Kristin Bundy

Scientific Journalism


While I started my career writing for CME/CE and pharmaceutical advertising, I've spent the past few years exploring the world of scientific journalism. 

Most of the articles I have written involve analyzing new study data, interviewing study authors and/or experts in the field, and weaving together the salient points from each into a concise piece for the HCP audience. 

Some of my clients include MedPage Today, Pitt Med Magazine, and MDLinx.

Please scroll down to see clips on the following topics:

Asthma ~ ADHD ~ Burnout ~ Cardiovascular Disease ~ Dermatology ~ Diabetes ~ Elder Care/Aging ~ Emergency Medicine ~ Epigenetics ~ Eye Health ~ Gastroenterology ~ Hematology ~ Infectious Disease ~ Iron-Deficiency Anemia ~ Migraine ~ Neurologic Disorders ~ Nutrition ~ Oncology ~ Osteoporosis ~ Pain Management ~ Pediatrics ~ Practice Management ~ Psoriasis ~ Rheumatoid Arthritis ~ Seasonal Health ~ Tardive Dyskinesia ~ Women's Health ~ Yoga and Wellness

Asthma

MedPage Today •

Asthma Control in the Elderly: A Test of Personalized Coaching

Imagine this scenario: an elderly patient with chronic, uncontrolled asthma receives one-on-one coaching to overcome barriers to asthma control 4 times over a 1-year period. Baked into this approach is customized training tailored to the patient’s needs related to inhaler technique, medication adherence, and self-management factors (including physical health, mental health, cognition, environment, and psychosocial considerations).1 Could this personalized approach improve asthma outcomes, espec
MedPage Today •

Age, Gender, & Systemic Corticosteroid Comorbidities

High doses of systemic corticosteroids can play a vital role in helping to control severe asthma, but they do come at a price. In particular, comorbidities are common among patients taking a substantial amount of oral corticosteroids (OCS).1 To make matters worse, the comorbidities do not present homogeneously across all patient types, making it difficult for physicians to anticipate who will experience what.1 That may soon change. A recent population-based study showed that certain patient ph
MedPage Today •

Ask the Expert: William Busse, MD, Challenges the Current Definition of the Atopic March

Earlier this year, William Busse, MD, turned the allergy world on its head. In a guest editorial published in the Annals of Allergy, Asthma and Immunology, he contested a firmly-held, quarter-of-a-century-old ideology on allergic disease progression with one question: Is the atopic march fact or folklore? He contends that the atopic march is more complicated—and takes more paths—than what is widely believed. Since his paper was published, Dr. Busse has received some interesting commentary—som
MedPage Today •

Do Mucus Plugs Play a Bigger Role in Chronic Severe Asthma than Previously Thought?

Recently, a consortium of researchers published data on the effects of mucus plugs in chronic severe asthma. Using bench and bedside analyses, they examined whether eosinophils have a role in the pathophysiology of mucus plug formation and whether mucus plugs influence airway obstruction.1 Ultimately, the investigators sought to answer 2 key questions: Pulling data from the Severe Asthma Research Program (SARP)—the most comprehensive study of severe asthma in the world and funded by the Nationa

Attention Deficit Hyperactivity Disorder


Burnout

Cardiovascular Disease

MedPage Today •

HF and Cigarette Smoking: Getting Granular with the Data

Prior studies have linked cigarette smoking with heart failure (HF), but more granular questions remain. For example, do various smoking patterns—such as cigarettes smoked per day, pack-year burden, and time since quitting, among others—influence the incidence of HF? And does current smoking affect both HF subtypes: HF with reduced ejection fraction (HFrEF; EF ≤40%) and HF with preserved EF (HFpEF; EF ≥50%)? Researchers from several well-regarded U.S. medical schools addressed these questions in
MedPage Today •

Does PAD Share Genetic Susceptibility with CAD?

The atherosclerotic vascular diseases—peripheral artery disease (PAD) and coronary heart disease (CHD)—have common features. They are thought to share similar disease pathways and have been found to have analogous pathophysiologic manifestations, including inflammation, thrombosis, and altered endothelial function. In addition, there is a 1.5-fold increase in the odds of PAD if an individual has a family history of CHD.1 And yet, says Iftikhar Kullo, MD, Professor of Medicine, Cardiovascular Dis
MedPage Today •

Mortality Risk in Psoriasis: More than Skin Deep

“Although traditionally thought of as a skin disease, it’s now well known that psoriasis has important health implications beyond the skin. It is associated with several comorbidities, such as diabetes, hypertension, and cardiovascular disease,” says Ashar Dhana, MBBCh, MPH, of Groote Schuur Hospital and the University of Cape Town in South Africa. “However, an understanding of risk of death in patients with psoriasis is still unclear.” To that end, Dr. Dhana and his colleagues recently publish
MedPage Today •

Pregnancy is a Cardiovascular Stress Test: Q&A With Nisha Parikh, MD, MPH

High blood pressure before pregnancy is a risk factor for preeclampsia, and preeclampsia is a risk factor for hypertension and high blood pressure later in life.1 Despite this, few women of childbearing age have been included in cardiovascular (CVD) studies that assess lifestyle modifications and blood pressure.1 In fact, in an editorial in JAMA Internal Medicine, Nisha Parikh, MD, MPH, and Juan Gonzalez, MD, PhD, noted that the best-known studies excluded women who wanted to become pregnant or
MedPage Today •

How Patient Advocacy and Community Resources Improve Cardiovascular Disease

It seems intuitive that if a person’s basic needs, like housing and food, are not being met that the status of their health would proportionally reflect those unmet needs.1 But what if patients are offered interventions at the primary-care level? “Though unmet needs affect health, it’s a separate question as to whether addressing unmet needs improves health,” said Seth Berkowitz, MD, MPH, internist and faculty member at Massachusetts General Hospital and Harvard Medical School in Boston. “It ta
MedPage Today •

How Genetics and a High-Fat Diet Mingle to Increase Blood Pressure

Cardiovascular homeostasis and blood pressure are regulated in part by angiotensin converting enzyme (ACE).1 Serum concentrations of ACE were once thought to remain relatively stable, but recent research has shown that ACE levels increase with weight gain and decrease with weight loss.1 In a study published in the Journal of the American Heart Association,1 investigators examined whether serum ACE concentrations fluctuate with one’s diet, independent of weight gain, and if genetic factors are in

Dermatology

MedPage Today •

Atopic Dermatitis is Linked to an Increased Risk of Extracutaneous Infections

“We have known for a long time that atopic dermatitis [AD] is associated with increased skin infections for several reasons, such as skin-barrier dysfunction, lower antimicrobial peptides, and increased bacterial colonization,” says Jonathan Silverberg, MD, PhD, MPH, director of the Northwestern Medicine Multidisciplinary Eczema Center in Chicago. But the association between AD and extracutaneous infections is not as well understood because studies have reported contrary findings. To address th
MedPage Today •

Mortality Risk in Psoriasis: More than Skin Deep

“Although traditionally thought of as a skin disease, it’s now well known that psoriasis has important health implications beyond the skin. It is associated with several comorbidities, such as diabetes, hypertension, and cardiovascular disease,” says Ashar Dhana, MBBCh, MPH, of Groote Schuur Hospital and the University of Cape Town in South Africa. “However, an understanding of risk of death in patients with psoriasis is still unclear.” To that end, Dr. Dhana and his colleagues recently publish
MedPage Today •

Sun Exposure and Nevi Development in Children and Adolescents

While melanoma is rare in children and adolescents,1 researchers have posited that sun exposure coupled with mole development during the first two decades of life could increase the risk of skin cancer in adulthood.2 “Childhood and adolescent skin may be distinguished from adult skin by its inherent growth potential that may provide a fertile microenvironment for nevus formation after UV exposures that ultimately result in activating mutations in oncogenes such as BRAF and NRAS that initiate ne
MedPage Today •

Don’t Let BCC Biopsy Margin Status Drive Treatment Decisions

Researchers recently questioned whether diagnostic biopsies for basal cell carcinoma (BCC) are sufficient to adequately assess a suspicious lesion.1 Their concern? Only a small fraction—1% to 2%—of the true margin is typically assessed at bisection. If a negative margin is reported on a biopsy, can patients forego additional further treatment? How often is residual disease found? To answer these questions, a group of investigators conducted a study to determine the negative predictive value of
MedPage Today •

Generational Influences and Latino Skin Cancer Risk: Q&A with Maritza Perez, MD

This year during the annual meeting of the American Academy of Dermatology, Maritza Perez, MD, presented data on the incidence of skin cancer within the Latino community.1 Dr. Perez, clinical professor of dermatology at Mount Sinai Beth Israel Hospital, New York City, reported that the incidence of skin cancer is rising in young Latinos, partly because families have unknowingly shared inaccurate information about risk for decades.1 Here, Perez talks about skin cancer risk in this population and
MedPage Today •

Is Walgreens Furthering the Teledermatology Movement?

Imagine facing a jam-packed week—errands to run, projects due, back-to-back meetings, kids’ extra-curricular activities—when a rash erupts on your arm. It’s itchy, embarrassing, not going away, and possibly contagious. You want to get it checked out, but you can’t get in to see a dermatologist for weeks. What do you do? An increasing number of patients are finding the answer in teledermatology, a relatively new form of telemedicine that delivers digital dermatologic advice to time-starved patie

Diabetes

Elder Care/Aging

Emergency Medicine

Pitt Med •

Blue Sky Idea: A Test Flight for Prehospital Plasma

Say a STAT MedEvac helicopter is flying a patient, a nonresponsive 44-year-old man, from the scene of a car accident. He is bleeding and at risk of hemorrhagic shock. His systolic blood pressure dips dangerously—below 70. But the patient is still 20 minutes from the hospital. “Giving early plasma in the emergency department was thought to be beneficial,” says Jason Sperry, MD professor of surgery and critical care at Pitt. He wanted to see what benefits a prehospital infusion would give a patie
Pitt Med •

Leon L . Haley Jr: Dean at Jacksonville

Growing up in Pittsburgh, Leon L. Haley Jr. (MD ’90) dreamed of becoming the first African American sportscaster on network television. “But that changed when I mixed basketball with a trampoline,” he says. Having missed a slam dunk, young Haley wound up with a torn meniscus—and an awakening fascination with medicine. As a student at Pitt med, he completed a summer program working afternoon shifts at the emergency department at St. Margaret’s Hospital. The variety of injury and trauma cases tha
Pitt Med •

Brian D’Cruz: Political Hotspot Trauma Doc

Wounded men, women, and children arrived by the truckload at the makeshift emergency bay of the chicken farm-turned-hospital. Brian D’Cruz and a dozen other Doctors Without Borders health care workers—all of whom volunteered to work in northern Syria—rushed to their aid. Scores of civilians had been targets of bombings that day in the lush, mountainous region near the Turkish border. D’Cruz remembers that three people died. Had the hospital not been there, he says, there would have been at least

Epigenetics

Eye Health

MedPage Today •

Encouraging Proper Contact Lens Maintenance Can Help Prevent Eye Infection

What kind of shortcuts do your patients take in their morning routines? Struggling to get out the door on time, many may rush through or skip otherwise important hygiene practices. One in particular that can be overlooked is contact lens care, which unbeknownst to your patients, may put them at risk for an eye infection. Contact lenses are convenient and relatively easy to use—probably two reasons an estimated 1 in 6 adults in the United States wear them.1 Evidence suggests that nearly all of t
MedPage Today •

LED Street Lights: Good for the Environment, Bad for Night Vision? Karl Citek, OD, PhD, of the AOA, Sheds Light on the Topic

As communities and car manufacturers turn to more efficient, longer-lasting light sources for streetlights and headlights, the health effects of each have spurred debate. The emission of blue light from newer technologies is the main point of controversy—some have speculated if it affects age-related macular degeneration or cataracts. Little data is available at present; the American Optometric Association has encouraged further research to assess the impact of blue light on eyesight. In the mea
Pitt Med •

Hand-Eye Coordination: First Viable Whole-Eye Transplant, in a Rat

[After clicking, please scroll down the page to find this article] "That’s the rat right there!” says Kia Washington (Fel ’08, Res ’11, Fel ’12), pointing to the scientific poster hanging in her office. “It inspires me. [And] I haven’t really had a chance to decorate.” At first glance, it’s a bit startling because, well, not too many people have photographs of rats on their walls. But look closer, and it’s a marvel to behold—a white-furred, pink-eyed rodent that sees with an eye that was once not its own. This rat is the first viable orthotopic rodent eye transplantation model ever developed—a feat that was spotlighted at the Department of Defense’s annual Military Health System Research Symposium in August—and Washington, an assistant professor of plastic surgery and associate director of the hand transplantation program at Pitt and UPMC, led the group that pulled it off.
Pitt Med •

Seeing Anew: Navigating Retinal Generation

"We FedExed all of our fish,” says Jeffrey Gross as he steps out of a brightly lit room full of 11,000 thin, green tanks of tiny, translucent zebra fish. In August, the 12,000-some fish embryos made the move from the University of Texas at Austin to their new home at the University of Pittsburgh School of Medicine, along with their handlers: four PhD students, two postdocs, and Gross, a PhD professor of ophthalmology and the E. Ronald Salvitti Professor of Ophthalmology Research. Gross and his

Gastroenterology

Hematology

MedPage Today •

Ripple Effect: Chronic ITP and Family Life

Disease and treatment burden, which includes vigilance in watching for sudden bleeding, can lay heavy on the lives of children with chronic immune thrombocytopenia (ITP) and their caregivers. In addition, treatment side effects can be difficult to handle, and certain invasive approaches can cause fear. Family lifestyle is often compromised because of restrictions on everyday activities, and there are interpersonal relationship and economic costs that can come with caring for a child with a chron
MedPage Today •

Hemophilia Tx Challenges: Listening to Patients & Caregivers

Every day, patients with hemophilia A (PWHA) and their caregivers, who are often family members, face difficult treatment barriers. The medication of choice for this condition—recombinant factor VIII—requires frequent intravenous (IV) infusions that often affect quality of life, adherence to therapy, and even employment decisions. Given the demands of current therapy, a group of Canadian investigators developed a survey to learn firsthand what challenges patients and caregivers find most proble
MedPage Today •

Helicobacter pylori Eradication and Its Effect on ITP

Several studies have suggested that some association may exist between Helicobacter pylori infection and immune thrombocytopenia (ITP). The nature of the relationship isn’t yet well-characterized, but some evidence suggests that H pylori cytotoxin-associated gene A (CagA) surface antigen can trigger an immune response against certain platelet surface receptors. Beyond that, little is known. There are no known differentiators between ITP patients with and without H pylori with the possible except
MedPage Today •

Making Sense of Pediatric ITP and Antithyroid Antibodies

When pediatric patients present with immune thrombocytopenia (ITP), the presence of antinuclear antibodies (ANA) is one measure that can be used to predict whether pathogenesis of ITP is chronic. In turn, chronic ITP—characterized as an acquired immune dysregulation disorder with isolated thrombocytopenia that lasts >12 months—has been postulated to serve as a canary in the coal mine, of sorts, for the development of autoimmune disorders.1 Recently, researchers in Italy evaluated the associatio
MedPage Today •

Measures of Bone Health and Assessment of Fracture Risk in Hemophilia

Factors related to hemophilia increase patients’ risk of joint damage and osteopenia/osteoporosis. Namely, spontaneous intra-articular hemorrhage, which is common among this population, is associated with irreversible joint damage, and limited physical activity related to arthropathy in hemophilia can lead to reduced bone mineral density (BMD). Despite these risk factors, “there are no studies referring to bone quality dual X-ray absorptiometry indexes in hemophilia,” says Fabio Massimo Ulivier
MedPage Today •

Hemophilia Joint Pain: Patients and Physicians are Miles Apart

Once people with hemophilia (PWH) experience joint pain, “the horse is already out of the barn,” says Margaret Ragni, MD, MPH, a professor of medicine and clinical translational science in the Division of Hematology/Oncology at the University of Pittsburgh. “The critical way to avoid pain is to prevent bleeds.” Prophylaxis to prevent bleeding in the joints—and the resulting inflammatory response that causes synovial changes, disability, swelling, and discomfort—is standard of care, says Dr. Rag

Infectious Disease

Pitt Med •

Baby Burn: A New Tool for UTI Detection

“When adults have a urinary tract infection [UTI], they can tell the doctor it burns when they pee,” says Nader Shaikh, MD/MPH associate professor of pediatrics at the University of Pittsburgh and UPMC Children’s Hospital of Pittsburgh. “You check their urine, and they’re usually right.” With diaper-wearing infants and pre-verbal toddlers who present with a fever in the emergency department (ED), diagnosing UTIs is much more difficult. “You can’t ask babies to pee in a cup,” says Shaikh, “and t
MedPage Today •

ICU Admission and Mortality during Flu Season

The Northern Hemisphere is in the thick of influenza season, with approximately 60% of U.S. states reporting widespread or regional activity by the end of December 2018.1 Estimates suggest that up to 10% of patients hospitalized with influenza will be admitted to the intensive care unit (ICU).2 It’s unclear why some people experience more-severe disease than others. Could it be co-infections? Reactivation of latent viruses? Patient-specific factors? A group of researchers recently published the
Pitt Med •

Assembly Rewired: A virus hacks the cell's factory

Virologist Terence Dermody likes to describe viral replication in terms of manufacturing. Think of a cell as a factory. Maybe a factory that makes flat-screen TVs, he suggests. Then along comes a virus, an inert chemical with instructions for completely rewiring the circuitry. “It changes the job of the people in the factory,” says Dermody. “So now, instead of making flat-screen TVs, the cells make thousands and thousands of iPhones.” The problem with this shift in production, Dermody says, i

What Encourages People to Get a Flu Shot?

Each year, more than half of American adults don’t receive the influenza vaccine.1 Perhaps that’s because many interventions have been proven too labor intensive for physicians and office staff. Recently researchers tested a quick and easy way to increase vaccination rates that uses technology to encourage decision-making between providers and patients—that is, setting an active choice in the electronic health record (EHR). Using an "active choice" approach within the EHR, clinicians are prompt
MedPage Today •

Brain-Eating Amebas: Finding Expertise for Rare Seasonal Infections

While millions of Americans safely swim in freshwater lakes and rivers every summer, there are an extraordinarily small number of people who become infected with free-living, “brain-eating” amebas; 37 cases were reported in the US between 2006-2015.1 These single-cell organisms, known as Naegleria fowleri, thrive in warm freshwater.1 In rare instances, the ameba enters the brain via contaminated water through the nose, causing a serious and often fatal illness known as primary amebic meningoence
MedPage Today •

ID e-Consults at the VA: How Are They Impacting Primary Care?

Five years ago, the infectious disease (ID) department at the Veterans Affairs Boston Healthcare System (VABHS) adopted the use of e-consultations to help increase primary care access to the subspecialty.1 E-consults are different from telemedicine appointments in that patients are not involved in the communication; instead, front-line physicians consult with specialists via electronic health records (EHRs).1 It’s an “asynchronous” approach in which the ID specialist responds to the referring ph
MedPage Today •

Antibiotic Exposure and the Microbiome

As scientific research continues to address the issues of antibiotic resistance and subsequent treatment failures, emerging evidence suggests there may be other effects to consider when using antibiotics, including the impact they have on commensal gut bacteria and host physiology. “There is a rapidly increasing body of evidence that suggests that antibiotics are also associated with negative impacts on the body through their disruption of the microbiome,” explained Geraint Rogers, PhD, associat
MedPage Today •

Short-Course Antibiotics for Otitis Media Fall Short, May Be Worse

The National Institute of Allergy and Infectious Diseases (NIAID) funded 3 clinical trials to determine if short-course antibiotic treatment would reduce antibiotic resistance in children with 1) acute otitis media (AOM), 2) bacterial pneumonia, and 3) urinary tract infections. While the latter 2 studies are ongoing, results for AOM were recently published in the New England Journal of Medicine.1-3 Investigators from the University of Pittsburgh and Kentucky Pediatric and Adult Research in Bard
MedPage Today •

Keeping the Discussion Short and Sweet Helps Increase HPV Vaccination Rates

Children born during the modern anti-vaccine movement are now becoming adolescents, making the doctor-parent conversation about the human papilloma virus (HPV) vaccine even more difficult. Many providers hesitate to mention the multishot series, despite definitive medical recommendations, because of “the time it takes to recommend the vaccine, anticipation of an uncomfortable conversation related to sex, and a false perception that parents do not value HPV vaccination,” report researchers in a r
MedPage Today •

Can Routine Dental Visits Prevent Pneumonia? Michelle Doll, MD, MPH, Shares Study Findings

During the IDWeek 2016 conference in New Orleans, Michelle Doll, MD, MPH, assistant professor and epidemiologist at the Virginia Commonwealth University School of Medicine presented her group’s findings on access to dental care and risk of pneumonia. Results showed that those who never attended a dental check-up had an 86% higher risk of pneumonia compared with those who went to the dentist twice a year (after adjusting for various social and demographic factors). The data came from the Medica
MedPage Today •

New WHO Guidelines: Treating STIs in the Face of Antibiotic Resistance

The World Health Organization (WHO) recently updated its recommendations on treating three sexually transmitted infections (STIs): gonorrhea, syphilis, and chlamydia.1-3 With shifts in antibiotic resistance, WHO suggests changes to care on a global scale, while urging national health authorities to track resistance patterns and advise physicians on the most effective antibiotic(s) in their regions.4 The last time the guidelines were updated was 2003. A synopsis of what changed in 2016 was provi
MedPage Today •

Google Search Data Help Identify Seasonal Childhood Disease Outbreaks

As a concerned mother sits down to Google her sick child’s symptoms, she’s not just helping her own situation but perhaps contributing to a worldwide surveillance of disease transmission. This is part of a burgeoning field called “digital epidemiology,” and scientists are just beginning to understand how online information-seeking behavior can help track infectious disease outbreaks.1 A group of digital epidemiologists, led by Kevin Bakker, PhD candidate in the Department of Ecology and Evoluti
MedPage Today •

Why Patients Self-Prescribe Antibiotics: Learning From Their Resistance

We’ve all been tempted. A few days after starting a course of antibiotics and feeling symptoms subside, we wonder, “Do I really have to take the rest of these pills?“ As healthcare providers, you know the answer. But what about the general public? A research group from Baylor College of Medicine and the Houston VA Center set out to get answers on how people use antibiotics. In the spring and summer of 2015, they polled a random sample of 400 respondents (representing a mix of uninsured, underin
MedPage Today •

The New Face of Heroin Use and Hepatitis C Infection

Baby boomers (those born between 1945 and 1965) have long been the generation with the highest rate of hepatitis C (HCV) infection.1 However, statistics from the Centers for Disease Control and Prevention (CDC) indicate that millennials are becoming the new face of this disease.1 Young people in their teens, 20s, and 30s now represent the second wave of HCV infection in the United States, with most cases arising among white youth who live outside major metropolitan areas.1 Experts believe that
MedPage Today •

Influence of the Microbiome: Is the Respiratory Tract the New Gut?

The effect of the gut microbiome on immune function and chronic disease has been at the forefront of research for nearly 15 years. Only recently, however, have investigators started to understand similar influences within the airway. Preliminary data show that the ecological balance of the microbiome—which consists of bacteria, fungi, and viruses—in the upper and lower airways may predict the difference between homeostasis and the development of acute respiratory infection and chronic airway inf
MedPage Today •

Viral or Bacterial? Geoffrey Ginsburg, MD, PhD, Discusses a New Diagnostic Pathway

Clinicians have had few reliable tests to help pinpoint whether a patient’s acute respiratory infection (ARI) is viral or bacterial—leading to the misuse of antibiotics and an increase in antibiotic resistance.1,2 Researchers at Duke University Medical Center decided to turn the table on the infection, and instead of using pathogen-specific diagnostics, they looked to see if the host gave any clues as to the etiology of the illness.2 They recently discussed their findings in Science Translation

Iron-Deficiency Anemia

LGBTQ Health

Migraine

Neurologic Disorders

MedPage Today •

Medical cannabis: Promising uses supported by medical data

Over the past several years, legalization of medical marijuana has caught on like wildfire across the United States. The latest three states to approve medical use—Michigan, Missouri, and Utah—were added to the list as of the 2018 mid-term elections. That makes 34 states that have legalized cannabis for medicinal use through February 2019. Despite the quick uptick of legislative and public approval, scientific evidence backed by large randomized, controlled trials is lacking. In addition, there are no straight forward data to help clinicians determine which formulation of cannabis to use, what route of administration is most appropriate, how often it should be dosed and for how long, and what is the appropriate ratio of tetrahydrocannabinol (THC) to cannabidiol (CBD)—the two most prominent ligands used for therapeutic purposes.
MedPage Today •

Dravet Syndrome Affects Sleep, and Not Only in the Patient

Researchers recently studied sleep disturbances in patients with Dravet Syndrome (DS)—a genetic epilepsy syndrome in which 80% of people have a mutation in SCN1A, affecting areas in the central nervous system responsible for neural excitability.1 Common attributes of DS include developmental delays, refractory seizures, and non-epileptic factors, such as crouch gait and ataxia. “DS is more and more recognized as a ‘multisystemic’ disorder and not only as an epilepsy syndrome,” says An-Sofie Sch
Pitt Med •

Split Revision: A new understanding of how the brain controls motor function

[After clicking, please scroll down to read the article.] Four decades ago, a neuroscientist at Johns Hopkins University put forth a revolutionary new idea—and took a lot of heat for it. Some said he lacked evidence. “When he proposed his command hypothesis, Vernon Mountcastle got a lot of grief,” says the University of Pittsburgh’s Peter Strick, a PhD, Thomas Detre Professor of Neuroscience, Distinguished Professor and chair of neurobiology, and scientific director of the Brain Institute. It might have taken 40 years, but Strick and colleagues finally vindicated Mountcastle and validated his work.
MedPage Today •

How Often Do You Address Emotional Symptoms of ALS?

“Most of my effort during an office encounter with a patient with ALS is spent addressing physical issues—namely motor, bulbar/nutritional, and respiratory aspects of care. Patients and families may not volunteer emotional symptoms during these visits.”            —neurologist Nimish Thakore, MD While existing disease-modifying therapies demonstrate only modest effects on the progression of amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease), emotional symptoms can and shoul
Pitt Med •

To The Letter: A Double Take On Reading

As you read this, your brain is moving from one word to the next at a rate of 100–250 milliseconds per word, using context clues to make sense of the clusters of letters that formulate sentences. In essence, you’re reading these words at a gist level. But if I pint a word that doesn’t fit the context (e.g., pint versus print—see that difference?), your brain catches up a word or two later and says, Hold on, that wasn’t right. You’ll backtrack to make sense of it—a process called true-word recognition, or individuation.
MedPage Today •

What Disturbs the Mind Upsets the Body: "Connectome" Found Between Brain and Adrenals

When we’re active, we feel better, both physically and emotionally. A walk in the park does wonders for the psyche after a stressful day at the office. A yoga class before dawn can preset the mind to be more easeful with decisions throughout the day. A few laps at the pool, and some of our anxieties drift away. The concept of a mind-body connection has been around for millennia, but it’s only recently that we have seen proof of its existence. This summer researchers from the University of Pitts
Pitt Med •

Where Others Don't Go: Neurosurgeon Eschews Familiar to Bring Comfort to Children

[After clicking, please scroll down to read article.] The damage resulted from an anesthetic disaster. About 30 years earlier, during a tonsillectomy, her brain suffered a lack of oxygen that eventually changed the shape of her body. Involuntary muscle contractions—known as dystonia—distorted her into abnormal postures, causing lifelong pain. At 35 years old, she entrusted her future to another surgical team—oddly, led by a pediatric neurosurgeon. He had treated her for years but decided to try something new, after she said a small dose of baclofen injected in her spinal fluid helped. Giving up on oral baclofen, the common but often ineffective treatment for dystonia, he implanted a pump that infuses baclofen right into the spinal fluid.
Pitt Med •

"We're Doing This for the Next Guy": Lou Gehrig's gratitude inspires a family

Suzanne Alexander is no stranger to telling the story of how her husband, Neil Alexander, was diagnosed with amyotrophic lateral sclerosis (ALS) or how his body deteriorated over time. She has recounted it dozens if not hundreds of times on her blog and to family, friends, and journalists. But on this sunny late-August morning, the element of surprise still lingers in her voice as she recalls her husband’s death just five months prior. His absence was especially palpable at breakfast that morni

Nutrition

MedPage Today •

Will this refined approach to nutrition change clinical care?

Gone are the days of one-size-fits-all patient care. A personalized approach—one specifically tailored to a person’s needs—is the new focus of clinical practice. This is precision medicine, and it has gained traction thanks to better access to genome sequencing and a constant stream of studies demonstrating that gene variants affect disease risk and treatment. Precision nutrition (PN) takes a similar approach, but rather than simply treat disease, aims to prevent it.
MDLinx •

The 10 Healthiest Foods You Should Eat as Much as Possible

While variety is key to a healthy diet, there’s no doubt that some foods contain more nutrients than others. If you’re looking to get the most out of your meals, here are 10 foods that are incredibly nutritious, delightfully tasty, and might even help dial down chronic inflammation—which is known to contribute to diseases like cancer, Alzheimer’s, and heart disease. If you’re adventurous enough, you might even be able to get all 10 into one recipe.
Elephant Journal •

Will our Sick Planet (Finally) Influence the 2015 U.S. Dietary Guidelines?

“Current evidence shows that the average U.S. diet has a larger environmental impact in terms of increased greenhouse gas emissions, land use, water use, and energy use compared to [recommended] dietary patterns.” The Committee advocates for “diets higher in plant-based foods, such as vegetables, fruits, whole grains, legumes, nuts, and seeds, and lower in calories and animal-based foods” to promote health and minimize the effect on the environment. This latest report is important because it i

Oncology

Cancer Therapy Advisor •

MGUS: Risk of Progression to Multiple Myeloma Can Change Over Time

Monoclonal gammopathy of undetermined significance (MGUS) has been established as a precursor condition for multiple myeloma (MM). And yet, despite the existence of such a warning signal, screening for MGUS in the general population is not routine. Instead, many individuals are incidentally diagnosed with MGUS during unrelated medical evaluations. For those who have been diagnosed with MGUS, risk of disease progression to MM is determined at a single time point — typically at the time of initia
Cancer Therapy Advisor •

T-Cell Cryopreservation for Use in Future Cancer Treatment: Hot or Hype?

This summer, a company by the name of Cell Vault announced the launch of the first T-cell cryopreservation bank in the United States. Given the current groundswell in funding for autologous chimeric antigen receptor (CAR) T-cell (CAR-T) therapies, and the promise it holds for patients with treatment-refractory cancer, prospective cancer patients are likely to buy-in to the phenomenon — at least, those patients who can afford it. Cancer Therapy Advisor spoke with one of the scientific advisors f
MedPage Today •

Stage I NHL: Safe to Rely on Histologic Subtype to Predict Survival?

Among individuals diagnosed with stage I non-Hodgkin lymphoma (NHL), prognosis is generally favorable in about 80% patients.1 But what about the other 20%? While localized disease often implies a better prognosis than advanced stage, disease recurrence in stage 1 NHL does occur. In addition, histologic subtypes present with a good deal of heterogeneity. Despite these paradoxes, little scientific evidence is available on stage 1 NHL. Given the rarity of the cancer, there is a dearth of informati
Cancer Therapy Advisor •

Talazoparib in Advanced HER2-Negative Breast Cancer and Other Solid Tumors Lacking BRCA1/2 Mutations

At the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting, researchers presented phase 2 data on the activity of the PARP inhibitor talazoparib in patients with advanced HER2-negative breast cancer and other solid tumors that lacked BRCA1/2 mutations. Among the patients in this single-institution study, all received 1 prior course of platinum therapy with no progression on or within 8 weeks of the last dose. In addition, participants had to have measurable disease at the time of e
Cancer Therapy Advisor •

Efficacy of Maintenance Therapy After Induction Therapy in Patients With Nonsquamous NSCLC and Wild-Type EGFR

Researchers shared phase 3 data on the efficacy of continuation maintenance treatment after induction therapy in patients with advanced non-squamous non−small cell lung cancer (nSQ-NSCLC) during the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, Illinois. In the COMPASS study, 907 participants with no prior history of treatment for advanced nSQ-NSCLC, received induction therapy consisting of carboplatin (CAB) AUC 6 + pemetrexed 500 mg/m2 (PEM) + bevacizumab 15 mg/k
Cancer Therapy Advisor •

RELAY Phase 3: Efficacy of the Addition of Ramucirumab to Erlotinib in EGFR-Mutant Metastatic NSCLC

One year after publishing phase Ib results of the RELAY trial, investigators presented phase 3 findings at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting.1,2 RELAY is a multicenter, double-blind, randomized clinical trial that enrolledin patients who had no prior treatment for 1L epidermal growth factor receptor (EGFR)-mutant metastatic non−small cell lung cancer.2 The objective was to assess progression-free survival (PFS) in patients receiving therapy that inhibits eith
Cancer Therapy Advisor •

EGFR-Mutant mNSCLC: Outcomes of Gefitinib + Pemetrexed-Carboplatin Chemotherapy Versus Gefitinib Alone

At the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting, investigators presented phase 3 data comparing the oral tyrosine kinase inhibitor gefitinib (250 mg, PO QD [GEF]) vs GEF + pemetrexed 500 mg/m2 IV and carboplatin AUC 5 IV every 3 weeks for 4 cycles, followed by maintenance pemetrexed 500 mg/m2 IV every 3 weeks (GEF + C), in patients with advanced epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer. A total of 350 patients (median age of 54 years, 48%
Cancer Therapy Advisor •

Update from AACR: Divergent Data on FLT3 Inhibitors Tell a Tale of 2 Outcomes in AML and mCRC

The genetic mutation of FMS-like tyrosine kinase 3 (FLT3) was a hot topic at the American Association for Cancer Research (AACR) Annual Meeting 2019. Several preclinical studies provided more refined and nuanced insights into the target itself, and bioinformatics uncovered a way to measure low levels of residual disease during morphologic remission.1 But some of the most intriguing findings on FLT3 came from two clinical studies with incredibly divergent results. One was a phase 3 clinical tr
MedPage Today •

Ovarian Ca Perioperative Planning and Post-op Outcomes Impacted by Frailty

A majority of patients with epithelial ovarian cancer (EOC) are diagnosed with advanced disease. Among these women, frailty—or the lack of physiologic reserve to manage stressors like surgery—is common, leaving oncologists with the conundrum of how to start treatment. Do they prescribe primary debulking surgery (PDS), which requires a higher level of fitness, or wait and begin neoadjuvant chemotherapy? While they consider that choice, there may be another factor at play. Do physicians, and even
MedPage Today •

New Guidelines on Using Biosimilar ESAs During Myelosuppressive Chemotherapy

Recently, new guidelines were published on the management of cancer-associated anemia with erythropoiesis-stimulating agents (ESAs). The latest clinical update, released by the American Society of Clinical Oncology (ASCO) and the American Society of Hematology (ASH), incorporates new data, accumulated clinical knowledge, and novel treatment options that have emerged since the last version was published in 2010.1 Among 10 clinical questions addressed in the guidelines, one specifically focused o
Cancer Therapy Advisor •

Dual Immunotherapy and an Emerging Biomarker in NSCLC

While programmed death ligand 1 (PD-L1)−directed immunotherapy grows more common, the biomarker itself comes with limitations. “PDL-1 has been contentious as a biomarker, as responses are still seen in PD-L1 negative patients,” said Greg Delgoffe, PhD, assistant professor in the department of immunology at the University of Pittsburgh, Pennsylvania. Given this constraint, researchers are turning toward new biomarkers to help guide cancer treatment with immune checkpoint inhibitors.
MedPage Today •

Simple Cysts Pose No Risk for Ovarian Ca: An interview with Rebecca Smith-Bindman, MD

Investigators recently conducted a study to quantify the risk of ovarian cancer among women with simple cysts identified on ultrasound. More than 72,000 women who had undergone 118,778 pelvic ultrasonography examinations in the Kaiser Permanente Washington healthcare system were included in this nested case-control study.1 Compared to women with normal ovaries, those with complex cysts or solid masses had a significantly higher risk of ovarian cancer. Likelihood ratios ranged from 8 to 74 and t
MedPage Today •

Outcomes of SABR Plus Surgery in Patients with NSCLC

When comorbidities or personal preferences among patients with non-small cell lung cancer (NSCLC) prevent surgical resection, stereotactic ablative body radiotherapy (SABR) might be an alternative option to conventional external beam radiation therapy radiation.1 “SABR is a relatively new radiation technique that’s highly effective in early-stage lung cancer, delivering high doses of very conformal radiation in only a few sessions,” says David Palma, MD, PhD, a radiation oncologist at the Londo
MedPage Today •

A One-Two Punch for HPV-16–positive Cancers?

Independent of one another, therapeutic vaccines and immune checkpoint inhibition with anti-programmed cell death 1 (PD-1) antibodies have proven largely ineffective in treating recurrent HPV-16–positive malignant neoplasms. But could they overcome a tumor-induced immunosuppressive environment when used together? Investigators from the University of Texas MD Anderson Cancer Center, in Houston, recently addressed this question in a phase 2 trial. Led by principle investigator Bonnie Glisson, MD
MedPage Today •

Medical cannabis: Promising uses supported by medical data

Over the past several years, legalization of medical marijuana has caught on like wildfire across the United States. The latest three states to approve medical use—Michigan, Missouri, and Utah—were added to the list as of the 2018 mid-term elections. That makes 34 states that have legalized cannabis for medicinal use through February 2019. Despite the quick uptick of legislative and public approval, scientific evidence backed by large randomized, controlled trials is lacking. In addition, there are no straight forward data to help clinicians determine which formulation of cannabis to use, what route of administration is most appropriate, how often it should be dosed and for how long, and what is the appropriate ratio of tetrahydrocannabinol (THC) to cannabidiol (CBD)—the two most prominent ligands used for therapeutic purposes.
MedPage Today •

Oncologists on Biosimilars: An Interview with Rebecca Pentz, PhD, and R. Donald Harvey, PharmD

With ever-increasing healthcare costs, the adoption of biosimilars in oncology practice was expected to soar after FDA approval, much as generic versions of brand-name drugs are typically accepted.1 But unlike generics, biosimilars are not exact replicas of currently approved agents, and this distinction has left some oncologists questioning the effectiveness of biosimilars and how and when to use them in their own practices, if at all.1 To get a better sense of clinicians’ knowledge of biosimil
MedPage Today •

Non-BRCA Susceptible Gene Variants for Breast and Ovarian Cancers

While the discovery of the BRCA1 and BRCA2 genetic mutations changed the diagnosis and treatment for many patients with breast (BC) and ovarian (OV) cancers, we haven’t yet completed mapping the full genetic landscape of these two malignancies.1 Further elucidating genetic variants that are not as well-characterized as BRCA1 and BRCA2 and discovering new associations are essential to help inform the results of multigene panel testing and improve clinical practice. To that end, a group of invest
MedPage Today •

Pro-inflammatory Foods and CRC Risk: Is There an Association?

The role of chronic inflammation as a causative factor for multiple disease processes is a topic of great interest in medical circles these days, with some saying it may be the linchpin for myriad diseases, including colorectal cancer (CRC). Emerging evidence implicates inflammation in select gastrointestinal disorders, including CRC in inflammatory bowel disease. Supporting this effect, anti-inflammatory medications, such as aspirin, have been shown to be associated with reduced risk of develo
MedPage Today •

Practice Patterns in the Treatment of Stage II NSCLC

The optimal initial management for patients with clinical stage II non-small cell lung cancer (NSCLC) has not been definitively established. Practice guidelines such as the National Comprehensive Cancer Network (NCCN) recommend surgical exploration and resection for disease that is potentially operable, and definitive radiation or chemo-radiation for patients who are not surgical candidates. Yet less is known regarding the real-world practice patterns associated with treatment. “There aren’t a
MedPage Today •

Are Patients with Polycythemia Vera Receiving Guideline-informed Treatment?

Polycythemia vera (PV), which is marked by an increased number of red blood cells, is a rare blood cancer known to be associated with a high risk of cardiovascular disease. Median survival is estimated to be 18 months. Yet even with treatment, patients have higher mortality rates than those of age-matched controls. Naturally, thrombotic risk reduction is paramount to treating PV.1 Current National Comprehensive Cancer Network (NCCN) guidelines recommend aspirin with phlebotomy and potential cyt
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Osteoporosis

Pain Management

Pitt Med •

Fair Warning: A better way to predict overdose

As the opioid epidemic rages on, the Centers for Disease Control and Prevention reports that there are about 130 overdose-related deaths per day in the United States. Despite the ongoing crisis, Walid Gellad, a Pitt physician and health policy specialist, says, “We just don’t have a good way of identifying” who is most likely to overdose. For example, Gellad notes, the way Medicare’s current risk algorithm is set up, 70 percent of overdoses occur in their low-risk group and 30 percent in their high-risk group.
MedPage Today •

Opioid Use in RA: An interview with Yvonne Lee, MD, and Daniel Solomon, MD

Earlier this year, researchers published data on the use of opioids in patients with rheumatoid arthritis (RA)—a systemic inflammatory disease. In addition to garnering a better understanding of patient-reported use of opioids in RA (as opposed to assessing prescription data), they also hoped to identify factors that might increase risk of chronic opioid use in this population. The investigators collected data from the Corrona registry—a robust registry with more than 42,000 people with RA enro
MedPage Today •

Medical cannabis: Promising uses supported by medical data

Over the past several years, legalization of medical marijuana has caught on like wildfire across the United States. The latest three states to approve medical use—Michigan, Missouri, and Utah—were added to the list as of the 2018 mid-term elections. That makes 34 states that have legalized cannabis for medicinal use through February 2019. Despite the quick uptick of legislative and public approval, scientific evidence backed by large randomized, controlled trials is lacking. In addition, there are no straight forward data to help clinicians determine which formulation of cannabis to use, what route of administration is most appropriate, how often it should be dosed and for how long, and what is the appropriate ratio of tetrahydrocannabinol (THC) to cannabidiol (CBD)—the two most prominent ligands used for therapeutic purposes.
MedPage Today •

Opioid Prescribing for Children and Adolescents in the ED

Between 2001 and 2010, opioid prescribing increased almost 30% among pediatric populations treated in the emergency department (ED).1 To their credit, providers have become more vigilant with opioid prescribing in recent years, but the challenge of prudent pain management remains: How can the need for acute pain relief in the ED be balanced against the risks associated with treatment, especially in younger populations? There’s a lot on the line for pediatric patients. A recent study showed that
MedPage Today •

What Role for Placebos in Pain Management?

While pain remains a physiologically complex, subjective experience, placebo analgesics have been shown to help reduce pain. Precisely how they modulate the brain’s response is unknown, however. Although some positive associations have been made with psychological processes, such as associative learning or adjusted expectations of pain, could a placebo also disrupt the direct neuronal activation patterns of pain? Researchers set out to answer that question using a relatively new measure called
MedPage Today •

Effects of Yoga and PT on Chronic Low Back Pain in a Racially Diverse, Low-SES Population

According to a recent study in Annals of Internal Medicine, 10% of the US population struggles with chronic low back pain, and those most affected are underserved populations. 1 “Individuals who are predominantly racial/ethnic minorities and/or with lower socioeconomic status are disproportionately negatively impacted by their chronic low back pain,” said Robert Saper, MD, director of integrative medicine and family medicine physician at Boston Medical Center. “They receive less referrals to sp
MedPage Today •

Beyond the Epidural: Pain Management Techniques that Support Natural Birth

There’s a difference between pain and suffering. Pain results from an unpleasant physical and emotional experience—something that arises through the senses of the body. Suffering is a negative emotional response to a perceived threat to the body or mind, which involves a sense of helplessness and loss of control.1,2 “One can have pain without suffering and suffering without pain,” says Penny Simkin, physical therapist and co-founder of DONA (Doulas of North America) International and PATTCh (Pr
MedPage Today •

Which Herpes Zoster Patients Have Higher Risk of Experiencing Neuropathic Pain?

Drive past any pharmacy in America, and you’re likely to see a sign advertising availability of the shingles vaccine. The presence of these ads was uncommon even a decade ago, but now they rival flu shot promotions. There’s good reason for this: The incidence of shingles in adult Americans has made a steady climb over the years.1 Scientists aren’t exactly sure why that is, but they think it may have something to do with the aging population—the baby boomers and Gen Xers who were born before the
MedPage Today •

Chronic Pain Assessment 101

With 100 million adult Americans believed to have chronic pain, there is a tremendous need for proper assessment and relief.1 Despite advancements in interventions and a basic understanding of the neurophysiology of chronic pain, the means to remedy this persistent condition still remain elusive. Only about half the people who receive treatment actually feel any pain reduction, and usually that decrease is only about 30% to 40%.1 The medical community has often viewed chronic pain as a conditio

Pediatrics

MedPage Today •

Atopic Dermatitis is Linked to an Increased Risk of Extracutaneous Infections

“We have known for a long time that atopic dermatitis [AD] is associated with increased skin infections for several reasons, such as skin-barrier dysfunction, lower antimicrobial peptides, and increased bacterial colonization,” says Jonathan Silverberg, MD, PhD, MPH, director of the Northwestern Medicine Multidisciplinary Eczema Center in Chicago. But the association between AD and extracutaneous infections is not as well understood because studies have reported contrary findings. To address th
MedPage Today •

Making Sense of Pediatric ITP and Antithyroid Antibodies

When pediatric patients present with immune thrombocytopenia (ITP), the presence of antinuclear antibodies (ANA) is one measure that can be used to predict whether pathogenesis of ITP is chronic. In turn, chronic ITP—characterized as an acquired immune dysregulation disorder with isolated thrombocytopenia that lasts >12 months—has been postulated to serve as a canary in the coal mine, of sorts, for the development of autoimmune disorders.1 Recently, researchers in Italy evaluated the associatio
Pitt Med •

Baby Burn: A New Tool for UTI Detection

“When adults have a urinary tract infection [UTI], they can tell the doctor it burns when they pee,” says Nader Shaikh, MD/MPH associate professor of pediatrics at the University of Pittsburgh and UPMC Children’s Hospital of Pittsburgh. “You check their urine, and they’re usually right.” With diaper-wearing infants and pre-verbal toddlers who present with a fever in the emergency department (ED), diagnosing UTIs is much more difficult. “You can’t ask babies to pee in a cup,” says Shaikh, “and t
MedPage Today •

Dravet Syndrome Affects Sleep, and Not Only in the Patient

Researchers recently studied sleep disturbances in patients with Dravet Syndrome (DS)—a genetic epilepsy syndrome in which 80% of people have a mutation in SCN1A, affecting areas in the central nervous system responsible for neural excitability.1 Common attributes of DS include developmental delays, refractory seizures, and non-epileptic factors, such as crouch gait and ataxia. “DS is more and more recognized as a ‘multisystemic’ disorder and not only as an epilepsy syndrome,” says An-Sofie Sch
MedPage Today •

Opioid Prescribing for Children and Adolescents in the ED

Between 2001 and 2010, opioid prescribing increased almost 30% among pediatric populations treated in the emergency department (ED).1 To their credit, providers have become more vigilant with opioid prescribing in recent years, but the challenge of prudent pain management remains: How can the need for acute pain relief in the ED be balanced against the risks associated with treatment, especially in younger populations? There’s a lot on the line for pediatric patients. A recent study showed that
MedPage Today •

The Pediatrician's Role in Helping Children Cope With Separation or Divorce

“I don’t think I’ll ever get married. Why should I? All it does is make you miserable.” These are the opening lines of Judy Blume’s 1972 book It’s Not the End of the World. Narrator and protagonist, Karen, is a child struggling with parents who are on the brink of divorce. As she grapples with a chaotic daily life, the reader gets a peek into the head and heart of a girl who thinks she can get her parents back together.1 Blume’s book, along with more than a dozen others, is part of the suggest
MedPage Today •

Adolescent Firearm Homicides: Results from the City of Brotherly Love

The racial and class divides that have formed a chasm in the United States for centuries continue to influence the health of communities today. Children raised under poverty-stricken conditions and toxic stress bear the brunt of their environments, putting them at a disadvantage during a critical time of development—one that may even result in death. Two startling statistics reported by the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention showed
MedPage Today •

Keeping Adolescents on Schedule: Vaccination Best Practices

As children become adolescents, wellness visits begin to wane. Fewer trips to their primary care provider equate to more missed opportunities to keep children on track with the universally recommended vaccine schedule. Couple that with parental misinformation or hesitancy about vaccines, and that adds up to fewer tweens and teens getting the immunizations they need.1 Recently, the American Academy of Pediatrics (AAP) Committee on Infectious Diseases released guidelines on best practices for ado
MedPage Today •

Screening for Maternal Depression: What Can We Do Better?

“Care for the mother is an advocacy issue for all who serve children and their families.” ~ American Academy of Pediatrics Society romanticizes what it is to be a mother. Movies and media portray new moms as happy and blissful, experiencing unwavering maternal love for their baby and partner—a life fulfilled by giving birth. But this rendition of motherhood hurts women when it does not become a reality. “If a new mom is having a hard time, she may think there’s something wrong with her and b
MedPage Today •

Have a Carrot and a Smile—Branding Vegetables Gets Kids to Put Them on Their Plate

A child slumped over a serving of vegetables and pouting at the dinner table is an image that doesn’t just appear on TV. Parents and healthcare providers around the country have tried many ways to get kids to eat healthfully—and now schools are jumping into the game. Tired of seeing the fruits and vegetables from the lunch tray land in the garbage, investigators from Ohio State and Cornell universities decided to use good old-fashioned marketing efforts to motivate elementary-school kids to cho
MedPage Today •

Despite Education, Parents Still Place Babies in Unsafe Sleep Environments

A baby cries in the middle of the night. Her father awakens, shuffles down the hallway in the dark, picks her up from her crib and brings her back to the bedroom to nurse. Mom turns to one side in bed, welcoming the infant and offering a nipple. As baby feeds, mom and dad drift in and out of sleep, worn-out from the day and their first 3 months of parenthood. A few hours later, baby cries again, this time in their bed, right next to them. Apparently, they all fell asleep during the feeding. How
MedPage Today •

Nail-Biting and Thumb-Sucking May Make Kids Healthier

The "hygiene hypothesis" suggests that infants and children who are exposed to an array of good bacteria have a better chance of avoiding allergic responses as they get older. As scientists continue to put the hygiene hypothesis to the test, three investigators analyzed a handful of common childhood “bad” habits to see if they actually had a positive effect on the immune system.1 They wondered: could nail-biting and thumb-sucking—practices that most certainly increase microbial exposure early in
MedPage Today •

Bueller? …Bueller? Attendance Works’ Hedy Chang Outlines How HCPs Can Help Hedge Chronic Absenteeism

Ben Stein’s monotone roll call in the 1986 movie Ferris Bueller’s Day Off just might represent one of the most iconic scenes of student absenteeism to date. Playing a high school economics teacher, dead-pan comedian Stein hypnotically repeats “Bueller?... Bueller?” as the camera focuses in on an empty school desk. If you don’t know it, this is one of those movies where the audience cheers on the protagonist played by Matthew Broderick as he plays hooky, dodges the school principal, and joyrides
MedPage Today •

Can the Size of a Baby Bottle Influence Obesity Later in Life?

As scientists try to unravel the reasons for the growing rates of childhood obesity in America, one group from the University of North Carolina (UNC) at Chapel Hill took a look at a risk factor that might begin at birth. They wondered—could the chances of a child becoming obese result from the size of their baby bottle?1 They knew that babies who are exclusively formula-fed are known to grow more rapidly than breastfed infants, have greater adiposity in infancy and childhood, and have a greater
MedPage Today •

What Do You See? A Refresher on Diagnosing Conjunctivitis

Acute conjunctivitis—inflammation of the white part of the eye and inner eyelid—is a prevalent disease that affects up to 6 million Americans annually.1,2 Also known as pinkeye, conjunctivitis can result from an infection by a virus or bacterium or from a noninfection, such as an allergic response. Although conjunctivitis can be caused by other diseases or disorders, these 3 etiologies—viral, bacterial, and allergic—are the most common forms.1-3 Understanding how pinkeye presents in its many it
Pitt Med •

Don't Miss: Fluid Dynamics, Michael Moritz's IV solutions

In 2003, Michael Moritz, an MD, and his fellowship mentor, Juan Carlos Ayus, rocked the parenteral nutrition boat with a paper in Pediatrics. They presented evidence against the use of hypotonic IV solution (fluid with less sodium than a patient’s plasma)—a practice that had been entrenched in pediatric hospital care for 50 years. They argued that the solution could cause hyponatremia, or low sodium levels, and eventually neurological problems and death. Today, Moritz says, “over 20 prospective
Pitt Med •

For Real! Tween Science: How We Grow Up. Literally

Hey kids, did you just jump up a shoe size? If so, watch out. Soon, you might have to replace those pants you’re wearing, too. Why? During puberty, our hands and feet grow faster than the long bones in our arms and legs. So, if you’ve outgrown your favorite shoes, then you’re likely about to get a heck of a lot taller, and quick—something called, you’ve probably heard of it, a growth spurt. Young men and women go through growth spurts at different times. Girls grow t
Elephant Journal •

Why Vaccinating Your Child is a Radical, Feminist Choice

I am the mother of a seven-year-old. My son was born during an upsurge in the debate over vaccination. I weighed the opinions of smart mothers on both sides, women who were dedicated to making good medical decisions for their children. And when it was time for my child’s vaccination, I took what I had learned and went with what I thought was best. It wasn’t until recently that I investigated how the controversy began, and I was stunned. The entire vaccination-autism dispute started with just one male doctor: One man led the study that suggested a link between the measles-mumps-rubella (MMR) vaccine and autism.

Practice Management

Psoriasis

Rheumatoid Arthritis

Seasonal Health

MedPage Today •

Taking the Sting Out: Guideline Changes for Venom Immunotherapy

In 1999, a group of allergy and immunology experts first published practice parameters on insect sting hypersensitivity.1 Nearly 20 years later, the fourth iteration of these guidelines has been published in Annals of Allergy, Asthma, & Immunology—with the intent to refine diagnostic and treatment methods and elucidate the optimal use of immunotherapy with venom (VIT) and imported fire ant whole-body extracts.1 The 12 members of the Joint Task Force on Practice Parameters—6 from the American Ac
MedPage Today •

Online Survey Shows That Seasonal Allergy Sufferers Are Finding More Relief

As the buds and blossoms of spring open up to warmer days, their beauty also brings a paradoxical unrest and irritability to seasonal allergy sufferers. Congestion, headaches, and itchy eyes infiltrate the daily lives of children and adults who suffer from rhinoconjunctivitis. Even sleep can be elusive.1 The good news is that more people are realizing that they don’t have to live with these symptoms and instead are taking an active role to find relief for themselves and/or their children.1 A re
MedPage Today •

Chronic Disease and Winter Weather: Outcomes of a Pharmacy-Outreach Program Before a Major Storm

On January 22 and 23, 2016, several Eastern and Mid-Atlantic states were buried by Winter Storm Jonas.1 In the aftermath, snowfall measured a foot or more in at least 14 states.1 The tarmacs at the Baltimore-Washington International Airport were covered with 29 inches of snow—the largest snowfall on record.1 Other metropolitan areas, including New York City, Philadelphia, and Washington D.C, were blanketed by 18 to 31 inches.1 Two days before, while residents braced themselves for the storm, CV
MedPage Today •

Seasonal Affective Disorder at the 44th Parallel: Vermont Researchers Report on 2 Treatment Options

Having made it to the other side of the winter solstice, periods of daylight are stretching longer between sunrise and sunset. But despite these few extra minutes each day, those who suffer from seasonal affective disorder (SAD) often experience symptoms well past March’s Spring equinox, especially in the higher latitudes, where winter weather continues into April. For people who live near the University of Vermont, SAD can last up to 5 months each year. Fortunately, there’s a dedicated team of

Tardive Dyskinesia

Women's Health

Cancer Therapy Advisor •

Talazoparib in Advanced HER2-Negative Breast Cancer and Other Solid Tumors Lacking BRCA1/2 Mutations

At the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting, researchers presented phase 2 data on the activity of the PARP inhibitor talazoparib in patients with advanced HER2-negative breast cancer and other solid tumors that lacked BRCA1/2 mutations. Among the patients in this single-institution study, all received 1 prior course of platinum therapy with no progression on or within 8 weeks of the last dose. In addition, participants had to have measurable disease at the time of e
MedPage Today •

Oral or IV Iron to treat IDA During Pregnancy?

According to National Health and Nutrition Examination Survey (NHANES) data, iron deficiency occurs in about 20% of pregnancies, with prevalence increasing from the first trimester to the third.1 Iron supplementation is recommended for those with prenatal iron-deficiency anemia (IDA) because, if IDA is present at delivery, there is an increased risk of blood transfusion, preterm birth, cesarean section, and neonate admission to intensive care.2 While the benefits of treating IDA during pregnan
MedPage Today •

Simple Cysts Pose No Risk for Ovarian Ca: An interview with Rebecca Smith-Bindman, MD

Investigators recently conducted a study to quantify the risk of ovarian cancer among women with simple cysts identified on ultrasound. More than 72,000 women who had undergone 118,778 pelvic ultrasonography examinations in the Kaiser Permanente Washington healthcare system were included in this nested case-control study.1 Compared to women with normal ovaries, those with complex cysts or solid masses had a significantly higher risk of ovarian cancer. Likelihood ratios ranged from 8 to 74 and t
MedPage Today •

Non-BRCA Susceptible Gene Variants for Breast and Ovarian Cancers

While the discovery of the BRCA1 and BRCA2 genetic mutations changed the diagnosis and treatment for many patients with breast (BC) and ovarian (OV) cancers, we haven’t yet completed mapping the full genetic landscape of these two malignancies.1 Further elucidating genetic variants that are not as well-characterized as BRCA1 and BRCA2 and discovering new associations are essential to help inform the results of multigene panel testing and improve clinical practice. To that end, a group of invest
MedPage Today •

Epidurals and Survival in Advanced OC

For patients with advanced ovarian cancer (OC), primary debulking surgery (PDS) is an essential part of treatment. Nonetheless, the body’s response to the procedure and the anesthesia itself may lead to negative survival outcomes.1 “The body's surgical stress response is thought to play a role in tumor micrometastases. General anesthesia and opioids are also proposed to affect the immune system's ability to inhibit tumor spread,” says Kara Long-Roche, MD, MSc, principal investigator of a new st
MedPage Today •

Fatty Acid Metabolites and Ovarian Cancer in the PLCO Screening Trial

Do the metabolites of arachidonic acid and the essential fatty acids omega-3 and omega-6 contribute to the development of ovarian cancer? Researchers have postulated that their role in several cellular functions—including cell differentiation and migration, immune regulation, platelet aggregation, and angiogenesis—implicate them in tumorigenesis by way of chronic inflammation. Studies have shown that chronic conditions, such as endometriosis and pelvic inflammatory disease, expose cells to prol
MedPage Today •

Screening Slip-ups in Breast Cancer Survivors

Recently, researchers published data on imaging patterns in breast cancer survivors.1 They were curious to learn whether women who had undergone curative-intent surgery—and still have remaining breast tissue—were receiving their recommended annual mammograms after treatment. They also wanted to determine how common the use of magnetic resonance imaging (MRI) is for screening; whether adherence to the annual screening schedule differs over time; and whether any potential factors, such as age, rac
MedPage Today •

Ask the Expert: Joshua Cohen on Liquid Biopsy in the Early Detection of Cancer

Early screening for select cancers, such as cervical and lung cancers, has helped to decrease advanced-stage disease and death.1 Other screening tools, including mammography and colonoscopies, have not been quite as dependable.1 Now, imagine having one method for early detection of 8 common cancers that also determines the location of the tumor. A study recently published in Science describes a blood test, or liquid biopsy, known as CancerSEEK that measures circulating proteins and mutations in
MedPage Today •

Ask the Expert: Melinda Irwin, PhD on Lower Limb Lymphedema in Ovarian Cancer Survivors

Cancer treatments and surgery can affect the lymphatic system, leading to chronic swelling. Lower limb lymphedema (LLL), which affects the abdomen and lower extremities, has been characterized in breast cancer patients but has not been as well documented in ovarian cancer survivors, despite the impact surgery has on the lymph beds in this population.1 Recently, a group of researchers from Yale and Cooper University Hospital in New Jersey published data on the prevalence of LLL in women who had
MedPage Today •

Prognostic Signatures for ER-positive, ERBB2-negative Breast Cancer: An Interview With Ivana Sestak, PhD

As molecular markers continue to support breast cancer treatment decisions and short-term prognoses, researchers have begun to test the boundaries of these prognostic signatures and their ability to accurately predict late distant recurrence. In a first-of-its-kind, within-patient biomarker analysis, a global team of investigators analyzed 6 multigene signatures and their prognostic value from 0 to 10 years and 5 to 10 years after diagnosis.1 They hoped to determine the role that endocrine ther
MedPage Today •

Can Tumor Marker Levels Predict VTE Risk in Cancer Patients?

Venous thromboembolism (VTE) is a comorbidity that affects 1 in 5 cancer patients. While the exact mechanism is unknown, some researchers have suggested that different aspects of cancer treatment—surgery, chemotherapy, central lines, and palliative agents—encourage the development of VTE. Others have hypothesized that the tumor itself plays a role, either by constricting the vascular system or releasing a procoagulant.1 While scientists continue to study how cancer creates a prothrombotic state
MedPage Today •

Pregnancy is a Cardiovascular Stress Test: Q&A With Nisha Parikh, MD, MPH

High blood pressure before pregnancy is a risk factor for preeclampsia, and preeclampsia is a risk factor for hypertension and high blood pressure later in life.1 Despite this, few women of childbearing age have been included in cardiovascular (CVD) studies that assess lifestyle modifications and blood pressure.1 In fact, in an editorial in JAMA Internal Medicine, Nisha Parikh, MD, MPH, and Juan Gonzalez, MD, PhD, noted that the best-known studies excluded women who wanted to become pregnant or
MedPage Today •

Ameliorating Emesis and Nausea During Pregnancy

Almost everyone has heard the term “morning sickness.” It’s a misnomer of pregnancy that many take at face value—that is, until they know someone who is expecting a baby. Then that falsehood of slight nausea in the morning that occurs during the first trimester quickly fades into reality. The truth is, morning sickness is really all-day sickness that can persist throughout an entire pregnancy.1 About 85% of pregnant women struggle with nausea and vomiting. In certain, more severe cases, patient

Yoga and Wellnes