Childhood and Adolescent Pesticide Exposure and Breast Cancer Risk

To date, epidemiological studies have not strongly supported an association between pesticide exposure and breast cancer. However, few previous studies had the ability to assess specific time periods of exposure. Studies that relied on adult serum levels of metabolites of organochlorine pesticides may not accurately reflect exposure during developmental periods. Further, exposure assessment often occurred after diagnosis and key tumor characteristics, such as hormone receptor status, have rarely been available to evaluate tumor-subtype specific associations. We examine the association between pesticide exposure during childhood and adolescence and breast cancer risk in the prospective Sister Study cohort (N=50,844 women) to assess this relation by tumor subtype

Antimüllerian hormone in relation to tobacco and marijuana use and sources of indoor heating/cooking

To evaluate exposure to tobacco, marijuana and indoor heating/cooking sources in relation to anti-Müllerian hormone (AMH) levels

Validity of self-reported breast cancer characteristics in a nationwide cohort of women with a family history of breast cancer

Abstract Background Women may have incomplete understanding of a breast cancer diagnosis, leading to inaccurate reporting in epidemiological studies. However, it is not feasible to obtain consent for medical records from all women participating in a study. Therefore, it is important to determine how well self-reported breast cancer characteristics correspond with what is found in medical records, but few studies have evaluated agreement of self-reported breast cancer characteristics with abstracted medical records. Methods We calculated the positive predictive value (PPV) of self-reports compared to medical records and explored whether participant characteristics may have influenced reporting accuracy. We analyzed data from 2518 reported breast cancer cases from the Sister Study, a large nationwide cohort of women with a family history of breast cancer. Results Medical records or pathology reports were obtained for 2066 of 2518 (82%) women who reported incident breast cancer. Breast cancer was confirmed for over 99% (n = 2054) of women with medical records. Confirmation rates were high for invasive, ductal, hormone receptor positive, and HER2 negative breast cancers, with little variation by race/ethnicity or age. Self-reported in situ breast cancer had a lower PPV (64.2%), with medical records showing invasive breast cancer instead, especially for older and Hispanic women. Hormone receptor (ER and PR) negative and HER2 positive self-reports had lower PPVs (83.0%, 71.6%, and 66.1% respectively). Hispanic women and women ages 65 or older at diagnosis were less able to accurately report breast cancer stage, excluding stage I. Conclusions Accuracy of reporting overall breast cancer and common subtypes is high. Despite having a family history of breast cancer and voluntarily enrolling in a study evaluating breast cancer risk factors, participants may have greater difficulty distinguishing between in situ and invasive breast cancer and may less accurately report other less common subtypes. Discrepancies may reflect women’s poor understanding of information conveyed by health care providers or lack of consistent terminology used to describe subtypes

Response to anti-IL17 therapy in inflammatory disease is not strongly impacted by genetic background

Response to the anti-IL17 monoclonal antibody secukinumab is heterogeneous, and not all participants respond to treatment. Understanding whether this heterogeneity is driven by genetic variation is a key aim of pharmacogenetics and could influence precision medicine approaches in inflammatory diseases. Using changes in disease activity scores across 5,218 genotyped individuals from 19 clinical trials across four indications (psoriatic arthritis, psoriasis, ankylosing spondylitis, and rheumatoid arthritis), we tested whether genetics predicted response to secukinumab. We did not find any evidence of association between treatment response and common variants, imputed HLA alleles, polygenic risk scores of disease susceptibility, or cross-disease components of shared genetic risk. This suggests that anti-IL17 therapy is equally effective regardless of an individual’s genetic background, a finding that has important implications for future genetic studies of biological therapy response in inflammatory diseases

Loperamide-Associated Opioid Use Disorder and Proposal of an Alternative Treatment with Buprenorphine.

: This case report describes a patient with opioid use disorder who developed cardiac toxicity secondary to non-medical use of loperamide. At recommended doses, loperamide remains in the periphery to treat diarrhea. At high doses, loperamide causes central nervous system (CNS) opioid agonism. Complications of high-dose loperamide have been documented, including cardiotoxicity, and death. This is particularly important in light of the ongoing opioid epidemic. This case presents a patient with sequela of high-dose loperamide as an illicit opioid replacement and the subsequent loperamide toxicity, including significant QTc prolongation. Abrupt cessation of his high-dose loperamide use resulted in opioid withdrawal symptoms, which were treated with buprenorphine. Buprenorphine was selected to avoid possible worsening of QTc secondary to an additional medication, such as methadone. To our knowledge, this is the first description of the use of buprenorphine for treatment of loperamide-associated opioid use disorder. Non-medical use of loperamide requires increased recognition by the health care community, including both physicians and pharmacists, because it can result in marked and life-threatening toxicity

Validity of self-reported breast cancer characteristics in a nationwide cohort of women with a family history of breast cancer

Abstract Background Women may have incomplete understanding of a breast cancer diagnosis, leading to inaccurate reporting in epidemiological studies. However, it is not feasible to obtain consent for medical records from all women participating in a study. Therefore, it is important to determine how well self-reported breast cancer characteristics correspond with what is found in medical records, but few studies have evaluated agreement of self-reported breast cancer characteristics with abstracted medical records. Methods We calculated the positive predictive value (PPV) of self-reports compared to medical records and explored whether participant characteristics may have influenced reporting accuracy. We analyzed data from 2518 reported breast cancer cases from the Sister Study, a large nationwide cohort of women with a family history of breast cancer. Results Medical records or pathology reports were obtained for 2066 of 2518 (82%) women who reported incident breast cancer. Breast cancer was confirmed for over 99% (n = 2054) of women with medical records. Confirmation rates were high for invasive, ductal, hormone receptor positive, and HER2 negative breast cancers, with little variation by race/ethnicity or age. Self-reported in situ breast cancer had a lower PPV (64.2%), with medical records showing invasive breast cancer instead, especially for older and Hispanic women. Hormone receptor (ER and PR) negative and HER2 positive self-reports had lower PPVs (83.0%, 71.6%, and 66.1% respectively). Hispanic women and women ages 65 or older at diagnosis were less able to accurately report breast cancer stage, excluding stage I. Conclusions Accuracy of reporting overall breast cancer and common subtypes is high. Despite having a family history of breast cancer and voluntarily enrolling in a study evaluating breast cancer risk factors, participants may have greater difficulty distinguishing between in situ and invasive breast cancer and may less accurately report other less common subtypes. Discrepancies may reflect women’s poor understanding of information conveyed by health care providers or lack of consistent terminology used to describe subtypes

Engagement Measures in Maltreatment Prevention Studies: A Scoping Review

Engagement Measures in Maltreatment Prevention Studies: A Scoping Review Authors Deborah Moon1 C. Bailey Nichols1 Aimee Sgourakis2 Amanda Cruce1 Yiran Zhang3 Hanna Haran3 Michelle Johnson-Motoyama3 1) University of Pittsburgh, School of Social Work 2) University of Pittsburgh, University Library System 3) Ohio State University, College of Social Work Objective: The objective of this scoping review is to investigate how family engagement is operationalized and measured in the studies of the interventions designed to prevent maltreatment and/or promote positive parenting. Introduction: The child welfare system is making an important shift toward prevention. It is crucial to understand how to engage potential beneficiaries in timely services to maximize the benefits of the transition. Family engagement is a complex and multidimensional construct with varied definitions and inconsistent emphasis on specific domains. The first step toward developing effective engagement strategies should begin with the effort to better operationalize and measure the construct. Previous reviews of engagement measures focus on those engaged in psychotherapy (Tetley et al., 2011) and families with identified needs such as those with issues related to mental health (Haine-Schlagel & Walsh, 2015) or substance use (Hock et al., 2015). A comprehensive overview of the existing measures of family engagement will point to areas which need further development and thereby contribute to the knowledge of engagement in maltreatment prevention research. Inclusion criteria: This study will examine quantitative and mixed methods studies in which multiple dimensions of family (parent) engagement are measured, including behavioural (i.e., attendance, dosage, service completion, etc.), attitudinal (cognitive and emotional) or relational engagement in interventions designed to prevent child maltreatment and/or promote positive parenting among parents within the United States. Studies focusing on interventions that target parents who are currently involved with the child welfare system due to maltreatment issues will be excluded. Qualitative or conceptual studies will be excluded. Additionally, studies which primarily target health, mental health, substance abuse, or other psychosocial outcomes without a focus on maltreatment prevention or positive parenting will be excluded. Methods: This review will include studies selected from Pubmed, CINAHL, ERIC, PsychInfo, Social Work Abstracts, Academic Search Premier, and Web of Science. We will include studies published in English after the year 2000. Google Scholar was used to identify an initial sample of studies to be included in the review. We will also conduct a backward search of all included articles to search for additional articles. Search results will be imported into Pico Portal software for screening. Two authors will screen titles and abstracts prior to a full text screen. Interrater reliability will be calculated throughout the screening process. After the full text screen, data from each study will be extracted by two reviewers and included in an Excel spreadsheet and any differences between reviewers will be resolved. A summary chart of extracted information will be included in the final manuscript alongside discussion of the findings. Review Question: How is family engagement operationalized and measured in studies of maltreatment prevention and/or positive parenting interventions?   Keywords: engagement, maltreatment, parenting, participation, prevention Start Date: February 1, 2022 Anticipated Completion Date: July 31, 202