincoli and colleagues at the University of Bari (Italy). “Therefore, in addition to dermatological and rheumatological implications, psoriasis seems to play a role in TMJ disorders, causing an increase in orofacial pain and an altered chewing function.”

Read the full study in the International Journal of Medical Sciences (2015;12:341-8 [doi:10.7150/ijms.11288]).

[email protected]

Psoriasis may play a role in temporomandibular joint disorders, according to an observational study that compared psoriasis patients to individuals without the disorder.

The Italian study, conducted from January 2014 to December 2014, included 112 patients with psoriasis and a 112-person control group. Of the patients with psoriasis, 25 (22%) had psoriatic arthritis (PsA). Patients were examined for temporomandibular disorder (TMD) signs and symptoms based on the standardized Research Diagnostic Criteria for Temporomandibular Disorders. TMD was assessed through a questionnaire and a clinical examination.

Overall, patients with psoriasis experienced TMD symptoms significantly more frequently than did members of the control group, with 69% of the psoriasis group reporting one or more symptoms, compared with 24% of the controls. Most often, the patients with psoriasis reported suffering from tenderness or stiffness in the neck and shoulders, muscle pain on chewing, and the sensation of a stuck or locked jaw. The control group’s major complaint was tenderness or stiffness in the neck and shoulders.

Temporomandibular joint sounds and opening derangement, which are signs of TMD, also were more common in the patients with psoriasis than in the control group.

TMD symptoms and signs were even more common in the subset of patients with PsA, with 80% of these patients reporting symptoms. Additionally, a statistically significant increase in opening derangement, bruxism, and temporomandibular joint sounds occurred in patients with PsA, compared with psoriasis patents without arthritis and controls.

Temporomandibular joint sounds and opening derangement “were found to be more frequent and severe in patients with psoriasis and PsA than in the healthy subjects, this result being highly significant,” wrote Dr. Vito Crincoli and colleagues at the University of Bari (Italy). “Therefore, in addition to dermatological and rheumatological implications, psoriasis seems to play a role in TMJ disorders, causing an increase in orofacial pain and an altered chewing function.”

Read the full study in the International Journal of Medical Sciences (2015;12:341-8 [doi:10.7150/ijms.11288]).

[email protected]

At least 25% of females from six out of seven countries studied and 10% of males in four of the countries reported suffering from sexual violence before age 18 years.

Researchers surveyed adults aged 18-24 years in Cambodia, Haiti, Kenya, Malawi, Swaziland, Tanzania, and Zimbabwe. Data were collected through household surveys from 2007 to 2013 by the Centers for Disease Control and Prevention (CDC) and the United Nations Children’s Fund (UNICEF) in partnership with host country governments, communities, and academic institutions.

The definition of sexual violence used in this survey included unwanted touching, unwanted attempted sex, pressured/coerced sex, and forced sex. For all countries that participated in the survey other than Swaziland and Malawi, sex was defined as vaginal/anal penetration by the penis, hands, fingers, mouth, or objects, or oral penetration by the penis, except in Swaziland (penetration of vagina or anus by penis only) and Malawi (oral, vaginal, or anal sex, or vaginal/anal object insertion).

Of the countries studied, Swaziland and Zimbabwe had the highest percentages of females that suffered from childhood sexual violence; the rates were 37.6% in Swaziland and 32.5% in Zimbabwe. In Haiti, the largest percentage of males reported having been victims of sexual violence under the age of 18; while the rate was 21.2% for males, an even higher rate – 25.7% – of females in Haiti reported suffering from childhood sexual violence.

Cambodia reported the lowest rates of childhood sexual violence for both females and males, at 4.4% and 5.6%. respectively.

Despite the high percentage of the study’s sample that suffered from childhood sexual violence, only 10% or less of male and female victims in most of the countries studied received services such as health care, legal/security aid, counseling support, or child protective services. Female victims in Haiti, Swaziland, and Tanzania were most often provided with services, with rates ranging from 10% in Haiti to 24% in Swaziland.

“Despite myriad adverse effects of sexual violence, in this study, most persons who reported experiencing it during childhood did not receive services for their abuse,” according to Dr. Steven A. Sumner of the National Center for Injury Prevention and Control, Atlanta, and his colleagues. “Although the control and response to violence traditionally has been seen as the responsibility of law enforcement and social welfare, health sectors can integrate violence prevention and care into routine programmatic activities, building clear links to social services to achieve maximal benefit for various health measures.”

Read the full study in MMWR.

[email protected]

At least 25% of females from six out of seven countries studied and 10% of males in four of the countries reported suffering from sexual violence before age 18 years.

Researchers surveyed adults aged 18-24 years in Cambodia, Haiti, Kenya, Malawi, Swaziland, Tanzania, and Zimbabwe. Data were collected through household surveys from 2007 to 2013 by the Centers for Disease Control and Prevention (CDC) and the United Nations Children’s Fund (UNICEF) in partnership with host country governments, communities, and academic institutions.

The definition of sexual violence used in this survey included unwanted touching, unwanted attempted sex, pressured/coerced sex, and forced sex. For all countries that participated in the survey other than Swaziland and Malawi, sex was defined as vaginal/anal penetration by the penis, hands, fingers, mouth, or objects, or oral penetration by the penis, except in Swaziland (penetration of vagina or anus by penis only) and Malawi (oral, vaginal, or anal sex, or vaginal/anal object insertion).

Of the countries studied, Swaziland and Zimbabwe had the highest percentages of females that suffered from childhood sexual violence; the rates were 37.6% in Swaziland and 32.5% in Zimbabwe. In Haiti, the largest percentage of males reported having been victims of sexual violence under the age of 18; while the rate was 21.2% for males, an even higher rate – 25.7% – of females in Haiti reported suffering from childhood sexual violence.

Cambodia reported the lowest rates of childhood sexual violence for both females and males, at 4.4% and 5.6%. respectively.

Despite the high percentage of the study’s sample that suffered from childhood sexual violence, only 10% or less of male and female victims in most of the countries studied received services such as health care, legal/security aid, counseling support, or child protective services. Female victims in Haiti, Swaziland, and Tanzania were most often provided with services, with rates ranging from 10% in Haiti to 24% in Swaziland.

“Despite myriad adverse effects of sexual violence, in this study, most persons who reported experiencing it during childhood did not receive services for their abuse,” according to Dr. Steven A. Sumner of the National Center for Injury Prevention and Control, Atlanta, and his colleagues. “Although the control and response to violence traditionally has been seen as the responsibility of law enforcement and social welfare, health sectors can integrate violence prevention and care into routine programmatic activities, building clear links to social services to achieve maximal benefit for various health measures.”

Read the full study in MMWR.

[email protected]

At least 25% of females from six out of seven countries studied and 10% of males in four of the countries reported suffering from sexual violence before age 18 years.

Researchers surveyed adults aged 18-24 years in Cambodia, Haiti, Kenya, Malawi, Swaziland, Tanzania, and Zimbabwe. Data were collected through household surveys from 2007 to 2013 by the Centers for Disease Control and Prevention (CDC) and the United Nations Children’s Fund (UNICEF) in partnership with host country governments, communities, and academic institutions.

The definition of sexual violence used in this survey included unwanted touching, unwanted attempted sex, pressured/coerced sex, and forced sex. For all countries that participated in the survey other than Swaziland and Malawi, sex was defined as vaginal/anal penetration by the penis, hands, fingers, mouth, or objects, or oral penetration by the penis, except in Swaziland (penetration of vagina or anus by penis only) and Malawi (oral, vaginal, or anal sex, or vaginal/anal object insertion).

Of the countries studied, Swaziland and Zimbabwe had the highest percentages of females that suffered from childhood sexual violence; the rates were 37.6% in Swaziland and 32.5% in Zimbabwe. In Haiti, the largest percentage of males reported having been victims of sexual violence under the age of 18; while the rate was 21.2% for males, an even higher rate – 25.7% – of females in Haiti reported suffering from childhood sexual violence.

Cambodia reported the lowest rates of childhood sexual violence for both females and males, at 4.4% and 5.6%. respectively.

Despite the high percentage of the study’s sample that suffered from childhood sexual violence, only 10% or less of male and female victims in most of the countries studied received services such as health care, legal/security aid, counseling support, or child protective services. Female victims in Haiti, Swaziland, and Tanzania were most often provided with services, with rates ranging from 10% in Haiti to 24% in Swaziland.

“Despite myriad adverse effects of sexual violence, in this study, most persons who reported experiencing it during childhood did not receive services for their abuse,” according to Dr. Steven A. Sumner of the National Center for Injury Prevention and Control, Atlanta, and his colleagues. “Although the control and response to violence traditionally has been seen as the responsibility of law enforcement and social welfare, health sectors can integrate violence prevention and care into routine programmatic activities, building clear links to social services to achieve maximal benefit for various health measures.”

Read the full study in MMWR.

[email protected]

Children with urinary levels of 3-phenoxybenzoic acid (3-PBA) above the limit of detection were twice as likely to have attention-deficit/hyperactivity disorder as those with lower levels of the metabolite of several pyrethroid pesticides, according to a study.

Such data came from the National Health and Nutrition Examination Survey (NHANES) results for 687 children aged 8-15 years. Of the sample, 15% had ADHD, which the researchers defined as meeting Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for ADHD and/or having a prior ADHD diagnosis. The limit of detection for 3-PBA was 0.1 mcg/L. It was below that level for 21% or 131 of the study’s participants. The average BPA level in the sample was 1.14 mcg/L.

Each tenfold increase in urinary 3-BPA level was associated with a 57% increase in the prevalence of ADHD. Higher 3-BPA levels also were associated with an increasing number of hyperactive-impulsive symptoms; the number of these symptoms found in children with detectable levels of 3-BPA was 77% higher than in children with nondetectable levels.

The researchers found some differences in 3-BPA levels’ associations with ADHD and the disorder’s symptoms in boys and girls. Stronger associations between urinary 3-BPA levels and ADHD were found in boys; boys with detectable levels of 3-BPA were almost three times as likely to have ADHD than other boys in the sample. In girls, the adjusted odds ratio was only 1.54.

“Our results suggest an association between childhood urinary pyrethroid pesticide biomarkers and ADHD, particularly hyperactive-impulsive symptoms, and these associations may be stronger in boys than girls,” according to Melissa Wagner-Schuman of the Cincinnati Children’s Hospital Center and her colleagues. “Given the growing use of pyrethroid pesticides and the perception that they represent a safer pesticide alternative, these results may be of considerable public importance. However, replication of findings is warranted in prospective, longitudinal studies with serial measurements of pyrethroid pesticide exposure.”

Read the full study in Environmental Health (doi: 10.1186/s12940-015-0030-y).

[email protected]

Children with urinary levels of 3-phenoxybenzoic acid (3-PBA) above the limit of detection were twice as likely to have attention-deficit/hyperactivity disorder as those with lower levels of the metabolite of several pyrethroid pesticides, according to a study.

Such data came from the National Health and Nutrition Examination Survey (NHANES) results for 687 children aged 8-15 years. Of the sample, 15% had ADHD, which the researchers defined as meeting Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for ADHD and/or having a prior ADHD diagnosis. The limit of detection for 3-PBA was 0.1 mcg/L. It was below that level for 21% or 131 of the study’s participants. The average BPA level in the sample was 1.14 mcg/L.

Each tenfold increase in urinary 3-BPA level was associated with a 57% increase in the prevalence of ADHD. Higher 3-BPA levels also were associated with an increasing number of hyperactive-impulsive symptoms; the number of these symptoms found in children with detectable levels of 3-BPA was 77% higher than in children with nondetectable levels.

The researchers found some differences in 3-BPA levels’ associations with ADHD and the disorder’s symptoms in boys and girls. Stronger associations between urinary 3-BPA levels and ADHD were found in boys; boys with detectable levels of 3-BPA were almost three times as likely to have ADHD than other boys in the sample. In girls, the adjusted odds ratio was only 1.54.

“Our results suggest an association between childhood urinary pyrethroid pesticide biomarkers and ADHD, particularly hyperactive-impulsive symptoms, and these associations may be stronger in boys than girls,” according to Melissa Wagner-Schuman of the Cincinnati Children’s Hospital Center and her colleagues. “Given the growing use of pyrethroid pesticides and the perception that they represent a safer pesticide alternative, these results may be of considerable public importance. However, replication of findings is warranted in prospective, longitudinal studies with serial measurements of pyrethroid pesticide exposure.”

Read the full study in Environmental Health (doi: 10.1186/s12940-015-0030-y).

[email protected]

Children with urinary levels of 3-phenoxybenzoic acid (3-PBA) above the limit of detection were twice as likely to have attention-deficit/hyperactivity disorder as those with lower levels of the metabolite of several pyrethroid pesticides, according to a study.

Such data came from the National Health and Nutrition Examination Survey (NHANES) results for 687 children aged 8-15 years. Of the sample, 15% had ADHD, which the researchers defined as meeting Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for ADHD and/or having a prior ADHD diagnosis. The limit of detection for 3-PBA was 0.1 mcg/L. It was below that level for 21% or 131 of the study’s participants. The average BPA level in the sample was 1.14 mcg/L.

Each tenfold increase in urinary 3-BPA level was associated with a 57% increase in the prevalence of ADHD. Higher 3-BPA levels also were associated with an increasing number of hyperactive-impulsive symptoms; the number of these symptoms found in children with detectable levels of 3-BPA was 77% higher than in children with nondetectable levels.

The researchers found some differences in 3-BPA levels’ associations with ADHD and the disorder’s symptoms in boys and girls. Stronger associations between urinary 3-BPA levels and ADHD were found in boys; boys with detectable levels of 3-BPA were almost three times as likely to have ADHD than other boys in the sample. In girls, the adjusted odds ratio was only 1.54.

“Our results suggest an association between childhood urinary pyrethroid pesticide biomarkers and ADHD, particularly hyperactive-impulsive symptoms, and these associations may be stronger in boys than girls,” according to Melissa Wagner-Schuman of the Cincinnati Children’s Hospital Center and her colleagues. “Given the growing use of pyrethroid pesticides and the perception that they represent a safer pesticide alternative, these results may be of considerable public importance. However, replication of findings is warranted in prospective, longitudinal studies with serial measurements of pyrethroid pesticide exposure.”

Read the full study in Environmental Health (doi: 10.1186/s12940-015-0030-y).

[email protected]

Patients with bipolar disorder with psychotic symptoms with a longer duration of untreated illness are worse off than patients diagnosed with the condition earlier, a retrospective study shows.

The duration of untreated psychosis (DUP), duration of untreated illness (DUI), and initial diagnosis of 240 bipolar disorder (BD) patients with psychotic symptoms were extrapolated through a retrospective review of clinical charts, Lombardy database, and, if necessary, through clinical interviews with patients and their relatives. DUP was defined as the time between the onset of psychotic symptoms and the start of antipsychotic treatment, while DUI was defined as the time between the onset of any symptoms of BD and the start of the appropriate mood-stabilizing therapy.

Most (61.5%) of the study’s participants initially were diagnosed with illnesses other than bipolar disorder with psychotic symptoms; the top most common misdiagnosis was delusional disorder.

For patients with DUIs of less than or equal to 8 years, Global Assessment of Functioning (GAF) scores were significantly higher than for patients with DUIs of greater than 8 years. Another significant difference that was found between these two groups was in the number of hospitalizations; participants in the group with longer DUIs faced significantly more of these.

The results of the study suggest that DUI, but not DUP, “seem to affect [at least partly] long-term prognosis” in patients with [bipolar disorder] with psychotic symptoms, according to Dr. A. Carlo Altamura and his colleagues.

Among the study’s conclusions is that “early-onset [bipolar disorder] patients with psychotic features have a long-term poorer working functioning” than late-onset BD patients with psychotic symptoms, according to the researchers.

Read the full study in the Journal of Affective Disorders (doi:10.1016/j.jd2015.04.024).

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Patients with bipolar disorder with psychotic symptoms with a longer duration of untreated illness are worse off than patients diagnosed with the condition earlier, a retrospective study shows.

The duration of untreated psychosis (DUP), duration of untreated illness (DUI), and initial diagnosis of 240 bipolar disorder (BD) patients with psychotic symptoms were extrapolated through a retrospective review of clinical charts, Lombardy database, and, if necessary, through clinical interviews with patients and their relatives. DUP was defined as the time between the onset of psychotic symptoms and the start of antipsychotic treatment, while DUI was defined as the time between the onset of any symptoms of BD and the start of the appropriate mood-stabilizing therapy.

Most (61.5%) of the study’s participants initially were diagnosed with illnesses other than bipolar disorder with psychotic symptoms; the top most common misdiagnosis was delusional disorder.

For patients with DUIs of less than or equal to 8 years, Global Assessment of Functioning (GAF) scores were significantly higher than for patients with DUIs of greater than 8 years. Another significant difference that was found between these two groups was in the number of hospitalizations; participants in the group with longer DUIs faced significantly more of these.

The results of the study suggest that DUI, but not DUP, “seem to affect [at least partly] long-term prognosis” in patients with [bipolar disorder] with psychotic symptoms, according to Dr. A. Carlo Altamura and his colleagues.

Among the study’s conclusions is that “early-onset [bipolar disorder] patients with psychotic features have a long-term poorer working functioning” than late-onset BD patients with psychotic symptoms, according to the researchers.

Read the full study in the Journal of Affective Disorders (doi:10.1016/j.jd2015.04.024).

[email protected]

Patients with bipolar disorder with psychotic symptoms with a longer duration of untreated illness are worse off than patients diagnosed with the condition earlier, a retrospective study shows.

The duration of untreated psychosis (DUP), duration of untreated illness (DUI), and initial diagnosis of 240 bipolar disorder (BD) patients with psychotic symptoms were extrapolated through a retrospective review of clinical charts, Lombardy database, and, if necessary, through clinical interviews with patients and their relatives. DUP was defined as the time between the onset of psychotic symptoms and the start of antipsychotic treatment, while DUI was defined as the time between the onset of any symptoms of BD and the start of the appropriate mood-stabilizing therapy.

Most (61.5%) of the study’s participants initially were diagnosed with illnesses other than bipolar disorder with psychotic symptoms; the top most common misdiagnosis was delusional disorder.

For patients with DUIs of less than or equal to 8 years, Global Assessment of Functioning (GAF) scores were significantly higher than for patients with DUIs of greater than 8 years. Another significant difference that was found between these two groups was in the number of hospitalizations; participants in the group with longer DUIs faced significantly more of these.

The results of the study suggest that DUI, but not DUP, “seem to affect [at least partly] long-term prognosis” in patients with [bipolar disorder] with psychotic symptoms, according to Dr. A. Carlo Altamura and his colleagues.

Among the study’s conclusions is that “early-onset [bipolar disorder] patients with psychotic features have a long-term poorer working functioning” than late-onset BD patients with psychotic symptoms, according to the researchers.

Read the full study in the Journal of Affective Disorders (doi:10.1016/j.jd2015.04.024).

[email protected]

Three North American nonprofit organizations that invest in scleroderma research are jointly trying to raise awareness about the autoimmune disorder.

Their efforts include posting information and urging people to pledge to raise awareness about the disease on Facebook and Twitter channels throughout June, which is Scleroderma Awareness Month. The partners in this campaign – Scleroderma Foundation, Scleroderma Research Foundation, and Scleroderma Society of Canada – have named their project, “Hard word. Harder disease.”

The campaign includes blogger outreach and sclerodermaaware.org, which serves as the landing page for the pledge and includes links to facts about the disease, organizers of the campaign, and scleroderma patients’ stories.

“Our strategy is to compel those who are not immediately impacted by scleroderma to relate to the disease, and therefore be more likely to empathize,” Robert J. Riggs, chief executive officer for the Scleroderma Foundation,said in a written statement.

[email protected]

Three North American nonprofit organizations that invest in scleroderma research are jointly trying to raise awareness about the autoimmune disorder.

Their efforts include posting information and urging people to pledge to raise awareness about the disease on Facebook and Twitter channels throughout June, which is Scleroderma Awareness Month. The partners in this campaign – Scleroderma Foundation, Scleroderma Research Foundation, and Scleroderma Society of Canada – have named their project, “Hard word. Harder disease.”

The campaign includes blogger outreach and sclerodermaaware.org, which serves as the landing page for the pledge and includes links to facts about the disease, organizers of the campaign, and scleroderma patients’ stories.

“Our strategy is to compel those who are not immediately impacted by scleroderma to relate to the disease, and therefore be more likely to empathize,” Robert J. Riggs, chief executive officer for the Scleroderma Foundation,said in a written statement.

[email protected]

Three North American nonprofit organizations that invest in scleroderma research are jointly trying to raise awareness about the autoimmune disorder.

Their efforts include posting information and urging people to pledge to raise awareness about the disease on Facebook and Twitter channels throughout June, which is Scleroderma Awareness Month. The partners in this campaign – Scleroderma Foundation, Scleroderma Research Foundation, and Scleroderma Society of Canada – have named their project, “Hard word. Harder disease.”

The campaign includes blogger outreach and sclerodermaaware.org, which serves as the landing page for the pledge and includes links to facts about the disease, organizers of the campaign, and scleroderma patients’ stories.

“Our strategy is to compel those who are not immediately impacted by scleroderma to relate to the disease, and therefore be more likely to empathize,” Robert J. Riggs, chief executive officer for the Scleroderma Foundation,said in a written statement.

[email protected]

Employees need to spend at least 2 hours of the work day on their feet, an international group of experts advised.

The group based this recommendation on studies showing possible links between illness and large amounts of time sitting. Among the findings of such research is that, in the United Kingdom, sedentary behavior occupies over 70% of the total waking hours of people with a high risk of chronic disease. Another data point used to reach the recommendation was that those with office jobs sit for 65%-75% of their time at work.

“In observational research, daily hours spent being sedentary (sitting), independent of levels of exercise or physical activity, are positively correlated with the risk of diabetes and cardiovascular disease, some cancers and premature mortality,” according to John P. Buckley of University Centre Shrewsbury and the University of Chester, England, and his colleagues. “For example, comprehensive reviews of the data found that compared with those who sit the least, those who sit the most have over twice the risk of developing type 2 diabetes and cardiovascular disease, and a 13% and 17% increased risk of cancer incidence and mortality, respectively.”

To potentially reduce the ill effects of prolonged sitting, the group of experts suggested that those with predominantly desk-based jobs adopt the following practices:

• Initially progress towards accumulating at least 2 hours a day of standing and performing light activity – such as walking – during work, and later increase the amount of time on foot to 4 hours a day (prorated to part-time hours).

• Take breaks from both seated- and standing-based work. Thus, sit-stand adjustable desk stations are highly recommended.

• Avoid prolonged static standing postures.

• If adding more standing to the work day causes pain that does not subside after altering posture, walking, or resting, then seek medical advice.

Such guidelines are justified even though longer-term intervention studies that assess standing and light activity in office environments are needed, according to the researchers.

Read the full report in the British Journal of Sports Medicine (2015 June 1 [doi:10.1136/bjsports-2015-094618]).

[email protected]

Employees need to spend at least 2 hours of the work day on their feet, an international group of experts advised.

The group based this recommendation on studies showing possible links between illness and large amounts of time sitting. Among the findings of such research is that, in the United Kingdom, sedentary behavior occupies over 70% of the total waking hours of people with a high risk of chronic disease. Another data point used to reach the recommendation was that those with office jobs sit for 65%-75% of their time at work.

“In observational research, daily hours spent being sedentary (sitting), independent of levels of exercise or physical activity, are positively correlated with the risk of diabetes and cardiovascular disease, some cancers and premature mortality,” according to John P. Buckley of University Centre Shrewsbury and the University of Chester, England, and his colleagues. “For example, comprehensive reviews of the data found that compared with those who sit the least, those who sit the most have over twice the risk of developing type 2 diabetes and cardiovascular disease, and a 13% and 17% increased risk of cancer incidence and mortality, respectively.”

To potentially reduce the ill effects of prolonged sitting, the group of experts suggested that those with predominantly desk-based jobs adopt the following practices:

• Initially progress towards accumulating at least 2 hours a day of standing and performing light activity – such as walking – during work, and later increase the amount of time on foot to 4 hours a day (prorated to part-time hours).

• Take breaks from both seated- and standing-based work. Thus, sit-stand adjustable desk stations are highly recommended.

• Avoid prolonged static standing postures.

• If adding more standing to the work day causes pain that does not subside after altering posture, walking, or resting, then seek medical advice.

Such guidelines are justified even though longer-term intervention studies that assess standing and light activity in office environments are needed, according to the researchers.

Read the full report in the British Journal of Sports Medicine (2015 June 1 [doi:10.1136/bjsports-2015-094618]).

[email protected]

Employees need to spend at least 2 hours of the work day on their feet, an international group of experts advised.

The group based this recommendation on studies showing possible links between illness and large amounts of time sitting. Among the findings of such research is that, in the United Kingdom, sedentary behavior occupies over 70% of the total waking hours of people with a high risk of chronic disease. Another data point used to reach the recommendation was that those with office jobs sit for 65%-75% of their time at work.

“In observational research, daily hours spent being sedentary (sitting), independent of levels of exercise or physical activity, are positively correlated with the risk of diabetes and cardiovascular disease, some cancers and premature mortality,” according to John P. Buckley of University Centre Shrewsbury and the University of Chester, England, and his colleagues. “For example, comprehensive reviews of the data found that compared with those who sit the least, those who sit the most have over twice the risk of developing type 2 diabetes and cardiovascular disease, and a 13% and 17% increased risk of cancer incidence and mortality, respectively.”

To potentially reduce the ill effects of prolonged sitting, the group of experts suggested that those with predominantly desk-based jobs adopt the following practices:

• Initially progress towards accumulating at least 2 hours a day of standing and performing light activity – such as walking – during work, and later increase the amount of time on foot to 4 hours a day (prorated to part-time hours).

• Take breaks from both seated- and standing-based work. Thus, sit-stand adjustable desk stations are highly recommended.

• Avoid prolonged static standing postures.

• If adding more standing to the work day causes pain that does not subside after altering posture, walking, or resting, then seek medical advice.

Such guidelines are justified even though longer-term intervention studies that assess standing and light activity in office environments are needed, according to the researchers.

Read the full report in the British Journal of Sports Medicine (2015 June 1 [doi:10.1136/bjsports-2015-094618]).

[email protected]

A psychiatrist in the United Kingdom is calling for the reclassification of psychedelic drugs to facilitate more research on their potential for treatment of psychiatric disorders.

In an opinion piece published in the BMJ, Dr. James J.H. Rucker asks that the U.K. Advisory Council on the Misuse of Drugs and the 2016 U.N. General Assembly Special Session on Drugs recommend that psychedelics be assigned the less stringent classification of schedule 2 compounds.

Among Dr. Rucker’s arguments in favor of this change is that there is little evidence showing that the use of these drugs is habit forming or harmful in controlled settings. He pointed out that various studies conducted prior to 1967 found that psychedelics served as “psychotherapeutic catalysts of mentally beneficial change in many psychiatric disorders, problems of personality development, recidivistic behavior, and existential anxiety.”

Studies had been demonstrating the positive outcomes of psychedelic drug use until a legal change to their classification brought research on them to halt after 1967, he said. At that time, psychedelics became classified as schedule 1 drugs under the U.K. Misuse of Drugs Act 1971 and 1971 United Nations Convention on Psychotropic Substances. Assigning these drugs such a classification “denoted psychedelic drugs as having no accepted medical use and the greatest potential for harm, despite the existence of research evidence to the contrary,” wrote Dr. Rucker of the Institute of Psychiatry, Psychology, and Neuroscience at King’s College in London.

Another criticism made by Dr. Rucker is that the drugs’ classification has made using them in clinical studies “almost impossible throughout the Western world,” because of the “financial and bureaucratic obstacles” it imposes.

“[T]he cost of clinical research using psychedelics is 5-10 times that of research into less restricted (but more harmful) drugs such as heroin – with no prospect that the benefits can be translated into wider medical practice,” he explained.

Outside of the United Kingdom, recent studies showed that these drugs were effective at treating anxiety associated with advanced cancer, obsessive-compulsive disorder, tobacco addiction, alcohol addiction, and cluster headaches, Dr. Rucker noted.

Read the full opinion piece in the BMJ.

[email protected]

A psychiatrist in the United Kingdom is calling for the reclassification of psychedelic drugs to facilitate more research on their potential for treatment of psychiatric disorders.

In an opinion piece published in the BMJ, Dr. James J.H. Rucker asks that the U.K. Advisory Council on the Misuse of Drugs and the 2016 U.N. General Assembly Special Session on Drugs recommend that psychedelics be assigned the less stringent classification of schedule 2 compounds.

Among Dr. Rucker’s arguments in favor of this change is that there is little evidence showing that the use of these drugs is habit forming or harmful in controlled settings. He pointed out that various studies conducted prior to 1967 found that psychedelics served as “psychotherapeutic catalysts of mentally beneficial change in many psychiatric disorders, problems of personality development, recidivistic behavior, and existential anxiety.”

Studies had been demonstrating the positive outcomes of psychedelic drug use until a legal change to their classification brought research on them to halt after 1967, he said. At that time, psychedelics became classified as schedule 1 drugs under the U.K. Misuse of Drugs Act 1971 and 1971 United Nations Convention on Psychotropic Substances. Assigning these drugs such a classification “denoted psychedelic drugs as having no accepted medical use and the greatest potential for harm, despite the existence of research evidence to the contrary,” wrote Dr. Rucker of the Institute of Psychiatry, Psychology, and Neuroscience at King’s College in London.

Another criticism made by Dr. Rucker is that the drugs’ classification has made using them in clinical studies “almost impossible throughout the Western world,” because of the “financial and bureaucratic obstacles” it imposes.

“[T]he cost of clinical research using psychedelics is 5-10 times that of research into less restricted (but more harmful) drugs such as heroin – with no prospect that the benefits can be translated into wider medical practice,” he explained.

Outside of the United Kingdom, recent studies showed that these drugs were effective at treating anxiety associated with advanced cancer, obsessive-compulsive disorder, tobacco addiction, alcohol addiction, and cluster headaches, Dr. Rucker noted.

Read the full opinion piece in the BMJ.

[email protected]

A psychiatrist in the United Kingdom is calling for the reclassification of psychedelic drugs to facilitate more research on their potential for treatment of psychiatric disorders.

In an opinion piece published in the BMJ, Dr. James J.H. Rucker asks that the U.K. Advisory Council on the Misuse of Drugs and the 2016 U.N. General Assembly Special Session on Drugs recommend that psychedelics be assigned the less stringent classification of schedule 2 compounds.

Among Dr. Rucker’s arguments in favor of this change is that there is little evidence showing that the use of these drugs is habit forming or harmful in controlled settings. He pointed out that various studies conducted prior to 1967 found that psychedelics served as “psychotherapeutic catalysts of mentally beneficial change in many psychiatric disorders, problems of personality development, recidivistic behavior, and existential anxiety.”

Studies had been demonstrating the positive outcomes of psychedelic drug use until a legal change to their classification brought research on them to halt after 1967, he said. At that time, psychedelics became classified as schedule 1 drugs under the U.K. Misuse of Drugs Act 1971 and 1971 United Nations Convention on Psychotropic Substances. Assigning these drugs such a classification “denoted psychedelic drugs as having no accepted medical use and the greatest potential for harm, despite the existence of research evidence to the contrary,” wrote Dr. Rucker of the Institute of Psychiatry, Psychology, and Neuroscience at King’s College in London.

Another criticism made by Dr. Rucker is that the drugs’ classification has made using them in clinical studies “almost impossible throughout the Western world,” because of the “financial and bureaucratic obstacles” it imposes.

“[T]he cost of clinical research using psychedelics is 5-10 times that of research into less restricted (but more harmful) drugs such as heroin – with no prospect that the benefits can be translated into wider medical practice,” he explained.

Outside of the United Kingdom, recent studies showed that these drugs were effective at treating anxiety associated with advanced cancer, obsessive-compulsive disorder, tobacco addiction, alcohol addiction, and cluster headaches, Dr. Rucker noted.

Read the full opinion piece in the BMJ.

[email protected]

Higher-than-normal body mass index and inflammation in late adolescence may be associated with colorectal cancer risk, a cohort study of 239,658 Swedish men showed.

The study’s results suggest that body mass index (BMI) and inflammation in early life may be important to the development of colorectal cancer (CRC), said Dr. Elizabeth D. Kantor and her colleagues.

The study’s participants, who were all between the ages of 16 and 20, were drawn from a cohort of men who underwent a compulsory conscription assessment for the Swedish military between 1969 and 1976 – when only men with severe disability or chronic diseases were exempt from serving in the military.

During the assessments, each young man’s height and weight was measured, which the study’s researchers used to calculate BMIs in kg/m² for the sample. The BMIs were categorized in the following ways: 15 to <18.5 was underweight, 18.5 to <25 was normal, 25 to <27.5 was the lower category of overweight, 27.5 to <30 was the upper category of overweight, and 30 to <55 was obese. Venous blood samples of the entire cohort were also collected during the assessment. These were used to assess inflammation levels as indicated by erythrocyte sedimentation rate (ESR), a nonspecific biomarker of inflammation. The researchers classified each study participant’s ESR as low, moderate, or high. The researchers tracked the incidences of malignant CRC in the cohort for an average of 35 years using the Swedish Cancer Registry.

Men who had been categorized as being in the upper category of overweight at the time of assessment were 2.08 times more likely to get CRC than normal weight men; obese men were 2.38 times more likely to get the disease. Both of these findings were statistically significant. The researchers also determined that a high ESR was associated with a significant 63% increased risk of CRC, using a multivariable adjustment.

“While no other studies have directly addressed the association between early-life inflammation and CRC risk, evidence supports the role of inflammation early in carcinogenesis,” the researchers wrote.

Another novelty of this study is that adolescents’ BMIs were measured instead of being based on recall, as they had been in other researchers’ attempts to determine the relationship between adolescent BMI and CRC risk in adulthood.

“With additional follow-up, and therefore, statistical power, future studies may address how adolescent inflammation and BMI interact to affect cancer risk. Further research is needed to better disentangle BMI and inflammation from associated exposures, and similarly, from exposures at other points in the life coarse,” the researchers wrote.

Read the full study in Gut (doi:10:1136/gutjnl-2014-309007).

[email protected]

Higher-than-normal body mass index and inflammation in late adolescence may be associated with colorectal cancer risk, a cohort study of 239,658 Swedish men showed.

The study’s results suggest that body mass index (BMI) and inflammation in early life may be important to the development of colorectal cancer (CRC), said Dr. Elizabeth D. Kantor and her colleagues.

The study’s participants, who were all between the ages of 16 and 20, were drawn from a cohort of men who underwent a compulsory conscription assessment for the Swedish military between 1969 and 1976 – when only men with severe disability or chronic diseases were exempt from serving in the military.

During the assessments, each young man’s height and weight was measured, which the study’s researchers used to calculate BMIs in kg/m² for the sample. The BMIs were categorized in the following ways: 15 to <18.5 was underweight, 18.5 to <25 was normal, 25 to <27.5 was the lower category of overweight, 27.5 to <30 was the upper category of overweight, and 30 to <55 was obese. Venous blood samples of the entire cohort were also collected during the assessment. These were used to assess inflammation levels as indicated by erythrocyte sedimentation rate (ESR), a nonspecific biomarker of inflammation. The researchers classified each study participant’s ESR as low, moderate, or high. The researchers tracked the incidences of malignant CRC in the cohort for an average of 35 years using the Swedish Cancer Registry.

Men who had been categorized as being in the upper category of overweight at the time of assessment were 2.08 times more likely to get CRC than normal weight men; obese men were 2.38 times more likely to get the disease. Both of these findings were statistically significant. The researchers also determined that a high ESR was associated with a significant 63% increased risk of CRC, using a multivariable adjustment.

“While no other studies have directly addressed the association between early-life inflammation and CRC risk, evidence supports the role of inflammation early in carcinogenesis,” the researchers wrote.

Another novelty of this study is that adolescents’ BMIs were measured instead of being based on recall, as they had been in other researchers’ attempts to determine the relationship between adolescent BMI and CRC risk in adulthood.

“With additional follow-up, and therefore, statistical power, future studies may address how adolescent inflammation and BMI interact to affect cancer risk. Further research is needed to better disentangle BMI and inflammation from associated exposures, and similarly, from exposures at other points in the life coarse,” the researchers wrote.

Read the full study in Gut (doi:10:1136/gutjnl-2014-309007).

[email protected]

Higher-than-normal body mass index and inflammation in late adolescence may be associated with colorectal cancer risk, a cohort study of 239,658 Swedish men showed.

The study’s results suggest that body mass index (BMI) and inflammation in early life may be important to the development of colorectal cancer (CRC), said Dr. Elizabeth D. Kantor and her colleagues.

The study’s participants, who were all between the ages of 16 and 20, were drawn from a cohort of men who underwent a compulsory conscription assessment for the Swedish military between 1969 and 1976 – when only men with severe disability or chronic diseases were exempt from serving in the military.

During the assessments, each young man’s height and weight was measured, which the study’s researchers used to calculate BMIs in kg/m² for the sample. The BMIs were categorized in the following ways: 15 to <18.5 was underweight, 18.5 to <25 was normal, 25 to <27.5 was the lower category of overweight, 27.5 to <30 was the upper category of overweight, and 30 to <55 was obese. Venous blood samples of the entire cohort were also collected during the assessment. These were used to assess inflammation levels as indicated by erythrocyte sedimentation rate (ESR), a nonspecific biomarker of inflammation. The researchers classified each study participant’s ESR as low, moderate, or high. The researchers tracked the incidences of malignant CRC in the cohort for an average of 35 years using the Swedish Cancer Registry.

Men who had been categorized as being in the upper category of overweight at the time of assessment were 2.08 times more likely to get CRC than normal weight men; obese men were 2.38 times more likely to get the disease. Both of these findings were statistically significant. The researchers also determined that a high ESR was associated with a significant 63% increased risk of CRC, using a multivariable adjustment.

“While no other studies have directly addressed the association between early-life inflammation and CRC risk, evidence supports the role of inflammation early in carcinogenesis,” the researchers wrote.

Another novelty of this study is that adolescents’ BMIs were measured instead of being based on recall, as they had been in other researchers’ attempts to determine the relationship between adolescent BMI and CRC risk in adulthood.

“With additional follow-up, and therefore, statistical power, future studies may address how adolescent inflammation and BMI interact to affect cancer risk. Further research is needed to better disentangle BMI and inflammation from associated exposures, and similarly, from exposures at other points in the life coarse,” the researchers wrote.

Read the full study in Gut (doi:10:1136/gutjnl-2014-309007).

[email protected]