Wednesday, September 01, 2021

Antibiotics increase the risk of colon cancer


Peer-Reviewed Publication

UMEA UNIVERSITY

Sophia Harlid 

IMAGE: SOPHIA HARLID, RESEARCHER AT DEPARTMENT OF RADIATION SCIENCES, UMEÅ UNIVERSITY, SWEDEN. view more 

CREDIT: MATTIAS PETTERSSON.

There is a clear link between taking antibiotics and an increased risk of developing colon cancer within the next five to ten years. This has been confirmed by researchers at Umeå University, Sweden, after a study of 40,000 cancer cases. The impact of antibiotics on the intestinal microbiome is thought to lie behind the increased risk of cancer.

“The results underline the fact that there are many reasons to be restrictive with antibiotics. While in many cases antibiotic therapy is necessary and saves lives, in the event of less serious ailments that can be expected to heal anyway, caution should be exercised. Above all to prevent bacteria from developing resistance but, as this study shows, also because antibiotics may increase the risk of future colon cancer,” explains Sophia Harlid, cancer researcher at Umeå University.

Researchers found that both women and men who took antibiotics for over six months ran a 17 per cent greater risk of developing cancer in the ascending colon, the first part of the colon to be reached by food after the small intestine, than those who were not prescribed any antibiotics. However, no increased risk was found for cancer in the descending colon. Nor was there an increased risk of rectal cancer in men taking antibiotics, while women taking antibiotics had a slightly reduced incidence of rectal cancer.

The increased risk of colon cancer was visible already five to ten years after taking antibiotics. Although the increase in risk was greatest for those taking most antibiotics, it was also possible to observe an admittedly small, but statistically significant, increase in the risk of cancer after a single course of antibiotics.

The present study uses data on 40,000 patients from the Swedish Colorectal Cancer Registry from the period 2010–2016. These have been compared to a matched control group of 200,000 cancer-free individuals drawn from the Swedish population at large. Data on the individuals’ antibiotic use was collected from the Swedish Prescribed Drug Register for the period 2005–2016. The Swedish study broadly confirms the results of an earlier, somewhat smaller British study.

In order to understand how antibiotics increase the risk, the researchers also studied a non-antibiotic bactericidal drug used against urinary infections that does not affect the microbiome. There was no difference in the frequency of colon cancer in those who used this drug, suggesting that it is the impact of antibiotics on the microbiome that increases the risk of cancer. While the study only covers orally administered antibiotics, even intravenous antibiotics may affect the gut microbiota in the intestinal system.

“There is absolutely no cause for alarm simply because you have taken antibiotics. The increase in risk is moderate and the affect on the absolute risk to the individual is fairly small. Sweden is also in the process of introducing routine screening for colorectal cancer. Like any other screening programme, it is important to take part so that any cancer can be detected early or even prevented, as cancer precursors can sometimes be removed,” says Sophia Harlid. 

New research in American Journal of Psychiatry identifies risk factors for suicide attempt among soldiers


Peer-Reviewed Publication

AMERICAN PSYCHIATRIC ASSOCIATION

New research in the American Journal of Psychiatry identifies factors that may help assess suicide risk in soldiers. According to the study, Predictors of Suicide Attempt Within 30 Days After First Medically Documented Suicidal Ideation in U.S. Army Soldiers, suicide risk was highest within 30 days after ideation diagnosis and was more likely among women and combat medics.   

“This Suicide Prevention Month, it’s important to remember that research can help us better understand risk factors and which populations are more vulnerable,” said APA President Vivian Pender, M.D.  “It is also a reminder that we can all play a role in preventing suicide by learning to recognize signs of distress and reaching out to connect anyone at risk with help.”

The authors examined risk factors for suicide attempt within the first month after a diagnosis of suicidal ideation, looking at sociodemographic and service-related characteristics, psychiatric diagnoses, physical health care visits, injuries, and others. Using data from the Army Study to Assess Risk and Resilience in Servicemembers, the researchers reviewed records from more than 11,000 active duty enlisted soldiers with documented suicidal ideation and no prior documented suicide attempts.

About half (52.7%) of the solders identified with suicide ideation were in their first two years of service and 57.7% had never deployed. About 80% had had at least one outpatient visit in the previous two months. The most common psychiatric diagnoses were depression and related disorders, tobacco use disorder, anxiety disorder and adjustment disorder.  
 

In the study, 7.4% soldiers with suicidal ideation subsequently attempted suicide. Almost half of the attempts, 3.5%, occurred within 30 days after suicidal ideation. The risk for suicide attempt was highest on the first day after suicidal ideation diagnosis and decreased over time.

 

The study found that females, combat medics, individuals with an anxiety disorder diagnosis prior to suicidal ideation, and those diagnosed with a sleep disorder on the same day as the suicidal ideation were more likely to attempt suicide within 30 days.

"Identifying suicide risk in the population, in patients in primary care, and in patients in psychiatric care who frequently have suicide ideation, are all challenging and different questions,” said Robert J. Ursano, M.D., one of the study authors and Director, Center for the Study of Traumatic Stress, Uniformed Services University. “This paper importantly speaks to psychiatrists and other mental health care providers who have to make difficult treatment and management decisions for those specifically struggling with suicide ideation."

While depression-related diagnoses were common among the soldiers with suicide ideation, they were not associated with an increased risk of suicide attempt during the first month. Major depression was diagnosed in 24% of soldiers with suicide ideation and depression-related diagnoses (such as dysthymic disorder and adjustment disorder with depressed mood) were diagnosed in nearly 60% of soldiers on the same day suicide ideation was diagnosed. A diagnosis of posttraumatic stress disorder was also not associated with an increased risk of suicide attempt within 30 days. 

 

     National Suicide Prevention Lifeline                   Crisis Textline
     800-273-8255 or Chat with Lifeline                    Text TALK to 741741                             


More information

See also two recent articles on suicide risk published in the APA journal Psychiatric Services:

More information is available in curated collections of Psychiatric Services articles on:


American Psychiatric Association
The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with 37,400 physician members specializing in the diagnosis, treatment, prevention and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information, please visit www.psychiatry.org.

Study reveals confusing mishmash of newborn bathing practices at US hospitals


Peer-Reviewed Publication

UNIVERSITY OF VIRGINIA HEALTH SYSTEM

Study reveals confusing mishmash of newborn bathing practices at U.S. hospitals 

IMAGE: "THE VARIATION IN WHAT HOSPITALS ARE DOING FOR NEWBORN SKINCARE IS A DIRECT RESULT OF PREVIOUSLY NOT HAVING A GOOD UNDERSTANDING OF WHAT REALLY IS THE BEST WAY TO CARE FOR A BABY'S SKIN," SAID RESEARCHER ANN L. KELLAMS, MD, OF UVA CHILDREN'S. "THE HOPE NOW IS THAT THIS WORK WILL CHALLENGE US ALL TO TAKE A LOOK AT THE EVIDENCE AND INCORPORATE PRACTICES THAT PROTECT BABIES THE MOST." view more 

CREDIT: DAN ADDISON | UVA COMMUNICATIONS

A nationwide survey of hospitals has revealed a wide variety of approaches to newborn skincare – including the timing of the first bath – that could ultimately have lasting effects on a baby’s health and wellbeing.

Believed to be the first of its kind, the survey sought to document newborn skincare practices at hospitals around the country. Doctors have increasingly come to appreciate the importance of infant exposure to natural skin microbes, but there are no clear evidence-based guidelines for hospitals to follow.

The result, the researchers found, is a mishmash of practices that sometimes break down along regional lines.

“The variation in what hospitals are doing for newborn skincare is a direct result of previously not having a good understanding of what really is the best way to care for a baby’s skin,” said researcher Ann L. Kellams, MD, of UVA Children’s. “The hope now is that this work will challenge us all to take a look at the evidence and incorporate practices that protect babies the most.”

Newborn Skincare: What’s Best for Baby?

The skincare babies receive in the hours and days after birth has long-term effects, shaping breastfeeding outcomes, infant skin health and even infection rates. For example, children who are birthed vaginally are known to have decreased rates of childhood allergies compared with those born by caesarian section.

That said, there is little hard evidence on health outcomes associated with delayed bathing and other newborn skin practices, such as the use of specific soaps and cleansers. That often leaves doctors with conflicting opinions, often built on anecdote and personal experience.

To get a sense of the practices in place around the country, the researchers sent 16 questions to nursery medical directors at 109 hospitals that are members of the Better Outcomes through Research for Newborns (BORN) network. The questions asked about bathing practices, the products used and the advice given to parents, among other topics.

The responses indicated:

  • 87% of hospitals delay the first bath by at least six hours. 
  • 10% send babies home without a bath, a practice more common in non-academic centers and on the West Coast. 
  • There is a huge variety of products and procedures used, though almost all include a “baby” soap containing detergents known to compromise the newborn’s skin integrity.
  • Bathing advice for parents, such as whether they should use soap when washing the baby, is “inconsistent and potentially contradictory” among healthcare providers. This can leave parents confused and uncertain what to do.

The evidence underpinning most hospitals’ skincare practices is “scant,” the researchers report in a new scientific paper outlining their findings. They are urging the formulation of more consistent guidelines built on hard evidence.

“Given the potential widespread clinical impact of newborn skincare and the paucity of data to support or refute widespread adoption of specific practices, further research is needed to improve and standardize care in U.S. nurseries and mother-baby units,” they state. 

COVID-19 guidelines may also be needed, they note. “Based on one large case series of maternal hospitals in New York City showing no increased morbidity to newborns, authors recommend that early skin-to-skin contact and delayed bathing can be practiced even in newborns born to mothers infected with COVID-19,” the researchers write.

Developing better, evidence-based guidelines in general would benefit all parents and infants, Kellams says. “In the future, we may be seeing a decreased emphasis on soap, an increased emphasis on oil-based cleansing and an increased emphasis on the application of emollients,” she said. “Better skin integrity would offer more protection to the babies against infection, development of allergies, etcetera.”

###

Findings Published

The researchers have published their findings in the scientific journal Hospital Pediatrics. The research team consisted of Julia A. Wisniewski, Carrie A. Phillipi, Neera Goyal, Anna Smith, Alice E.W. Hoyt, Elizabeth King, Dennis West, W. Christopher Golden and Kellams. The authors thank the members of the BORN network for their participation in the study.

To keep up with the latest medical research news from UVA, subscribe to the Making of Medicine blog at https://makingofmedicine.virginia.edu.

 

People look alike if we think they have similar personalities, new study finds


Research shows how knowledge of an individual’s personality can affect facial recognition


Peer-Reviewed Publication

NEW YORK UNIVERSITY

Perceptual Similarity: Justin Bieber and Vladimir Putin 

IMAGE: KNOWLEDGE OF A PERSON’S PERSONALITY CAN WARP THE PERCEPTION OF A FACE’S IDENTITY AND BIAS IT TOWARD ALTERNATE IDENTITIES THAT ARE OSTENSIBLY UNRELATED. FOR EXAMPLE, IF VLADIMIR PUTIN AND JUSTIN BIEBER (ABOVE) HAVE MORE SIMILAR PERSONALITIES IN YOUR MIND, THEN THEY VISUALLY APPEAR MORE SIMILAR TO YOU AS WELL--AS SHOWN IN THE IMAGE. view more 

CREDIT: IMAGE COURTESY OF NYU’S JONATHAN FREEMAN

Do Vladimir Putin and Justin Bieber look alike? They do if you think they have similar personalities, shows a new study by a team of psychologists. 

Its findings, which appear in the journal Cognition, reveal that knowledge of a person’s personality can influence the perception of a face’s identity and bias it toward unrelated identities. For example, if Vladimir Putin and Justin Bieber, a pair of faces among many tested in the research, have more similar personalities in your mind, then they visually appear more similar to you as well, even if they lack any physical resemblance. 

“Our face is another’s portal into our thoughts, feelings, and intentions,” explains Jonathan Freeman, an associate professor in New York University’s Department of Psychology and the paper’s senior author. “If the perception of others’ faces is systematically warped by our prior understanding of their personality, as our findings show, it could affect the ways we behave and interact with them.”

The paper’s other authors were DongWon Oh, a postdoctoral researcher in NYU’s Department of Psychology, and Mirella Walker, a researcher at the University of Basel.

The authors add that the research informs fundamental scientific understanding of how face recognition works in the brain, suggesting that not only a face’s visual cues but also prior social knowledge plays an active role in perceiving faces.

Face recognition is essential to everyday life--in identifying a neighbor at the supermarket, an actor in a film trailer, or a relative in a photograph. And, in recent years, it has been applied to technologies, ranging from the Apple iPhone to extensive counterterrorism and law enforcement applications--with many raising concerns over accuracy. 

The Association for Computing Machinery called for a suspension of both private and government use of facial-recognition technology, citing “clear bias based on ethnic, racial, gender, and other human characteristics,” Nature reported last year.

To better understand how our own perceptions--and biases--might influence how we recognize faces, the researchers conducted a series of experiments centering on perceptions of well-known individuals--Bieber, Putin, John Travolta, George W. Bush, and Ryan Gosling, among others (Note: White males were selected in order to establish a racial and gender baseline across tested faces). Racially and ethnically diverse male and female participants were drawn from “Mechanical Turk” (MTurk), a tool in which individuals are compensated for completing small tasks; it is frequently used in running behavioral science studies. 

Overall, they found that when a participant believed any two individuals were more similar in personality, their faces were perceived to be correspondingly more similar. 

To provide causal evidence, the researchers determined if the effect held for individuals they had never encountered before. The participants viewed images of other White males whom they reported no familiarity with. If the participants learned that these individuals’ personalities were similar (as opposed to dissimilar), their faces were perceived as more visually similar, too. 

The researchers used several techniques to assess how faces were perceived at a less conscious level. Subjects’ responses were measured with an innovative mouse-tracking software Freeman previously developed; it uses individuals’ hand movements to reveal unconscious cognitive processes. Unlike surveys or ratings, in which test subjects can consciously alter their responses, this technique requires subjects to make split-second decisions, thereby uncovering less conscious tendencies through subtle deflections in their hand-motion trajectory as they move a mouse during experiments. They also used a technique known as reverse correlation, which allowed the researchers to generate face images depicting how participants perceived others “in the mind’s eye.” 

“Our findings show that the perception of facial identity is driven not only by facial features, such as the eyes and chin, but also distorted by the social knowledge we have learned about others, biasing it toward alternate identities despite the fact that those identities lack any physical resemblance,” observes Freeman.

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The study was supported by a grant from the National Science Foundation (BCS-1654731).