More attention needs to be paid to evaluating quality of life and cognitive/behavioral outcomes in children with status epilepticus, according to a review of the relevant medical literature.

• An analysis of MEDLINE derived studies looked at the short-term and long-term outcomes in pediatric patients with status epilepticus.
• The review found that mortality in this patient population was relatively low.
• Health-related quality of life, neuroimaging, the use of continuous infusions, and cognitive/behavioral outcomes were not adequately addressed in the studies that were evaluated.
• The researchers point out, however, that the full effects of status epilepticus on the outcomes being evaluated were difficult to accurately establish because there were so many differences in the way the studies were conducted.

Jafarpour S, Stredny CM, Piantino J, Chapman KE. Baseline and outcome assessment in pediatric status epilepticus. [Published online ahead of print April 26, 2018]. Seizure. DOI: https://doi.org/10.1016/j.seizure.2018.04.019

More attention needs to be paid to evaluating quality of life and cognitive/behavioral outcomes in children with status epilepticus, according to a review of the relevant medical literature.

• An analysis of MEDLINE derived studies looked at the short-term and long-term outcomes in pediatric patients with status epilepticus.
• The review found that mortality in this patient population was relatively low.
• Health-related quality of life, neuroimaging, the use of continuous infusions, and cognitive/behavioral outcomes were not adequately addressed in the studies that were evaluated.
• The researchers point out, however, that the full effects of status epilepticus on the outcomes being evaluated were difficult to accurately establish because there were so many differences in the way the studies were conducted.

Jafarpour S, Stredny CM, Piantino J, Chapman KE. Baseline and outcome assessment in pediatric status epilepticus. [Published online ahead of print April 26, 2018]. Seizure. DOI: https://doi.org/10.1016/j.seizure.2018.04.019

More attention needs to be paid to evaluating quality of life and cognitive/behavioral outcomes in children with status epilepticus, according to a review of the relevant medical literature.

• An analysis of MEDLINE derived studies looked at the short-term and long-term outcomes in pediatric patients with status epilepticus.
• The review found that mortality in this patient population was relatively low.
• Health-related quality of life, neuroimaging, the use of continuous infusions, and cognitive/behavioral outcomes were not adequately addressed in the studies that were evaluated.
• The researchers point out, however, that the full effects of status epilepticus on the outcomes being evaluated were difficult to accurately establish because there were so many differences in the way the studies were conducted.

Jafarpour S, Stredny CM, Piantino J, Chapman KE. Baseline and outcome assessment in pediatric status epilepticus. [Published online ahead of print April 26, 2018]. Seizure. DOI: https://doi.org/10.1016/j.seizure.2018.04.019

A cross-sectional analysis of epilepsy intervention trials suggests there may be bias in the reporting of these investigations according to a recent review of the research.

• Investigators analyzed 126 epilepsy intervention trials, comparing two reporting periods: 2008 to 2011 and 2012 to 2015.
• Twenty five percent of the trials were not reported (31/126).
• 72 of the 126 trials were conducted in at least one US center.
• 56 of 72 trials (78%) met the US Food and Drug Administration’s Amendments Act requirements.
• Researchers found that the time it took to report trial results had become shorter over time, when comparing 2008-2011 to 2012-2015.
• However, only a third of the trials (19/56) reported their results within the FDA’s mandated one-year time frame. 

Rayi A, Thompson S, Gloss D, Malhotra K. Reporting bias in completed epilepsy intervention trials: a cross-sectional analysis. Epilepsy Res. 2018;143:1-6

A cross-sectional analysis of epilepsy intervention trials suggests there may be bias in the reporting of these investigations according to a recent review of the research.

• Investigators analyzed 126 epilepsy intervention trials, comparing two reporting periods: 2008 to 2011 and 2012 to 2015.
• Twenty five percent of the trials were not reported (31/126).
• 72 of the 126 trials were conducted in at least one US center.
• 56 of 72 trials (78%) met the US Food and Drug Administration’s Amendments Act requirements.
• Researchers found that the time it took to report trial results had become shorter over time, when comparing 2008-2011 to 2012-2015.
• However, only a third of the trials (19/56) reported their results within the FDA’s mandated one-year time frame. 

Rayi A, Thompson S, Gloss D, Malhotra K. Reporting bias in completed epilepsy intervention trials: a cross-sectional analysis. Epilepsy Res. 2018;143:1-6

A cross-sectional analysis of epilepsy intervention trials suggests there may be bias in the reporting of these investigations according to a recent review of the research.

• Investigators analyzed 126 epilepsy intervention trials, comparing two reporting periods: 2008 to 2011 and 2012 to 2015.
• Twenty five percent of the trials were not reported (31/126).
• 72 of the 126 trials were conducted in at least one US center.
• 56 of 72 trials (78%) met the US Food and Drug Administration’s Amendments Act requirements.
• Researchers found that the time it took to report trial results had become shorter over time, when comparing 2008-2011 to 2012-2015.
• However, only a third of the trials (19/56) reported their results within the FDA’s mandated one-year time frame. 

Rayi A, Thompson S, Gloss D, Malhotra K. Reporting bias in completed epilepsy intervention trials: a cross-sectional analysis. Epilepsy Res. 2018;143:1-6

Adults were more likely to try e-cigarettes in 2016 than they were in 2014, but they were less likely to use them regularly, according to a study published online on May 15 by JAMA.

The prevalence of ever use of e-cigarettes among adults aged 18 years and older rose significantly from 12.6% in 2014 to 15.3% in 2016, while the prevalence of current use (defined as use every day or some days) decreased significantly from 3.7% to 3.2% over that same period, suggesting “that some individuals are trying but not continuing use of e-cigarettes,” Wei Bao, MD, PhD, and his associates said in a research letter.

rfranki@mdedge.com

SOURCE: Bao W et al. JAMA. 2018 May 15;319(19):2039-41.

Adults were more likely to try e-cigarettes in 2016 than they were in 2014, but they were less likely to use them regularly, according to a study published online on May 15 by JAMA.

The prevalence of ever use of e-cigarettes among adults aged 18 years and older rose significantly from 12.6% in 2014 to 15.3% in 2016, while the prevalence of current use (defined as use every day or some days) decreased significantly from 3.7% to 3.2% over that same period, suggesting “that some individuals are trying but not continuing use of e-cigarettes,” Wei Bao, MD, PhD, and his associates said in a research letter.

rfranki@mdedge.com

SOURCE: Bao W et al. JAMA. 2018 May 15;319(19):2039-41.

Adults were more likely to try e-cigarettes in 2016 than they were in 2014, but they were less likely to use them regularly, according to a study published online on May 15 by JAMA.

The prevalence of ever use of e-cigarettes among adults aged 18 years and older rose significantly from 12.6% in 2014 to 15.3% in 2016, while the prevalence of current use (defined as use every day or some days) decreased significantly from 3.7% to 3.2% over that same period, suggesting “that some individuals are trying but not continuing use of e-cigarettes,” Wei Bao, MD, PhD, and his associates said in a research letter.

rfranki@mdedge.com

SOURCE: Bao W et al. JAMA. 2018 May 15;319(19):2039-41.

Patients with episodic migraines had significantly fewer headache days when treated with a monoclonal antibody targeting calcitonin gene–related peptide (CGRP), results of a recent randomized clinical trial show.

The treatment was generally well tolerated, and also improved secondary efficacy outcomes; however, the investigators qualified the results, noting that the trial included patients who had failed two or fewer previous classes of migraine preventive medication.

“Further research is needed to assess effectiveness against other preventive medications, and in patients in whom multiple preventive drug classes have failed,” wrote David W. Dodick, MD, of Mayo Clinic, Phoenix, Ariz., and his coauthors. Long-term safety and efficacy also are needed, they added. Their report was published in JAMA.

Fremanezumab is a subcutaneously administered, fully humanized monoclonal antibody that binds to the CGRP ligand. A previous randomized phase 2b study showed that the treatment was effective in preventing migraine, with no serious treatment-related adverse events.

The current 12-week phase 3 trial (clinicaltrials.gov Identifier: NCT02629861) was designed to evaluate the efficacy and safety of fremanezumab in two different dosing regimens. A total of 875 patients (742 women; 85%) with episodic migraine were randomly assigned to fremanezumab monthly dosing (225 mg at baseline, 4 weeks, and 8 weeks), a single higher dose of fremanezumab (675 mg at baseline) intended to support a quarterly dosing regimen, or placebo.

Both dosing approaches significantly reduced the mean number of migraine days per month vs. placebo, Dr. Dodick and his coinvestigators reported.

In the monthly dosing group, the mean number of migraine days per month decreased from 8.9 to 4.9, and compared with placebo (with a decrease from 9.1 to 6.5 days), the mean number of migraine days at 12 weeks was 1.5 days lower (P less than .001). Similarly, the mean number of migraine days decreased from 9.2 to 5.3 days in the single higher dose group, with a difference of 1.3 days vs. placebo (P less than .001).

Significantly more patients receiving fremanezumab had a 50% or greater reduction in mean number of migraine days per month, suggesting a clinical response to the CGRP monoclonal antibody, the investigators said.

The most common adverse events leading to discontinuation included erythema at the injection site in three patients, along with induration, diarrhea, anxiety, and depression occurring in two patients each, according to the report. There was one death in the study due to suicide 109 days after the patient received a single higher dose of the study drug. However, the investigators determined that the death was unrelated to treatment.

One limitation of the study, investigators said, is that it excluded patients with treatment refractory migraine who had failed at least two previous preventive drug classes, and those who had continuous headache.

“Further studies are needed to define the full spectrum of efficacy and tolerability of fremanezumab, including in patients who are treatment refractory and who have a range of coexistent diseases,” they wrote.

Teva Pharmaceuticals supported the study. Dr. Dodick and his coauthors reported disclosures related to Teva, Amgen, Novartis, Pfizer, and Merck, among other entities.

SOURCE: Dodick DW et al. JAMA. 2018.319[19]:1999-2008.

Patients with episodic migraines had significantly fewer headache days when treated with a monoclonal antibody targeting calcitonin gene–related peptide (CGRP), results of a recent randomized clinical trial show.

The treatment was generally well tolerated, and also improved secondary efficacy outcomes; however, the investigators qualified the results, noting that the trial included patients who had failed two or fewer previous classes of migraine preventive medication.

“Further research is needed to assess effectiveness against other preventive medications, and in patients in whom multiple preventive drug classes have failed,” wrote David W. Dodick, MD, of Mayo Clinic, Phoenix, Ariz., and his coauthors. Long-term safety and efficacy also are needed, they added. Their report was published in JAMA.

Fremanezumab is a subcutaneously administered, fully humanized monoclonal antibody that binds to the CGRP ligand. A previous randomized phase 2b study showed that the treatment was effective in preventing migraine, with no serious treatment-related adverse events.

The current 12-week phase 3 trial (clinicaltrials.gov Identifier: NCT02629861) was designed to evaluate the efficacy and safety of fremanezumab in two different dosing regimens. A total of 875 patients (742 women; 85%) with episodic migraine were randomly assigned to fremanezumab monthly dosing (225 mg at baseline, 4 weeks, and 8 weeks), a single higher dose of fremanezumab (675 mg at baseline) intended to support a quarterly dosing regimen, or placebo.

Both dosing approaches significantly reduced the mean number of migraine days per month vs. placebo, Dr. Dodick and his coinvestigators reported.

In the monthly dosing group, the mean number of migraine days per month decreased from 8.9 to 4.9, and compared with placebo (with a decrease from 9.1 to 6.5 days), the mean number of migraine days at 12 weeks was 1.5 days lower (P less than .001). Similarly, the mean number of migraine days decreased from 9.2 to 5.3 days in the single higher dose group, with a difference of 1.3 days vs. placebo (P less than .001).

Significantly more patients receiving fremanezumab had a 50% or greater reduction in mean number of migraine days per month, suggesting a clinical response to the CGRP monoclonal antibody, the investigators said.

The most common adverse events leading to discontinuation included erythema at the injection site in three patients, along with induration, diarrhea, anxiety, and depression occurring in two patients each, according to the report. There was one death in the study due to suicide 109 days after the patient received a single higher dose of the study drug. However, the investigators determined that the death was unrelated to treatment.

One limitation of the study, investigators said, is that it excluded patients with treatment refractory migraine who had failed at least two previous preventive drug classes, and those who had continuous headache.

“Further studies are needed to define the full spectrum of efficacy and tolerability of fremanezumab, including in patients who are treatment refractory and who have a range of coexistent diseases,” they wrote.

Teva Pharmaceuticals supported the study. Dr. Dodick and his coauthors reported disclosures related to Teva, Amgen, Novartis, Pfizer, and Merck, among other entities.

SOURCE: Dodick DW et al. JAMA. 2018.319[19]:1999-2008.

Patients with episodic migraines had significantly fewer headache days when treated with a monoclonal antibody targeting calcitonin gene–related peptide (CGRP), results of a recent randomized clinical trial show.

The treatment was generally well tolerated, and also improved secondary efficacy outcomes; however, the investigators qualified the results, noting that the trial included patients who had failed two or fewer previous classes of migraine preventive medication.

“Further research is needed to assess effectiveness against other preventive medications, and in patients in whom multiple preventive drug classes have failed,” wrote David W. Dodick, MD, of Mayo Clinic, Phoenix, Ariz., and his coauthors. Long-term safety and efficacy also are needed, they added. Their report was published in JAMA.

Fremanezumab is a subcutaneously administered, fully humanized monoclonal antibody that binds to the CGRP ligand. A previous randomized phase 2b study showed that the treatment was effective in preventing migraine, with no serious treatment-related adverse events.

The current 12-week phase 3 trial (clinicaltrials.gov Identifier: NCT02629861) was designed to evaluate the efficacy and safety of fremanezumab in two different dosing regimens. A total of 875 patients (742 women; 85%) with episodic migraine were randomly assigned to fremanezumab monthly dosing (225 mg at baseline, 4 weeks, and 8 weeks), a single higher dose of fremanezumab (675 mg at baseline) intended to support a quarterly dosing regimen, or placebo.

Both dosing approaches significantly reduced the mean number of migraine days per month vs. placebo, Dr. Dodick and his coinvestigators reported.

In the monthly dosing group, the mean number of migraine days per month decreased from 8.9 to 4.9, and compared with placebo (with a decrease from 9.1 to 6.5 days), the mean number of migraine days at 12 weeks was 1.5 days lower (P less than .001). Similarly, the mean number of migraine days decreased from 9.2 to 5.3 days in the single higher dose group, with a difference of 1.3 days vs. placebo (P less than .001).

Significantly more patients receiving fremanezumab had a 50% or greater reduction in mean number of migraine days per month, suggesting a clinical response to the CGRP monoclonal antibody, the investigators said.

The most common adverse events leading to discontinuation included erythema at the injection site in three patients, along with induration, diarrhea, anxiety, and depression occurring in two patients each, according to the report. There was one death in the study due to suicide 109 days after the patient received a single higher dose of the study drug. However, the investigators determined that the death was unrelated to treatment.

One limitation of the study, investigators said, is that it excluded patients with treatment refractory migraine who had failed at least two previous preventive drug classes, and those who had continuous headache.

“Further studies are needed to define the full spectrum of efficacy and tolerability of fremanezumab, including in patients who are treatment refractory and who have a range of coexistent diseases,” they wrote.

Teva Pharmaceuticals supported the study. Dr. Dodick and his coauthors reported disclosures related to Teva, Amgen, Novartis, Pfizer, and Merck, among other entities.

SOURCE: Dodick DW et al. JAMA. 2018.319[19]:1999-2008.

Advanced adenomas found on diagnostic colonoscopy were associated with increased risk of developing colorectal cancer, while nonadvanced adenomas were not, according to long-term follow-up results from a large screening study.

The findings come from a post hoc analysis of the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial that enrolled 154,900 individuals, of whom 15,935 underwent colonoscopy following an abnormal flexible sigmoidoscopy screening result.

With a median of 13 years of follow-up, the incidence of colorectal cancer was 20.0 per 10,000 person-years for patients who had advanced adenoma found on colonoscopy, according to a report on the study published in JAMA. By comparison, colorectal cancer incidence was 9.1 and 7.5 per 10,000 person-years for nonadvanced adenoma and no adenoma, respectively.

“By demonstrating that individuals diagnosed with an advanced adenoma are at increased long-term risk for subsequent incident CRC, these findings support periodic, ongoing surveillance colonoscopy in these patients,” wrote Benjamin Click, MD, of the division of gastroenterology, hepatology, and nutrition, University of Pittsburgh, and his coauthors.

Compared with patients who had no adenoma, those with advanced adenoma were significantly more likely to develop colorectal cancer (rate ratio, 2.7; 95% confidence interval, 1.9-3.7; P less than .001). By contrast, there was no significant difference in risk of colorectal cancer for patients with nonadvanced adenoma and no adenoma (RR, 1.2; 95% CI, 0.8-1.7; P = .30).

Risk of death related to colorectal cancer was also significantly increased for patients with advanced adenoma versus no adenoma, and again, the investigators said, no such difference in mortality was found when nonadvanced adenoma was compared with no adenoma.

The PLCO screening study enrolled men and women aged 55-74 years beginning in 1993, with follow-up continuing until Dec. 31, 2013.

Small, nonadvanced adenomas are commonly found in colonoscopy, occurring in approximately 30% of patients, the investigators said. In the United States, when patients have one to two nonadvanced adenomas, they are typically advised to return in 5-10 years, the researchers noted. However, evidence is lacking in terms of who should return in 5 years, as opposed to 10 years.

“If appropriately powered prospective trials were to replicate these findings, demonstrating no significant difference in cancer incidence between participants with 1 to 2 nonadvanced adenoma(s) and no adenomas, colonoscopy use could be reduced by a large extent, as a surveillance examination at 5 years would not be needed,” the study authors said.

The National Cancer Institute Division of Cancer Prevention supported the study. One author reported receiving grant support from Medtronic.

SOURCE: Click B et al. JAMA. 2018;319(19):2021-31.

Advanced adenomas found on diagnostic colonoscopy were associated with increased risk of developing colorectal cancer, while nonadvanced adenomas were not, according to long-term follow-up results from a large screening study.

The findings come from a post hoc analysis of the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial that enrolled 154,900 individuals, of whom 15,935 underwent colonoscopy following an abnormal flexible sigmoidoscopy screening result.

With a median of 13 years of follow-up, the incidence of colorectal cancer was 20.0 per 10,000 person-years for patients who had advanced adenoma found on colonoscopy, according to a report on the study published in JAMA. By comparison, colorectal cancer incidence was 9.1 and 7.5 per 10,000 person-years for nonadvanced adenoma and no adenoma, respectively.

“By demonstrating that individuals diagnosed with an advanced adenoma are at increased long-term risk for subsequent incident CRC, these findings support periodic, ongoing surveillance colonoscopy in these patients,” wrote Benjamin Click, MD, of the division of gastroenterology, hepatology, and nutrition, University of Pittsburgh, and his coauthors.

Compared with patients who had no adenoma, those with advanced adenoma were significantly more likely to develop colorectal cancer (rate ratio, 2.7; 95% confidence interval, 1.9-3.7; P less than .001). By contrast, there was no significant difference in risk of colorectal cancer for patients with nonadvanced adenoma and no adenoma (RR, 1.2; 95% CI, 0.8-1.7; P = .30).

Risk of death related to colorectal cancer was also significantly increased for patients with advanced adenoma versus no adenoma, and again, the investigators said, no such difference in mortality was found when nonadvanced adenoma was compared with no adenoma.

The PLCO screening study enrolled men and women aged 55-74 years beginning in 1993, with follow-up continuing until Dec. 31, 2013.

Small, nonadvanced adenomas are commonly found in colonoscopy, occurring in approximately 30% of patients, the investigators said. In the United States, when patients have one to two nonadvanced adenomas, they are typically advised to return in 5-10 years, the researchers noted. However, evidence is lacking in terms of who should return in 5 years, as opposed to 10 years.

“If appropriately powered prospective trials were to replicate these findings, demonstrating no significant difference in cancer incidence between participants with 1 to 2 nonadvanced adenoma(s) and no adenomas, colonoscopy use could be reduced by a large extent, as a surveillance examination at 5 years would not be needed,” the study authors said.

The National Cancer Institute Division of Cancer Prevention supported the study. One author reported receiving grant support from Medtronic.

SOURCE: Click B et al. JAMA. 2018;319(19):2021-31.

Advanced adenomas found on diagnostic colonoscopy were associated with increased risk of developing colorectal cancer, while nonadvanced adenomas were not, according to long-term follow-up results from a large screening study.

The findings come from a post hoc analysis of the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial that enrolled 154,900 individuals, of whom 15,935 underwent colonoscopy following an abnormal flexible sigmoidoscopy screening result.

With a median of 13 years of follow-up, the incidence of colorectal cancer was 20.0 per 10,000 person-years for patients who had advanced adenoma found on colonoscopy, according to a report on the study published in JAMA. By comparison, colorectal cancer incidence was 9.1 and 7.5 per 10,000 person-years for nonadvanced adenoma and no adenoma, respectively.

“By demonstrating that individuals diagnosed with an advanced adenoma are at increased long-term risk for subsequent incident CRC, these findings support periodic, ongoing surveillance colonoscopy in these patients,” wrote Benjamin Click, MD, of the division of gastroenterology, hepatology, and nutrition, University of Pittsburgh, and his coauthors.

Compared with patients who had no adenoma, those with advanced adenoma were significantly more likely to develop colorectal cancer (rate ratio, 2.7; 95% confidence interval, 1.9-3.7; P less than .001). By contrast, there was no significant difference in risk of colorectal cancer for patients with nonadvanced adenoma and no adenoma (RR, 1.2; 95% CI, 0.8-1.7; P = .30).

Risk of death related to colorectal cancer was also significantly increased for patients with advanced adenoma versus no adenoma, and again, the investigators said, no such difference in mortality was found when nonadvanced adenoma was compared with no adenoma.

The PLCO screening study enrolled men and women aged 55-74 years beginning in 1993, with follow-up continuing until Dec. 31, 2013.

Small, nonadvanced adenomas are commonly found in colonoscopy, occurring in approximately 30% of patients, the investigators said. In the United States, when patients have one to two nonadvanced adenomas, they are typically advised to return in 5-10 years, the researchers noted. However, evidence is lacking in terms of who should return in 5 years, as opposed to 10 years.

“If appropriately powered prospective trials were to replicate these findings, demonstrating no significant difference in cancer incidence between participants with 1 to 2 nonadvanced adenoma(s) and no adenomas, colonoscopy use could be reduced by a large extent, as a surveillance examination at 5 years would not be needed,” the study authors said.

The National Cancer Institute Division of Cancer Prevention supported the study. One author reported receiving grant support from Medtronic.

SOURCE: Click B et al. JAMA. 2018;319(19):2021-31.

In today’s edition of the MDedge Daily News podcast, the link between gun ownership and suicide, insertable monitors are unequaled in the detection of atrial fibrillation, toddlers are showing signs of Internet addiction, and parents are smoking less tobacco in the home, but more cannabis.

Listen to the MDedge Daily News podcast for all the details on today’s top news.


 

In today’s edition of the MDedge Daily News podcast, the link between gun ownership and suicide, insertable monitors are unequaled in the detection of atrial fibrillation, toddlers are showing signs of Internet addiction, and parents are smoking less tobacco in the home, but more cannabis.

Listen to the MDedge Daily News podcast for all the details on today’s top news.


 

In today’s edition of the MDedge Daily News podcast, the link between gun ownership and suicide, insertable monitors are unequaled in the detection of atrial fibrillation, toddlers are showing signs of Internet addiction, and parents are smoking less tobacco in the home, but more cannabis.

Listen to the MDedge Daily News podcast for all the details on today’s top news.


 

As psychiatrists, we must be more precise with our language. When we speak, we must not use psychiatric diagnoses to describe common, everyday problems in life.

For example, at the recent American Psychiatric Association meeting in New York City, I frequently heard my colleagues talking about being “traumatized” over a microinsult or a microaggression. Although these individuals suggested that they were so fragile and vulnerable that stressful events caused them to develop posttraumatic stress disorder (PTSD), I seriously doubted it. Moreover, with further dialogue, it became clear that they were stressed or distressed over the stressful event – not traumatized in the purest sense of the term.

Dr. Bell is staff psychiatrist at Jackson Park Hospital Surgical-Medical/Psychiatric Inpatient Unit; clinical professor emeritus, department of psychiatry, University of Illinois at Chicago; and former director of the Institute for Juvenile Research (the birthplace of child psychiatry), all in Chicago. He also serves as chair of psychiatry at Windsor University, St. Kitts.

As psychiatrists, we must be more precise with our language. When we speak, we must not use psychiatric diagnoses to describe common, everyday problems in life.

For example, at the recent American Psychiatric Association meeting in New York City, I frequently heard my colleagues talking about being “traumatized” over a microinsult or a microaggression. Although these individuals suggested that they were so fragile and vulnerable that stressful events caused them to develop posttraumatic stress disorder (PTSD), I seriously doubted it. Moreover, with further dialogue, it became clear that they were stressed or distressed over the stressful event – not traumatized in the purest sense of the term.

Dr. Bell is staff psychiatrist at Jackson Park Hospital Surgical-Medical/Psychiatric Inpatient Unit; clinical professor emeritus, department of psychiatry, University of Illinois at Chicago; and former director of the Institute for Juvenile Research (the birthplace of child psychiatry), all in Chicago. He also serves as chair of psychiatry at Windsor University, St. Kitts.

As psychiatrists, we must be more precise with our language. When we speak, we must not use psychiatric diagnoses to describe common, everyday problems in life.

For example, at the recent American Psychiatric Association meeting in New York City, I frequently heard my colleagues talking about being “traumatized” over a microinsult or a microaggression. Although these individuals suggested that they were so fragile and vulnerable that stressful events caused them to develop posttraumatic stress disorder (PTSD), I seriously doubted it. Moreover, with further dialogue, it became clear that they were stressed or distressed over the stressful event – not traumatized in the purest sense of the term.

Dr. Bell is staff psychiatrist at Jackson Park Hospital Surgical-Medical/Psychiatric Inpatient Unit; clinical professor emeritus, department of psychiatry, University of Illinois at Chicago; and former director of the Institute for Juvenile Research (the birthplace of child psychiatry), all in Chicago. He also serves as chair of psychiatry at Windsor University, St. Kitts.

According to the Centers for Disease Control and Prevention’s (CDC) study, 1 in 4 germ samples sent to the AR Lab Network for testing had special genes that allow them to spread their resistance to other germs. Further investigation in facilities with unusual resistance revealed that about 1 in 10 screening tests from patients without symptoms identified a hard-to-treat germ that spreads easily, meaning the germ could have spread undetected in that health care facility, the CDC said.

The CDC containment strategy includes continued infection control assessments until spread is stopped, which takes a coordinated response among facilities, labs, health departments, and CDC through the AR Lab Network. Health departments using the approach have conducted infection control assessments and colonization screenings within 48 hours of finding unusual resistance and have reported no further transmission during follow-up over several weeks. Estimates show that for carbapenem-resistant Enterobacteriaceae alone, the containment strategy would prevent as many as 1,600 new infections in 3 years in a single state—a 76% reduction.

Health care practitioners can help by using contact precautions, asking patients about recent travel or health care, and communicating about status when patients are transferred.

According to the Centers for Disease Control and Prevention’s (CDC) study, 1 in 4 germ samples sent to the AR Lab Network for testing had special genes that allow them to spread their resistance to other germs. Further investigation in facilities with unusual resistance revealed that about 1 in 10 screening tests from patients without symptoms identified a hard-to-treat germ that spreads easily, meaning the germ could have spread undetected in that health care facility, the CDC said.

The CDC containment strategy includes continued infection control assessments until spread is stopped, which takes a coordinated response among facilities, labs, health departments, and CDC through the AR Lab Network. Health departments using the approach have conducted infection control assessments and colonization screenings within 48 hours of finding unusual resistance and have reported no further transmission during follow-up over several weeks. Estimates show that for carbapenem-resistant Enterobacteriaceae alone, the containment strategy would prevent as many as 1,600 new infections in 3 years in a single state—a 76% reduction.

Health care practitioners can help by using contact precautions, asking patients about recent travel or health care, and communicating about status when patients are transferred.

According to the Centers for Disease Control and Prevention’s (CDC) study, 1 in 4 germ samples sent to the AR Lab Network for testing had special genes that allow them to spread their resistance to other germs. Further investigation in facilities with unusual resistance revealed that about 1 in 10 screening tests from patients without symptoms identified a hard-to-treat germ that spreads easily, meaning the germ could have spread undetected in that health care facility, the CDC said.

The CDC containment strategy includes continued infection control assessments until spread is stopped, which takes a coordinated response among facilities, labs, health departments, and CDC through the AR Lab Network. Health departments using the approach have conducted infection control assessments and colonization screenings within 48 hours of finding unusual resistance and have reported no further transmission during follow-up over several weeks. Estimates show that for carbapenem-resistant Enterobacteriaceae alone, the containment strategy would prevent as many as 1,600 new infections in 3 years in a single state—a 76% reduction.

Health care practitioners can help by using contact precautions, asking patients about recent travel or health care, and communicating about status when patients are transferred.

Photo from UAB Hospital

The US Food and Drug Administration (FDA) has approved an additional use for the cobas Zika test.

The approval allows for the streamlined screening of multiple individual blood or plasma donations that have been pooled together.

The cobas Zika test is a qualitative in vitro nucleic acid screening test for the direct detection of Zika virus RNA in plasma specimens from blood donors.

The test is used with the cobas 6800/8800 systems, which are fully automated, high-volume systems that perform sample pooling, sample preparation (nucleic acid extraction and purification), and polymerase chain reaction amplification and detection.

Automated data management is performed by the cobas 6800/8800 software, which assigns a test result of non-reactive, reactive, or invalid.

Roche deployed the cobas Zika test in April 2016 under the FDA’s investigational new drug application protocol to screen blood donations collected in Puerto Rico.

This initial testing protocol enabled the reinstatement of blood services in Puerto Rico after concerns over high rates of Zika infection posed a threat to the blood supply.

The cobas Zika test received commercial approval from the FDA in October 2017, enabling routine use of the test to support individual donor screening efforts throughout Puerto Rico and the continental US.

“More than 6 million blood donations from the United States and Puerto Rico have been screened with the cobas Zika test since its initial release under the investigational new drug application protocol in 2016 and subsequent commercial approval in 2017,” said Uwe Oberlaender, head of Roche Molecular Diagnostics.

Photo from UAB Hospital

The US Food and Drug Administration (FDA) has approved an additional use for the cobas Zika test.

The approval allows for the streamlined screening of multiple individual blood or plasma donations that have been pooled together.

The cobas Zika test is a qualitative in vitro nucleic acid screening test for the direct detection of Zika virus RNA in plasma specimens from blood donors.

The test is used with the cobas 6800/8800 systems, which are fully automated, high-volume systems that perform sample pooling, sample preparation (nucleic acid extraction and purification), and polymerase chain reaction amplification and detection.

Automated data management is performed by the cobas 6800/8800 software, which assigns a test result of non-reactive, reactive, or invalid.

Roche deployed the cobas Zika test in April 2016 under the FDA’s investigational new drug application protocol to screen blood donations collected in Puerto Rico.

This initial testing protocol enabled the reinstatement of blood services in Puerto Rico after concerns over high rates of Zika infection posed a threat to the blood supply.

The cobas Zika test received commercial approval from the FDA in October 2017, enabling routine use of the test to support individual donor screening efforts throughout Puerto Rico and the continental US.

“More than 6 million blood donations from the United States and Puerto Rico have been screened with the cobas Zika test since its initial release under the investigational new drug application protocol in 2016 and subsequent commercial approval in 2017,” said Uwe Oberlaender, head of Roche Molecular Diagnostics.

Photo from UAB Hospital

The US Food and Drug Administration (FDA) has approved an additional use for the cobas Zika test.

The approval allows for the streamlined screening of multiple individual blood or plasma donations that have been pooled together.

The cobas Zika test is a qualitative in vitro nucleic acid screening test for the direct detection of Zika virus RNA in plasma specimens from blood donors.

The test is used with the cobas 6800/8800 systems, which are fully automated, high-volume systems that perform sample pooling, sample preparation (nucleic acid extraction and purification), and polymerase chain reaction amplification and detection.

Automated data management is performed by the cobas 6800/8800 software, which assigns a test result of non-reactive, reactive, or invalid.

Roche deployed the cobas Zika test in April 2016 under the FDA’s investigational new drug application protocol to screen blood donations collected in Puerto Rico.

This initial testing protocol enabled the reinstatement of blood services in Puerto Rico after concerns over high rates of Zika infection posed a threat to the blood supply.

The cobas Zika test received commercial approval from the FDA in October 2017, enabling routine use of the test to support individual donor screening efforts throughout Puerto Rico and the continental US.

“More than 6 million blood donations from the United States and Puerto Rico have been screened with the cobas Zika test since its initial release under the investigational new drug application protocol in 2016 and subsequent commercial approval in 2017,” said Uwe Oberlaender, head of Roche Molecular Diagnostics.

Photo by Rhoda Baer

A new study suggests male investigators in the UK receive more funding for cancer research than their female counterparts.

Researchers analyzed funding for more than 4000 studies and found that male primary investigators (PIs) were consistently awarded more funding.

The total investment value was 3.6 times greater for male PIs than for female PIs.

The mean award value was 1.6 times greater, and the median award value was 1.3 times greater for males.

Rifat Atun, MBBS, of Harvard T. H. Chan School of Public Health in Boston, Massachusetts, and his colleagues reported these findings in BMJ Open.

The researchers analyzed data on public and philanthropic cancer research funding awarded to UK institutions between 2000 and 2013.

From this data, the team identified 4186 eligible studies with a total investment value of £2.33 billion.

The researchers compared the total investment, number of awards, and mean and median award value between male and female PIs.

Male PIs were awarded 2890 (69%) grants with a total value of £1.8 billion (78%), while female PIs were awarded 1296 (31%) grants with a total value of £0.5 billion (22%).

The median award value was £252,647 (interquartile range, £127,343–£553,560) for men and £198,485 (interquartile range, £99,317–£382,650) for women.

The mean award value was £630,324 (standard deviation, £1,662,559) for men and £394,730 (standard deviation, £666,574) for women.

Dr Atun and his colleagues acknowledged that this study was dependent on the accuracy of original investment data from the funding bodies, and the team could not openly access data of private sector research funding nor obtain disaggregated data from Cancer Research UK, one of the largest funders of cancer research.

The researchers also noted that the gender discrepancies they observed “are likely multifactorial,” and the team was unable to “postulate the underlying mechanisms responsible.” Still, the data do suggest a “substantial” imbalance, which should be investigated.

Photo by Rhoda Baer

A new study suggests male investigators in the UK receive more funding for cancer research than their female counterparts.

Researchers analyzed funding for more than 4000 studies and found that male primary investigators (PIs) were consistently awarded more funding.

The total investment value was 3.6 times greater for male PIs than for female PIs.

The mean award value was 1.6 times greater, and the median award value was 1.3 times greater for males.

Rifat Atun, MBBS, of Harvard T. H. Chan School of Public Health in Boston, Massachusetts, and his colleagues reported these findings in BMJ Open.

The researchers analyzed data on public and philanthropic cancer research funding awarded to UK institutions between 2000 and 2013.

From this data, the team identified 4186 eligible studies with a total investment value of £2.33 billion.

The researchers compared the total investment, number of awards, and mean and median award value between male and female PIs.

Male PIs were awarded 2890 (69%) grants with a total value of £1.8 billion (78%), while female PIs were awarded 1296 (31%) grants with a total value of £0.5 billion (22%).

The median award value was £252,647 (interquartile range, £127,343–£553,560) for men and £198,485 (interquartile range, £99,317–£382,650) for women.

The mean award value was £630,324 (standard deviation, £1,662,559) for men and £394,730 (standard deviation, £666,574) for women.

Dr Atun and his colleagues acknowledged that this study was dependent on the accuracy of original investment data from the funding bodies, and the team could not openly access data of private sector research funding nor obtain disaggregated data from Cancer Research UK, one of the largest funders of cancer research.

The researchers also noted that the gender discrepancies they observed “are likely multifactorial,” and the team was unable to “postulate the underlying mechanisms responsible.” Still, the data do suggest a “substantial” imbalance, which should be investigated.

Photo by Rhoda Baer

A new study suggests male investigators in the UK receive more funding for cancer research than their female counterparts.

Researchers analyzed funding for more than 4000 studies and found that male primary investigators (PIs) were consistently awarded more funding.

The total investment value was 3.6 times greater for male PIs than for female PIs.

The mean award value was 1.6 times greater, and the median award value was 1.3 times greater for males.

Rifat Atun, MBBS, of Harvard T. H. Chan School of Public Health in Boston, Massachusetts, and his colleagues reported these findings in BMJ Open.

The researchers analyzed data on public and philanthropic cancer research funding awarded to UK institutions between 2000 and 2013.

From this data, the team identified 4186 eligible studies with a total investment value of £2.33 billion.

The researchers compared the total investment, number of awards, and mean and median award value between male and female PIs.

Male PIs were awarded 2890 (69%) grants with a total value of £1.8 billion (78%), while female PIs were awarded 1296 (31%) grants with a total value of £0.5 billion (22%).

The median award value was £252,647 (interquartile range, £127,343–£553,560) for men and £198,485 (interquartile range, £99,317–£382,650) for women.

The mean award value was £630,324 (standard deviation, £1,662,559) for men and £394,730 (standard deviation, £666,574) for women.

Dr Atun and his colleagues acknowledged that this study was dependent on the accuracy of original investment data from the funding bodies, and the team could not openly access data of private sector research funding nor obtain disaggregated data from Cancer Research UK, one of the largest funders of cancer research.

The researchers also noted that the gender discrepancies they observed “are likely multifactorial,” and the team was unable to “postulate the underlying mechanisms responsible.” Still, the data do suggest a “substantial” imbalance, which should be investigated.