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Three miRNA biomarkers predicted osteoarthritis severity
PARIS – Three micro RNAs have been shown to be associated with disease severity in patients with hip or knee osteoarthritis, based on data from a large population-based cohort in Italy*.
The presence of three specific miRNAs are biomarkers that might prove to be useful for predicting OA severity if validated in other cohorts and diverse populations of OA patients, Dr. Christian Beyer reported at a press conference during the annual European Congress of Rheumatology (Ann. Rheum. Dis. 2014 [doi:10.1136/annrheumdis-2013-204698]).
The miRNAs could also be a first step toward finding new OA therapies, such as approaches that avert cartilage loss, said Dr. Beyer of the University of Erlangen–Nuremberg (Germany).
For the study, serum samples from 816 cohort members who had osteoarthritis and were followed for at least 15 years were analyzed for the presence of any of the 374 miRNAs. A microarray screening identified 12 candidate miRNAs, validated in the entire cohort. Based on a regression analysis, the 67 cohort members who went on to have knee or hip arthroplasty were found to differentially express three of the miRNAs: let-7e, miR-454, and miR-885-5p. The most promising of the markers appears to be let-7e.
Let-7e was a negative predictor for total joint arthroplasty with an adjusted hazard ratio of 0.75 (95% confidence interval, 0.58-0.96; P = .021) when normalized to U6, and 0.76 (95% CI, 0.6-0.97; P = .026) after normalization to the Ct-average. However, miR-454 was inversely correlated with severe knee or hip osteoarthritis with an adjusted HR of 0.77 (95% CI, 0.61-0.97; P = .028) when normalized to U6. This correlation was lost when data were normalized to Ct-average (P = .118). Finally, miR-885-5p showed a trend toward a positive relationship with arthroplasty when normalized to U6 (HR, 1.24; 95% CI, 0.95-1.62; P = .107) or to Ct-average (HR, 1.30; 95% CI, 0.99-1.70; P = .056).
If specific miRNAs prove to be biomarkers to predict OA severity, it would offer the ability to use markers that are found in the peripheral circulation, stable over time, and not sex dependent. Such markers also could prove useful for finding new OA therapies, he said.
Next steps for further study include validation of the miRNA biomarkers in other OA cohorts, Dr. Beyer said. The well-defined Bruneck cohort is a stable community that has been extensively studied similar to the Framingham cohort in the United States. The Bruneck cohort is all white, however, and the results of this study need to be validated in diverse populations.
Dr. Beyer declared having no relevant financial disclosures.
On Twitter@maryjodales
CORRECTION, 6/12/2014: An earlier version of the article misstated the location of the study cohort.
PARIS – Three micro RNAs have been shown to be associated with disease severity in patients with hip or knee osteoarthritis, based on data from a large population-based cohort in Italy*.
The presence of three specific miRNAs are biomarkers that might prove to be useful for predicting OA severity if validated in other cohorts and diverse populations of OA patients, Dr. Christian Beyer reported at a press conference during the annual European Congress of Rheumatology (Ann. Rheum. Dis. 2014 [doi:10.1136/annrheumdis-2013-204698]).
The miRNAs could also be a first step toward finding new OA therapies, such as approaches that avert cartilage loss, said Dr. Beyer of the University of Erlangen–Nuremberg (Germany).
For the study, serum samples from 816 cohort members who had osteoarthritis and were followed for at least 15 years were analyzed for the presence of any of the 374 miRNAs. A microarray screening identified 12 candidate miRNAs, validated in the entire cohort. Based on a regression analysis, the 67 cohort members who went on to have knee or hip arthroplasty were found to differentially express three of the miRNAs: let-7e, miR-454, and miR-885-5p. The most promising of the markers appears to be let-7e.
Let-7e was a negative predictor for total joint arthroplasty with an adjusted hazard ratio of 0.75 (95% confidence interval, 0.58-0.96; P = .021) when normalized to U6, and 0.76 (95% CI, 0.6-0.97; P = .026) after normalization to the Ct-average. However, miR-454 was inversely correlated with severe knee or hip osteoarthritis with an adjusted HR of 0.77 (95% CI, 0.61-0.97; P = .028) when normalized to U6. This correlation was lost when data were normalized to Ct-average (P = .118). Finally, miR-885-5p showed a trend toward a positive relationship with arthroplasty when normalized to U6 (HR, 1.24; 95% CI, 0.95-1.62; P = .107) or to Ct-average (HR, 1.30; 95% CI, 0.99-1.70; P = .056).
If specific miRNAs prove to be biomarkers to predict OA severity, it would offer the ability to use markers that are found in the peripheral circulation, stable over time, and not sex dependent. Such markers also could prove useful for finding new OA therapies, he said.
Next steps for further study include validation of the miRNA biomarkers in other OA cohorts, Dr. Beyer said. The well-defined Bruneck cohort is a stable community that has been extensively studied similar to the Framingham cohort in the United States. The Bruneck cohort is all white, however, and the results of this study need to be validated in diverse populations.
Dr. Beyer declared having no relevant financial disclosures.
On Twitter@maryjodales
CORRECTION, 6/12/2014: An earlier version of the article misstated the location of the study cohort.
PARIS – Three micro RNAs have been shown to be associated with disease severity in patients with hip or knee osteoarthritis, based on data from a large population-based cohort in Italy*.
The presence of three specific miRNAs are biomarkers that might prove to be useful for predicting OA severity if validated in other cohorts and diverse populations of OA patients, Dr. Christian Beyer reported at a press conference during the annual European Congress of Rheumatology (Ann. Rheum. Dis. 2014 [doi:10.1136/annrheumdis-2013-204698]).
The miRNAs could also be a first step toward finding new OA therapies, such as approaches that avert cartilage loss, said Dr. Beyer of the University of Erlangen–Nuremberg (Germany).
For the study, serum samples from 816 cohort members who had osteoarthritis and were followed for at least 15 years were analyzed for the presence of any of the 374 miRNAs. A microarray screening identified 12 candidate miRNAs, validated in the entire cohort. Based on a regression analysis, the 67 cohort members who went on to have knee or hip arthroplasty were found to differentially express three of the miRNAs: let-7e, miR-454, and miR-885-5p. The most promising of the markers appears to be let-7e.
Let-7e was a negative predictor for total joint arthroplasty with an adjusted hazard ratio of 0.75 (95% confidence interval, 0.58-0.96; P = .021) when normalized to U6, and 0.76 (95% CI, 0.6-0.97; P = .026) after normalization to the Ct-average. However, miR-454 was inversely correlated with severe knee or hip osteoarthritis with an adjusted HR of 0.77 (95% CI, 0.61-0.97; P = .028) when normalized to U6. This correlation was lost when data were normalized to Ct-average (P = .118). Finally, miR-885-5p showed a trend toward a positive relationship with arthroplasty when normalized to U6 (HR, 1.24; 95% CI, 0.95-1.62; P = .107) or to Ct-average (HR, 1.30; 95% CI, 0.99-1.70; P = .056).
If specific miRNAs prove to be biomarkers to predict OA severity, it would offer the ability to use markers that are found in the peripheral circulation, stable over time, and not sex dependent. Such markers also could prove useful for finding new OA therapies, he said.
Next steps for further study include validation of the miRNA biomarkers in other OA cohorts, Dr. Beyer said. The well-defined Bruneck cohort is a stable community that has been extensively studied similar to the Framingham cohort in the United States. The Bruneck cohort is all white, however, and the results of this study need to be validated in diverse populations.
Dr. Beyer declared having no relevant financial disclosures.
On Twitter@maryjodales
CORRECTION, 6/12/2014: An earlier version of the article misstated the location of the study cohort.
AT THE EULAR CONGRESS 2014
Key clinical point: Biomarkers may allow early interventions to limit osteoarthritis risks, such as cartilage damage.
Major finding: Let-7e was a negative predictor for total joint arthroplasty with an adjusted HR of 0.75 (95% CI, 0.58-0.96; P = .021) when normalized to U6, and 0.76 (95% CI, 0.6-0.97; P = .026) after normalization to the Ct-average.
Data source: The large population-based Bruneck cohort in Italy.
Disclosures: Dr. Beyer had no relevant financial disclosures.
FDA approves generic celecoxib
The first generic versions of celecoxib received approval May 30 by the Food and Drug Administration.
Teva Pharmaceutical Industries received approval to market celecoxib capsules in 50 mg, 100 mg, 200 mg, and 400 mg strengths, and has 180-day exclusivity on the 100 mg, 200 mg, and 400 mg strength products. Mylan Pharmaceuticals received approval to market 50 mg celecoxib capsules.
Citing the importance of "affordable treatment options for chronic conditions," Dr. Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research, added in a written statement, the assurance "that these FDA-approved generic drugs have met our rigorous approval standards." Generic prescription drugs approved by the FDA are of the same strength as brand-name drugs, and generic drug manufacturing and packaging sites must pass the same quality standards as those of brand-name drugs.
As with its trade version Celebrex and all nonsteroidal anti-inflammatory drugs, the two new generics will carry a boxed warning in their prescribing information regarding the risks of heart attack or stroke and serious gastrointestinal bleeding. These labels also will note that risk is increased for patients who have heart disease or heart disease risk factors, as it is for patients who take NSAIDs for prolonged periods of time.
Information about the availability of generic celecoxib is available from the companies.
On Twitter @maryjodales
The first generic versions of celecoxib received approval May 30 by the Food and Drug Administration.
Teva Pharmaceutical Industries received approval to market celecoxib capsules in 50 mg, 100 mg, 200 mg, and 400 mg strengths, and has 180-day exclusivity on the 100 mg, 200 mg, and 400 mg strength products. Mylan Pharmaceuticals received approval to market 50 mg celecoxib capsules.
Citing the importance of "affordable treatment options for chronic conditions," Dr. Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research, added in a written statement, the assurance "that these FDA-approved generic drugs have met our rigorous approval standards." Generic prescription drugs approved by the FDA are of the same strength as brand-name drugs, and generic drug manufacturing and packaging sites must pass the same quality standards as those of brand-name drugs.
As with its trade version Celebrex and all nonsteroidal anti-inflammatory drugs, the two new generics will carry a boxed warning in their prescribing information regarding the risks of heart attack or stroke and serious gastrointestinal bleeding. These labels also will note that risk is increased for patients who have heart disease or heart disease risk factors, as it is for patients who take NSAIDs for prolonged periods of time.
Information about the availability of generic celecoxib is available from the companies.
On Twitter @maryjodales
The first generic versions of celecoxib received approval May 30 by the Food and Drug Administration.
Teva Pharmaceutical Industries received approval to market celecoxib capsules in 50 mg, 100 mg, 200 mg, and 400 mg strengths, and has 180-day exclusivity on the 100 mg, 200 mg, and 400 mg strength products. Mylan Pharmaceuticals received approval to market 50 mg celecoxib capsules.
Citing the importance of "affordable treatment options for chronic conditions," Dr. Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research, added in a written statement, the assurance "that these FDA-approved generic drugs have met our rigorous approval standards." Generic prescription drugs approved by the FDA are of the same strength as brand-name drugs, and generic drug manufacturing and packaging sites must pass the same quality standards as those of brand-name drugs.
As with its trade version Celebrex and all nonsteroidal anti-inflammatory drugs, the two new generics will carry a boxed warning in their prescribing information regarding the risks of heart attack or stroke and serious gastrointestinal bleeding. These labels also will note that risk is increased for patients who have heart disease or heart disease risk factors, as it is for patients who take NSAIDs for prolonged periods of time.
Information about the availability of generic celecoxib is available from the companies.
On Twitter @maryjodales
ADX-N05: Favorable results in narcolepsy patients
A novel agent for symptoms of excessive daytime sleepiness in narcolepsy patients has shown evidence of efficacy, according to researchers who will report their results as a late-breaking abstract at Sleep 2014.
ADX-N05, a wake-promoting agent with dopaminergic and noradrenergic activity, reduced symptoms in a 12-week, placebo-controlled, double-blind study of nearly 100 patients with narcolepsy, according to Dr. Jed Black of Jazz Pharmaceuticals and Stanford (Calif.) Sleep Medicine Center, and his colleagues.
Efficacy was based on improvements at 4 and 12 weeks from baseline in average sleep-onset latency on the Maintenance of Wakefulness Test and Clinical Global Impression-Change scale. A secondary endpoint was change on the Epworth Sleepiness Scale.
For the study, 49 patients were randomized to placebo and 44 to the active drug. The active drug was initiated at 150 mg/day for 4 weeks and increased to 300 mg/day for weeks 5-12.
At week 4, average sleep-onset latency on the Maintenance of Wakefulness Test was 9.5 minutes in those on the active drug and 1.4 minutes in those on placebo, a difference that was statistically significant (P less than .0001). Improvements on the Clinical Global Impression-Change scale were 80% vs. 51%; (P = .0066), and Epworth Sleepiness Scale scores had decreased (5.6 points vs. 2.4 points; P = 0.0038).
Further improvements were noted at 12 weeks, with average sleep-onset latency on the Maintenance of Wakefulness Test of 12.8 minutes vs. 2.1 minutes; (P less than .0001). Epworth Sleepiness Scale scores were 8.5 points vs. 2.5 points (P less than .0001), and the proportion of patients with Clinical Global Impression-Change scale improvements was 86% vs. 38% (P less than .0001), according to the researchers, who will present their complete study results at the annual meeting of the Associated Professional Sleep Societies.
Adverse events were more common with the active drug and included headache, nausea, diarrhea, insomnia, decreased appetite, and anxiety. Three study subjects halted active therapy because of adverse events. Two serious events—conversion disorder and acute cholecystitis—occurred in the active treatment group and were probably unrelated to drug therapy, according to the researchers.
The study was supported by Aerial BioPharma. Dr. Black is with Jazz Pharmaceuticals, which has acquired ADX-N05 from Aerial BioPharma.
A novel agent for symptoms of excessive daytime sleepiness in narcolepsy patients has shown evidence of efficacy, according to researchers who will report their results as a late-breaking abstract at Sleep 2014.
ADX-N05, a wake-promoting agent with dopaminergic and noradrenergic activity, reduced symptoms in a 12-week, placebo-controlled, double-blind study of nearly 100 patients with narcolepsy, according to Dr. Jed Black of Jazz Pharmaceuticals and Stanford (Calif.) Sleep Medicine Center, and his colleagues.
Efficacy was based on improvements at 4 and 12 weeks from baseline in average sleep-onset latency on the Maintenance of Wakefulness Test and Clinical Global Impression-Change scale. A secondary endpoint was change on the Epworth Sleepiness Scale.
For the study, 49 patients were randomized to placebo and 44 to the active drug. The active drug was initiated at 150 mg/day for 4 weeks and increased to 300 mg/day for weeks 5-12.
At week 4, average sleep-onset latency on the Maintenance of Wakefulness Test was 9.5 minutes in those on the active drug and 1.4 minutes in those on placebo, a difference that was statistically significant (P less than .0001). Improvements on the Clinical Global Impression-Change scale were 80% vs. 51%; (P = .0066), and Epworth Sleepiness Scale scores had decreased (5.6 points vs. 2.4 points; P = 0.0038).
Further improvements were noted at 12 weeks, with average sleep-onset latency on the Maintenance of Wakefulness Test of 12.8 minutes vs. 2.1 minutes; (P less than .0001). Epworth Sleepiness Scale scores were 8.5 points vs. 2.5 points (P less than .0001), and the proportion of patients with Clinical Global Impression-Change scale improvements was 86% vs. 38% (P less than .0001), according to the researchers, who will present their complete study results at the annual meeting of the Associated Professional Sleep Societies.
Adverse events were more common with the active drug and included headache, nausea, diarrhea, insomnia, decreased appetite, and anxiety. Three study subjects halted active therapy because of adverse events. Two serious events—conversion disorder and acute cholecystitis—occurred in the active treatment group and were probably unrelated to drug therapy, according to the researchers.
The study was supported by Aerial BioPharma. Dr. Black is with Jazz Pharmaceuticals, which has acquired ADX-N05 from Aerial BioPharma.
A novel agent for symptoms of excessive daytime sleepiness in narcolepsy patients has shown evidence of efficacy, according to researchers who will report their results as a late-breaking abstract at Sleep 2014.
ADX-N05, a wake-promoting agent with dopaminergic and noradrenergic activity, reduced symptoms in a 12-week, placebo-controlled, double-blind study of nearly 100 patients with narcolepsy, according to Dr. Jed Black of Jazz Pharmaceuticals and Stanford (Calif.) Sleep Medicine Center, and his colleagues.
Efficacy was based on improvements at 4 and 12 weeks from baseline in average sleep-onset latency on the Maintenance of Wakefulness Test and Clinical Global Impression-Change scale. A secondary endpoint was change on the Epworth Sleepiness Scale.
For the study, 49 patients were randomized to placebo and 44 to the active drug. The active drug was initiated at 150 mg/day for 4 weeks and increased to 300 mg/day for weeks 5-12.
At week 4, average sleep-onset latency on the Maintenance of Wakefulness Test was 9.5 minutes in those on the active drug and 1.4 minutes in those on placebo, a difference that was statistically significant (P less than .0001). Improvements on the Clinical Global Impression-Change scale were 80% vs. 51%; (P = .0066), and Epworth Sleepiness Scale scores had decreased (5.6 points vs. 2.4 points; P = 0.0038).
Further improvements were noted at 12 weeks, with average sleep-onset latency on the Maintenance of Wakefulness Test of 12.8 minutes vs. 2.1 minutes; (P less than .0001). Epworth Sleepiness Scale scores were 8.5 points vs. 2.5 points (P less than .0001), and the proportion of patients with Clinical Global Impression-Change scale improvements was 86% vs. 38% (P less than .0001), according to the researchers, who will present their complete study results at the annual meeting of the Associated Professional Sleep Societies.
Adverse events were more common with the active drug and included headache, nausea, diarrhea, insomnia, decreased appetite, and anxiety. Three study subjects halted active therapy because of adverse events. Two serious events—conversion disorder and acute cholecystitis—occurred in the active treatment group and were probably unrelated to drug therapy, according to the researchers.
The study was supported by Aerial BioPharma. Dr. Black is with Jazz Pharmaceuticals, which has acquired ADX-N05 from Aerial BioPharma.
FROM SLEEP 2014
Key clinical point: ADX-N05, a wake-promoting agent with dopaminergic and noradrenergic activity, may prove to limit daytime sleepiness in narcolepsy.
Major finding: After 12 weeks, average sleep-onset latency on the Maintenance of Wakefulness Test was 12.8 minutes for those on the active drug and 2.1 minutes for those on placebo (P less than .0001).
Data source: A 12-week, placebo-controlled, double-blind study of nearly 100 patients with narcolepsy.
Disclosures: The study was supported by Aerial BioPharma. Dr. Black is with Jazz Pharmaceuticals, which has acquired ADX-N05 from Aerial BioPharma.
In seasonal affective disorder, the eyes have it
Pupil response to light differs in people with seasonal affective disorder and is affected by their total exposure to light, researchers will report at Sleep 2014 in Minneapolis.
"We speculate that low light levels in SAD [seasonal affective disorder] trigger downstream changes in mood and behavior, and that the link between light and SAD may be mediated by the PIPR [postillumination pupil response]," Kathryn A. Roecklein, Ph.D., of the University of Pittsburgh and her colleagues wrote in a late-breaker abstract to be presented at the annual meeting of the Associated Professional Sleep Societies.
For their study, the researchers examined postillumination pupil response during summer and winter in 33 people with SAD and 17 controls. One-second light exposures to red light and to blue light were used for testing. Actigraphy was used to measure light exposure in the days before the tests.
In the study subjects with SAD, most of the variance in postillumination pupil response was associated with total photon exposures on the day of testing. In the controls, however, postillumination pupil response was independent of total photon exposures on the day of testing. Blue total photon exposures accounted for the greatest proportion of variance in postillumination pupil response (P = .013) and were predictive of SAD independent of the subject’s gender, time since waking, and whether they were early risers or night owls (P = .013).
The postillumination pupil response was lower in subjects with SAD than in controls (P less than .05), especially among those with SAD who were night owls (P less than .001).
The data, which are the first to link light exposure and the postillumination pupil response in SAD, will be presented in their entirety at the meeting.
The study was funded by a grant from the National Institutes of Health. The authors reported having no financial disclosures.
Pupil response to light differs in people with seasonal affective disorder and is affected by their total exposure to light, researchers will report at Sleep 2014 in Minneapolis.
"We speculate that low light levels in SAD [seasonal affective disorder] trigger downstream changes in mood and behavior, and that the link between light and SAD may be mediated by the PIPR [postillumination pupil response]," Kathryn A. Roecklein, Ph.D., of the University of Pittsburgh and her colleagues wrote in a late-breaker abstract to be presented at the annual meeting of the Associated Professional Sleep Societies.
For their study, the researchers examined postillumination pupil response during summer and winter in 33 people with SAD and 17 controls. One-second light exposures to red light and to blue light were used for testing. Actigraphy was used to measure light exposure in the days before the tests.
In the study subjects with SAD, most of the variance in postillumination pupil response was associated with total photon exposures on the day of testing. In the controls, however, postillumination pupil response was independent of total photon exposures on the day of testing. Blue total photon exposures accounted for the greatest proportion of variance in postillumination pupil response (P = .013) and were predictive of SAD independent of the subject’s gender, time since waking, and whether they were early risers or night owls (P = .013).
The postillumination pupil response was lower in subjects with SAD than in controls (P less than .05), especially among those with SAD who were night owls (P less than .001).
The data, which are the first to link light exposure and the postillumination pupil response in SAD, will be presented in their entirety at the meeting.
The study was funded by a grant from the National Institutes of Health. The authors reported having no financial disclosures.
Pupil response to light differs in people with seasonal affective disorder and is affected by their total exposure to light, researchers will report at Sleep 2014 in Minneapolis.
"We speculate that low light levels in SAD [seasonal affective disorder] trigger downstream changes in mood and behavior, and that the link between light and SAD may be mediated by the PIPR [postillumination pupil response]," Kathryn A. Roecklein, Ph.D., of the University of Pittsburgh and her colleagues wrote in a late-breaker abstract to be presented at the annual meeting of the Associated Professional Sleep Societies.
For their study, the researchers examined postillumination pupil response during summer and winter in 33 people with SAD and 17 controls. One-second light exposures to red light and to blue light were used for testing. Actigraphy was used to measure light exposure in the days before the tests.
In the study subjects with SAD, most of the variance in postillumination pupil response was associated with total photon exposures on the day of testing. In the controls, however, postillumination pupil response was independent of total photon exposures on the day of testing. Blue total photon exposures accounted for the greatest proportion of variance in postillumination pupil response (P = .013) and were predictive of SAD independent of the subject’s gender, time since waking, and whether they were early risers or night owls (P = .013).
The postillumination pupil response was lower in subjects with SAD than in controls (P less than .05), especially among those with SAD who were night owls (P less than .001).
The data, which are the first to link light exposure and the postillumination pupil response in SAD, will be presented in their entirety at the meeting.
The study was funded by a grant from the National Institutes of Health. The authors reported having no financial disclosures.
FROM SLEEP 2014
Key clinical point: Those with seasonal affective disorder, especially night owls, might benefit from more light exposure.
Major finding: The postillumination pupil response was lower in subjects with SAD than in controls (P less than .05) and especially those who were night owls (P less than .001).
Data source: Postillumination pupil response during summer and winter in 33 people with SAD and 17 controls.
Disclosures: The study was funded by a grant from the National Institutes of Health. The authors reported having no financial disclosures.
Teens who skip sleep risk insulin resistance
Teens who miss sleep are more likely to set their metabolism in motion for insulin resistance.
Based on a pilot study of 10 lean and obese adolescents, sleep duration was the primary predictor of abnormal 90-minute glucose values on oral glucose tolerance tests, Dr. Dorit Koren and her colleagues will report at the annual meeting of the Associated Professional Sleep Societies in Minneapolis. The finding was independent of the teens’ body weights.
The University of Chicago researchers wrote in their late-breaking abstract that the pilot study is "the first to our knowledge to examine potential interrelationships between home sleep duration and dynamic insulin and glucose homeostasis in adolescents." Previous studies in children have associated short sleep with insulin resistance, but have not examined the relationship between home sleep and postprandial glucose metabolism. Studies in adults have linked type 2 diabetes risks and experimental sleep restriction to acute insulin resistance and glucose intolerance.
For the study, the 13- to 18-year-olds had oral glucose tolerance tests, evaluations of body weight, an overnight polysomnogram, and home sleep assessments based on actigraphy and sleep diaries. Sleep duration was linearly correlated with 90-minute oral glucose tolerance test results (r = –0.66, P = .036). There were trends toward negative associations between home sleep duration, obesity, and insulin resistance.
The study was supported by a grant from the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health.
Teens who miss sleep are more likely to set their metabolism in motion for insulin resistance.
Based on a pilot study of 10 lean and obese adolescents, sleep duration was the primary predictor of abnormal 90-minute glucose values on oral glucose tolerance tests, Dr. Dorit Koren and her colleagues will report at the annual meeting of the Associated Professional Sleep Societies in Minneapolis. The finding was independent of the teens’ body weights.
The University of Chicago researchers wrote in their late-breaking abstract that the pilot study is "the first to our knowledge to examine potential interrelationships between home sleep duration and dynamic insulin and glucose homeostasis in adolescents." Previous studies in children have associated short sleep with insulin resistance, but have not examined the relationship between home sleep and postprandial glucose metabolism. Studies in adults have linked type 2 diabetes risks and experimental sleep restriction to acute insulin resistance and glucose intolerance.
For the study, the 13- to 18-year-olds had oral glucose tolerance tests, evaluations of body weight, an overnight polysomnogram, and home sleep assessments based on actigraphy and sleep diaries. Sleep duration was linearly correlated with 90-minute oral glucose tolerance test results (r = –0.66, P = .036). There were trends toward negative associations between home sleep duration, obesity, and insulin resistance.
The study was supported by a grant from the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health.
Teens who miss sleep are more likely to set their metabolism in motion for insulin resistance.
Based on a pilot study of 10 lean and obese adolescents, sleep duration was the primary predictor of abnormal 90-minute glucose values on oral glucose tolerance tests, Dr. Dorit Koren and her colleagues will report at the annual meeting of the Associated Professional Sleep Societies in Minneapolis. The finding was independent of the teens’ body weights.
The University of Chicago researchers wrote in their late-breaking abstract that the pilot study is "the first to our knowledge to examine potential interrelationships between home sleep duration and dynamic insulin and glucose homeostasis in adolescents." Previous studies in children have associated short sleep with insulin resistance, but have not examined the relationship between home sleep and postprandial glucose metabolism. Studies in adults have linked type 2 diabetes risks and experimental sleep restriction to acute insulin resistance and glucose intolerance.
For the study, the 13- to 18-year-olds had oral glucose tolerance tests, evaluations of body weight, an overnight polysomnogram, and home sleep assessments based on actigraphy and sleep diaries. Sleep duration was linearly correlated with 90-minute oral glucose tolerance test results (r = –0.66, P = .036). There were trends toward negative associations between home sleep duration, obesity, and insulin resistance.
The study was supported by a grant from the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health.
FROM SLEEP 2014
Key clinical point: Sleep deprivation in teens affects insulin metabolism.
Major finding: Independent of weight, sleep duration was linearly associated with 90-minute results on oral glucose tolerance tests (r = –0.66, P = .036).
Data source: A pilot study of 10 lean and obese adolescents.
Disclosures: The study was supported by a grant from the National Institutes of Health.
FDA approves dalbavancin for acute bacterial skin infections
Dalbavancin is the first drug with a Qualified Infectious Disease Product designation to be approved by the Food and Drug Administration.
On May 23, the agency approved dalbavancin (Dalvance) for the treatment of adults with acute bacterial skin and skin structure infections (ABSSSI) caused by certain susceptible bacteria like Staphylococcus aureus. The drug, which is given intravenously, is effective for methicillin-susceptible and methicillin-resistant strains as well as Streptococcus pyogenes.
Under the Generating Antibiotic Incentives Now (GAIN) title of the FDA Safety and Innovation Act, dalbavancin was granted Qualified Infectious Disease Product designation because it is an antibacterial or antifungal human drug intended to treat serious or life-threatening infections, according to a statement issued by the FDA.
As part of its QIDP designation, dalbavancin was given priority review and qualifies for an additional 5 years of marketing exclusivity, in addition to the exclusivity period already provided by the Food, Drug and Cosmetic Act.
Dalbavancin was shown to be as safe and effective as vancomycin for the treatment of ABSSSI in two clinical trials with a total of 1,289 adults who had ABSSSI and were randomly assigned to one of the two drugs.
The most common side effects identified in the clinical trials were nausea, headache and diarrhea. More participants in the dalbavancin group had elevated liver enzymes.
Dalvance is marketed by Durata Therapeutics.
Dalbavancin is the first drug with a Qualified Infectious Disease Product designation to be approved by the Food and Drug Administration.
On May 23, the agency approved dalbavancin (Dalvance) for the treatment of adults with acute bacterial skin and skin structure infections (ABSSSI) caused by certain susceptible bacteria like Staphylococcus aureus. The drug, which is given intravenously, is effective for methicillin-susceptible and methicillin-resistant strains as well as Streptococcus pyogenes.
Under the Generating Antibiotic Incentives Now (GAIN) title of the FDA Safety and Innovation Act, dalbavancin was granted Qualified Infectious Disease Product designation because it is an antibacterial or antifungal human drug intended to treat serious or life-threatening infections, according to a statement issued by the FDA.
As part of its QIDP designation, dalbavancin was given priority review and qualifies for an additional 5 years of marketing exclusivity, in addition to the exclusivity period already provided by the Food, Drug and Cosmetic Act.
Dalbavancin was shown to be as safe and effective as vancomycin for the treatment of ABSSSI in two clinical trials with a total of 1,289 adults who had ABSSSI and were randomly assigned to one of the two drugs.
The most common side effects identified in the clinical trials were nausea, headache and diarrhea. More participants in the dalbavancin group had elevated liver enzymes.
Dalvance is marketed by Durata Therapeutics.
Dalbavancin is the first drug with a Qualified Infectious Disease Product designation to be approved by the Food and Drug Administration.
On May 23, the agency approved dalbavancin (Dalvance) for the treatment of adults with acute bacterial skin and skin structure infections (ABSSSI) caused by certain susceptible bacteria like Staphylococcus aureus. The drug, which is given intravenously, is effective for methicillin-susceptible and methicillin-resistant strains as well as Streptococcus pyogenes.
Under the Generating Antibiotic Incentives Now (GAIN) title of the FDA Safety and Innovation Act, dalbavancin was granted Qualified Infectious Disease Product designation because it is an antibacterial or antifungal human drug intended to treat serious or life-threatening infections, according to a statement issued by the FDA.
As part of its QIDP designation, dalbavancin was given priority review and qualifies for an additional 5 years of marketing exclusivity, in addition to the exclusivity period already provided by the Food, Drug and Cosmetic Act.
Dalbavancin was shown to be as safe and effective as vancomycin for the treatment of ABSSSI in two clinical trials with a total of 1,289 adults who had ABSSSI and were randomly assigned to one of the two drugs.
The most common side effects identified in the clinical trials were nausea, headache and diarrhea. More participants in the dalbavancin group had elevated liver enzymes.
Dalvance is marketed by Durata Therapeutics.
VIDEO – Personalized medicine for schizophrenia is a reality
NEW YORK – Selecting patients according to genotype and repurposing existing drugs for use in combination with drugs that enhance psychosocial interventions are among the new therapeutic opportunities in treating schizophrenia, Dr. Donald C. Goff said in an interview during the annual meeting of the American Psychiatric Association.
In this video, Dr. Goff of the Nathan Kline Institute for Psychiatric Research at New York University also discusses how combining drugs with psychosocial interventions can lead to areas of growth.
NEW YORK – Selecting patients according to genotype and repurposing existing drugs for use in combination with drugs that enhance psychosocial interventions are among the new therapeutic opportunities in treating schizophrenia, Dr. Donald C. Goff said in an interview during the annual meeting of the American Psychiatric Association.
In this video, Dr. Goff of the Nathan Kline Institute for Psychiatric Research at New York University also discusses how combining drugs with psychosocial interventions can lead to areas of growth.
NEW YORK – Selecting patients according to genotype and repurposing existing drugs for use in combination with drugs that enhance psychosocial interventions are among the new therapeutic opportunities in treating schizophrenia, Dr. Donald C. Goff said in an interview during the annual meeting of the American Psychiatric Association.
In this video, Dr. Goff of the Nathan Kline Institute for Psychiatric Research at New York University also discusses how combining drugs with psychosocial interventions can lead to areas of growth.
FROM THE APA ANNUAL MEETING
Inflammation correlates with new bone formation in ankylosing spondylitis
Inflammation in ankylosing spondylitis was associated with new spinal bone formation in a 12-year follow-up study of 184 patients in the Outcome in AS International Study (OASIS).
"We have demonstrated here for the first time that the effect of disease activity on radiographic damage is actually rather impressive and longitudinal: Per one ASDAS unit increase a 0.7 mSASSS (modified Stoke Ankylosing Spondylitis Spine Score) units progression in 2 years can be expected. This longitudinal relationship was pertinent over the entire 12 years of follow-up," said Dr. Sofia Ramiro of the Amsterdam Rheumatology Center, University of Amsterdam.
The effect was more pronounced in men and in the earlier phases of the disease, Dr. Ramiro and her associates wrote in an article published online May 7 in Annals of the Rheumatic Diseases (doi:10.1136/annrheumdis-2014-205178).
For the study, all patients had biennial clinical and radiographic assessments and two readers independently scored the x-rays according to the mSASSS. Disease activity measures included the Bath AS Disease Activity Index (BASDAI), AS Disease Activity Index (ASDAS)-C-reactive protein (CRP), CRP, erythrocyte sedimentation rate (ESR), patient’s global assessment, and spinal pain.
As a disease activity measure, ASDAS outperformed the models with all other disease activity measures. The finding importantly adds to the validity of ASDAS as the disease activity measure of choice, the researchers said.
Patients with an ASDAS less than 1.3 at baseline had an average progression of 0.71 mSASSS units/2-years. Those with an ASDAS of more than 3.5 at baseline had a progression of 3.1 mSASSS units/2-year progression. A similar relationship was found for BASDAI: patients with a BASDAI less than 4 at baseline had an average progression of 1.4 mSASSS units/2 years, while patients with a BASDAI of 4 or more at baseline had an average progression of 2.7 mSASSS units/2 years.
However, inflammation "by far does not fully explain radiographic damage in AS: Even without measurable disease activity there is still considerable radiographic progression," they said. Patients who have inactive disease for the entire 12 years still can expect a progression of 5 mSASSS units on average. It seems as if increased bone formation in AS is partly constitutive and partly inflammation dependent.
The effect of disease activity on radiographic progression seems to be stronger in men, who had an additional progression of about 1 mSASSS unit per 2-year interval per additional unit of ASDAS. The researchers also found a stronger effect of disease activity on radiographic progression in the early phase of AS.
The models with ASDAS as the disease activity measure fitted the data better than did models with BASDAI, CRP, or BASDAI+CRP. An increase of one ASDAS unit led to an increase of 0.72 mSASSS units/2 years. An ASDAS exceeding 3.5 compared with an ASDAS of less than 1.3 resulted in an additional 2-year progression of 2.31 mSASSS units.
Dr. Romero was supported by the Fundação para a Ciência e Tecnologia (FCT) grant SFRH/BD/68684/2010.
We now have clear evidence that inflammation and new bone formation are related in ankylosing spondylitis. The current model even allows such a relationship to be quantified, with an increase of 1 ASDAS unit leading to an increase of 0.72 mSASSS units/2 years, an estimation that might also be useful for daily clinical practice.
However, the mean disease duration in this study was rather long at 20 years and can be seen as a limitation, since it is unclear whether an ASDAS increase has a similar effect on radiographic progression at an earlier stage of the disease. Thus, structural damage already present would lead to new or further bone formation over time, independent of the presence of inflammation. Further, only 30% of the study patients were women, and the limited data indicate that there is no or less correlation between parameters of activity and radiographic progression in women.
Nevertheless, the effect of elevated disease activity on new bone formation shown here is a big advance in understanding this rather complex relationship and is also potentially important for future treatment strategies, including the ‘treat to target’ approach. However, it has to be shown in therapeutic studies that lowering disease activity effectively can indeed retard radiographic progression in AS.
Long-term treatment studies in patients with early axial ankylosing spondylitis, including those with nonradiographic axial disease before structural damage is visible on x-ray, are now possible based on the new ASAS classification criteria. In light of the current evidence, we would hypothesize that early treatment with a tumor necrosis factor (TNF) blocker might retard radiographic progression, but that in long-standing ankylosing spondylitis a combination with another drug inhibiting new bone formation might be necessary. As some evidence indicates that NSAIDs might be able to inhibit radiographic progression, a clinical trial investigating the effect of combination therapy of a TNF blocker with an NSAID would be of interest.
Dr. Joachim Sieper and Dr. Denis Poddubnyy are with the Campus Benjamin Franklin, Charité, Berlin. They reported having no relevant financial disclosures. They made their remarks in an editorial that accompanied the study (Ann. Rheum Dis. 2014 May 8 [10.1136/annrheumdis-2014-205464]).
We now have clear evidence that inflammation and new bone formation are related in ankylosing spondylitis. The current model even allows such a relationship to be quantified, with an increase of 1 ASDAS unit leading to an increase of 0.72 mSASSS units/2 years, an estimation that might also be useful for daily clinical practice.
However, the mean disease duration in this study was rather long at 20 years and can be seen as a limitation, since it is unclear whether an ASDAS increase has a similar effect on radiographic progression at an earlier stage of the disease. Thus, structural damage already present would lead to new or further bone formation over time, independent of the presence of inflammation. Further, only 30% of the study patients were women, and the limited data indicate that there is no or less correlation between parameters of activity and radiographic progression in women.
Nevertheless, the effect of elevated disease activity on new bone formation shown here is a big advance in understanding this rather complex relationship and is also potentially important for future treatment strategies, including the ‘treat to target’ approach. However, it has to be shown in therapeutic studies that lowering disease activity effectively can indeed retard radiographic progression in AS.
Long-term treatment studies in patients with early axial ankylosing spondylitis, including those with nonradiographic axial disease before structural damage is visible on x-ray, are now possible based on the new ASAS classification criteria. In light of the current evidence, we would hypothesize that early treatment with a tumor necrosis factor (TNF) blocker might retard radiographic progression, but that in long-standing ankylosing spondylitis a combination with another drug inhibiting new bone formation might be necessary. As some evidence indicates that NSAIDs might be able to inhibit radiographic progression, a clinical trial investigating the effect of combination therapy of a TNF blocker with an NSAID would be of interest.
Dr. Joachim Sieper and Dr. Denis Poddubnyy are with the Campus Benjamin Franklin, Charité, Berlin. They reported having no relevant financial disclosures. They made their remarks in an editorial that accompanied the study (Ann. Rheum Dis. 2014 May 8 [10.1136/annrheumdis-2014-205464]).
We now have clear evidence that inflammation and new bone formation are related in ankylosing spondylitis. The current model even allows such a relationship to be quantified, with an increase of 1 ASDAS unit leading to an increase of 0.72 mSASSS units/2 years, an estimation that might also be useful for daily clinical practice.
However, the mean disease duration in this study was rather long at 20 years and can be seen as a limitation, since it is unclear whether an ASDAS increase has a similar effect on radiographic progression at an earlier stage of the disease. Thus, structural damage already present would lead to new or further bone formation over time, independent of the presence of inflammation. Further, only 30% of the study patients were women, and the limited data indicate that there is no or less correlation between parameters of activity and radiographic progression in women.
Nevertheless, the effect of elevated disease activity on new bone formation shown here is a big advance in understanding this rather complex relationship and is also potentially important for future treatment strategies, including the ‘treat to target’ approach. However, it has to be shown in therapeutic studies that lowering disease activity effectively can indeed retard radiographic progression in AS.
Long-term treatment studies in patients with early axial ankylosing spondylitis, including those with nonradiographic axial disease before structural damage is visible on x-ray, are now possible based on the new ASAS classification criteria. In light of the current evidence, we would hypothesize that early treatment with a tumor necrosis factor (TNF) blocker might retard radiographic progression, but that in long-standing ankylosing spondylitis a combination with another drug inhibiting new bone formation might be necessary. As some evidence indicates that NSAIDs might be able to inhibit radiographic progression, a clinical trial investigating the effect of combination therapy of a TNF blocker with an NSAID would be of interest.
Dr. Joachim Sieper and Dr. Denis Poddubnyy are with the Campus Benjamin Franklin, Charité, Berlin. They reported having no relevant financial disclosures. They made their remarks in an editorial that accompanied the study (Ann. Rheum Dis. 2014 May 8 [10.1136/annrheumdis-2014-205464]).
Inflammation in ankylosing spondylitis was associated with new spinal bone formation in a 12-year follow-up study of 184 patients in the Outcome in AS International Study (OASIS).
"We have demonstrated here for the first time that the effect of disease activity on radiographic damage is actually rather impressive and longitudinal: Per one ASDAS unit increase a 0.7 mSASSS (modified Stoke Ankylosing Spondylitis Spine Score) units progression in 2 years can be expected. This longitudinal relationship was pertinent over the entire 12 years of follow-up," said Dr. Sofia Ramiro of the Amsterdam Rheumatology Center, University of Amsterdam.
The effect was more pronounced in men and in the earlier phases of the disease, Dr. Ramiro and her associates wrote in an article published online May 7 in Annals of the Rheumatic Diseases (doi:10.1136/annrheumdis-2014-205178).
For the study, all patients had biennial clinical and radiographic assessments and two readers independently scored the x-rays according to the mSASSS. Disease activity measures included the Bath AS Disease Activity Index (BASDAI), AS Disease Activity Index (ASDAS)-C-reactive protein (CRP), CRP, erythrocyte sedimentation rate (ESR), patient’s global assessment, and spinal pain.
As a disease activity measure, ASDAS outperformed the models with all other disease activity measures. The finding importantly adds to the validity of ASDAS as the disease activity measure of choice, the researchers said.
Patients with an ASDAS less than 1.3 at baseline had an average progression of 0.71 mSASSS units/2-years. Those with an ASDAS of more than 3.5 at baseline had a progression of 3.1 mSASSS units/2-year progression. A similar relationship was found for BASDAI: patients with a BASDAI less than 4 at baseline had an average progression of 1.4 mSASSS units/2 years, while patients with a BASDAI of 4 or more at baseline had an average progression of 2.7 mSASSS units/2 years.
However, inflammation "by far does not fully explain radiographic damage in AS: Even without measurable disease activity there is still considerable radiographic progression," they said. Patients who have inactive disease for the entire 12 years still can expect a progression of 5 mSASSS units on average. It seems as if increased bone formation in AS is partly constitutive and partly inflammation dependent.
The effect of disease activity on radiographic progression seems to be stronger in men, who had an additional progression of about 1 mSASSS unit per 2-year interval per additional unit of ASDAS. The researchers also found a stronger effect of disease activity on radiographic progression in the early phase of AS.
The models with ASDAS as the disease activity measure fitted the data better than did models with BASDAI, CRP, or BASDAI+CRP. An increase of one ASDAS unit led to an increase of 0.72 mSASSS units/2 years. An ASDAS exceeding 3.5 compared with an ASDAS of less than 1.3 resulted in an additional 2-year progression of 2.31 mSASSS units.
Dr. Romero was supported by the Fundação para a Ciência e Tecnologia (FCT) grant SFRH/BD/68684/2010.
Inflammation in ankylosing spondylitis was associated with new spinal bone formation in a 12-year follow-up study of 184 patients in the Outcome in AS International Study (OASIS).
"We have demonstrated here for the first time that the effect of disease activity on radiographic damage is actually rather impressive and longitudinal: Per one ASDAS unit increase a 0.7 mSASSS (modified Stoke Ankylosing Spondylitis Spine Score) units progression in 2 years can be expected. This longitudinal relationship was pertinent over the entire 12 years of follow-up," said Dr. Sofia Ramiro of the Amsterdam Rheumatology Center, University of Amsterdam.
The effect was more pronounced in men and in the earlier phases of the disease, Dr. Ramiro and her associates wrote in an article published online May 7 in Annals of the Rheumatic Diseases (doi:10.1136/annrheumdis-2014-205178).
For the study, all patients had biennial clinical and radiographic assessments and two readers independently scored the x-rays according to the mSASSS. Disease activity measures included the Bath AS Disease Activity Index (BASDAI), AS Disease Activity Index (ASDAS)-C-reactive protein (CRP), CRP, erythrocyte sedimentation rate (ESR), patient’s global assessment, and spinal pain.
As a disease activity measure, ASDAS outperformed the models with all other disease activity measures. The finding importantly adds to the validity of ASDAS as the disease activity measure of choice, the researchers said.
Patients with an ASDAS less than 1.3 at baseline had an average progression of 0.71 mSASSS units/2-years. Those with an ASDAS of more than 3.5 at baseline had a progression of 3.1 mSASSS units/2-year progression. A similar relationship was found for BASDAI: patients with a BASDAI less than 4 at baseline had an average progression of 1.4 mSASSS units/2 years, while patients with a BASDAI of 4 or more at baseline had an average progression of 2.7 mSASSS units/2 years.
However, inflammation "by far does not fully explain radiographic damage in AS: Even without measurable disease activity there is still considerable radiographic progression," they said. Patients who have inactive disease for the entire 12 years still can expect a progression of 5 mSASSS units on average. It seems as if increased bone formation in AS is partly constitutive and partly inflammation dependent.
The effect of disease activity on radiographic progression seems to be stronger in men, who had an additional progression of about 1 mSASSS unit per 2-year interval per additional unit of ASDAS. The researchers also found a stronger effect of disease activity on radiographic progression in the early phase of AS.
The models with ASDAS as the disease activity measure fitted the data better than did models with BASDAI, CRP, or BASDAI+CRP. An increase of one ASDAS unit led to an increase of 0.72 mSASSS units/2 years. An ASDAS exceeding 3.5 compared with an ASDAS of less than 1.3 resulted in an additional 2-year progression of 2.31 mSASSS units.
Dr. Romero was supported by the Fundação para a Ciência e Tecnologia (FCT) grant SFRH/BD/68684/2010.
From Annals of Rheumatic Diseases
Key clinical point: New bone formation in ankylosing spondylitis correlates with inflammation.
Major finding: Patients with an ASDAS less than 1.3 at baseline had an average progression of 0.71 mSASSS units/2-years. Those with an ASDAS of more than 3.5 at baseline had a progression of 3.1 mSASSS units/2-year progression.
Data source: A 12-year follow up study of 184 patients in the Outcome in AS International Study (OASIS).
Disclosures: Dr. Romero was supported by the Fundação para a Ciência e Tecnologia (FCT) grant SFRH/BD/68684/2010.
VIDEO – National effort to reduce maternal deaths and morbidities gains traction
CHICAGO – The 3,200 U. S. hospitals that offer obstetric care are being urged to reduce maternal morbidity and mortality by joining the National Partnership for Maternal Safety. The initial aim of the collaborative is to implement priority bundles for the three most common preventable causes of maternal death and severe morbidity: obstetric hemorrhage, severe hypertension in pregnancy, and peripartum venous thromboembolism.
Efforts by Dr. Elliott Main to turn maternal mortality reviews into quality improvement materials for preeclampsia and hemorrhage were instrumental in the efforts. In this exclusive video, Dr. Main, medical director of the California Maternal Quality Care Collaborative and chair of obstetrics and gynecology at California Pacific Medical Center in San Francisco, discusses how those efforts are beginning to take root nationally with Dr. Mary Elizabeth D’Alton, chair of obstetrics and gynecology at Columbia University, New York, and Dr. Sarah J. Kilpatrick, chair of obstetrics and gynecology at Cedars-Sinai, Los Angeles.
Dr. Main interviewed Dr. D’Alton and Dr. Kilpatrick at the 2014 ACOG annual clinical meeting after they presented the Edith Louise Potter Memorial Lecture titled "Maternal Morbidity and Mortality in the U.S.: Time to Wake Up and Take the Lead."
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
CHICAGO – The 3,200 U. S. hospitals that offer obstetric care are being urged to reduce maternal morbidity and mortality by joining the National Partnership for Maternal Safety. The initial aim of the collaborative is to implement priority bundles for the three most common preventable causes of maternal death and severe morbidity: obstetric hemorrhage, severe hypertension in pregnancy, and peripartum venous thromboembolism.
Efforts by Dr. Elliott Main to turn maternal mortality reviews into quality improvement materials for preeclampsia and hemorrhage were instrumental in the efforts. In this exclusive video, Dr. Main, medical director of the California Maternal Quality Care Collaborative and chair of obstetrics and gynecology at California Pacific Medical Center in San Francisco, discusses how those efforts are beginning to take root nationally with Dr. Mary Elizabeth D’Alton, chair of obstetrics and gynecology at Columbia University, New York, and Dr. Sarah J. Kilpatrick, chair of obstetrics and gynecology at Cedars-Sinai, Los Angeles.
Dr. Main interviewed Dr. D’Alton and Dr. Kilpatrick at the 2014 ACOG annual clinical meeting after they presented the Edith Louise Potter Memorial Lecture titled "Maternal Morbidity and Mortality in the U.S.: Time to Wake Up and Take the Lead."
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
CHICAGO – The 3,200 U. S. hospitals that offer obstetric care are being urged to reduce maternal morbidity and mortality by joining the National Partnership for Maternal Safety. The initial aim of the collaborative is to implement priority bundles for the three most common preventable causes of maternal death and severe morbidity: obstetric hemorrhage, severe hypertension in pregnancy, and peripartum venous thromboembolism.
Efforts by Dr. Elliott Main to turn maternal mortality reviews into quality improvement materials for preeclampsia and hemorrhage were instrumental in the efforts. In this exclusive video, Dr. Main, medical director of the California Maternal Quality Care Collaborative and chair of obstetrics and gynecology at California Pacific Medical Center in San Francisco, discusses how those efforts are beginning to take root nationally with Dr. Mary Elizabeth D’Alton, chair of obstetrics and gynecology at Columbia University, New York, and Dr. Sarah J. Kilpatrick, chair of obstetrics and gynecology at Cedars-Sinai, Los Angeles.
Dr. Main interviewed Dr. D’Alton and Dr. Kilpatrick at the 2014 ACOG annual clinical meeting after they presented the Edith Louise Potter Memorial Lecture titled "Maternal Morbidity and Mortality in the U.S.: Time to Wake Up and Take the Lead."
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
EXPERT ANALYSIS FROM THE ACOG ANNUAL CLINICAL MEETING
VIDEO: Cervical length at 16-22 weeks predicts preterm birth
CHICAGO – Transvaginal ultrasound measures of cervical length at 16-22 weeks gestation can identify patients who have a short cervix and are at risk of preterm birth, allowing selection of patients for vaginal progesterone therapy.
At the annual meeting of the American Congress of Obstetricians and Gynecologists, Dr. Eric Strand, director of the division of general obstetrics and gynecology at Washington University, St. Louis, interviews Dr. George Andrew Macones, the Mitchell and Elaine Yanow Professor and chair of the department of obstetrics and gynecology at Washington University, about these findings and how clinicians can get free training in performing transvaginal screening to determine cervical length. Dr. Macones presented the March of Dimes Annual Lecture entitled "Preventing Preterm Birth: Recent Progress and Future Directions."
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
CHICAGO – Transvaginal ultrasound measures of cervical length at 16-22 weeks gestation can identify patients who have a short cervix and are at risk of preterm birth, allowing selection of patients for vaginal progesterone therapy.
At the annual meeting of the American Congress of Obstetricians and Gynecologists, Dr. Eric Strand, director of the division of general obstetrics and gynecology at Washington University, St. Louis, interviews Dr. George Andrew Macones, the Mitchell and Elaine Yanow Professor and chair of the department of obstetrics and gynecology at Washington University, about these findings and how clinicians can get free training in performing transvaginal screening to determine cervical length. Dr. Macones presented the March of Dimes Annual Lecture entitled "Preventing Preterm Birth: Recent Progress and Future Directions."
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
CHICAGO – Transvaginal ultrasound measures of cervical length at 16-22 weeks gestation can identify patients who have a short cervix and are at risk of preterm birth, allowing selection of patients for vaginal progesterone therapy.
At the annual meeting of the American Congress of Obstetricians and Gynecologists, Dr. Eric Strand, director of the division of general obstetrics and gynecology at Washington University, St. Louis, interviews Dr. George Andrew Macones, the Mitchell and Elaine Yanow Professor and chair of the department of obstetrics and gynecology at Washington University, about these findings and how clinicians can get free training in performing transvaginal screening to determine cervical length. Dr. Macones presented the March of Dimes Annual Lecture entitled "Preventing Preterm Birth: Recent Progress and Future Directions."
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
AT THE ACOG ANNUAL CLINICAL MEETING
