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Tuesday, December 09, 2014
Eczema Cases Rising Among U.S. Children: Report
Eczema is a chronic condition that usually starts in childhood, and causes patches of skin to become dry, inflamed and often intensely itchy.
And, studies have shown, eczema seems to be on the rise.
Based on a household survey by the U.S. Centers for Disease Control and Prevention, the prevalence of eczema among kids younger than 18 rose between 2000 and 2010: from around 9 percent to 17 percent among black children; from 5 percent to 10 percent among Hispanic kids; and from around 8 percent to almost 13 percent among white children.
"We don't know for certain why that is," said Dr. Anna Bruckner, one of the authors of the American Academy of Pediatrics (AAP) report.
Greater awareness of eczema and higher rates of diagnosis are likely part of it, according to Bruckner, who directs pediatric dermatology at Children's Hospital Colorado.
"But the incidence of the [eczema] is probably increasing, too," she said.
The AAP detailed the best ways to manage atopic dermatitis, more commonly known as eczema, in a report released online Nov. 24 in the journal Pediatrics.
The treatments described in the AAP report are not new, Bruckner said. But since so many kids have eczema -- and there are so few pediatric dermatologists -- all pediatricians need to be up to speed on the skin condition, according to Bruckner.
A pediatric dermatologist who reviewed the report agreed. "Pediatricians really need to understand this condition, and how to manage it," said Dr. Ana Duarte, director of pediatric dermatology at Miami Children's Hospital.
For most children with eczema, topical treatments and careful skin care are enough to control the condition, according to Bruckner.
Topical steroids are the mainstay for treating inflammation. Low-potency products, like hydrocortisone, usually work well -- but parents often hesitate to use them, Bruckner noted.
"There are a lot of misconceptions about the safety of [topical steroids]," she said. Oral or high-potency topical steroids can cause side effects like thinning of the skin, or even growth retardation, Bruckner pointed out -- but the milder products needed for most cases of eczema are safe.
View the original article here
Early Trial Promising for Ebola Vaccine
The success of the phase I clinical trial for the vaccine paves the way for field-testing it in the Ebola-stricken West African nations of Liberia and Sierra Leone as early as January, said Dr. Anthony Fauci, director of the NIH's National Institute of Allergy and Infectious Diseases.
The genetically engineered vaccine caused no major side effects in 20 healthy adults who received a dose in September at the NIH Clinical Center in Bethesda, Md., the researchers report in the Nov. 26 issue of the New England Journal of Medicine.
The vaccine also created an immune system response in humans very similar to that of monkeys who, once inoculated, survived lab tests that exposed them to potentially fatal doses of Ebola, Fauci said.
"All in all, one can say this is a successful vaccine, from the standpoint of phase I," Fauci said. "Now the critical question is, will it work?"
Ebola has killed more than 5,450 people during the West African epidemic, according to the World Health Organization. In response, international efforts to develop a preventive vaccine have accelerated.
The current vaccine, developed by the Institute of Allergy and Infectious Diseases and GlaxoSmithKline, is based on a virus called chimpanzee-derived adenovirus, which causes a common cold in chimps but has no effect on humans.
Researchers have spliced portions of Ebola's genetic material into the chimp virus, to trick the immune system into creating Ebola-attacking antibodies without exposing the body to the virus itself.
The clinical trial enrolled volunteers aged 18 to 50. Ten volunteers received a low-dose injection of the vaccine, while another 10 received the same vaccine at a higher dose.
Within a day of vaccination, two people who got the higher dose developed a fever, which was "short-lived and easily handled," Fauci said.
View the original article here
Early Puberty Linked to Increased Risk of Depression in Teens
Early puberty was linked with a number of factors associated with depression, such as poor self-image and high anxiety levels, according to the researchers. Early puberty was also linked to social problems, such as conflict with family and peers, and having friends who were prone to getting into trouble, the study found.
Although the study found an association between early puberty and these factors, it's important to note that the study wasn't designed to show that early puberty was the cause of these issues.
"Only some teens are vulnerable to the effects of early maturation, particularly those with more disruption in their families and less support in their peer relationships," study leader Karen Rudolph, a psychology professor at the University of Illinois, said in a university news release.
The study also found that early puberty was associated with an increased risk of depression in boys as well as girls.
"It is often believed that going through puberty earlier than peers only contributes to depression in girls," Rudolph said. "We found that early maturation can also be a risk for boys as they progress through adolescence, but the timing is different than in girls," she added.
"In girls, early maturation seems to trigger immediate psychological and environmental risks and consequent depression," Rudolph said. "Pubertal changes cause early maturing girls to feel badly about themselves, cope less effectively with social problems, affiliate with deviant peers, enter riskier and more stressful social contexts and experience disruption and conflict within their relationships."
Initially, boys who entered puberty early had much lower rates of depression than girls, but had similar rates by the end of the study's fourth year.
"While early maturation seemed to protect boys from the challenges of puberty initially, boys experienced an emerging cascade of personal and contextual risks -- negative self-image, anxiety, social problems and interpersonal stress -- that eventuated in depression as they moved through adolescence," Rudolph said.
The study followed 160 youth for four years. It was published online in the journal Development and Psychopathology.
View the original article here
Dairy and Diabetes Risk: New Thinking?
Although experts say it’s too soon to draw clear conclusions, the findings seem to run counter to current advice to people with diabetes, who are generally told to pick low- or non-fat dairy products.
Recent studies on how dairy products might lower diabetes risk don't all reach the same verdict. Nor do they agree about exactly which types of dairy and which fat contents are best.
Some studies have found that yogurt has a strong effect on cutting diabetes risk, but not other dairy products.
What's clear is that dairy products benefit more than our bones, says Michael Tunick, PhD. He's a research chemist at the Agricultural Research Service at the U.S. Department of Agriculture.
He reviewed recent research on dairy goods and health in a report published in November in the Journal of Agricultural and Food Chemistry. Besides preventing diabetes, lowering blood pressure, and reducing heart disease risk, he found research showing dairy products can even prevent tooth decay, obesity, and cancer.
''Diabetes prevention may be an added benefit that is unexpected," he says.
Last year, researchers pooled the results of 17 different studies that had looked at dairy foods and type 2 diabetes. Those who ate dairy products, including low-fat dairy and cheese, had a lower diabetes risk than those who did not.
More recently, Harvard researchers looked at the diet habits of more than 289,000 health professionals, including nurses and doctors. They also checked the results of 14 published studies looking at dairy and diabetes risk.
In this research, yogurt emerged as the star. While other types of dairy were not linked with a substantial drop in diabetes risk, yogurt was. The study didn't focus on one particular type of yogurt, beyond “plain” or “flavored.”
Eating a serving a day of yogurt lowered diabetes risk by about 19%, the researchers reported in November in BMC Medicine.
In another recent study, Swedish researchers looked separately at low-fat and high-fat dairy. They reported that men and women who ate eight or more servings of high-fat dairy products daily had a 23% lower risk of getting type 2 diabetes, compared to those who had one or less serving daily.
They found no link with low-fat dairy and diabetes, a finding that some experts say warrants more study.
View the original article here
Daily Statin Might Raise Your Risk for Cataracts: Study
While statins such as Zocor, Crestor and Lipitor protect many people from heart attack and stroke, they may raise the odds of developing the vision problem by 27 percent, the researchers report.
But the risk of developing cataracts -- a clouding of the lens of the eye -- is insignificant compared with the benefits of these drugs, said lead researcher Dr. G.B. John Mancini.
"The benefits of statins are far outweighed by any small risk for cataract surgery," said Mancini, a professor of medicine at the University of British Columbia in Vancouver.
"However, the indication for statin use should be solid from the outset and fully understood by patients," he added.
Mancini said this study can't prove that statins cause cataracts. "Careful observations in clinical trials are needed to support or refute this association," he said.
Dr. Mark Fromer, an ophthalmologist at Lenox Hill Hospital in New York City, said cataracts are very common. "In one's lifetime, the chance of developing a cataract is 100 percent," he said.
"The goal is we want to keep you alive long enough to get one, and that's where statins come in," he said. "Statins increase the length of life by decreasing strokes and heart attacks."
Cataracts can be treated with surgery that is "quick, painless and 99.9 percent successful," Fromer said. "So, since you are going to get a cataract anyway, you might as well take your statin -- it's in your best interest."
The study was published in the December issue of the Canadian Journal of Cardiology.
For the study, Mancini's team used the British Columbia Ministry of Health database from 2000 to 2007 and the IMS LifeLink U.S. database from 2001 to 2011. In all, they looked at more than 207,000 adults with cataracts and more than 1.1 million without them.
Among people in the Canadian database, those who took statins for at least a year had about a 27 percent increased risk of developing cataracts that needed surgery, compared with people not taking statins. The increased risk for patients in the U.S. database was only 7 percent, but that was still statistically significant, the researchers said.
Common Knee Surgery May Boost Arthritis Risk, Study Suggests
The procedure repairs tears in the meniscus, a piece of cartilage that acts as a shock absorber. There are two in each knee, and they stabilize the knee joint. Meniscal tears are one of the most common knee injuries, and surgery is often performed to reduce pain and improve joint function, the researchers said.
In their study, the scientists used MRI scans to look at 355 knees with arthritis, and compared them to a similar number of knees without arthritis. The average age of the patients was about 60 and most were overweight.
All 31 knees that were operated on to repair meniscal tears developed arthritis within a year, compared with 59 percent of knees with meniscal damage that did not have surgery.
Cartilage loss occurred in nearly 81 percent of knees that had meniscal surgery, compared with almost 40 percent of knees with meniscal damage that did not have surgery, the study found.
The study was to be presented Wednesday at the Radiological Society of North America annual meeting in Chicago.
Even though surgery to repair meniscal tears is common, "increasing evidence is emerging that suggests meniscal surgery may be detrimental to the knee joint," study author Dr. Frank Roemer, from Boston University School of Medicine and the University of Erlangen-Nuremberg in Germany, said in a society news release.
"The indications for meniscal surgery might need to be discussed more carefully in order to avoid accelerated knee joint degeneration," he suggested.
An alternative to surgery is physical therapy to help maintain and restore knee muscle strength and range of motion. Ice and nonsteroidal anti-inflammatory medications (NSAIDs) are also used to treat pain and symptoms, according to the release.
Consumers Will Pay More Out Of Pocket Next Year For Specialty Drugs
Americans with health coverage – including those who buy it through government insurance exchanges and Medicare beneficiaries – are likely to pay more out-of-pocket next year for so-called “specialty drugs,” which treat complex conditions, according to two studies from consulting firm Avalere Health.
More than half of the “bronze” plans now being sold to individuals through federal and state marketplaces for coverage that begins in January, for example, require payments of 30 percent or more of the cost of such drugs, Avalere said in a report out Tuesday. That’s up from 38 percent of bronze plans this year.
In “silver” level plans, the most commonly purchased exchange plans, 41 percent will require payments of 30 percent or more for specialty drugs, up from 27 percent in 2014.
As the cost of prescription medications rise, insurers are responding by requiring patients to pay a percentage of specialty drug costs, rather than a flat dollar amount, which is often far less. Insurers say the move helps slow premium increases.
But “in some cases this could make it difficult for patients to afford and stay on medications,” Avalere CEO Dan Mendelson said in a written statement.
While there is no standard definition of such drugs outside of the Medicare program, they are often expensive medications used to treat serious, chronic illnesses, such as multiple sclerosis, rheumatoid arthritis, hemophilia, some cancers and hepatitis C. While lists of specialty drugs can differ by insurer and by policy type, drugs can include arthritis treatments Enbrel and Humira, cancer drugs Gleevec and Tarceva, hepatitis C treatment Sovaldi and MS drugs, Betaseron and Copaxone.
While they add up to only about 1 percent of all prescriptions written, specialty drugs account for 25 percent of spending on all drugs – an amount expected to rise rapidly, according to various studies.
An earlier Avalere analysis found that for the first time since Medicare’s drug program began in 2006, all of the stand-alone drug insurance plans place some drugs into specialty “tiers.” Two thirds of those plans require patients to pay a percentage of the costs of drugs in those tiers, rather than a flat dollar payment. Medicare plans can place a product into a specialty category only if the price negotiated with the drugmaker exceeds $600 a month.
Could a 'Mediterranean' Diet Extend Your Life?
Researchers found that the regimen -- rich in whole grains, vegetables, fruits, legumes, nuts, fish and olive oil -- appears to be associated with longer telomere length, which are indicators of slower aging.
Telomeres are located on the ends of chromosomes -- much like the plastic tips on the end of shoelaces. According to geneticists, telomeres prevent chromosomes from fraying and scrambling the genetic codes they contain. These bits of genetic material naturally shorten with age, but they tend to shorten more slowly in healthy people.
Shorter telomeres have long been associated with a greater risk of age-related diseases and a shorter life span, experts say.
The new study was led by Immaculata De Vivo, an associate professor at Brigham and Women's Hospital and Harvard Medical School, in Boston. Her team looked at data from more than 4,600 participants in the ongoing Nurses' Health Study, which has been tracking the health of U.S. nurses since 1976.
The participants were given a score of 0 to 9 on how closely they followed a Mediterranean diet, with a higher score indicating greater adherence to the regimen.
After adjusting for other factors, the researchers concluded that telomeres aged more slowly for every point a person went up on the scale.
However, the intake of individual food items in the Mediterranean diet was not associated with telomere length, which shows the importance of overall eating patterns on health, De Vivo's team said.
"To our knowledge, this is the largest population-based study specifically addressing the association between Mediterranean diet adherence and telomere length in healthy, middle-aged women," the researchers wrote. "Our results further support the benefits of adherence to the Mediterranean diet for promoting health and longevity."
According to De Vivo's team, prior research has linked the Mediterranean diet with better heart health, as well as a lowered risk for chronic disease and death.
The study, published Dec. 2 in the BMJ, was not designed to prove that the Mediterranean diet slowed the shortening of telomeres; it could only show an association.
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