Heidi Splete

WASHINGTON — The Obama administration recently launched the first major U.S. initiative against HIV/AIDS in more than a decade.

The 5-year campaign, "Act Against Aids," is a joint effort of the Centers for Disease Control and Prevention, the Department of Health and Human Services, and the White House to educate the public about HIV/AIDS, which remains a serious problem in the United States despite advances in treatment that allow more patients to survive.

Recent data from the Kaiser Family Foundation show that concern about HIV infection has declined in recent years, said Dr. Kevin Fenton, director of the CDC's National Center for HIV/AIDS.

"People don't recognize that they are at risk, and they engage in high-risk behavior," Dr. Fenton said at a press briefing.

The goal of the campaign is to educate the public about the risks of HIV and encourage them to get the right information to protect themselves and their communities.

The campaign kicks off with a series of public service announcements, including radio ads, online ads, and public transportation ads, with the theme, "Every 9.5 minutes."

According to data from the CDC, approximately 56,000 Americans become infected with HIV each year, which translates to one person becoming infected about every 9.5 minutes.

The campaign also will target specific communities that are at increased risk for HIV, starting with the African American community, said Melody Barnes, who is assistant to the president and director of the White House Domestic Policy Council.

Targeted outreach is also planned for the gay, bisexual, and Latino communities, she added.

Doctors need to know that the Act Against AIDS campaign will be working to raise awareness about HIV infection and encourage testing, Dr. Fenton said in an interview.

"This [effort] is likely to have an impact on health seeking behaviors," he said.

Consumer information regarding the HIV campaign can be found online at www.NineAndaHalfMinutes.org

WASHINGTON — The Obama administration recently launched the first major U.S. initiative against HIV/AIDS in more than a decade.

The 5-year campaign, "Act Against Aids," is a joint effort of the Centers for Disease Control and Prevention, the Department of Health and Human Services, and the White House to educate the public about HIV/AIDS, which remains a serious problem in the United States despite advances in treatment that allow more patients to survive.

Recent data from the Kaiser Family Foundation show that concern about HIV infection has declined in recent years, said Dr. Kevin Fenton, director of the CDC's National Center for HIV/AIDS.

"People don't recognize that they are at risk, and they engage in high-risk behavior," Dr. Fenton said at a press briefing.

The goal of the campaign is to educate the public about the risks of HIV and encourage them to get the right information to protect themselves and their communities.

The campaign kicks off with a series of public service announcements, including radio ads, online ads, and public transportation ads, with the theme, "Every 9.5 minutes."

According to data from the CDC, approximately 56,000 Americans become infected with HIV each year, which translates to one person becoming infected about every 9.5 minutes.

The campaign also will target specific communities that are at increased risk for HIV, starting with the African American community, said Melody Barnes, who is assistant to the president and director of the White House Domestic Policy Council.

Targeted outreach is also planned for the gay, bisexual, and Latino communities, she added.

Doctors need to know that the Act Against AIDS campaign will be working to raise awareness about HIV infection and encourage testing, Dr. Fenton said in an interview.

"This [effort] is likely to have an impact on health seeking behaviors," he said.

Consumer information regarding the HIV campaign can be found online at www.NineAndaHalfMinutes.org

WASHINGTON — The Obama administration recently launched the first major U.S. initiative against HIV/AIDS in more than a decade.

The 5-year campaign, "Act Against Aids," is a joint effort of the Centers for Disease Control and Prevention, the Department of Health and Human Services, and the White House to educate the public about HIV/AIDS, which remains a serious problem in the United States despite advances in treatment that allow more patients to survive.

Recent data from the Kaiser Family Foundation show that concern about HIV infection has declined in recent years, said Dr. Kevin Fenton, director of the CDC's National Center for HIV/AIDS.

"People don't recognize that they are at risk, and they engage in high-risk behavior," Dr. Fenton said at a press briefing.

The goal of the campaign is to educate the public about the risks of HIV and encourage them to get the right information to protect themselves and their communities.

The campaign kicks off with a series of public service announcements, including radio ads, online ads, and public transportation ads, with the theme, "Every 9.5 minutes."

According to data from the CDC, approximately 56,000 Americans become infected with HIV each year, which translates to one person becoming infected about every 9.5 minutes.

The campaign also will target specific communities that are at increased risk for HIV, starting with the African American community, said Melody Barnes, who is assistant to the president and director of the White House Domestic Policy Council.

Targeted outreach is also planned for the gay, bisexual, and Latino communities, she added.

Doctors need to know that the Act Against AIDS campaign will be working to raise awareness about HIV infection and encourage testing, Dr. Fenton said in an interview.

"This [effort] is likely to have an impact on health seeking behaviors," he said.

Consumer information regarding the HIV campaign can be found online at www.NineAndaHalfMinutes.org

RIO GRANDE, P.R. — Approximately one in four elderly black women have osteoporosis, findings from a small study suggest.

Physicians should not ignore the possibility of osteoporosis in their older black female patients, although these women are not usually considered at high risk, compared with other demographic groups, said Dr. Sally P. Weaver, research director of the McLennan County Medical Education and Research Foundation, Waco, Tex.

Previous studies of osteoporosis in women have focused mainly on whites because of evidence of an elevated risk for osteoporosis in that population. Yet older women of any ethnicity are prone to age-related fractures if their bone mineral density (BMD) is low, she said in an interview.

Dr. Weaver and her colleagues measured BMD scans from the electronic health records of 44 black women aged 70 years and older. Patients with conditions that could affect bone turnover, vitamin D absorption, or calcium absorption were excluded.

About 50% of the study participants met the criteria for osteopenia, and 10% met the criteria for osteoporosis at the left femoral neck. Approximately 25% met criteria for osteopenia or osteoporosis at the lumbar spine.

Dr. Weaver presented the results in a poster at the annual meeting of the North American Primary Care Research Group. She had no financial conflicts to disclose.

RIO GRANDE, P.R. — Approximately one in four elderly black women have osteoporosis, findings from a small study suggest.

Physicians should not ignore the possibility of osteoporosis in their older black female patients, although these women are not usually considered at high risk, compared with other demographic groups, said Dr. Sally P. Weaver, research director of the McLennan County Medical Education and Research Foundation, Waco, Tex.

Previous studies of osteoporosis in women have focused mainly on whites because of evidence of an elevated risk for osteoporosis in that population. Yet older women of any ethnicity are prone to age-related fractures if their bone mineral density (BMD) is low, she said in an interview.

Dr. Weaver and her colleagues measured BMD scans from the electronic health records of 44 black women aged 70 years and older. Patients with conditions that could affect bone turnover, vitamin D absorption, or calcium absorption were excluded.

About 50% of the study participants met the criteria for osteopenia, and 10% met the criteria for osteoporosis at the left femoral neck. Approximately 25% met criteria for osteopenia or osteoporosis at the lumbar spine.

Dr. Weaver presented the results in a poster at the annual meeting of the North American Primary Care Research Group. She had no financial conflicts to disclose.

RIO GRANDE, P.R. — Approximately one in four elderly black women have osteoporosis, findings from a small study suggest.

Physicians should not ignore the possibility of osteoporosis in their older black female patients, although these women are not usually considered at high risk, compared with other demographic groups, said Dr. Sally P. Weaver, research director of the McLennan County Medical Education and Research Foundation, Waco, Tex.

Previous studies of osteoporosis in women have focused mainly on whites because of evidence of an elevated risk for osteoporosis in that population. Yet older women of any ethnicity are prone to age-related fractures if their bone mineral density (BMD) is low, she said in an interview.

Dr. Weaver and her colleagues measured BMD scans from the electronic health records of 44 black women aged 70 years and older. Patients with conditions that could affect bone turnover, vitamin D absorption, or calcium absorption were excluded.

About 50% of the study participants met the criteria for osteopenia, and 10% met the criteria for osteoporosis at the left femoral neck. Approximately 25% met criteria for osteopenia or osteoporosis at the lumbar spine.

Dr. Weaver presented the results in a poster at the annual meeting of the North American Primary Care Research Group. She had no financial conflicts to disclose.

Sepsis patients with diabetes are significantly less likely to experience acute respiratory failure than are patients without diabetes, according to data from a review of 930 million hospitalizations over 25 years.

Previous studies have shown that sepsis is common in people with diabetes, and that those patients are less likely to develop acute lung injuries as a result of sepsis. But those studies did not compare organ dysfunction in sepsis patients with and without diabetes.

Dr. Annette Esper of Emory University in Atlanta and her colleagues reviewed National Hospital Discharge Survey data from 1979-2003. The researchers used ICD-9 codes to identify cases of sepsis and the sources of the infections. The researchers identified 12.5 million cases of sepsis, and 17% of the patients had diabetes. Among the population of patients with diabetes and sepsis, 57% were women, and 64% were white. The average patient age was 68 years.

Overall, patients with diabetes and sepsis were significantly more likely to develop acute renal failure than were patients without diabetes, but were significantly less likely to develop acute respiratory failure (see chart) (Crit. Care 2009 Feb. 12 [doi: 10.1186/cc7717]).

No other significant differences appeared in the occurrence of other organ dysfunctions, or in the average total number of organ dysfunctions in the two groups. However, the difference in acute respiratory failure persisted regardless of the source of infection. Among patients with a respiratory source of sepsis, those with diabetes were significantly less likely to develop acute respiratory failure than were those without diabetes (16% vs. 23%). The difference in acute respiratory failure rates was also significant for patients with and without diabetes (6% vs. 10%) who had nonpulmonary sources of infection.

The overall fatality rate for sepsis patients with diabetes was significantly lower than for those without diabetes (19% vs. 21%), but fatality rates between patients with and without diabetes who developed acute respiratory failure were not significantly different (52% vs. 48%).

The reasons for the distinction in respiratory failure rates between patients with and without diabetes remain uncertain. Theories include the potential blunted inflammatory response to organ dysfunction in people with diabetes, the investigators said, and the possibility that diabetes patients may be hospitalized for sepsis sooner because they may be more alert to signs of infection. Diabetes medications may play a role, too.

“Pharmacological aspects of [diabetes] may also influence the development of organ dysfunction, because many medications administered to patients with [diabetes], including insulin and thiazolidinediones, are known to have anti-inflammatory effects in addition to lowering blood glucose,” the researchers noted.

But more research is needed to show the effects of diabetes medications and other factors on respiratory problems in sepsis patients in order to develop more effective treatments, they added.

The researchers had no financial conflicts to disclose.

Elsevier Global Medical News

Sepsis patients with diabetes are significantly less likely to experience acute respiratory failure than are patients without diabetes, according to data from a review of 930 million hospitalizations over 25 years.

Previous studies have shown that sepsis is common in people with diabetes, and that those patients are less likely to develop acute lung injuries as a result of sepsis. But those studies did not compare organ dysfunction in sepsis patients with and without diabetes.

Dr. Annette Esper of Emory University in Atlanta and her colleagues reviewed National Hospital Discharge Survey data from 1979-2003. The researchers used ICD-9 codes to identify cases of sepsis and the sources of the infections. The researchers identified 12.5 million cases of sepsis, and 17% of the patients had diabetes. Among the population of patients with diabetes and sepsis, 57% were women, and 64% were white. The average patient age was 68 years.

Overall, patients with diabetes and sepsis were significantly more likely to develop acute renal failure than were patients without diabetes, but were significantly less likely to develop acute respiratory failure (see chart) (Crit. Care 2009 Feb. 12 [doi: 10.1186/cc7717]).

No other significant differences appeared in the occurrence of other organ dysfunctions, or in the average total number of organ dysfunctions in the two groups. However, the difference in acute respiratory failure persisted regardless of the source of infection. Among patients with a respiratory source of sepsis, those with diabetes were significantly less likely to develop acute respiratory failure than were those without diabetes (16% vs. 23%). The difference in acute respiratory failure rates was also significant for patients with and without diabetes (6% vs. 10%) who had nonpulmonary sources of infection.

The overall fatality rate for sepsis patients with diabetes was significantly lower than for those without diabetes (19% vs. 21%), but fatality rates between patients with and without diabetes who developed acute respiratory failure were not significantly different (52% vs. 48%).

The reasons for the distinction in respiratory failure rates between patients with and without diabetes remain uncertain. Theories include the potential blunted inflammatory response to organ dysfunction in people with diabetes, the investigators said, and the possibility that diabetes patients may be hospitalized for sepsis sooner because they may be more alert to signs of infection. Diabetes medications may play a role, too.

“Pharmacological aspects of [diabetes] may also influence the development of organ dysfunction, because many medications administered to patients with [diabetes], including insulin and thiazolidinediones, are known to have anti-inflammatory effects in addition to lowering blood glucose,” the researchers noted.

But more research is needed to show the effects of diabetes medications and other factors on respiratory problems in sepsis patients in order to develop more effective treatments, they added.

The researchers had no financial conflicts to disclose.

Elsevier Global Medical News

Sepsis patients with diabetes are significantly less likely to experience acute respiratory failure than are patients without diabetes, according to data from a review of 930 million hospitalizations over 25 years.

Previous studies have shown that sepsis is common in people with diabetes, and that those patients are less likely to develop acute lung injuries as a result of sepsis. But those studies did not compare organ dysfunction in sepsis patients with and without diabetes.

Dr. Annette Esper of Emory University in Atlanta and her colleagues reviewed National Hospital Discharge Survey data from 1979-2003. The researchers used ICD-9 codes to identify cases of sepsis and the sources of the infections. The researchers identified 12.5 million cases of sepsis, and 17% of the patients had diabetes. Among the population of patients with diabetes and sepsis, 57% were women, and 64% were white. The average patient age was 68 years.

Overall, patients with diabetes and sepsis were significantly more likely to develop acute renal failure than were patients without diabetes, but were significantly less likely to develop acute respiratory failure (see chart) (Crit. Care 2009 Feb. 12 [doi: 10.1186/cc7717]).

No other significant differences appeared in the occurrence of other organ dysfunctions, or in the average total number of organ dysfunctions in the two groups. However, the difference in acute respiratory failure persisted regardless of the source of infection. Among patients with a respiratory source of sepsis, those with diabetes were significantly less likely to develop acute respiratory failure than were those without diabetes (16% vs. 23%). The difference in acute respiratory failure rates was also significant for patients with and without diabetes (6% vs. 10%) who had nonpulmonary sources of infection.

The overall fatality rate for sepsis patients with diabetes was significantly lower than for those without diabetes (19% vs. 21%), but fatality rates between patients with and without diabetes who developed acute respiratory failure were not significantly different (52% vs. 48%).

The reasons for the distinction in respiratory failure rates between patients with and without diabetes remain uncertain. Theories include the potential blunted inflammatory response to organ dysfunction in people with diabetes, the investigators said, and the possibility that diabetes patients may be hospitalized for sepsis sooner because they may be more alert to signs of infection. Diabetes medications may play a role, too.

“Pharmacological aspects of [diabetes] may also influence the development of organ dysfunction, because many medications administered to patients with [diabetes], including insulin and thiazolidinediones, are known to have anti-inflammatory effects in addition to lowering blood glucose,” the researchers noted.

But more research is needed to show the effects of diabetes medications and other factors on respiratory problems in sepsis patients in order to develop more effective treatments, they added.

The researchers had no financial conflicts to disclose.

Elsevier Global Medical News

PENTAGON CITY, VA. — Sexual health problems in breast cancer survivors peaked about 12 months after the completion of treatment, and mental health symptoms significantly predicted these problems, according to findings from a study involving 54 female breast cancer survivors.

The findings suggest a need for providers to discuss with breast cancer patients the potential for sexual problems after therapy, and to be alert for mental health symptoms that may increase the risk for these problems, said Beth Fischgrund, a medical student at Northwestern University, Chicago.

To examine which mental health problems were associated with sexual problems and to pinpoint the peak time for these problems, Ms. Fischgrund and her colleagues, surveyed women who had completed breast cancer treatment within 24 months of study enrollment.

After their treatment was finished participants completed two surveys—one at 6–12 months and the other at 18–24 months. Each woman had been in a monogamous relationship since at least a year before her breast cancer diagnosis. The study results were presented in a poster at the annual meeting of the Society for Sex Therapy and Research.

At the time of the first survey, 40% of the women reported moderate to severe sexual problems, but this number increased to 53% at the time of the second survey. Sexual health was assessed using the Sexual Problems Scale, which measured lack of interest in sex, difficulties with arousal and orgasm, lack of pleasure during sex, and pain during sex. These components were combined to calculate a total sexual score.

The findings suggest that reports of sexual problems peaked at about 12 months post treatment, and decreased by 18–24 months. Mental health symptoms were significant predictors of sexual health problems 6 months later, the researchers said. But there were no significant differences in mental health scores between the two time periods. The strongest predictors of sexual problems were interpersonal difficulties and depression.

When asked why sexual problems didn't emerge immediately after treatment, Ms. Fischgrund suggested that during therapy, women with breast cancer are in “survival mode.” At that time, they likely focus on their treatment and on beating the disease, and they don't focus as much on their sexual relationships, she theorized. The study was supported by the Lynn Sage Cancer Research Foundation. The researchers had no financial conflicts to disclose.

PENTAGON CITY, VA. — Sexual health problems in breast cancer survivors peaked about 12 months after the completion of treatment, and mental health symptoms significantly predicted these problems, according to findings from a study involving 54 female breast cancer survivors.

The findings suggest a need for providers to discuss with breast cancer patients the potential for sexual problems after therapy, and to be alert for mental health symptoms that may increase the risk for these problems, said Beth Fischgrund, a medical student at Northwestern University, Chicago.

To examine which mental health problems were associated with sexual problems and to pinpoint the peak time for these problems, Ms. Fischgrund and her colleagues, surveyed women who had completed breast cancer treatment within 24 months of study enrollment.

After their treatment was finished participants completed two surveys—one at 6–12 months and the other at 18–24 months. Each woman had been in a monogamous relationship since at least a year before her breast cancer diagnosis. The study results were presented in a poster at the annual meeting of the Society for Sex Therapy and Research.

At the time of the first survey, 40% of the women reported moderate to severe sexual problems, but this number increased to 53% at the time of the second survey. Sexual health was assessed using the Sexual Problems Scale, which measured lack of interest in sex, difficulties with arousal and orgasm, lack of pleasure during sex, and pain during sex. These components were combined to calculate a total sexual score.

The findings suggest that reports of sexual problems peaked at about 12 months post treatment, and decreased by 18–24 months. Mental health symptoms were significant predictors of sexual health problems 6 months later, the researchers said. But there were no significant differences in mental health scores between the two time periods. The strongest predictors of sexual problems were interpersonal difficulties and depression.

When asked why sexual problems didn't emerge immediately after treatment, Ms. Fischgrund suggested that during therapy, women with breast cancer are in “survival mode.” At that time, they likely focus on their treatment and on beating the disease, and they don't focus as much on their sexual relationships, she theorized. The study was supported by the Lynn Sage Cancer Research Foundation. The researchers had no financial conflicts to disclose.

PENTAGON CITY, VA. — Sexual health problems in breast cancer survivors peaked about 12 months after the completion of treatment, and mental health symptoms significantly predicted these problems, according to findings from a study involving 54 female breast cancer survivors.

The findings suggest a need for providers to discuss with breast cancer patients the potential for sexual problems after therapy, and to be alert for mental health symptoms that may increase the risk for these problems, said Beth Fischgrund, a medical student at Northwestern University, Chicago.

To examine which mental health problems were associated with sexual problems and to pinpoint the peak time for these problems, Ms. Fischgrund and her colleagues, surveyed women who had completed breast cancer treatment within 24 months of study enrollment.

After their treatment was finished participants completed two surveys—one at 6–12 months and the other at 18–24 months. Each woman had been in a monogamous relationship since at least a year before her breast cancer diagnosis. The study results were presented in a poster at the annual meeting of the Society for Sex Therapy and Research.

At the time of the first survey, 40% of the women reported moderate to severe sexual problems, but this number increased to 53% at the time of the second survey. Sexual health was assessed using the Sexual Problems Scale, which measured lack of interest in sex, difficulties with arousal and orgasm, lack of pleasure during sex, and pain during sex. These components were combined to calculate a total sexual score.

The findings suggest that reports of sexual problems peaked at about 12 months post treatment, and decreased by 18–24 months. Mental health symptoms were significant predictors of sexual health problems 6 months later, the researchers said. But there were no significant differences in mental health scores between the two time periods. The strongest predictors of sexual problems were interpersonal difficulties and depression.

When asked why sexual problems didn't emerge immediately after treatment, Ms. Fischgrund suggested that during therapy, women with breast cancer are in “survival mode.” At that time, they likely focus on their treatment and on beating the disease, and they don't focus as much on their sexual relationships, she theorized. The study was supported by the Lynn Sage Cancer Research Foundation. The researchers had no financial conflicts to disclose.

Statins have no impact on the development of dementia or Alzheimer's disease, according to a Cochrane Review of two randomized, controlled trials involving more than 26,000 adults.

Previous studies in animal models have shown that lowering cholesterol slows pathologic signs of Alzheimer's disease (AD), and data from clinical studies in older adults who took statins for vascular disease have suggested that statin users had a reduced risk of developing AD. But the clinical studies in humans were not randomized trials, said Dr. Bernadette McGuinness of Queen's University Belfast, Northern Ireland.

In this review, Dr. McGuinness and her colleagues examined data from two large, randomized controlled trials that included 26,340 adults aged 40-82 years (Cochrane Database Syst. Rev. 2009 April 15; doi: 10.1002/14651858.cd007514

The Medical Research Council/British Heart Foundation Heart Protection Study (HPS) conducted in 2002 was a randomized, placebo-controlled trial of the effect of a daily dose of 40 mg simvastatin vs. placebo on the development of vascular disease in 20,536 high-risk adults, including 5,806 adults aged 70 years and older.

Cognitive decline was assessed via a questionnaire completed in person at the clinic or by phone. No significant differences appeared between the treatment and placebo groups in the overall percentages of patients who met criteria for cognitive impairment at the start of the study (23.7% vs. 24.2%). And 31 individuals in each group developed dementia during a 5-year follow-up period (Lancet 2002;360:7-22).

In another 2002 study, the Prospective Study of Pravastatin in the Elderly at Risk (known as the PROSPER trial), 5,804 adults aged 70-82 years were randomized to receive a daily dose of 40 mg pravastatin or a placebo. All the study participants had risk factors for vascular disease or a history of vascular disease. The cognitive function of the participants was assessed using neuropsychologic tests and the Mini-Mental State Examination. During a 3-year follow-up period, pravastatin had no significant impact on cognitive function (Lancet 2002;360:1623-30).

“The two trials identified were large scale and included patients at high risk of vascular disease,” noted the researchers, who had no relevant conflicts of interest to disclose. “The fact that they had similar findings was reassuring.”

Statins have no impact on the development of dementia or Alzheimer's disease, according to a Cochrane Review of two randomized, controlled trials involving more than 26,000 adults.

Previous studies in animal models have shown that lowering cholesterol slows pathologic signs of Alzheimer's disease (AD), and data from clinical studies in older adults who took statins for vascular disease have suggested that statin users had a reduced risk of developing AD. But the clinical studies in humans were not randomized trials, said Dr. Bernadette McGuinness of Queen's University Belfast, Northern Ireland.

In this review, Dr. McGuinness and her colleagues examined data from two large, randomized controlled trials that included 26,340 adults aged 40-82 years (Cochrane Database Syst. Rev. 2009 April 15; doi: 10.1002/14651858.cd007514

The Medical Research Council/British Heart Foundation Heart Protection Study (HPS) conducted in 2002 was a randomized, placebo-controlled trial of the effect of a daily dose of 40 mg simvastatin vs. placebo on the development of vascular disease in 20,536 high-risk adults, including 5,806 adults aged 70 years and older.

Cognitive decline was assessed via a questionnaire completed in person at the clinic or by phone. No significant differences appeared between the treatment and placebo groups in the overall percentages of patients who met criteria for cognitive impairment at the start of the study (23.7% vs. 24.2%). And 31 individuals in each group developed dementia during a 5-year follow-up period (Lancet 2002;360:7-22).

In another 2002 study, the Prospective Study of Pravastatin in the Elderly at Risk (known as the PROSPER trial), 5,804 adults aged 70-82 years were randomized to receive a daily dose of 40 mg pravastatin or a placebo. All the study participants had risk factors for vascular disease or a history of vascular disease. The cognitive function of the participants was assessed using neuropsychologic tests and the Mini-Mental State Examination. During a 3-year follow-up period, pravastatin had no significant impact on cognitive function (Lancet 2002;360:1623-30).

“The two trials identified were large scale and included patients at high risk of vascular disease,” noted the researchers, who had no relevant conflicts of interest to disclose. “The fact that they had similar findings was reassuring.”

Statins have no impact on the development of dementia or Alzheimer's disease, according to a Cochrane Review of two randomized, controlled trials involving more than 26,000 adults.

Previous studies in animal models have shown that lowering cholesterol slows pathologic signs of Alzheimer's disease (AD), and data from clinical studies in older adults who took statins for vascular disease have suggested that statin users had a reduced risk of developing AD. But the clinical studies in humans were not randomized trials, said Dr. Bernadette McGuinness of Queen's University Belfast, Northern Ireland.

In this review, Dr. McGuinness and her colleagues examined data from two large, randomized controlled trials that included 26,340 adults aged 40-82 years (Cochrane Database Syst. Rev. 2009 April 15; doi: 10.1002/14651858.cd007514

The Medical Research Council/British Heart Foundation Heart Protection Study (HPS) conducted in 2002 was a randomized, placebo-controlled trial of the effect of a daily dose of 40 mg simvastatin vs. placebo on the development of vascular disease in 20,536 high-risk adults, including 5,806 adults aged 70 years and older.

Cognitive decline was assessed via a questionnaire completed in person at the clinic or by phone. No significant differences appeared between the treatment and placebo groups in the overall percentages of patients who met criteria for cognitive impairment at the start of the study (23.7% vs. 24.2%). And 31 individuals in each group developed dementia during a 5-year follow-up period (Lancet 2002;360:7-22).

In another 2002 study, the Prospective Study of Pravastatin in the Elderly at Risk (known as the PROSPER trial), 5,804 adults aged 70-82 years were randomized to receive a daily dose of 40 mg pravastatin or a placebo. All the study participants had risk factors for vascular disease or a history of vascular disease. The cognitive function of the participants was assessed using neuropsychologic tests and the Mini-Mental State Examination. During a 3-year follow-up period, pravastatin had no significant impact on cognitive function (Lancet 2002;360:1623-30).

“The two trials identified were large scale and included patients at high risk of vascular disease,” noted the researchers, who had no relevant conflicts of interest to disclose. “The fact that they had similar findings was reassuring.”

WASHINGTON — Measures of exhaled nitric oxide levels may add another dimension to the evaluation of asthma beyond the information available from the Asthma Control Test and spirometry findings, based on data from a study presented at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

Fractional exhaled nitric oxide (FeNO) may be “a surrogate marker for airway inflammation,” Dr. Brian C. Schroer of the Cleveland Clinic said in an interview. Neither the Asthma Control Test (ACT) nor spirometry evaluate airway inflammation.

Dr. Schroer and his colleagues reviewed charts from the asthma-related medical visits of 139 adults, all of whom concurrently completed the ACT, FeNO, and spirometry tests. Approximately 66% of the patients were female, and 78% were white. The study excluded smokers and patients with concomitant conditions including chronic obstructive pulmonary disease and cystic fibrosis.

Overall, the average FeNO score was 30.8 parts per billion (ppb), the average ACT score was 19.2, the average forced expiratory volume in 1 second (FEV₁) score was 86.5%, and the average FEV₁/forced vital capacity (FVC) score was 87.4%. Scatter plots showed no correlation between FeNO and either ACT or spirometry measures.

Dr. Schroer said that he was initially surprised by the finding that inflammation was not increased in patients whose ACT scores were either decreased or normal. But the ACT doesn't take airway inflammation into account, and spirometry measures only airway hyperresponsiveness, he said. The lack of correlation held true when the patients were divided into four groups based on severity.

The FeNO measures in patients with intermittent asthma, mild persistent asthma, moderate persistent asthma, and severe persistent asthma were 20.4 ppb, 29.3 ppb, 25.9 ppb, and 39.7 ppb, respectively. The ACT scores in these groups were 22.2, 20.0, 19.7, and 17.1, respectively. The FEV₁ scores were 103%, 95.1%, 90.4%, and 70.4%, respectively, and the FEV₁/FVC scores were 93.3%, 90.7%, 91.2%, and 79.0%, respectively.

The study was supported by the William O. Wagner, M.D., Research and Education Fund. Dr. Schroer had no financial conflicts to disclose.

To view a related video, go to www.youtube.com/FamilyPracticeNews

WASHINGTON — Measures of exhaled nitric oxide levels may add another dimension to the evaluation of asthma beyond the information available from the Asthma Control Test and spirometry findings, based on data from a study presented at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

Fractional exhaled nitric oxide (FeNO) may be “a surrogate marker for airway inflammation,” Dr. Brian C. Schroer of the Cleveland Clinic said in an interview. Neither the Asthma Control Test (ACT) nor spirometry evaluate airway inflammation.

Dr. Schroer and his colleagues reviewed charts from the asthma-related medical visits of 139 adults, all of whom concurrently completed the ACT, FeNO, and spirometry tests. Approximately 66% of the patients were female, and 78% were white. The study excluded smokers and patients with concomitant conditions including chronic obstructive pulmonary disease and cystic fibrosis.

Overall, the average FeNO score was 30.8 parts per billion (ppb), the average ACT score was 19.2, the average forced expiratory volume in 1 second (FEV₁) score was 86.5%, and the average FEV₁/forced vital capacity (FVC) score was 87.4%. Scatter plots showed no correlation between FeNO and either ACT or spirometry measures.

Dr. Schroer said that he was initially surprised by the finding that inflammation was not increased in patients whose ACT scores were either decreased or normal. But the ACT doesn't take airway inflammation into account, and spirometry measures only airway hyperresponsiveness, he said. The lack of correlation held true when the patients were divided into four groups based on severity.

The FeNO measures in patients with intermittent asthma, mild persistent asthma, moderate persistent asthma, and severe persistent asthma were 20.4 ppb, 29.3 ppb, 25.9 ppb, and 39.7 ppb, respectively. The ACT scores in these groups were 22.2, 20.0, 19.7, and 17.1, respectively. The FEV₁ scores were 103%, 95.1%, 90.4%, and 70.4%, respectively, and the FEV₁/FVC scores were 93.3%, 90.7%, 91.2%, and 79.0%, respectively.

The study was supported by the William O. Wagner, M.D., Research and Education Fund. Dr. Schroer had no financial conflicts to disclose.

To view a related video, go to www.youtube.com/FamilyPracticeNews

WASHINGTON — Measures of exhaled nitric oxide levels may add another dimension to the evaluation of asthma beyond the information available from the Asthma Control Test and spirometry findings, based on data from a study presented at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

Fractional exhaled nitric oxide (FeNO) may be “a surrogate marker for airway inflammation,” Dr. Brian C. Schroer of the Cleveland Clinic said in an interview. Neither the Asthma Control Test (ACT) nor spirometry evaluate airway inflammation.

Dr. Schroer and his colleagues reviewed charts from the asthma-related medical visits of 139 adults, all of whom concurrently completed the ACT, FeNO, and spirometry tests. Approximately 66% of the patients were female, and 78% were white. The study excluded smokers and patients with concomitant conditions including chronic obstructive pulmonary disease and cystic fibrosis.

Overall, the average FeNO score was 30.8 parts per billion (ppb), the average ACT score was 19.2, the average forced expiratory volume in 1 second (FEV₁) score was 86.5%, and the average FEV₁/forced vital capacity (FVC) score was 87.4%. Scatter plots showed no correlation between FeNO and either ACT or spirometry measures.

Dr. Schroer said that he was initially surprised by the finding that inflammation was not increased in patients whose ACT scores were either decreased or normal. But the ACT doesn't take airway inflammation into account, and spirometry measures only airway hyperresponsiveness, he said. The lack of correlation held true when the patients were divided into four groups based on severity.

The FeNO measures in patients with intermittent asthma, mild persistent asthma, moderate persistent asthma, and severe persistent asthma were 20.4 ppb, 29.3 ppb, 25.9 ppb, and 39.7 ppb, respectively. The ACT scores in these groups were 22.2, 20.0, 19.7, and 17.1, respectively. The FEV₁ scores were 103%, 95.1%, 90.4%, and 70.4%, respectively, and the FEV₁/FVC scores were 93.3%, 90.7%, 91.2%, and 79.0%, respectively.

The study was supported by the William O. Wagner, M.D., Research and Education Fund. Dr. Schroer had no financial conflicts to disclose.

To view a related video, go to www.youtube.com/FamilyPracticeNews

WASHINGTON – The Obama administration has launched the first major U.S. initiative against HIV/AIDS in more than a decade.

The 5-year campaign, “Act Against Aids,” is a joint effort of the Centers for Disease Control and Prevention, the Department of Health and Human Services, and the White House to educate the public about HIV/AIDS, which remains a serious problem in the United States despite advances in treatment that allow more patients to survive.

Recent data from the Kaiser Family Foundation show that concern about HIV infection has declined in recent years, said Dr. Kevin Fenton, director of the CDC National Center for HIV/AIDS.

“People don't recognize that they are at risk, and they engage in high-risk behavior,” Dr. Fenton said.

The campaign, launched in early April, kicks off with a series of public service announcements, including radio ads, online ads, and public transportation ads, with the theme, “Every 91/2 minutes.” Data from the CDC show that about 56,000 Americans become infected with HIV each year, which translates to 1 person becoming infected every 91/2 minutes. Doctors need to know that the Act Against AIDS campaign will be working to raise awareness about HIV infection and encourage testing, Dr. Fenton said in an interview.

“This [effort] is likely to have an impact on health seeking behaviors,” he said.

Consumer information about the campaign can be found at NineAndaHalfMinutes.org

WASHINGTON – The Obama administration has launched the first major U.S. initiative against HIV/AIDS in more than a decade.

The 5-year campaign, “Act Against Aids,” is a joint effort of the Centers for Disease Control and Prevention, the Department of Health and Human Services, and the White House to educate the public about HIV/AIDS, which remains a serious problem in the United States despite advances in treatment that allow more patients to survive.

Recent data from the Kaiser Family Foundation show that concern about HIV infection has declined in recent years, said Dr. Kevin Fenton, director of the CDC National Center for HIV/AIDS.

“People don't recognize that they are at risk, and they engage in high-risk behavior,” Dr. Fenton said.

The campaign, launched in early April, kicks off with a series of public service announcements, including radio ads, online ads, and public transportation ads, with the theme, “Every 91/2 minutes.” Data from the CDC show that about 56,000 Americans become infected with HIV each year, which translates to 1 person becoming infected every 91/2 minutes. Doctors need to know that the Act Against AIDS campaign will be working to raise awareness about HIV infection and encourage testing, Dr. Fenton said in an interview.

“This [effort] is likely to have an impact on health seeking behaviors,” he said.

Consumer information about the campaign can be found at NineAndaHalfMinutes.org

WASHINGTON – The Obama administration has launched the first major U.S. initiative against HIV/AIDS in more than a decade.

The 5-year campaign, “Act Against Aids,” is a joint effort of the Centers for Disease Control and Prevention, the Department of Health and Human Services, and the White House to educate the public about HIV/AIDS, which remains a serious problem in the United States despite advances in treatment that allow more patients to survive.

Recent data from the Kaiser Family Foundation show that concern about HIV infection has declined in recent years, said Dr. Kevin Fenton, director of the CDC National Center for HIV/AIDS.

“People don't recognize that they are at risk, and they engage in high-risk behavior,” Dr. Fenton said.

The campaign, launched in early April, kicks off with a series of public service announcements, including radio ads, online ads, and public transportation ads, with the theme, “Every 91/2 minutes.” Data from the CDC show that about 56,000 Americans become infected with HIV each year, which translates to 1 person becoming infected every 91/2 minutes. Doctors need to know that the Act Against AIDS campaign will be working to raise awareness about HIV infection and encourage testing, Dr. Fenton said in an interview.

“This [effort] is likely to have an impact on health seeking behaviors,” he said.

Consumer information about the campaign can be found at NineAndaHalfMinutes.org

WASHINGTON — The Obama administration has launched the first major U.S. initiative against HIV/AIDS in more than a decade.

The 5-year campaign, “Act Against AIDS,” is a joint effort of the Centers for Disease Control and Prevention, the Department of Health and Human Services, and the White House to educate the public about HIV/AIDS, which remains a serious problem in the United States despite advances in treatment that allow more patients to survive longer.

Recent data from the Kaiser Family Foundation show that concern about HIV has declined in recent years, said Dr. Kevin Fenton, director of the CDC National Center for HIV/AIDS. “People don't recognize that they are at risk, and they engage in high-risk behavior,” he said.

The goal of the campaign is to educate the public about the risks of HIV.

The campaign kicks off with a series of public service announcements, including radio, online, and public transportation ads with the theme “Every 91/2 Minutes.” According to data from the CDC, approximately 56,000 Americans become infected with HIV each year, which translates to one person becoming infected every 91/2 minutes.

The campaign also will target specific communities that are at increased risk for HIV, starting with the African American community, said Melody Barnes, assistant to the president and director of the White House Domestic Policy Council. Targeted outreach is also planned for the gay, bisexual, and Latino communities, she said.

Consumer information regarding the educational campaign can be found at nineandahalfminutes.org

WASHINGTON — The Obama administration has launched the first major U.S. initiative against HIV/AIDS in more than a decade.

The 5-year campaign, “Act Against AIDS,” is a joint effort of the Centers for Disease Control and Prevention, the Department of Health and Human Services, and the White House to educate the public about HIV/AIDS, which remains a serious problem in the United States despite advances in treatment that allow more patients to survive longer.

Recent data from the Kaiser Family Foundation show that concern about HIV has declined in recent years, said Dr. Kevin Fenton, director of the CDC National Center for HIV/AIDS. “People don't recognize that they are at risk, and they engage in high-risk behavior,” he said.

The goal of the campaign is to educate the public about the risks of HIV.

The campaign kicks off with a series of public service announcements, including radio, online, and public transportation ads with the theme “Every 91/2 Minutes.” According to data from the CDC, approximately 56,000 Americans become infected with HIV each year, which translates to one person becoming infected every 91/2 minutes.

The campaign also will target specific communities that are at increased risk for HIV, starting with the African American community, said Melody Barnes, assistant to the president and director of the White House Domestic Policy Council. Targeted outreach is also planned for the gay, bisexual, and Latino communities, she said.

Consumer information regarding the educational campaign can be found at nineandahalfminutes.org

WASHINGTON — The Obama administration has launched the first major U.S. initiative against HIV/AIDS in more than a decade.

The 5-year campaign, “Act Against AIDS,” is a joint effort of the Centers for Disease Control and Prevention, the Department of Health and Human Services, and the White House to educate the public about HIV/AIDS, which remains a serious problem in the United States despite advances in treatment that allow more patients to survive longer.

Recent data from the Kaiser Family Foundation show that concern about HIV has declined in recent years, said Dr. Kevin Fenton, director of the CDC National Center for HIV/AIDS. “People don't recognize that they are at risk, and they engage in high-risk behavior,” he said.

The goal of the campaign is to educate the public about the risks of HIV.

The campaign kicks off with a series of public service announcements, including radio, online, and public transportation ads with the theme “Every 91/2 Minutes.” According to data from the CDC, approximately 56,000 Americans become infected with HIV each year, which translates to one person becoming infected every 91/2 minutes.

The campaign also will target specific communities that are at increased risk for HIV, starting with the African American community, said Melody Barnes, assistant to the president and director of the White House Domestic Policy Council. Targeted outreach is also planned for the gay, bisexual, and Latino communities, she said.

Consumer information regarding the educational campaign can be found at nineandahalfminutes.org

WASHINGTON — Heavier people may have worse asthma control than do their lighter counterparts, but they are not significantly less likely to respond to treatment, based on data from a pair of studies presented at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

In one study of 221 adults with severe asthma, body mass index (BMI) had no significant effect on impaired prednisone absorption or on any abnormalities in prednisone clearance.

Previous studies have shown a relationship between increased weight and asthma severity, said Dr. Joshua Davidson of National Jewish Health in Denver. Dr. Davidson and his colleagues measured the in vitro glucocorticoid responses to prednisone, dexamethasone, fluticasone propionate, and budesonide in asthma patients in three different weight categories.

BMI was positively associated with an increased number of steroid side effects, said Dr. Davidson, who had no conflicts of interest to disclose. But BMI was not associated with any reduction in prednisone absorption or clearance, or in steroid response.

But asthma control remains a problem for heavier patients. Dr. Hector Ortega of GlaxoSmithKline and his colleagues reviewed data from the Asthma Control Characteristics and Prevalence Survey Study (ACCESS), which included 2,238 patients aged 15 years and older from 35 asthma clinics across the United States.

The researchers found that 65% of the adults with a BMI greater than 30 had poorly controlled asthma vs. 52% of those with a BMI of 30 or less. This difference was statistically significant, Dr. Ortega said.

After controlling for multiple variables, a BMI greater than 30 was independently associated with a 54% increased risk of poorly controlled asthma, Dr. Ortega said.

WASHINGTON — Heavier people may have worse asthma control than do their lighter counterparts, but they are not significantly less likely to respond to treatment, based on data from a pair of studies presented at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

In one study of 221 adults with severe asthma, body mass index (BMI) had no significant effect on impaired prednisone absorption or on any abnormalities in prednisone clearance.

Previous studies have shown a relationship between increased weight and asthma severity, said Dr. Joshua Davidson of National Jewish Health in Denver. Dr. Davidson and his colleagues measured the in vitro glucocorticoid responses to prednisone, dexamethasone, fluticasone propionate, and budesonide in asthma patients in three different weight categories.

BMI was positively associated with an increased number of steroid side effects, said Dr. Davidson, who had no conflicts of interest to disclose. But BMI was not associated with any reduction in prednisone absorption or clearance, or in steroid response.

But asthma control remains a problem for heavier patients. Dr. Hector Ortega of GlaxoSmithKline and his colleagues reviewed data from the Asthma Control Characteristics and Prevalence Survey Study (ACCESS), which included 2,238 patients aged 15 years and older from 35 asthma clinics across the United States.

The researchers found that 65% of the adults with a BMI greater than 30 had poorly controlled asthma vs. 52% of those with a BMI of 30 or less. This difference was statistically significant, Dr. Ortega said.

After controlling for multiple variables, a BMI greater than 30 was independently associated with a 54% increased risk of poorly controlled asthma, Dr. Ortega said.

WASHINGTON — Heavier people may have worse asthma control than do their lighter counterparts, but they are not significantly less likely to respond to treatment, based on data from a pair of studies presented at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

In one study of 221 adults with severe asthma, body mass index (BMI) had no significant effect on impaired prednisone absorption or on any abnormalities in prednisone clearance.

Previous studies have shown a relationship between increased weight and asthma severity, said Dr. Joshua Davidson of National Jewish Health in Denver. Dr. Davidson and his colleagues measured the in vitro glucocorticoid responses to prednisone, dexamethasone, fluticasone propionate, and budesonide in asthma patients in three different weight categories.

BMI was positively associated with an increased number of steroid side effects, said Dr. Davidson, who had no conflicts of interest to disclose. But BMI was not associated with any reduction in prednisone absorption or clearance, or in steroid response.

But asthma control remains a problem for heavier patients. Dr. Hector Ortega of GlaxoSmithKline and his colleagues reviewed data from the Asthma Control Characteristics and Prevalence Survey Study (ACCESS), which included 2,238 patients aged 15 years and older from 35 asthma clinics across the United States.

The researchers found that 65% of the adults with a BMI greater than 30 had poorly controlled asthma vs. 52% of those with a BMI of 30 or less. This difference was statistically significant, Dr. Ortega said.

After controlling for multiple variables, a BMI greater than 30 was independently associated with a 54% increased risk of poorly controlled asthma, Dr. Ortega said.

WASHINGTON — Measures of exhaled nitric oxide levels may add another dimension to the evaluation of asthma, based on data from a study presented at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

Fractional exhaled nitric oxide (FeNO) may be “a surrogate marker for airway inflammation,” Dr. Brian C. Schroer of the Cleveland Clinic said in an interview. Neither the Asthma Control Test (ACT) nor spirometry evaluate airway inflammation.

Dr. Schroer and his colleagues reviewed charts from the asthma-related medical visits of 139 adults, all of whom concurrently completed the ACT, FeNO, and spirometry tests. Approximately 66% of the patients were female, and 78% were white. The study excluded smokers and patients with concomitant conditions including chronic obstructive pulmonary disease, cystic fibrosis, and hypereosinophilic syndrome.

Overall, the average FeNO score was 30.8 parts per billion (ppb), the average ACT score was 19.2, the average forced expiratory volume in 1 second (FEV₁) score was 86.5%, and the average FEV₁/forced vital capacity (FVC) score was 87.4%. Scatter plots showed no correlation between FeNO and either ACT or spirometry measures.

Dr. Schroer said that he was initially surprised by the finding that inflammation was not increased in patients whose ACT scores were either decreased or normal. But the ACT doesn't take airway inflammation into account, and spirometry measures only airway hyperresponsiveness, he said, “so it doesn't surprise me in the long run that the airway inflammation isn't correlated with these other measurements of asthma control.”

The lack of correlation held true when the patients were divided into four groups based on asthma severity.

The study was supported by the William O. Wagner, M.D., Research and Education Fund. Dr. Schroer had no financial conflicts to disclose.

A related video is at ww.youtube.com/InternalMedicineNews

WASHINGTON — Measures of exhaled nitric oxide levels may add another dimension to the evaluation of asthma, based on data from a study presented at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

Fractional exhaled nitric oxide (FeNO) may be “a surrogate marker for airway inflammation,” Dr. Brian C. Schroer of the Cleveland Clinic said in an interview. Neither the Asthma Control Test (ACT) nor spirometry evaluate airway inflammation.

Dr. Schroer and his colleagues reviewed charts from the asthma-related medical visits of 139 adults, all of whom concurrently completed the ACT, FeNO, and spirometry tests. Approximately 66% of the patients were female, and 78% were white. The study excluded smokers and patients with concomitant conditions including chronic obstructive pulmonary disease, cystic fibrosis, and hypereosinophilic syndrome.

Overall, the average FeNO score was 30.8 parts per billion (ppb), the average ACT score was 19.2, the average forced expiratory volume in 1 second (FEV₁) score was 86.5%, and the average FEV₁/forced vital capacity (FVC) score was 87.4%. Scatter plots showed no correlation between FeNO and either ACT or spirometry measures.

Dr. Schroer said that he was initially surprised by the finding that inflammation was not increased in patients whose ACT scores were either decreased or normal. But the ACT doesn't take airway inflammation into account, and spirometry measures only airway hyperresponsiveness, he said, “so it doesn't surprise me in the long run that the airway inflammation isn't correlated with these other measurements of asthma control.”

The lack of correlation held true when the patients were divided into four groups based on asthma severity.

The study was supported by the William O. Wagner, M.D., Research and Education Fund. Dr. Schroer had no financial conflicts to disclose.

A related video is at ww.youtube.com/InternalMedicineNews

WASHINGTON — Measures of exhaled nitric oxide levels may add another dimension to the evaluation of asthma, based on data from a study presented at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

Fractional exhaled nitric oxide (FeNO) may be “a surrogate marker for airway inflammation,” Dr. Brian C. Schroer of the Cleveland Clinic said in an interview. Neither the Asthma Control Test (ACT) nor spirometry evaluate airway inflammation.

Dr. Schroer and his colleagues reviewed charts from the asthma-related medical visits of 139 adults, all of whom concurrently completed the ACT, FeNO, and spirometry tests. Approximately 66% of the patients were female, and 78% were white. The study excluded smokers and patients with concomitant conditions including chronic obstructive pulmonary disease, cystic fibrosis, and hypereosinophilic syndrome.

Overall, the average FeNO score was 30.8 parts per billion (ppb), the average ACT score was 19.2, the average forced expiratory volume in 1 second (FEV₁) score was 86.5%, and the average FEV₁/forced vital capacity (FVC) score was 87.4%. Scatter plots showed no correlation between FeNO and either ACT or spirometry measures.

Dr. Schroer said that he was initially surprised by the finding that inflammation was not increased in patients whose ACT scores were either decreased or normal. But the ACT doesn't take airway inflammation into account, and spirometry measures only airway hyperresponsiveness, he said, “so it doesn't surprise me in the long run that the airway inflammation isn't correlated with these other measurements of asthma control.”

The lack of correlation held true when the patients were divided into four groups based on asthma severity.

The study was supported by the William O. Wagner, M.D., Research and Education Fund. Dr. Schroer had no financial conflicts to disclose.

A related video is at ww.youtube.com/InternalMedicineNews