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.
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Neutrophil-lymphocyte ratio linked to renal cancer prognosis
Mounting evidence suggests that cancer-related inflammation is linked to disease, and several inflammatory markers have been shown to be linked to prognosis in patients with renal cell carcinoma (RCC). Now, a meta-analysis has been conducted to determine the association between the neutrophil-lymphocyte ratio (NLR) – a blood marker of inflammation – and clinical outcome in RCC patients. Analyzing data from 15 studies, the authors found that elevated NLR is associated with poor survival in these patients, suggesting that NLR could be monitored in the clinic to improve risk stratification and guide treatment decisions.
Hu et al. BMJ Open
Treating severe infection in resource-limited settings
Severe infections are one of the leading causes of death in newborn babies and young children worldwide. While the recommended treatment for severe infection is injectable antibiotic treatment administered in hospital, limitations in the provision of hospital care can lead to delayed or inadequate therapy in low- and middle-income countries. To address this gap in care, a randomized controlled trial has been conducted in Bangladesh to identify alternative antibiotic treatment options for settings where hospital admission is not always possible. The participants – young infants treated in either an urban hospital or a rural field site – were randomized to receive either the recommended injectable antibiotic therapy, or one of two alternative treatment regimens containing a mixture of injectable and oral antibiotics. Survival and relapse rates were similar across all treatment groups, suggesting that the alternative treatment options could be used in resource-poor settings where hospital admission is not possible.
Baqui et al. The Lancet Global Health
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Exploring the association between red meat and cancer
Consuming a diet high in red meat is known to increase colorectal cancer (CRC) risk, but the mechanisms underlying this association are not completely understood. Now, a comprehensive analysis of meat intake, cooking practices and CRC incidence has been undertaken. The authors found no overall link between total red meat or total processed meat consumption and CRC risk. When breaking down the analysis by cooking practice, the strongest association was seen between pan-fried beef steak, and analyses taking tumor subtypes and marinades into account suggest that heterocyclic amines could explain the association between red meat and CRC risk. These findings provide evidence for the role of specific meat types and cooking practices as possible sources of carcinogens contributing to CRC risk.
Joshi et al. Cancer Medicine
Antiarrhythmic drugs and atrial fibrillation
In 2006, guidelines published by the American College of Cardiology, American Heart Association, and the European Society of Cardiology made recommendations for the use of antiarrhythmic drugs (AAD) to manage atrial fibrillation (AF). Nearly a decade later, a retrospective study has been conducted to assess whether stronger adherence to these guidelines is associated with better outcome in AF patients. Guideline adherence was found to be higher when the prescriber had greater specialization in arrhythmias, and over an average follow-up of 45 months, patients treated with greater adherence to guidelines had a lower risk of AF recurrence and fewer hospitalizations for AF. Together, these results provide support for guidelines recommending AAD treatment for cardiac arrhythmia, and suggest that improved adherence to guidelines could result in better patient outcome.
Qin et al. Journal of the American Heart Association
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Score predicts CKD risk in HIV-positive individuals
Chronic kidney disease (CKD) affects up to a third of people infected with HIV, and is associated with increased morbidity and mortality. It is important to know which individuals with HIV are at high risk of developing CKD so that the most appropriate antiretroviral regimens can be selected. Now, in a large global collaboration, researchers have developed a CKD risk score using data collected from over 17,000 HIV-positive individuals. The score – taking into account age, intravenous drug use, eGFR, sex, CD4 counts, and various comorbidities – was used to define low, medium and high CKD risk groups, and was validated in two independent cohorts. The authors conclude that the score could be used by clinicians and patients to identify those at greatest risk of CKD and choose the appropriate type of antiretroviral therapy accordingly.
Mocroft et al. PLOS Medicine
Written by Claire Barnard, Deputy Editor for BMC Medicine
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