Heidi Splete

WASHINGTON — Herpes simplex virus type 2 infected approximately one-third of the young women in a study of 127 adolescents, but behavioral and demographic factors were more predictive of disease than were clinical symptoms.

Data from population-based studies have shown that herpes simplex virus type 2 (HSV-2) most often is acquired by women between the ages of 20 and 29 years, but many of them have no clinical symptoms, said Dr. Kenneth Fife of Indiana University in Indianapolis.

To determine the demographic and behavioral factors associated with HSV-2 infection in young women, Dr. Fife and his colleagues collected data for 4–6 years from 127 adolescents aged 14–18 years at baseline. The researchers presented their results in a poster at the jointly held annual meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy and the Infectious Diseases Society of America.

Of the study population, 92% were black and 7% were white; 33% were antibody positive for HSV-2 at baseline. Only three participants had a history of clinically diagnosed herpes when they entered the study, and the participants underwent quarterly screening for incident STDs.

Each participant kept a detailed behavioral diary for two 12-week periods each year and collected weekly vaginal swab samples during these 12-week periods. At the conclusion of the study, the average age of the participants was 21 years.

“Only increasing age, increased time since sexual debut, and an increased number of lifetime sexual partners were significantly correlated with a positive HSV-2 test,” Dr. Fife noted. The odds ratios for these factors were 1.36, 1.17, and 1.09, respectively.

The researchers found no significant association between a positive test result and recorded clinical symptoms of genital pain or discharge.

Of 121 participants for whom complete behavioral data were available, 67 had previous sera available for HSV-2 antibody testing, and 17 (25%) of these women seroconverted from negative to positive during the course of the study.

The DNA testing for HSV-2 in the study population is ongoing, but preliminary results from 13 women with positive results on polymerase chain reaction tests showed that most of the participants shed virus from the genital tract and most had several positive DNA tests over a single 12-week period.

The study was limited by the use of self-reports, but the results suggest that HSV-2 control programs should include young women because they shed virus frequently despite a lack of clinical symptoms, and early signs of infection may go unrecognized, Dr. Fife said.

The study was supported by a grant to Dr. Fife from GlaxoSmithKline and funding from the National Institutes of Health.

WASHINGTON — Herpes simplex virus type 2 infected approximately one-third of the young women in a study of 127 adolescents, but behavioral and demographic factors were more predictive of disease than were clinical symptoms.

Data from population-based studies have shown that herpes simplex virus type 2 (HSV-2) most often is acquired by women between the ages of 20 and 29 years, but many of them have no clinical symptoms, said Dr. Kenneth Fife of Indiana University in Indianapolis.

To determine the demographic and behavioral factors associated with HSV-2 infection in young women, Dr. Fife and his colleagues collected data for 4–6 years from 127 adolescents aged 14–18 years at baseline. The researchers presented their results in a poster at the jointly held annual meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy and the Infectious Diseases Society of America.

Of the study population, 92% were black and 7% were white; 33% were antibody positive for HSV-2 at baseline. Only three participants had a history of clinically diagnosed herpes when they entered the study, and the participants underwent quarterly screening for incident STDs.

Each participant kept a detailed behavioral diary for two 12-week periods each year and collected weekly vaginal swab samples during these 12-week periods. At the conclusion of the study, the average age of the participants was 21 years.

“Only increasing age, increased time since sexual debut, and an increased number of lifetime sexual partners were significantly correlated with a positive HSV-2 test,” Dr. Fife noted. The odds ratios for these factors were 1.36, 1.17, and 1.09, respectively.

The researchers found no significant association between a positive test result and recorded clinical symptoms of genital pain or discharge.

Of 121 participants for whom complete behavioral data were available, 67 had previous sera available for HSV-2 antibody testing, and 17 (25%) of these women seroconverted from negative to positive during the course of the study.

The DNA testing for HSV-2 in the study population is ongoing, but preliminary results from 13 women with positive results on polymerase chain reaction tests showed that most of the participants shed virus from the genital tract and most had several positive DNA tests over a single 12-week period.

The study was limited by the use of self-reports, but the results suggest that HSV-2 control programs should include young women because they shed virus frequently despite a lack of clinical symptoms, and early signs of infection may go unrecognized, Dr. Fife said.

The study was supported by a grant to Dr. Fife from GlaxoSmithKline and funding from the National Institutes of Health.

WASHINGTON — Herpes simplex virus type 2 infected approximately one-third of the young women in a study of 127 adolescents, but behavioral and demographic factors were more predictive of disease than were clinical symptoms.

Data from population-based studies have shown that herpes simplex virus type 2 (HSV-2) most often is acquired by women between the ages of 20 and 29 years, but many of them have no clinical symptoms, said Dr. Kenneth Fife of Indiana University in Indianapolis.

To determine the demographic and behavioral factors associated with HSV-2 infection in young women, Dr. Fife and his colleagues collected data for 4–6 years from 127 adolescents aged 14–18 years at baseline. The researchers presented their results in a poster at the jointly held annual meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy and the Infectious Diseases Society of America.

Of the study population, 92% were black and 7% were white; 33% were antibody positive for HSV-2 at baseline. Only three participants had a history of clinically diagnosed herpes when they entered the study, and the participants underwent quarterly screening for incident STDs.

Each participant kept a detailed behavioral diary for two 12-week periods each year and collected weekly vaginal swab samples during these 12-week periods. At the conclusion of the study, the average age of the participants was 21 years.

“Only increasing age, increased time since sexual debut, and an increased number of lifetime sexual partners were significantly correlated with a positive HSV-2 test,” Dr. Fife noted. The odds ratios for these factors were 1.36, 1.17, and 1.09, respectively.

The researchers found no significant association between a positive test result and recorded clinical symptoms of genital pain or discharge.

Of 121 participants for whom complete behavioral data were available, 67 had previous sera available for HSV-2 antibody testing, and 17 (25%) of these women seroconverted from negative to positive during the course of the study.

The DNA testing for HSV-2 in the study population is ongoing, but preliminary results from 13 women with positive results on polymerase chain reaction tests showed that most of the participants shed virus from the genital tract and most had several positive DNA tests over a single 12-week period.

The study was limited by the use of self-reports, but the results suggest that HSV-2 control programs should include young women because they shed virus frequently despite a lack of clinical symptoms, and early signs of infection may go unrecognized, Dr. Fife said.

The study was supported by a grant to Dr. Fife from GlaxoSmithKline and funding from the National Institutes of Health.

Escitalopram and sertraline were the most effective of a dozen second-generation antidepressants for treating major depression in adults, results of a review of randomized controlled trials that included more than 25,000 patients show.

Previous studies of the effectiveness of second-generation antidepressants have been inconsistent, said Dr. Andrea Cipriani of the University of Verona (Italy). Dr. Cipriani and his colleagues reviewed 117 randomized, controlled trials using a multiple-treatment meta-analysis, so they could compare treatments within and between trials.

The average length of treatment was 8 weeks, and the average sample size was 110 patients. The studies included a total of 25,928 adults (65% women) who participated in studies for the treatment of acute unipolar major depression between 1991 and 2007.

The review included the following drugs: bupropion, citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, milnacipran, mirtazapine, paroxetine, reboxetine, sertraline, and venlafaxine (Lancet 2009 [doi: 10.1016/S0140-6736(09)60046-5]).

Overall, some of the medications were significantly and clinically different in their effectiveness and acceptability. The four medications that were best tolerated were escitalopram, sertraline, citalopram, and bupropion. But the four drugs that were the most effective were mirtazapine, escitalopram, venlafaxine, and sertraline. Reboxetine was significantly less effective than any of the other 11 medications.

“The results indicate the two of the most efficacious treatments (mirtazapine and venlafaxine) might not be the best for overall acceptability,” they said.

“Our findings might help to choose among new generation antidepressants for acute treatment of major depression,” they noted.

The study results were limited to 8-week acute-phase treatment of depression and did not include a formal cost-effectiveness analysis, but the researchers suggested that sertraline may be the first choice financially in many countries.

Dr. Cipriani had no financial conflicts to disclose.

Escitalopram and sertraline were the most effective of a dozen second-generation antidepressants for treating major depression in adults, results of a review of randomized controlled trials that included more than 25,000 patients show.

Previous studies of the effectiveness of second-generation antidepressants have been inconsistent, said Dr. Andrea Cipriani of the University of Verona (Italy). Dr. Cipriani and his colleagues reviewed 117 randomized, controlled trials using a multiple-treatment meta-analysis, so they could compare treatments within and between trials.

The average length of treatment was 8 weeks, and the average sample size was 110 patients. The studies included a total of 25,928 adults (65% women) who participated in studies for the treatment of acute unipolar major depression between 1991 and 2007.

The review included the following drugs: bupropion, citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, milnacipran, mirtazapine, paroxetine, reboxetine, sertraline, and venlafaxine (Lancet 2009 [doi: 10.1016/S0140-6736(09)60046-5]).

Overall, some of the medications were significantly and clinically different in their effectiveness and acceptability. The four medications that were best tolerated were escitalopram, sertraline, citalopram, and bupropion. But the four drugs that were the most effective were mirtazapine, escitalopram, venlafaxine, and sertraline. Reboxetine was significantly less effective than any of the other 11 medications.

“The results indicate the two of the most efficacious treatments (mirtazapine and venlafaxine) might not be the best for overall acceptability,” they said.

“Our findings might help to choose among new generation antidepressants for acute treatment of major depression,” they noted.

The study results were limited to 8-week acute-phase treatment of depression and did not include a formal cost-effectiveness analysis, but the researchers suggested that sertraline may be the first choice financially in many countries.

Dr. Cipriani had no financial conflicts to disclose.

Escitalopram and sertraline were the most effective of a dozen second-generation antidepressants for treating major depression in adults, results of a review of randomized controlled trials that included more than 25,000 patients show.

Previous studies of the effectiveness of second-generation antidepressants have been inconsistent, said Dr. Andrea Cipriani of the University of Verona (Italy). Dr. Cipriani and his colleagues reviewed 117 randomized, controlled trials using a multiple-treatment meta-analysis, so they could compare treatments within and between trials.

The average length of treatment was 8 weeks, and the average sample size was 110 patients. The studies included a total of 25,928 adults (65% women) who participated in studies for the treatment of acute unipolar major depression between 1991 and 2007.

The review included the following drugs: bupropion, citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, milnacipran, mirtazapine, paroxetine, reboxetine, sertraline, and venlafaxine (Lancet 2009 [doi: 10.1016/S0140-6736(09)60046-5]).

Overall, some of the medications were significantly and clinically different in their effectiveness and acceptability. The four medications that were best tolerated were escitalopram, sertraline, citalopram, and bupropion. But the four drugs that were the most effective were mirtazapine, escitalopram, venlafaxine, and sertraline. Reboxetine was significantly less effective than any of the other 11 medications.

“The results indicate the two of the most efficacious treatments (mirtazapine and venlafaxine) might not be the best for overall acceptability,” they said.

“Our findings might help to choose among new generation antidepressants for acute treatment of major depression,” they noted.

The study results were limited to 8-week acute-phase treatment of depression and did not include a formal cost-effectiveness analysis, but the researchers suggested that sertraline may be the first choice financially in many countries.

Dr. Cipriani had no financial conflicts to disclose.

WASHINGTON — Using hormonal contraceptives might weaken a woman's natural immunity to the herpesvirus, according to findings from a pilot study of healthy women aged 18-35 years.

Findings from previous epidemiologic studies suggest that women who use hormonal contraception are at increased risk for sexually transmitted infections and herpes simplex virus (HSV) shedding. Yet clinical studies have shown that "cervicovaginal lavage fluid protects against HSV, HIV, and bacteria," lead author Dr. Gail F. Shust said at the jointly held annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) and the annual meeting of the Infectious Diseases Society of America (IDSA).

Dr. Shust and colleagues from Albert Einstein College of Medicine, New York, measured anti-HSV activity and levels of immunity associated with hormonal contraception use by collecting samples of cervicovaginal lavage (CVL) fluid from 16 women once a week for 3-8 weeks. Nine women had normal ovulatory cycles and served as controls, and seven women used hormonal contraception.

When average values from the repeat CVL samples from each woman were compared, in the follicular phase, women using hormonal contraception showed significantly less anti-HSV activity compared with the controls. In the luteal phase, the difference did not reach statistical significance.

When individual fluid samples were compared (for a total of 94 samples), the anti-HSV activity in women using hormonal contraception was significantly lower, compared with the controls, in both the follicular and luteal phases.

Correlations between anti-HSV activity and specific mucosal mediators that can inhibit herpes infection were measured through a Spearman's rank correlation coefficient analysis. Based on this measure, anti-HSV activity was positively correlated with levels of human neutrophil peptides (HNPs) 1, 2, and 3 (Spearman's rho = 0.45), lactoferrin (rs = 0.52), lysozyme (rs = 0.58), and IgA (rs = 0.44).

In addition, anti-HSV activity was negatively correlated with interferon-alpha 2 (rs = −0.36). Each of these correlations was statistically significant.

The study was limited by its small size and intrasubject and intersubject variability in anti-HSV activity.

These findings may provide a biologic explanation for the epidemiologic findings of increased risk for acquisition of sexually transmitted infections, and for HSV shedding, in the setting of hormonal contraception, the researchers said. Studies of the factors that modify anti-HSV activity are ongoing, and larger, prospective studies are needed to support the results, they noted.

Dr. Shust reported no financial conflicts of interest.

WASHINGTON — Using hormonal contraceptives might weaken a woman's natural immunity to the herpesvirus, according to findings from a pilot study of healthy women aged 18-35 years.

Findings from previous epidemiologic studies suggest that women who use hormonal contraception are at increased risk for sexually transmitted infections and herpes simplex virus (HSV) shedding. Yet clinical studies have shown that "cervicovaginal lavage fluid protects against HSV, HIV, and bacteria," lead author Dr. Gail F. Shust said at the jointly held annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) and the annual meeting of the Infectious Diseases Society of America (IDSA).

Dr. Shust and colleagues from Albert Einstein College of Medicine, New York, measured anti-HSV activity and levels of immunity associated with hormonal contraception use by collecting samples of cervicovaginal lavage (CVL) fluid from 16 women once a week for 3-8 weeks. Nine women had normal ovulatory cycles and served as controls, and seven women used hormonal contraception.

When average values from the repeat CVL samples from each woman were compared, in the follicular phase, women using hormonal contraception showed significantly less anti-HSV activity compared with the controls. In the luteal phase, the difference did not reach statistical significance.

When individual fluid samples were compared (for a total of 94 samples), the anti-HSV activity in women using hormonal contraception was significantly lower, compared with the controls, in both the follicular and luteal phases.

Correlations between anti-HSV activity and specific mucosal mediators that can inhibit herpes infection were measured through a Spearman's rank correlation coefficient analysis. Based on this measure, anti-HSV activity was positively correlated with levels of human neutrophil peptides (HNPs) 1, 2, and 3 (Spearman's rho = 0.45), lactoferrin (rs = 0.52), lysozyme (rs = 0.58), and IgA (rs = 0.44).

In addition, anti-HSV activity was negatively correlated with interferon-alpha 2 (rs = −0.36). Each of these correlations was statistically significant.

The study was limited by its small size and intrasubject and intersubject variability in anti-HSV activity.

These findings may provide a biologic explanation for the epidemiologic findings of increased risk for acquisition of sexually transmitted infections, and for HSV shedding, in the setting of hormonal contraception, the researchers said. Studies of the factors that modify anti-HSV activity are ongoing, and larger, prospective studies are needed to support the results, they noted.

Dr. Shust reported no financial conflicts of interest.

WASHINGTON — Using hormonal contraceptives might weaken a woman's natural immunity to the herpesvirus, according to findings from a pilot study of healthy women aged 18-35 years.

Findings from previous epidemiologic studies suggest that women who use hormonal contraception are at increased risk for sexually transmitted infections and herpes simplex virus (HSV) shedding. Yet clinical studies have shown that "cervicovaginal lavage fluid protects against HSV, HIV, and bacteria," lead author Dr. Gail F. Shust said at the jointly held annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) and the annual meeting of the Infectious Diseases Society of America (IDSA).

Dr. Shust and colleagues from Albert Einstein College of Medicine, New York, measured anti-HSV activity and levels of immunity associated with hormonal contraception use by collecting samples of cervicovaginal lavage (CVL) fluid from 16 women once a week for 3-8 weeks. Nine women had normal ovulatory cycles and served as controls, and seven women used hormonal contraception.

When average values from the repeat CVL samples from each woman were compared, in the follicular phase, women using hormonal contraception showed significantly less anti-HSV activity compared with the controls. In the luteal phase, the difference did not reach statistical significance.

When individual fluid samples were compared (for a total of 94 samples), the anti-HSV activity in women using hormonal contraception was significantly lower, compared with the controls, in both the follicular and luteal phases.

Correlations between anti-HSV activity and specific mucosal mediators that can inhibit herpes infection were measured through a Spearman's rank correlation coefficient analysis. Based on this measure, anti-HSV activity was positively correlated with levels of human neutrophil peptides (HNPs) 1, 2, and 3 (Spearman's rho = 0.45), lactoferrin (rs = 0.52), lysozyme (rs = 0.58), and IgA (rs = 0.44).

In addition, anti-HSV activity was negatively correlated with interferon-alpha 2 (rs = −0.36). Each of these correlations was statistically significant.

The study was limited by its small size and intrasubject and intersubject variability in anti-HSV activity.

These findings may provide a biologic explanation for the epidemiologic findings of increased risk for acquisition of sexually transmitted infections, and for HSV shedding, in the setting of hormonal contraception, the researchers said. Studies of the factors that modify anti-HSV activity are ongoing, and larger, prospective studies are needed to support the results, they noted.

Dr. Shust reported no financial conflicts of interest.

RIO GRANDE, P.R. — Primary care physicians can successfully perform screening colonoscopies and identify patients at increased risk for developing colorectal cancer, according to a review of 559 colonoscopies.

Colonoscopy is the preferred screening method for patients who are at increased risk for developing colorectal cancer, while flexible sigmoidoscopy is considered adequate for average risk individuals, said Dr. Khalid Jaboori of Madigan Army Medical Center in Fort Lewis, Washington.

There aren't enough gastroenterologists to perform screening colonoscopies on all the patients who need them, whether they are at high risk or not, said Dr. Jaboori. Colonoscopy is a safe, cost-effective procedure that allows a full view of the colon and management of the findings, he added.

The researchers reviewed outpatient colonoscopies performed by a family physician between September 2003 and October 2007 on patients aged 26–87 years. The study population included 324 patients at average risk and 235 at high risk. The researchers recorded the location of all neoplasias and calculated the diagnostic yield of a flexible sigmoidoscopy for how many neoplasias would have been found with flexible sigmoidoscopy alone. The neoplasias that would have been detected by flexible sigmoidoscopy alone were defined as those in the left colon or in the distal part of the right colon. Dr. Jaboori presented the results in a poster at the annual meeting of the North American Primary Care Research Group.

Overall, the presence of colonic neoplasia was 23% in the average-risk group and 33% in the high-risk group. There was no significant difference in the prevalence of proximal colonic neoplasia that would have been found by colonoscopy between average-risk (10%) and high-risk patients (15%). Also, isolated advanced lesions on the right side of the colon were identified in four patients (1.2%) in the average-risk group and one patient (0.4%) in the high-risk group, which was not a significant difference.

The diagnostic ability of flexible sigmoidoscopy to detect any neoplasia was similar for the average-risk and high-risk groups (both 56%).

“Approximately 44% of the neoplasias would have been missed in both groups with flexible sigmoidoscopy alone,” Dr. Jaboori said.

The results suggest that primary care residents and physicians should be trained in colonoscopies. “Increasing the pool of competently trained endoscopists will allow more patients to benefit from screening colonoscopy as the standard of care,” the researchers noted.

Dr. Jaboori had no conflicts of interest to report. The views in the study are those of the authors and do not reflect the policy of the U.S. Army, the Department of Defense, or the U.S. government. To watch a video go to www.youtube.com/user/FamilyPracticeNews

RIO GRANDE, P.R. — Primary care physicians can successfully perform screening colonoscopies and identify patients at increased risk for developing colorectal cancer, according to a review of 559 colonoscopies.

Colonoscopy is the preferred screening method for patients who are at increased risk for developing colorectal cancer, while flexible sigmoidoscopy is considered adequate for average risk individuals, said Dr. Khalid Jaboori of Madigan Army Medical Center in Fort Lewis, Washington.

There aren't enough gastroenterologists to perform screening colonoscopies on all the patients who need them, whether they are at high risk or not, said Dr. Jaboori. Colonoscopy is a safe, cost-effective procedure that allows a full view of the colon and management of the findings, he added.

The researchers reviewed outpatient colonoscopies performed by a family physician between September 2003 and October 2007 on patients aged 26–87 years. The study population included 324 patients at average risk and 235 at high risk. The researchers recorded the location of all neoplasias and calculated the diagnostic yield of a flexible sigmoidoscopy for how many neoplasias would have been found with flexible sigmoidoscopy alone. The neoplasias that would have been detected by flexible sigmoidoscopy alone were defined as those in the left colon or in the distal part of the right colon. Dr. Jaboori presented the results in a poster at the annual meeting of the North American Primary Care Research Group.

Overall, the presence of colonic neoplasia was 23% in the average-risk group and 33% in the high-risk group. There was no significant difference in the prevalence of proximal colonic neoplasia that would have been found by colonoscopy between average-risk (10%) and high-risk patients (15%). Also, isolated advanced lesions on the right side of the colon were identified in four patients (1.2%) in the average-risk group and one patient (0.4%) in the high-risk group, which was not a significant difference.

The diagnostic ability of flexible sigmoidoscopy to detect any neoplasia was similar for the average-risk and high-risk groups (both 56%).

“Approximately 44% of the neoplasias would have been missed in both groups with flexible sigmoidoscopy alone,” Dr. Jaboori said.

The results suggest that primary care residents and physicians should be trained in colonoscopies. “Increasing the pool of competently trained endoscopists will allow more patients to benefit from screening colonoscopy as the standard of care,” the researchers noted.

Dr. Jaboori had no conflicts of interest to report. The views in the study are those of the authors and do not reflect the policy of the U.S. Army, the Department of Defense, or the U.S. government. To watch a video go to www.youtube.com/user/FamilyPracticeNews

RIO GRANDE, P.R. — Primary care physicians can successfully perform screening colonoscopies and identify patients at increased risk for developing colorectal cancer, according to a review of 559 colonoscopies.

Colonoscopy is the preferred screening method for patients who are at increased risk for developing colorectal cancer, while flexible sigmoidoscopy is considered adequate for average risk individuals, said Dr. Khalid Jaboori of Madigan Army Medical Center in Fort Lewis, Washington.

There aren't enough gastroenterologists to perform screening colonoscopies on all the patients who need them, whether they are at high risk or not, said Dr. Jaboori. Colonoscopy is a safe, cost-effective procedure that allows a full view of the colon and management of the findings, he added.

The researchers reviewed outpatient colonoscopies performed by a family physician between September 2003 and October 2007 on patients aged 26–87 years. The study population included 324 patients at average risk and 235 at high risk. The researchers recorded the location of all neoplasias and calculated the diagnostic yield of a flexible sigmoidoscopy for how many neoplasias would have been found with flexible sigmoidoscopy alone. The neoplasias that would have been detected by flexible sigmoidoscopy alone were defined as those in the left colon or in the distal part of the right colon. Dr. Jaboori presented the results in a poster at the annual meeting of the North American Primary Care Research Group.

Overall, the presence of colonic neoplasia was 23% in the average-risk group and 33% in the high-risk group. There was no significant difference in the prevalence of proximal colonic neoplasia that would have been found by colonoscopy between average-risk (10%) and high-risk patients (15%). Also, isolated advanced lesions on the right side of the colon were identified in four patients (1.2%) in the average-risk group and one patient (0.4%) in the high-risk group, which was not a significant difference.

The diagnostic ability of flexible sigmoidoscopy to detect any neoplasia was similar for the average-risk and high-risk groups (both 56%).

“Approximately 44% of the neoplasias would have been missed in both groups with flexible sigmoidoscopy alone,” Dr. Jaboori said.

The results suggest that primary care residents and physicians should be trained in colonoscopies. “Increasing the pool of competently trained endoscopists will allow more patients to benefit from screening colonoscopy as the standard of care,” the researchers noted.

Dr. Jaboori had no conflicts of interest to report. The views in the study are those of the authors and do not reflect the policy of the U.S. Army, the Department of Defense, or the U.S. government. To watch a video go to www.youtube.com/user/FamilyPracticeNews

ARLINGTON, VA. — Despite the lack of evidence that over-the-counter cold medicines cure the common cold, nearly two-thirds of American adults choose them to treat symptoms, according to survey results from 1,005 individuals aged 18 and older.

The findings suggest that physicians should continue to educate patients about the limits of nonproven OTC medications and natural remedies for cold prevention and treatment, wrote Dr. Mark Moyad and his colleagues in a poster presented at the annual meeting of the American College of Nutrition.

However, Americans appear to be getting the message about hand hygiene. Overall, 72% of the survey respondents reported frequent handwashing as a first line of defense against cold prevention. Other prevention methods included taking multivitamins (48%), getting plenty of rest (41%), and taking vitamin C supplements (36%).

Once they had developed a cold, 79% of the survey respondents reported drinking lots of fluids, 71% reported getting plenty of rest, and 68% reported using OTC medications.

Data for this study were culled from a nationwide sample of respondents to an online survey conducted as part of a larger research project on the common cold in America that was commissioned by U.S. Nutrition and conducted by Booth Research Services Inc. of Atlanta. Dr. Moyad, of the University of Michigan, Ann Arbor, is on the advisory board of Zila Pharmaceuticals, the manufacturer of the vitamin C supplement Ester-C.

ELSEVIER GLOBAL MEDICAL NEWS

ARLINGTON, VA. — Despite the lack of evidence that over-the-counter cold medicines cure the common cold, nearly two-thirds of American adults choose them to treat symptoms, according to survey results from 1,005 individuals aged 18 and older.

The findings suggest that physicians should continue to educate patients about the limits of nonproven OTC medications and natural remedies for cold prevention and treatment, wrote Dr. Mark Moyad and his colleagues in a poster presented at the annual meeting of the American College of Nutrition.

However, Americans appear to be getting the message about hand hygiene. Overall, 72% of the survey respondents reported frequent handwashing as a first line of defense against cold prevention. Other prevention methods included taking multivitamins (48%), getting plenty of rest (41%), and taking vitamin C supplements (36%).

Once they had developed a cold, 79% of the survey respondents reported drinking lots of fluids, 71% reported getting plenty of rest, and 68% reported using OTC medications.

Data for this study were culled from a nationwide sample of respondents to an online survey conducted as part of a larger research project on the common cold in America that was commissioned by U.S. Nutrition and conducted by Booth Research Services Inc. of Atlanta. Dr. Moyad, of the University of Michigan, Ann Arbor, is on the advisory board of Zila Pharmaceuticals, the manufacturer of the vitamin C supplement Ester-C.

ELSEVIER GLOBAL MEDICAL NEWS

ARLINGTON, VA. — Despite the lack of evidence that over-the-counter cold medicines cure the common cold, nearly two-thirds of American adults choose them to treat symptoms, according to survey results from 1,005 individuals aged 18 and older.

The findings suggest that physicians should continue to educate patients about the limits of nonproven OTC medications and natural remedies for cold prevention and treatment, wrote Dr. Mark Moyad and his colleagues in a poster presented at the annual meeting of the American College of Nutrition.

However, Americans appear to be getting the message about hand hygiene. Overall, 72% of the survey respondents reported frequent handwashing as a first line of defense against cold prevention. Other prevention methods included taking multivitamins (48%), getting plenty of rest (41%), and taking vitamin C supplements (36%).

Once they had developed a cold, 79% of the survey respondents reported drinking lots of fluids, 71% reported getting plenty of rest, and 68% reported using OTC medications.

Data for this study were culled from a nationwide sample of respondents to an online survey conducted as part of a larger research project on the common cold in America that was commissioned by U.S. Nutrition and conducted by Booth Research Services Inc. of Atlanta. Dr. Moyad, of the University of Michigan, Ann Arbor, is on the advisory board of Zila Pharmaceuticals, the manufacturer of the vitamin C supplement Ester-C.

ELSEVIER GLOBAL MEDICAL NEWS

For a related video, go to www.youtube.com/InternalMedicineNews

WASHINGTON — Drug abuse among U.S. adolescents remained steady in 2008, compared with recent years, but cigarette smoking is at a historic low, according to the 2008 Monitoring the Future survey, released by the National Institute on Drug Abuse.

Students in grades 8, 10, and 12 continue to show a gradual decline in their use of certain drugs, specifically amphetamines, methamphetamine, crystal methamphetamine, cocaine, and crack, according to the latest survey. However, the results, which were announced at a press conference, are “very, very fragile,” said John Walters, director of the Office of National Drug Control Policy. “We still have more work to do.” Contributing to the decline in use are efforts by the federal government to reduce drug availability.

The survey, entitled “Monitoring the Future: National Survey Results on Drug Use” (MTF), has been conducted annually among 12th-grade students in the United States since 1975, and among 8th and 10th graders since 1991. This year's survey included data from 46,348 students in 386 public and private schools in the continental United States.

Overall, 14.6% of teens reported using illicit drugs in the previous month, representing a 25% decrease in use from 2001, which is statistically significant. In addition, 15.4% of 12th graders reported abusing prescription drugs during 2008, with 9.7% of this student group reporting nonmedical use of the prescription painkiller Vicodin, and 4.7% reporting abuse of OxyContin. These rates are essentially unchanged from 2007.

In addition, marijuana use plateaued: 10.9%, 23.9%, and 32.4% of 8th, 10th, and 12th graders, respectively, reported using marijuana in the past year, basically mirroring 2007 findings. However, fewer eighth graders said they thought smoking marijuana was harmful or said that they disapproved of using it. Also, fewer eighth graders said they thought inhalants were harmful or said that they disapproved of their use, compared with responses from the previous year's survey.

Notable data on older teens' attitudes about drugs included a continuing downward trend in the numbers of 12th graders who said they thought LSD use was harmful.

On a positive note, cigarette smoking rates continued to show a steady decline for all grades. The percentage of teens who reported cigarette use was 12.6% in 2008, compared with 20.2% in 2001. But smoking remains a significant threat to adolescent health. More than 1 in 10 of 12th graders who participated in the survey reported daily cigarette smoking, and 5.4% reported smoking half a pack of cigarettes daily.

Alcohol use continued to decline at all three grade levels, but underage drinking remains a problem, especially among older teens. Nearly 25% of 12th graders reported having five or more consecutive drinks at least once during the 2 weeks prior to taking the survey.

“Drug addiction is a disease of the brain,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse. She said physicians should be vigilant about screening teenagers and, when appropriate, providing interventions.

The MTF survey is conducted by a team of researchers at the University of Michigan, Ann Arbor, and is funded by a grant from the National Institute on Drug Abuse, part of the National Institutes of Health and the United States Department of Health and Human Services.

For the full report and more information on substance use among teenagers, visit monitoringthefuture.org.

Be vigilant about screening teenagers and, when appropriate, provide interventions. DR. VOLKOW

For a related video, go to www.youtube.com/InternalMedicineNews

WASHINGTON — Drug abuse among U.S. adolescents remained steady in 2008, compared with recent years, but cigarette smoking is at a historic low, according to the 2008 Monitoring the Future survey, released by the National Institute on Drug Abuse.

Students in grades 8, 10, and 12 continue to show a gradual decline in their use of certain drugs, specifically amphetamines, methamphetamine, crystal methamphetamine, cocaine, and crack, according to the latest survey. However, the results, which were announced at a press conference, are “very, very fragile,” said John Walters, director of the Office of National Drug Control Policy. “We still have more work to do.” Contributing to the decline in use are efforts by the federal government to reduce drug availability.

The survey, entitled “Monitoring the Future: National Survey Results on Drug Use” (MTF), has been conducted annually among 12th-grade students in the United States since 1975, and among 8th and 10th graders since 1991. This year's survey included data from 46,348 students in 386 public and private schools in the continental United States.

Overall, 14.6% of teens reported using illicit drugs in the previous month, representing a 25% decrease in use from 2001, which is statistically significant. In addition, 15.4% of 12th graders reported abusing prescription drugs during 2008, with 9.7% of this student group reporting nonmedical use of the prescription painkiller Vicodin, and 4.7% reporting abuse of OxyContin. These rates are essentially unchanged from 2007.

In addition, marijuana use plateaued: 10.9%, 23.9%, and 32.4% of 8th, 10th, and 12th graders, respectively, reported using marijuana in the past year, basically mirroring 2007 findings. However, fewer eighth graders said they thought smoking marijuana was harmful or said that they disapproved of using it. Also, fewer eighth graders said they thought inhalants were harmful or said that they disapproved of their use, compared with responses from the previous year's survey.

Notable data on older teens' attitudes about drugs included a continuing downward trend in the numbers of 12th graders who said they thought LSD use was harmful.

On a positive note, cigarette smoking rates continued to show a steady decline for all grades. The percentage of teens who reported cigarette use was 12.6% in 2008, compared with 20.2% in 2001. But smoking remains a significant threat to adolescent health. More than 1 in 10 of 12th graders who participated in the survey reported daily cigarette smoking, and 5.4% reported smoking half a pack of cigarettes daily.

Alcohol use continued to decline at all three grade levels, but underage drinking remains a problem, especially among older teens. Nearly 25% of 12th graders reported having five or more consecutive drinks at least once during the 2 weeks prior to taking the survey.

“Drug addiction is a disease of the brain,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse. She said physicians should be vigilant about screening teenagers and, when appropriate, providing interventions.

The MTF survey is conducted by a team of researchers at the University of Michigan, Ann Arbor, and is funded by a grant from the National Institute on Drug Abuse, part of the National Institutes of Health and the United States Department of Health and Human Services.

For the full report and more information on substance use among teenagers, visit monitoringthefuture.org.

Be vigilant about screening teenagers and, when appropriate, provide interventions. DR. VOLKOW

For a related video, go to www.youtube.com/InternalMedicineNews

WASHINGTON — Drug abuse among U.S. adolescents remained steady in 2008, compared with recent years, but cigarette smoking is at a historic low, according to the 2008 Monitoring the Future survey, released by the National Institute on Drug Abuse.

Students in grades 8, 10, and 12 continue to show a gradual decline in their use of certain drugs, specifically amphetamines, methamphetamine, crystal methamphetamine, cocaine, and crack, according to the latest survey. However, the results, which were announced at a press conference, are “very, very fragile,” said John Walters, director of the Office of National Drug Control Policy. “We still have more work to do.” Contributing to the decline in use are efforts by the federal government to reduce drug availability.

The survey, entitled “Monitoring the Future: National Survey Results on Drug Use” (MTF), has been conducted annually among 12th-grade students in the United States since 1975, and among 8th and 10th graders since 1991. This year's survey included data from 46,348 students in 386 public and private schools in the continental United States.

Overall, 14.6% of teens reported using illicit drugs in the previous month, representing a 25% decrease in use from 2001, which is statistically significant. In addition, 15.4% of 12th graders reported abusing prescription drugs during 2008, with 9.7% of this student group reporting nonmedical use of the prescription painkiller Vicodin, and 4.7% reporting abuse of OxyContin. These rates are essentially unchanged from 2007.

In addition, marijuana use plateaued: 10.9%, 23.9%, and 32.4% of 8th, 10th, and 12th graders, respectively, reported using marijuana in the past year, basically mirroring 2007 findings. However, fewer eighth graders said they thought smoking marijuana was harmful or said that they disapproved of using it. Also, fewer eighth graders said they thought inhalants were harmful or said that they disapproved of their use, compared with responses from the previous year's survey.

Notable data on older teens' attitudes about drugs included a continuing downward trend in the numbers of 12th graders who said they thought LSD use was harmful.

On a positive note, cigarette smoking rates continued to show a steady decline for all grades. The percentage of teens who reported cigarette use was 12.6% in 2008, compared with 20.2% in 2001. But smoking remains a significant threat to adolescent health. More than 1 in 10 of 12th graders who participated in the survey reported daily cigarette smoking, and 5.4% reported smoking half a pack of cigarettes daily.

Alcohol use continued to decline at all three grade levels, but underage drinking remains a problem, especially among older teens. Nearly 25% of 12th graders reported having five or more consecutive drinks at least once during the 2 weeks prior to taking the survey.

“Drug addiction is a disease of the brain,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse. She said physicians should be vigilant about screening teenagers and, when appropriate, providing interventions.

The MTF survey is conducted by a team of researchers at the University of Michigan, Ann Arbor, and is funded by a grant from the National Institute on Drug Abuse, part of the National Institutes of Health and the United States Department of Health and Human Services.

For the full report and more information on substance use among teenagers, visit monitoringthefuture.org.

Be vigilant about screening teenagers and, when appropriate, provide interventions. DR. VOLKOW

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, of the McLennan County Medical Education and Research Foundation, Waco, Tex.

Previous studies of osteoporosis in women have focused mainly on white women 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 from the study.

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. Overall, the left femoral neck had the lowest regional BMD. Dr. Weaver presented the results in a poster at the annual meeting of the North American Primary Care Research Group.

Dr. Weaver 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, of the McLennan County Medical Education and Research Foundation, Waco, Tex.

Previous studies of osteoporosis in women have focused mainly on white women 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 from the study.

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. Overall, the left femoral neck had the lowest regional BMD. Dr. Weaver presented the results in a poster at the annual meeting of the North American Primary Care Research Group.

Dr. Weaver 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, of the McLennan County Medical Education and Research Foundation, Waco, Tex.

Previous studies of osteoporosis in women have focused mainly on white women 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 from the study.

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. Overall, the left femoral neck had the lowest regional BMD. Dr. Weaver presented the results in a poster at the annual meeting of the North American Primary Care Research Group.

Dr. Weaver had no financial conflicts to disclose.

WASHINGTON — Behavioral and demographic factors were more predictive of herpes simplex virus type 2 than were clinical symptoms in a study of 127 adolescents, approximately one-third of whom were infected with the disease.

Data from population-based studies have shown that herpes simplex virus type 2 (HSV-2) most often is acquired by women between the ages of 20 and 29 years, but many of them have no clinical symptoms, said Dr. Kenneth Fife of Indiana University, Indianapolis.

To determine the demographic and behavioral factors associated with HSV-2 infection in young women, Dr. Fife and his colleagues collected data for 4–6 years from 127 adolescents aged 14–18 years at baseline. The researchers presented their results in a poster at the jointly held annual meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy and the Infectious Diseases Society of America.

Of the study population, 92% were black and 7% were white; 33% were antibody positive for HSV-2 at baseline. Only three participants had a history of clinically diagnosed herpes when they entered the study, and the participants underwent quarterly screening for incident STDs. Each participant kept a detailed behavioral diary for two 12-week periods each year and collected weekly vaginal swab samples during these 12-week periods. At the conclusion of the study, the average age of the participants was 21 years.

“Only increasing age, increased time since sexual debut, and an increased number of lifetime sexual partners were significantly correlated with a positive HSV-2 test,” Dr. Fife noted. The odds ratios for these factors were 1.36, 1.17, and 1.09, respectively.

The researchers found no significant association between a positive test result and recorded clinical symptoms of genital pain or discharge.

Of 121 participants for whom complete behavioral data were available, 67 had previous sera available for HSV-2 antibody testing, and 17 (25%) of these women seroconverted from negative to positive during the course of the study.

The DNA testing for HSV-2 in the study population is ongoing, but preliminary results from 13 women with positive results on PCR tests showed that most of the participants shed virus from the genital tract and most had several positive DNA tests over a single 12-week period.

The study was limited by the use of self-reports, but the results suggest that HSV-2 control programs should include young women because they shed virus frequently despite a lack of clinical symptoms, and early signs of infection may go unrecognized, Dr. Fife said.

The study was supported by a grant to Dr. Fife from GlaxoSmithKline and funding from the National Institutes of Health.

WASHINGTON — Behavioral and demographic factors were more predictive of herpes simplex virus type 2 than were clinical symptoms in a study of 127 adolescents, approximately one-third of whom were infected with the disease.

Data from population-based studies have shown that herpes simplex virus type 2 (HSV-2) most often is acquired by women between the ages of 20 and 29 years, but many of them have no clinical symptoms, said Dr. Kenneth Fife of Indiana University, Indianapolis.

To determine the demographic and behavioral factors associated with HSV-2 infection in young women, Dr. Fife and his colleagues collected data for 4–6 years from 127 adolescents aged 14–18 years at baseline. The researchers presented their results in a poster at the jointly held annual meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy and the Infectious Diseases Society of America.

Of the study population, 92% were black and 7% were white; 33% were antibody positive for HSV-2 at baseline. Only three participants had a history of clinically diagnosed herpes when they entered the study, and the participants underwent quarterly screening for incident STDs. Each participant kept a detailed behavioral diary for two 12-week periods each year and collected weekly vaginal swab samples during these 12-week periods. At the conclusion of the study, the average age of the participants was 21 years.

“Only increasing age, increased time since sexual debut, and an increased number of lifetime sexual partners were significantly correlated with a positive HSV-2 test,” Dr. Fife noted. The odds ratios for these factors were 1.36, 1.17, and 1.09, respectively.

The researchers found no significant association between a positive test result and recorded clinical symptoms of genital pain or discharge.

Of 121 participants for whom complete behavioral data were available, 67 had previous sera available for HSV-2 antibody testing, and 17 (25%) of these women seroconverted from negative to positive during the course of the study.

The DNA testing for HSV-2 in the study population is ongoing, but preliminary results from 13 women with positive results on PCR tests showed that most of the participants shed virus from the genital tract and most had several positive DNA tests over a single 12-week period.

The study was limited by the use of self-reports, but the results suggest that HSV-2 control programs should include young women because they shed virus frequently despite a lack of clinical symptoms, and early signs of infection may go unrecognized, Dr. Fife said.

The study was supported by a grant to Dr. Fife from GlaxoSmithKline and funding from the National Institutes of Health.

WASHINGTON — Behavioral and demographic factors were more predictive of herpes simplex virus type 2 than were clinical symptoms in a study of 127 adolescents, approximately one-third of whom were infected with the disease.

Data from population-based studies have shown that herpes simplex virus type 2 (HSV-2) most often is acquired by women between the ages of 20 and 29 years, but many of them have no clinical symptoms, said Dr. Kenneth Fife of Indiana University, Indianapolis.

To determine the demographic and behavioral factors associated with HSV-2 infection in young women, Dr. Fife and his colleagues collected data for 4–6 years from 127 adolescents aged 14–18 years at baseline. The researchers presented their results in a poster at the jointly held annual meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy and the Infectious Diseases Society of America.

Of the study population, 92% were black and 7% were white; 33% were antibody positive for HSV-2 at baseline. Only three participants had a history of clinically diagnosed herpes when they entered the study, and the participants underwent quarterly screening for incident STDs. Each participant kept a detailed behavioral diary for two 12-week periods each year and collected weekly vaginal swab samples during these 12-week periods. At the conclusion of the study, the average age of the participants was 21 years.

“Only increasing age, increased time since sexual debut, and an increased number of lifetime sexual partners were significantly correlated with a positive HSV-2 test,” Dr. Fife noted. The odds ratios for these factors were 1.36, 1.17, and 1.09, respectively.

The researchers found no significant association between a positive test result and recorded clinical symptoms of genital pain or discharge.

Of 121 participants for whom complete behavioral data were available, 67 had previous sera available for HSV-2 antibody testing, and 17 (25%) of these women seroconverted from negative to positive during the course of the study.

The DNA testing for HSV-2 in the study population is ongoing, but preliminary results from 13 women with positive results on PCR tests showed that most of the participants shed virus from the genital tract and most had several positive DNA tests over a single 12-week period.

The study was limited by the use of self-reports, but the results suggest that HSV-2 control programs should include young women because they shed virus frequently despite a lack of clinical symptoms, and early signs of infection may go unrecognized, Dr. Fife said.

The study was supported by a grant to Dr. Fife from GlaxoSmithKline and funding from the National Institutes of Health.

RIO GRANDE, PUERTO RICO — Intranasal corticosteroids were no better than placebo for curing otitis media in children aged 4-11 years, based on data from a study of more than 200 children.

Dr. Ian Williamson of the University of Southampton (England) and his colleagues hypothesized that off-label intranasal corticosteroids might be effective against otitis media with effusion (OME), which is among the most common indications for surgery in young children in the United Kingdom.

The investigators randomized 217 children with OME diagnoses to receive 50 mcg of mometasone spray or a placebo spray in each nostril once daily for 3 months. The children were referred for the study from 99 family practices in the United Kingdom between 2004 and 2007.

The primary outcome was resolution of infection in at least one ear after 1 month, based on tympanometry data. Overall, the cure rate at 1 month was 41% among the 105 children who received corticosteroids and 45% among the 112 children who received the placebo spray. A secondary analysis at 3 months showed similar results, with cure rates of approximately 50% in each group, Dr. Williamson said at the annual meeting of the North American Primary Care Research Group.

Adverse events included nasal stinging, dry throat, cough, and nosebleed, but the incidence of these events was not significantly different.

Dr. Williamson stated that he had no financial conflicts to disclose.

RIO GRANDE, PUERTO RICO — Intranasal corticosteroids were no better than placebo for curing otitis media in children aged 4-11 years, based on data from a study of more than 200 children.

Dr. Ian Williamson of the University of Southampton (England) and his colleagues hypothesized that off-label intranasal corticosteroids might be effective against otitis media with effusion (OME), which is among the most common indications for surgery in young children in the United Kingdom.

The investigators randomized 217 children with OME diagnoses to receive 50 mcg of mometasone spray or a placebo spray in each nostril once daily for 3 months. The children were referred for the study from 99 family practices in the United Kingdom between 2004 and 2007.

The primary outcome was resolution of infection in at least one ear after 1 month, based on tympanometry data. Overall, the cure rate at 1 month was 41% among the 105 children who received corticosteroids and 45% among the 112 children who received the placebo spray. A secondary analysis at 3 months showed similar results, with cure rates of approximately 50% in each group, Dr. Williamson said at the annual meeting of the North American Primary Care Research Group.

Adverse events included nasal stinging, dry throat, cough, and nosebleed, but the incidence of these events was not significantly different.

Dr. Williamson stated that he had no financial conflicts to disclose.

RIO GRANDE, PUERTO RICO — Intranasal corticosteroids were no better than placebo for curing otitis media in children aged 4-11 years, based on data from a study of more than 200 children.

Dr. Ian Williamson of the University of Southampton (England) and his colleagues hypothesized that off-label intranasal corticosteroids might be effective against otitis media with effusion (OME), which is among the most common indications for surgery in young children in the United Kingdom.

The investigators randomized 217 children with OME diagnoses to receive 50 mcg of mometasone spray or a placebo spray in each nostril once daily for 3 months. The children were referred for the study from 99 family practices in the United Kingdom between 2004 and 2007.

The primary outcome was resolution of infection in at least one ear after 1 month, based on tympanometry data. Overall, the cure rate at 1 month was 41% among the 105 children who received corticosteroids and 45% among the 112 children who received the placebo spray. A secondary analysis at 3 months showed similar results, with cure rates of approximately 50% in each group, Dr. Williamson said at the annual meeting of the North American Primary Care Research Group.

Adverse events included nasal stinging, dry throat, cough, and nosebleed, but the incidence of these events was not significantly different.

Dr. Williamson stated that he had no financial conflicts to disclose.

To view a video interview of investigators discussing the survey results, go to http://www.youtube.com/watch?v=QfIL1ZUf5gI

WASHINGTON — Drug abuse among U.S. adolescents remained steady in 2008, compared with recent years, but cigarette smoking is at a historic low, according to the 2008 Monitoring the Future survey, released by the National Institute on Drug Abuse.

Students in grades 8, 10, and 12 continue to show a gradual decline in their use of certain drugs, specifically amphetamines, methamphetamine, crystal methamphetamine, cocaine, and crack, according to the latest survey. But the results, which were announced at a press conference, are “very, very fragile,” said John Walters, director of the Office of National Drug Control Policy. “We still have more work to do.” Contributing to the decline in use are efforts by the federal government to reduce drug availability.

The survey, entitled “Monitoring the Future: National Survey Results on Drug Use” (MTF), has been conducted annually among 12th-grade students in the United States since 1975, and among 8th and 10th graders since 1991. It includes data from classroom surveys, and this year included data from 46,348 students in 386 public and private schools in the continental United States.

Overall, 14.6% of teens reported using illicit drugs in the previous month, representing a 25% decrease in use from 2001, which is statistically significant. In addition, 15.4% of 12th graders reported abusing prescription drugs during 2008, with 9.7% of this student group reporting nonmedical use of the prescription painkiller Vicodin, and 4.7% reporting abuse of OxyContin. These rates are essentially unchanged from 2007.

In addition, marijuana use plateaued: 10.9%, 23.9%, and 32.4% of 8th, 10th, and 12th graders respectively reported using marijuana in the past year, basically mirroring 2007 findings. However, fewer eighth graders said they thought inhalants or smoking marijuana was harmful or said that they disapproved of their use, compared with responses from the previous year's survey.

Notable data on older teens' attitudes about drugs included a continuing downward trend in the numbers of 12th graders who think LSD use is harmful.

Cigarette smoking rates continued to show a steady decline for all grades. The percentage of teens reporting cigarette use was 12.6% in 2008 (20.2% in 2001). But smoking remains a significant threat to adolescent health. More than 1 in 10 of 12th-grade participant reported daily cigarette smoking, and 5.4% reported smoking half a pack of cigarettes daily.

Alcohol use continued to decline at all three grade levels. Yet, underage drinking remains a problem, especially among older teens. Nearly 25% of 12th graders reported having five or more consecutive drinks at least once during the 2 weeks prior to taking the survey.

“Drug addiction is a disease of the brain,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse. She said physicians should be vigilant about screening teenagers and providing intervention that can improve their health.

Presenters at the press conference said those who deal in adolescent health cannot afford to become complacent; they must continue to put out the message about the dangers and consequences of smoking, alcohol, and drug use.

The MTF survey is conducted by researchers at the University of Michigan, Ann Arbor and funded by a grant from the National Institute on Drug Abuse, part of the National Institutes of Health and the United States Department of Health and Human Services. The full report is at www.monitoringthefuture.org

Physicians must be vigilant about screening for drug use and providing interventions that can improve teens' health. DR. VOLKOW

To view a video interview of investigators discussing the survey results, go to http://www.youtube.com/watch?v=QfIL1ZUf5gI

WASHINGTON — Drug abuse among U.S. adolescents remained steady in 2008, compared with recent years, but cigarette smoking is at a historic low, according to the 2008 Monitoring the Future survey, released by the National Institute on Drug Abuse.

Students in grades 8, 10, and 12 continue to show a gradual decline in their use of certain drugs, specifically amphetamines, methamphetamine, crystal methamphetamine, cocaine, and crack, according to the latest survey. But the results, which were announced at a press conference, are “very, very fragile,” said John Walters, director of the Office of National Drug Control Policy. “We still have more work to do.” Contributing to the decline in use are efforts by the federal government to reduce drug availability.

The survey, entitled “Monitoring the Future: National Survey Results on Drug Use” (MTF), has been conducted annually among 12th-grade students in the United States since 1975, and among 8th and 10th graders since 1991. It includes data from classroom surveys, and this year included data from 46,348 students in 386 public and private schools in the continental United States.

Overall, 14.6% of teens reported using illicit drugs in the previous month, representing a 25% decrease in use from 2001, which is statistically significant. In addition, 15.4% of 12th graders reported abusing prescription drugs during 2008, with 9.7% of this student group reporting nonmedical use of the prescription painkiller Vicodin, and 4.7% reporting abuse of OxyContin. These rates are essentially unchanged from 2007.

In addition, marijuana use plateaued: 10.9%, 23.9%, and 32.4% of 8th, 10th, and 12th graders respectively reported using marijuana in the past year, basically mirroring 2007 findings. However, fewer eighth graders said they thought inhalants or smoking marijuana was harmful or said that they disapproved of their use, compared with responses from the previous year's survey.

Notable data on older teens' attitudes about drugs included a continuing downward trend in the numbers of 12th graders who think LSD use is harmful.

Cigarette smoking rates continued to show a steady decline for all grades. The percentage of teens reporting cigarette use was 12.6% in 2008 (20.2% in 2001). But smoking remains a significant threat to adolescent health. More than 1 in 10 of 12th-grade participant reported daily cigarette smoking, and 5.4% reported smoking half a pack of cigarettes daily.

Alcohol use continued to decline at all three grade levels. Yet, underage drinking remains a problem, especially among older teens. Nearly 25% of 12th graders reported having five or more consecutive drinks at least once during the 2 weeks prior to taking the survey.

“Drug addiction is a disease of the brain,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse. She said physicians should be vigilant about screening teenagers and providing intervention that can improve their health.

Presenters at the press conference said those who deal in adolescent health cannot afford to become complacent; they must continue to put out the message about the dangers and consequences of smoking, alcohol, and drug use.

The MTF survey is conducted by researchers at the University of Michigan, Ann Arbor and funded by a grant from the National Institute on Drug Abuse, part of the National Institutes of Health and the United States Department of Health and Human Services. The full report is at www.monitoringthefuture.org

Physicians must be vigilant about screening for drug use and providing interventions that can improve teens' health. DR. VOLKOW

To view a video interview of investigators discussing the survey results, go to http://www.youtube.com/watch?v=QfIL1ZUf5gI

WASHINGTON — Drug abuse among U.S. adolescents remained steady in 2008, compared with recent years, but cigarette smoking is at a historic low, according to the 2008 Monitoring the Future survey, released by the National Institute on Drug Abuse.

Students in grades 8, 10, and 12 continue to show a gradual decline in their use of certain drugs, specifically amphetamines, methamphetamine, crystal methamphetamine, cocaine, and crack, according to the latest survey. But the results, which were announced at a press conference, are “very, very fragile,” said John Walters, director of the Office of National Drug Control Policy. “We still have more work to do.” Contributing to the decline in use are efforts by the federal government to reduce drug availability.

The survey, entitled “Monitoring the Future: National Survey Results on Drug Use” (MTF), has been conducted annually among 12th-grade students in the United States since 1975, and among 8th and 10th graders since 1991. It includes data from classroom surveys, and this year included data from 46,348 students in 386 public and private schools in the continental United States.

Overall, 14.6% of teens reported using illicit drugs in the previous month, representing a 25% decrease in use from 2001, which is statistically significant. In addition, 15.4% of 12th graders reported abusing prescription drugs during 2008, with 9.7% of this student group reporting nonmedical use of the prescription painkiller Vicodin, and 4.7% reporting abuse of OxyContin. These rates are essentially unchanged from 2007.

In addition, marijuana use plateaued: 10.9%, 23.9%, and 32.4% of 8th, 10th, and 12th graders respectively reported using marijuana in the past year, basically mirroring 2007 findings. However, fewer eighth graders said they thought inhalants or smoking marijuana was harmful or said that they disapproved of their use, compared with responses from the previous year's survey.

Notable data on older teens' attitudes about drugs included a continuing downward trend in the numbers of 12th graders who think LSD use is harmful.

Cigarette smoking rates continued to show a steady decline for all grades. The percentage of teens reporting cigarette use was 12.6% in 2008 (20.2% in 2001). But smoking remains a significant threat to adolescent health. More than 1 in 10 of 12th-grade participant reported daily cigarette smoking, and 5.4% reported smoking half a pack of cigarettes daily.

Alcohol use continued to decline at all three grade levels. Yet, underage drinking remains a problem, especially among older teens. Nearly 25% of 12th graders reported having five or more consecutive drinks at least once during the 2 weeks prior to taking the survey.

“Drug addiction is a disease of the brain,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse. She said physicians should be vigilant about screening teenagers and providing intervention that can improve their health.

Presenters at the press conference said those who deal in adolescent health cannot afford to become complacent; they must continue to put out the message about the dangers and consequences of smoking, alcohol, and drug use.

The MTF survey is conducted by researchers at the University of Michigan, Ann Arbor and funded by a grant from the National Institute on Drug Abuse, part of the National Institutes of Health and the United States Department of Health and Human Services. The full report is at www.monitoringthefuture.org

Physicians must be vigilant about screening for drug use and providing interventions that can improve teens' health. DR. VOLKOW