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.
Depression during pregnancy: is there an effect on birth outcomes?
Depression during pregnancy is a relatively common problem, affecting around eight in every 1000 women. Now, an analysis of over 500,000 women who gave birth in Finland has been conducted to better understand the factors associated with perinatal depression. The strongest predictor for major depression during pregnancy was found to be prior history of mental illness, and fear of childbirth led to a 2.6-fold increased risk. Low socioeconomic status, lack of social support and smoking were also linked to elevated risk of depression. The authors also assessed pregnancy outcome, revealing that women with perinatal depression are more likely to suffer adverse pregnancy outcomes, including low birth weight and preterm birth, than those without depression. Smoking during pregnancy had a substantial impact on adverse birth outcomes linked to depression. Taken together, these results emphasize the importance of mental health care in pregnant women, and support the need for smoking cessation programs, especially for women at risk of perinatal depression.
Räisänen et al. BMJ Open
Diet, muscle mass and hip fractures
Hip fractures are common in older people, affecting around 1.6 million people annually. The complications associated with hip fractures can be life threatening, and treatment usually involves surgery followed by months of rehabilitation. There is therefore an urgent need to understand the risk factors associated with hip fracture to inform prevention and treatment strategies. A study has been carried out in Italy to assess whether there is a link between diet and reduced muscle mass, a risk factor for falls and hip fractures. The authors found that low calorie and protein intake are associated with low muscle mass in those with hip fracture, highlighting the need for comprehensive dietary assessment in older people to identify those at risk of falls, in order to prevent hip fractures and other injuries.
Calvani et al. Frontiers in Aging Neuroscience
The genomic landscape of colorectal cancer
Colorectal cancer is the second leading cause of cancer death in western countries, and occurs as a result of multiple genetic rearrangements. While some targeted therapies are available for patients with genetic changes in the epidermal growth factor receptor (EGFR) protein, most are treated with chemotherapy such as irinotecan and oxaliplatin. Now, an analysis of two phase III clinical trials has revealed genetic differences linked to chemotherapy response. The authors analyzed data from the CAIRO and CAIRO2 trials, where patients received different combinations of chemotherapy and antibody-based drugs. 194 different chromosomal regions were found to be associated with progression-free survival, and following validation with data from The Cancer Genome Atlas, three regions associated with survival after irinotecan treatment were identified. These important results provide insights into the genetic factors affecting chemotherapy response in patients with colorectal cancer, which could be used as biomarkers of response to ensure that individual patients are given the most appropriate treatment, whilst avoiding unnecessary side effects from therapies unlikely to be effective.
Haan et al. Nature Communications
NSAIDs and PPIs: the gastroprotective treatment gap
Patients with osteoarthritis (OA) and rheumatoid arthritis (RA) are often treated with non-steroidal inflammatory drugs (NSAIDs). Because NSAIDs are linked to adverse effects such as gastric bleeding and peptic ulcers, many RA and OA patients also take gastroprotective proton pump inhibitor (PPI) treatment. Adhering to PPI treatment is important to prevent the risks associated with NSAIDs; to investigate real-life adherence to PPIs, a questionnaire study has been carried out. The researchers asked patients with OA, RA or ankylosing spondylitis about their adherence to NSAID and PPI treatment, finding that overall adherence to coprescribed PPIs and NSAIDs was between 73 percent and 81 percent when different analytical methods were employed. Twenty-six percent of patients reported lower than 80 percent adherence to treatment, highlighting a “gastoprotective treatment gap”. The authors conclude that strategies are needed to improve patients’ adherence to PPI treatment in order to prevent NSAID-associated ulcers and bleeding.
Henriksson et al. Patient Preference and Adherence
Is ‘brain training’ effective for older people?
While cognitive decline – worsening in memory, decision making, language and understanding – can be a normal part of aging, it can also be an early sign of dementia. Keeping fit and engaging in brain-stimulating activities are thought to be effective ways to reduce the risk of cognitive decline. ‘Brain training’, which consists of computerized cognitive training (CCT) packages to enhance cognition, has been suggested as an effective technique to keep mentally fit. Now, a systematic review and meta-analysis has addressed the questions of whether CCT packages can really enhance cognition in older people, and which techniques are the most effective. The authors’ meta-analysis revealed that CCT is moderately effective in increasing overall cognitive function, but the effects varied across domains. For example, the training improved memory but had no effect on planning, judgment or attention. Effective results were seen for people attending supervised training, whereas no cognitive benefits occurred for those participating in unsupervised CCT at home. Overall, these results suggest that CCT may be effective under supervised conditions, but more work is required to enhance the effectiveness of such interventions.
Lampit et al. PLOS Medicine
Mortality risk in adolescent mothers
Approximately 16 million adolescent women (aged 15-19) are thought to give birth every year across the world, and the majority of these births occur in low- and middle-income countries (LMICs). Childbirth during adolescence is associated with a number of risks for mothers such as premature delivery and postnatal conditions; complications associated with pregnancy and childbirth are among the leading global causes of death among women aged 15–19 years. Low use of healthcare services by pregnant women is one of the reasons why maternal mortality is high among adolescent women in LMICs. To address the reasons why many adolescent mothers do not use healthcare services, a survey study in urban India has examined factors associated with service utilization. Only 22 percent of mothers reported receiving full antenatal care, and approximately 70 percent gave birth while assisted by a skilled professional. Several sociodemographic factors associated with antenatal care use were revealed, including education, religion, socioeconomic status, exposure to healthcare messages and region of residence. The authors conclude that promoting the use of contraception and higher age at marriage among vulnerable women, in collaboration between healthcare systems and community leaders, should be done to help reduce maternal mortality in LMICs.
Singh et al. PeerJ
Written by Claire Barnard, Senior Editor for BMC Medicine.