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Bad science: “FDA Approves New Fast-Acting Mealtime Insulin”

http://www.pharmacytimes.com/product-news/fda-approves-new-fastacting-mealtime-insulin

Author’s Conclusion

In this article, the author focused on informing the public of the new drug, but did not provide their own conclusion. For the purpose of this section, the conclusion of the manufacturer’s announcement that was cited in the article will be used. Novo Nordisk stated, “In clinical trials Fiasp® has demonstrated clinically relevant improvement in long-term glucose level (HbA1c). These results were achieved with a comparable overall rate of severe or blood-sugar confirmed hypoglycaemia, between Fiasp® and insulin aspart… “The fast action profile of Fiasp® allows people with diabetes convenient timing in terms of when to take their insulin in connection with meals to achieve the optimal blood sugar control.’”

Student’s Conclusion

This article was published on a website called Pharmacy Times by an unknown author. In this article, the author seeks to inform the public of a newly manufactured medication known as faster acting insulin aspart, or Fiasp. While they utilized some results from the ONSET 1 trial to educate the public on the benefits of Fiasp, the actual clinical trial was not cited. The article also appears to have used more statements from the company’s drug release announcement and another press release rather than information from the trial itself.  After researching ONSET 1, which was mentioned in the article, I located the trial and read the information myself. It appears the results and overall information were very vague, and the statistics mentioned in the news article did not entirely match up with the trial document. The trial was heavily biased due to funding by the manufacturer and did not include all the necessary information to make a conclusion, which leads me to question the validity of the information. Therefore, based on my research and the information in the trial report, I would not recommend this article for  review.

 

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Good science: “UNC Study Finds Some HIV Patients with Low Viral Loads Forgo Treatment”

http://www.contagionlive.com/news/unc-study-finds-some-hiv-patients-with-low-viral-loads-forgo-treatment

Author’s Conclusion:

The author of this article did not state a form of conclusion about the article but based conclusion on the researcher’s conclusion of the study.  The researchers of this study had concluded that characteristics or factors of demographics, history of injection drug use, lower CD4 count, increasing viral load, and a prevalent AIDS diagnosis were associated with delayed ART initiation.  According to the author, researchers wrote that despite the known benefits of early retroviral therapy initiation, a lower viral load measurement might continue to be an important clinical characteristic in current ART initiation guidelines.  Of all factors of the study, lower viral load showed the most statistically significant factor in delaying ART.  “For example, for each one year increase…In enrollment date, patients were 0.94 times (95% CI: 0.92, 0.97) as likely to delay ART initiation,” researchers wrote.

 Student’s Conclusion (Joanne Salvador):

The article that I found was published on August 28, 2017, on a site via Contagion Live Infectious Diseases Today.  The article sites a 2017 study done by University of North Carolina researchers.  The study was conducted to investigate the factors that are associated with failure to initiate ART within two years of entering into care among those with CD4 counts below 350 cells/mm3.  The researchers concluded that among the ART-naïve patients with the CD4 count at or below 350 cells/mm3, higher CD4 count, lower viral load, a prevalent AIDS diagnosis, and an earlier CNICS enrollment date were each independently associated with delay of ART initiation.  The study found that the sole clinical factor associated with failure to initiate ART was a lower viral load.  Those with viral loads less than 10,000 copies/mL at enrollment were more likely to delay ART initiation compared to those at least 100,000 copies/mL (adjusted RR=1.89; 95% CI: 1.53, 2.33).  Those with prevalent AIDS diagnoses also showed significance to delay in ART initiation.  With those whose CD4 count is at least 200 cells/mm3 for the first two years were 1.59 (95% CI: 1.28, 1.97) times as likely to delay ART initiation compared to those with CD4 counts less than 200 cells/mm3 but results were reduced two years after.  In accordance with the results, the researchers believed that the delay in ART initiation was associated with lower engagement in care among these patients.  Those who were diagnosed earlier in the HIV epidemic were more likely to start therapy sooner.

 Tags (key terms to improve searching the website for this post; examples below)

HIV, Viral Load, HIV treatment

http://kdvr.com/2017/01/30/nearly-half-of-men-in-the-u-s-have-hpv-1-in-4-have-strains-linked-to-cancer/

 Author’s Conclusion:

The author of the article did not express a personal conclusion, so the conclusion of the article will be used. “CDC officials urge men and women who are eligible for the vaccination to get it, but the study found only about 11 percent of men in the U.S. have received it. All girls and boys who are 11 or 12 years old should get the recommended series of HPV vaccine. Teen boys and girls who did not get vaccinated when they were younger should get it now. HPV vaccine is recommended for young women through age 26, and young men through age 21.”

Student’s Conclusion (Tiffany Taliaferro):

The article that I found on Google news was published on KDVR.com a national website connected with WGN American and Fox31 News in Denver. The author of the study Anica Padilla gave only the facts that she found in the study that was published in JAMA Oncology in Mid-January, that men were largely being exposed to HPV and an increase in vaccination would protect them as well as women from transmitting the virus and prevent cancer. The article was based on a study performed in 2013-2014 by the National Health and Nutrition Examination Survey on the prevalence of both genital human papillomavirus (HPV) and the vaccination rate among men age 18-59 in the United States. The results of the study found that 45.2% of men under the age of 60 had a genital HPV infection and at least 25.1% of the men tested had at least 1 high risk HPV strain. In the men who were eligible to receive the HPV-4 or HPV-9 valent vaccine, 7.1% and 15.4% respectively had a strain that could have been prevented. In addition, only 10.7% of vaccinated eligible men had received their vaccination. Therefore, the author’s article well supported by facts published in a well-known journal although the author is a journalist with no medical background. Based on the research I have done for this article I would recommend this article for anyone to read or check.

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Good science: “HF Patients Steady as Rock with Short-Term High-Dose Caffeine”

http://www.medscape.com/viewarticle/870409

Author’s Conclusion

The Author of the article express that long-term safety of moderate and high dose consumption of caffeine including in popular energy drinks and in patients at high risk for arryhytmias, remain unknown. For the time being, it seems reasonable to reassure our patients that modest caffeine consumption appears to be safe, including for most patients with heart failure.

Student’s Conclusion (Nebiat Mekonnen)

The article, and the study that the article highlights, discusses and assesses the effect of high doses of caffeine in patients with HF. As an intuitive notion that caffeine intake should be limited in patients with heart failure because of the intrinsic factors. Although the study sought to shed light on how taking high doses of caffeine does not appear to increase coronary artery events. The median plasma caffeine concentration was 9480 microgram over liters in the caffeine group. Based on the data presented It was found that coffee intake is fine unless patients have bothersome symptoms and arrhythmias.

 

Bad science: “Data: May be OK to give ‘T’ to men with prostate cancer”

Hyperlink to the article: http://www.medscape.com/viewarticle/869126#vp_2

Author’s Conclusion

            “In testosterone deficient men with a history of treated or untreated CaP testosterone therapy resulted in increases in serum testosterone levels with a small but significant increase in PSA. These findings are similar to what is seen in the literature currently and they are explained by the saturation model proposed by others. While our rates of BCR were lower than clinical norms, our trial design did not allow for comment on causative factors. It is important to recognize the limitations of the retrospective nature of the current study. Future results from randomized, controlled trials could lead to a change in our current treatment approach. Until these studies are completed, the use of TT among hypogonadal men with treated CaP or on AS should be monitored closely with serial PSA measurements and involve a detailed discussion of the potential risks and benefits with the patient prior to initiation of therapy.”

Student’s Conclusion (Jordan Carrillo)

                The study aimed to assess the effects of testosterone therapy in hypogonadal men with prostate cancer. The results that were calculated showed that those men in the active surveillance group showed the highest prostate specific antigen velocity at 1.1mcg/L per year, while the prostectomy and radiation therapy groups showed a mean PSA velocity of 0.001 and 0.12 mcg/L per year respectively. The presentation of these results led the author of the study to say “Treatment with testosterone may be oncologically safe” Although the data does not show any adverse reactions, the lack of beneficial effects and a placebo group make it difficult to support this study conclusive. There is still more research that needs to be done in order for this information to be applied in a clinical practice setting without physicians feeling uneasy about this recommendation.

 

Good Science: Mediterranean Diet Lowers CVD Risk in Prospective Study

http://www.medscape.com/viewarticle/869505

Author’s Conclusion:

The author did not provide a conclusion; therefore the conclusion from the original article will be used. “A lower incidence of CVD was found with higher adherence to a Mediterranean diet in a UK cohort study. This study informs potential population impact of increasing adherence to a Mediterranean diet amongst the UK population. The study’s findings stimulate future population based and clinical investigations into the efficacy and effectiveness of adherence to a Mediterranean diet in Mediterranean and non-Mediterranean populations.”

 

Student’s conclusion (Vandrea Watts):

Based on a prospective study, a Mediterranean diet including: fruits, vegetables, legumes, cereals, and olive oil, can reduce CV mortality and the incidence of CVD amongst the UK population. Results showed with increased adherence to a Mediterranean diet, there was 5% decrease in the incidence of CVD, hazard ratio [HR], 0.95; 95% confidence interval [CI], 0.92 – 0.97), and a 6 % reduction in the incidence of Ischemic Heart Disease(HR, 0.94; 95% CI, 0.90 – 0.98, and a 5 %reduction in all-cause mortality (HR, 0.95; 95% CI, 0.93 – 0.98). In my opinion, the study suggests possible contributions to reducing CV outcomes by adhering to a Mediterranean diet. However, I would like to see this study replicated in the U.S.

 

 

 

Good Science: Treating Infantile Hemangioma: Adverse Drug Events with Propranolol

http://www.medscape.com/viewarticle/861247

Author’s Conclusion:

The author concludes with a general perspective in reference to treating Infantile Hemangioma. The author states, “More and more children are treated for Infantile Hemangioma with propranolol, yet pediatric providers do not have experience with propranolol. As providers, it is vital to be familiar with propranolol side effects in the infant population, such as: risks for hypoglycemia, bradycardia, and bronchospasms.” The author agrees with authors of the original study, that parental education is also needed.

Student’s Conclusion (Vandrea Watts)

Infantile Hemangioma, also known as IH, is a vascularized tumor that develops in infants during their first weeks of life. Propranolol has been shown to reduce regression of IH; however, the safety of propranolol has yet to be considered in the infant population.  A Cohort study of infants with IH was studied. Propranolol was stopped in 45 (51%) of 88 children because of adverse drug reactions including: respiratory infections, nightmares (sleep disturbances), hypoglycemia, and bradycardia. Even though adverse reactions occurred, 40% of the infants were able to restart the use of propranolol. The study suggests ongoing monitoring during the use of propranolol in infants with IH and to discontinue propranolol during times of illness.