Evaluations by students

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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Health effects of cannabis

The National Academies of Sciences, Engineering, and Medicine released the report “The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research.”

Here’s the link.

Despite a lot of rhetoric, current research supports value for three conditions as noted in the following quote.

“There is conclusive or substantial evidence that cannabis or cannabinoids are effective:

  • For the treatment for chronic pain in adults (cannabis) (4-1)
  • Antiemetics in the treatment of chemotherapy-induced nausea and vomiting (oral cannabinoids) (4-3)
  • For improving patient-reported multiple sclerosis spasticity symptoms (oral cannabinoids) (4-7a)”

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.

Good Science: Better Outcomes with Bone Marrow vs. Peripheral Blood

http://www.medscape.com/viewarticle/868543

 Author’s Conclusion:

“Recipients of unrelated donor Bone Marrow (BM) had better psychological well-being, less burdensome chronic GVHD symptoms, and were more likely to return to work than recipients of peripheral blood (PB) at 5 years after transplantation. Bone marrow should be the standard of care for these types of transplant procedures”

Student’s Conclusion (Jordan Carrillo)

The study and its related article support fact-based and well-researched data that objectively shows bone marrow stem cell transplants have better outcomes in a 5- year study than those receiving stem cell from peripheral blood. The group that was getting BM had a much lower risk of developing a graft vs. host disease with 71% of the BM group showing no signs of disease whereas 49% of the PB group did not show any signs of disease. This is a 22% difference in the incidence of a GVHD. Not only is there a lower incidence of post-surgery aide effects but those who received a BM transplant were able to return to full-time work faster than those who got a PB (52%vs. 40%). This study shows why BM is clinically advantageous over PB but there are some limitations and reasons as to why PB may be used more in an average setting. The main reason being that PB transplants are much less complicated and easier to receive than a BM transplant. This difference in treatment may be dependent on a number of factors ranging from doctor and patient preference to hospital logistics, but in time many facilities will change their standards and eventually BM transplants will become the clinical standard for these patients.