Closer Look
For cancer patients, measuring 'time toxicity' matters
Caroline Yang for STAT
At-home chemotherapy for her stage 4 pancreatic cancer sounded like a good idea to Jeannette Cleland, above. But when she added up the days she'd spend waiting for nurses and supplies to come to her Minneapolis home, she decided infusions at her hospital would be more convenient. That's a calculus few health care providers make, STAT contributor Charlotte Huff reports, but in the last few years, some researchers have proposed measuring something they call "time toxicity."
Besides not making patients feel like they come last, there's another compelling reason. Helping patients estimate how much time treatment will take could better frame difficult conversations about different options, particularly as the end of life nears. "Taking up another good day to just be around my house and waiting for the person to come to draw my labs or drop off stuff at my house just sounded horrible," Cleland said. Read more.
research Scheduling childbirth might prevent preeclampsia, study suggests
Preeclampsia — dangerously high blood pressure during pregnancy — is a leading cause of maternal death and a contributor to heart health problems in those who survive. Screening for risk factors early in pregnancy and taking aspirin can help prevent the condition before preterm birth, but there is no treatment for preeclampsia before a full-term birth. More than half of cases occur in the last five weeks of pregnancy.
Today's study in Hypertension says planned labor induction and cesarean delivery could significantly reduce the risk of preeclampsia in births at or after 37 weeks. To reach their conclusion, researchers performed a modeling analysis based on 10 years of health records at two U.K. hospitals. "Risk-stratified timing of birth at term is likely to more than halve the risk of term preeclampsia," they concluded. "A randomized trial is needed to evaluate the effectiveness and perinatal safety of this intervention."
health
Opinion: Always offer genetic testing to children with neurodevelopmental differences
When pediatrician Deborah Ondrasik saw the MRI results showing brain abnormalities for her 10-month-old daughter, she crumpled to the ground. Gabrielle was later diagnosed with epilepsy, global developmental delays, and autism spectrum disorder. But the story didn't end there, as Ondrasik and her husband, also a physician, pursued whole genome sequencing.
They learned a mutation on Gabrielle's CACNA1A gene was causing her neurodevelopmental differences, giving them not just an explanation, but also connection with other families and better care, treatment, and hope for research opportunities. "As a board-certified pediatrician and the mother of a child with a rare disease, I believe the medical system is failing the rare disease community by vastly underdiagnosing genetic disorders," Ondrasik writes in a STAT First Opinion. "Gabrielle's genetic diagnosis changed everything for our family." Read more.
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