Asthma may boost pneumococcal infection risk
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People with asthma are at increased risk of serious infection with pneumococcal bacteria, according to a new analysis of medical records.
The findings, along with the high fatality rate from such infections, suggest that adults with asthma would benefit from the pneumococcal vaccine, Dr. Young J. Juhn of the Mayo Clinic in Rochester, Minnesota and colleagues say. However, the ability of asthmatics to react normally to the vaccine must be determined before such recommendations can be made, they add.
A previous study found that Medicaid patients with asthma were more than twice as likely to contract invasive pneumococcal disease, in which pneumococcal pneumonia develops and the bacteria invades the bloodstream or the membranes surrounding the brain, Juhn and colleagues note.
Brand-Name Drugs Do Not Appear Superior to Generic Drugs for Treating Cardiovascular Diseases
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Contrary to the perception of some patients and physicians, there is no evidence that brand-name drugs are clinically superior to their generic counterparts, according to an article in the December 3 issue of JAMA, which examined studies comparing the effectiveness of generic vs. brand-name drugs for treating cardiovascular diseases.
“The problem of rising prescription drug costs has emerged as a critical policy issue, straining the budgets of patients and public/private insurers and directly contributing to adverse health outcomes by reducing adherence to important medications. The primary drivers of elevated drug costs are brand-name drugs, which are sold at high prices during a period of patent protection and market exclusivity after approval by the Food and Drug Administration (FDA),” the authors write. To control spending, many payers and clinicians have encouraged substitution of inexpensive bioequivalent generic versions of these drugs after the brand-name manufacturer’s market exclusivity period ends.
Some patients and physicians have expressed concern that generic drugs may not be equivalent in their effectiveness. “Brand-name manufacturers have suggested that generic drugs may be less effective and safe than their brand-name counterparts. Anecdotes have appeared in the lay press raising doubts about the efficacy and safety of certain generic drugs,” the authors note.
Women with Mitral Valve Prolapse Are Treated Less Aggressively than Men and May be at High Risk
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Disturbing evidence of higher mortality and lower surgery rates in women versus men with mitral valve prolapse and severe leakage may be related to the complexity of evaluating the condition’s severity in women, according to findings of a Mayo Clinic study published this month in the Annals of Internal Medicine.
Mitral valve prolapse affects approximately 150 million people worldwide and often requires cardiac surgery, preferably valve repair rather than replacement, to restore life expectancy of patients with severe leakage, says senior author Maurice Enriquez-Sarano, M.D., a cardiologist at Mayo Clinic. Cardiac valves allow the heart to move blood forward without leakage. Mitral valve prolapse occurs when the leaflets and supporting cords of the mitral valve have excessive tissue and weaken, leading to leakage (regurgitation), he says.
Previous studies on mitral valve disease have examined several sex-based differences, discovering, for example, that mitral valve prolapse is more common in women than men, and that more men than women undergo mitral valve surgery.
MRI shows new types of injuries in young gymnasts
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Adolescent gymnasts are developing a wide variety of arm, wrist and hand injuries that are beyond the scope of previously described gymnastic-related trauma, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).
“The broad constellation of recent injuries is unusual and might point to something new going on in gymnastics training that is affecting young athletes in different ways,” said the study’s lead author, Jerry Dwek, M.D., an assistant clinical professor of radiology at the University of California, San Diego and a partner of San Diego Imaging at Rady Children’s Hospital and Health Center.
Previous studies have reported on numerous injuries to the growing portion of adolescent gymnasts’ bones. However, this study uncovered some injuries to the bones in the wrists and knuckles that have not been previously described. In addition, the researchers noted that these gymnasts had necrosis, or “early death,” of the bones of their knuckles.
New statistical model could help reduce breast-lesion biopsies
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A new method of characterizing breast lesions found during an MRI exam could result in fewer biopsies of benign tumors with the benefits of reduced pain and expense for patients and providers, according to a paper that will be presented today (Sunday, Nov. 30) at the annual meeting of the Radiological Society of North America (RSNA).
Wendy DeMartini, M.D., and colleagues in the breast imaging department at the Seattle Cancer Care Alliance developed a preliminary statistical model that breast radiologists could use eventually when deciding whether a lesion found on breast MRI is likely to be malignant or benign. Their retrospective review of almost 2,600 breast MRI exams performed during a four-year period at the SCCA found three crucial patient and lesion characteristics that, when used in combination, could predict the likelihood of malignancy, including identifying some lesions with probabilities of cancer close to zero.
Such a model, if confirmed by more research, could be beneficial because MRI exams are so sensitive that they reveal cancerous and non-cancerous lesions that often look alike and behave similarly when contrast dye is injected into the patient. Biopsy is often necessary to determine whether a lesion is cancerous. Statistical models may improve the ability to distinguish between such lesions and avoid unnecessary biopsies.
Exercise, calcium may lower metabolic syndrome risk
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Regular exercise and a calcium-rich diet could be two ways to help lower the risk of metabolic syndrome, according to a new study.
Metabolic syndrome refers to a cluster of risk factors for diabetes and heart disease—including abdominal obesity, high blood pressure, high blood sugar, low levels of “good” HDL cholesterol and high triglycerides (another type of blood fat). The syndrome is typically diagnosed when a person has three or more of these conditions.
In the new study, of more than 5,000 Illinois adults, researchers found that metabolic syndrome was less common among those who got the recommended amounts of exercise and dietary calcium.
Testing for cancer at home
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It might not be pleasant, but it could save your life. A new Canadian campaign advocating home screening for colorectal cancer could reduce deaths from the disease by catching it early, when it is often asymptomatic but also highly curable.
The Canadian province of Ontario has one of the world’s highest rates of colorectal cancer, according to the provincial health ministry, and it’s the second deadliest cancer in the province. The disease has a 90-percent cure rate when caught during its early stages but because the cancer is often asymptomatic until it is further progressed, it can be missed.
About 40 percent of the 20,000 Ontarians diagnosed with colon cancer each year will die, said Dr. Philip Branton, scientific director of the Canadian Health Research Institute, in a release.
Domestic violence may raise kids’ abuse risk
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Mothers who experience violence or aggression at the hands of an intimate partner are at greater risk for maltreating their children than mothers who do not experience intimate partner abuse.
Intimate partner aggression and violence “impacts the whole family, raising health risks for children in the home as well as adult victims,” Dr. Catherine A. Taylor told Reuters Health.
Moreover, the presence of intimate partner aggression and violence appears to confer a unique burden of maltreatment risk to children, Taylor, of Tulane University School of Public Health and Tropical Medicine, in New Orleans, Louisiana, and colleagues have found.
Delay in AIDS drug use in South Africa costly
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Researchers from Harvard School of Public Health in Boston estimate that between 2000 and 2005 more than 330,000 lives were lost because a “feasible and timely” AIDS drug treatment program was not implemented in South Africa.
By not implementing a mother-to-child transmission HIV prevention program during the same 5-year period, an estimated 35,000 infants were born with HIV.
Dr. Pride Chigwedere and colleagues describe their analyses that generated these estimates in a Perspectives article published online in the Journal of Acquired Immune Deficiency Syndromes.
Treating depression seen important in heart failure
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Depression increases the risk of death in patients with heart failure, but the risk apparently disappears with antidepressant use, according to a study.
“Recent studies suggest that the use of antidepressants may be associated with increased mortality (death) in patients with cardiac disease,” Dr. Christopher M. O’Connor, of Duke University Medical Center, Durham, North Carolina, and colleagues note in the medical journal Archives of Internal Medicine.
“Because depression has also been shown to be associated with increased mortality in these patients, it remains unclear if this association is attributable to the use of antidepressants or to depression.”
Smoking’s effect on child weight may vary by race
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Studies have linked prenatal smoking to a higher risk of childhood obesity, but new findings suggest that effect may vary based on race and ethnicity.
In a study of more than 155,000 preschool children, U.S. researchers found that the link between mothers’ smoking during pregnancy and their children’s risk of obesity was most clear among white families.
In contrast, only heavy prenatal smoking was tied to childhood obesity among African Americans. And there was no clear evidence that it raised the odds of obesity among children of Hispanic, Native American or Asian descent.
Periodontal disease linked to metabolic syndrome
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In middle-aged adults, gum disease goes hand in hand with the metabolic syndrome, UK researchers report.
“Further studies are required to test whether improvements in oral health could affect the onset/progression of the metabolic syndrome or vice-versa,” Dr. Francesco D’Aiuto of the UCL Eastman Dental Institute in London, one of the researchers on the study, told Reuters Health.
Metabolic syndrome is a cluster of risk factors for heart disease, stroke and diabetes—including high blood pressure, abdominal obesity, high blood sugar, low levels of “good” HDL cholesterol and high triglycerides (another type of blood fat). The syndrome is usually diagnosed when a person has three or more of these traits.
“Watchful waiting” okay for hernias in pregnancy
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A look back at 12 women who developed hernias while pregnant lends support to a “watchful waiting” management strategy during pregnancy, followed by hernia repair after delivery.
Hernia repair after delivery “provides similar results to the non-pregnant population,” report Dr. Celia M. Divino and colleagues from the department of surgery, Mount Sinai School of Medicine, New York.
The course of hernias in pregnancy, the effect of hernias on delivery, and the timing of hernia repair have not been established, the research team notes.
Losing belly fat may cut risk of eye disease
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New research suggests that people who lose weight around their middle, particularly those who are obese, can decrease their odds of developing age-related macular degeneration (AMD), the leading cause of severe vision loss among elderly people.
“Reduction in risk of AMD may be an additional benefit of reducing weight, especially in obese and overweight patients,” Dr. Tien Y. Wong, from the University of Melbourne, Australia, and co-researchers wrote in report published this month.
Prior research looking at the link between obesity and AMD has yielded conflicting results. In the current study, Wong’s team examined how changes in weight impact the risk of AMD in 12,515 adults between 45 and 64 years old who were followed for 6 years.
Tamoxifen easier on the brain than thought: study
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Concern that treatment with tamoxifen and other “anti-estrogen” therapies in women with breast cancer may contribute to compromised brain function does not appear to be warranted, at least over the short term, according to a report in the medical journal Cancer.
Anti-estrogen therapy “did not have any significant effects on cognitive function, and I think it is safe to say that patients needn’t worry about cognitive side effects of these medications,” Dr. Kerstin Hermelink from Ludwig Maximilian University, Munich, Germany told Reuters Health.
Hermelink and colleagues assessed the effects of hormonal treatment-induced menopause and anti-estrogen therapy on cognitive function in 101 women with breast cancer. They used 12 cognitive tests to assess the patients before the start of cancer therapy, towards the end of chemotherapy, and 1 year after the start of the study.
