Open Reading Frame: cardiac biomarkers in COPD, testosterone therapy & DNR orders

Posted by Biome on 31st January 2014 - 0 Comments


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.

 

Markers of comorbidity in COPD patients
Patients with chronic obstructive pulmonary disease (COPD) suffer from a number of comorbidities, including cardiovascular disease (CVD), which is more prevalent in COPD patients compared with the general population. It is important to identify COPD patients at risk of myocardial infarction and other heart conditions early, so that monitoring and interventions can be targeted to high risk patients. Now, a study has been carried out to assess levels of high sensitivity cardiac troponin T (hs-cTnT), a biomarker of heart disorders, in patients with acute exacerbation COPD. The authors found that when compared with rise/fall patterns of hs-cTnT, which are indicative of myocardial infarction, stable elevated hs-cTnT levels are associated with poor long-term prognosis in these patients. These results indicate that other comorbidities, which could be identified by stable elevated hs-cTnT levels, could be linked to poor prognosis in acute exacerbation COPD patients, and it is important to search for these underlying conditions.
Høiseth et al. Open Heart

 

Assessing the risk:benefit ratio of testosterone therapy
Testosterone therapy is widely used to treat men with hypogonadism, and there have been marketing campaigns to promote testosterone supplementation in those with low levels of the hormone. However, a number of recent studies have identified adverse events associated with testosterone supplementation. Ranjith Ramasamy and colleagues discuss the potential risks of testosterone therapy in a correspondence article, highlighting that in one study, men receiving testosterone had an elevated risk of atherosclerotic events compared with those not taking the supplement. The authors conclude that recent studies have provided conflicting results about the risks associated with testosterone therapy, and until larger randomized studies have been carried out, physicians should remain cautious about prescribing testosterone.
Ramasamy et al. F1000 Research

 

Thiamine supplementation: a promising strategy to prevent complications in type 2 diabetes
Thiamine (vitamin B1) deficiency is prevalent in people with diabetes, and may be linked to complications such as dyslipidemia and cardiovascular disease. Correcting thiamine deficiency in these patients could therefore be beneficial, and a study has been carried out in which patients with type 2 diabetes were given daily thiamine supplementation. After six months, improvements were observed in lipid profile and creatinine levels, suggesting beneficial effects on cardiovascular and kidney health. These findings require validation in a cohort with longer follow-up, but suggest that oral thiamine supplementation could help prevent complications in patients with type 2 diabetes.
Al-Attas et al. Clinical Medicine Insights: Endocrinology and Diabetes

 

Gender differences in migraine: EEG insights
Migraine has gender-specific incidence, affecting twice as many women as men in China. It is thought that hormones could play a role in this difference, but very little is known about the underlying mechanisms. Now, a study carried out in China has revealed differences in electroencephalography (EEG) recordings between male and female migraine sufferers, which are indicative of distinct cognitive functioning. These findings provide further evidence for gender differences in migraine, and emphasize the importance of considering gender when researching cognitive function in migraine patients.
Wang et al. The Journal of Headache and Pain

 

Pre-term birth increases asthma risk
Premature babies – those born before 37 weeks of pregnancy – may have more health problems than those born later, and are at increased risk of early complications such as respiratory distress syndrome. In a systematic review and meta-analysis, researchers analyzed the link between preterm birth and wheezing disorders in children. The authors found that the risk of asthma was 1.71 times higher in those born preterm compared with those born at term, and this risk increased with more severe prematurity. These findings highlight the need to elucidate the mechanisms linking preterm birth and asthma, so that prevention and therapeutic strategies can be developed.
Been et al. PLOS Medicine

 

DNR orders associated with poor outcome in surgery
Advance directives, including do-not-resuscitate (DNR) orders, are often active in patients with multiple conditions, and there is a great deal of controversy surrounding DNR in those undergoing surgical procedures. In an analysis of hospital discharge records, DNR status was found to be associated with worse outcome in cardiothoracic surgery, even when controlling for confounding factors such as age and comorbid disease. The authors conclude that DNR status could be a marker of perioperative risk, and should be taken into account when considering the risks and benefits of surgery in clincial decision making.
Maxwell et al. PeerJ

 

Written by Claire Barnard, Senior Editor for BMC Medicine.