Open Reading Frame brings together a selection of recent publication highlights from elsewhere in the open access ecosystem. This week we take a look at the past few weeks in medicine.
Obesity: an increasing problem in Canada
An analysis of health survey data in Canada indicates that the prevalence of adult obesity has increased from 6.1 percent to 18.3 percent since 1985, with continued increases predicted in the future. These data add to worrying statistics showing a dramatic increase in obesity prevalence worldwide. Obese people are at increased risk of hypertension, type 2 diabetes, cardiovascular disease and many other medical conditions, placing a substantial burden on healthcare systems. These recent findings in Canada further emphasize the need for effective multidisciplinary prevention strategies, as well as improved management and treatment of obesity.
Twells et al. CMAJ Open
Exploring the link between depression and mortality risk in heart disease
Depression is common in patients with coronary artery disease (CAD), and is known to be associated with cardiovascular mortality. However, the reasons explaining this link are not fully understood. A new study has been carried out in Sweden to investigate whether the use of secondary CAD prevention strategies is appropriate in patients with depression. The authors found that depression is not associated with reduced use of secondary prevention drugs – including beta-blockers and statins – over a four year period. These findings suggest that strategies to prevent further cardiovascular events are adequate in patients with depression, and further work is required to explain the increased mortality risk in these patients.
Stenman et al. IJC Heart & Vessels
Risk factors for nosocomial infection in the ICU
Hospital-acquired (nosocomial) infections are an important problem, particularly in intensive care units (ICU). The pathogen Acinetobacter baumannii is the leading cause of nosocomial bloodstream infection in the ICU, leading to prolonged length of stay in hospital, and death in severe cases. The risk factors for A. baumannii infection have been analyzed in a systematic review and meta-analysis, in order to identify how to prevent infection. The evidence suggests that prior catheterization, mechanical ventilation and feeding tube use are associated with a higher risk of infection with this pathogen, indicating that infection prevention strategies should take these procedures into account. The authors recommend that infection with A. baumannii should be considered when deciding whether procedures such as catheterization are necessary, and sanitation must be a priority in the ICU.
Zhou et al. International Journal of Infectious Diseases
Monitoring bone health in hypothyroidism
Hypothyroidism is commonly treated with thyroid hormone preparations such as levothyroxine (LT4). While effective in correcting thyroid hormone deficiency, LT4 is associated with adverse effects such as reduced bone mass and increased incidence of fractures, and it is important to monitor these effects in patients undergoing treatment for hypothyroidism. A study carried out in India has shown that the bone remodeling marker C-terminal telopeptide (CTx) can measure bone loss and bone mineral density in postmenopausal women taking LT4 therapy. CTx can be measured using a simple blood test, and the authors conclude that regular monitoring of CTx levels could be carried out in patients undergoing LT4 treatment, allowing LT4 dose adjustments when necessary, in order to delay osteoporosis occurring as a result of thyroid replacement therapy.
Christy et al. Biomarker Insights
The effect of inequality on neonatal mortality rates
Neonatal mortality rates (NMR) have been decreasing slowly in low- and middle-income countries (LMICs) as a result of interventions such as clean delivery practices, but are falling at a slower pace than deaths of older children. A greater understanding of the factors influencing NMR is required to reduce unnecessary deaths in resource-limited settings. Now, a global-level analysis carried out across 24 LMICs has shown that socioeconomic inequality in NMR has decreased in the past two decades, but babies born into wealthier households with a higher level of education still have a substantial survival advantage. The authors conclude that determinants of inequality and child health policies in specific countries should now be assessed to extend this research and contribute to global efforts to reduce neonatal mortality.
Victora and Barros. The Lancet Global Health
HOTAIR: a new target for small cell lung cancer therapy?
Small cell lung cancer (SCLC) is an aggressive form of lung cancer, and while chemotherapy is effective in some patients, there are currently no targeted therapies used in the clinic to treat SCLC. Now, a small study using surgical samples from SCLC patients has revealed that a short noncoding RNA – termed HOTAIR (Hox transcript antisense intergenic RNA) – is highly expressed in SCLC tissue, and is associated with poor prognosis. Genetic knock-down of HOTAIR in a SCLC cell line decreased cancer cell proliferation and metastatic ability, suggesting that this small RNA has an important role in SCLC progression. These findings require validation in a larger study, but provide evidence for the oncogenic potential of HOTAIR, and suggest it could be a specific target for therapies against SCLC.
Ono et al. Cancer Medicine
Written by Claire Barnard, Senior Editor for BMC Medicine.