Jan Dyer

Extreme weight gain during pregnancy may contribute to  risk factors for early childhood asthma, say researchers from University of South Carolina. They found obesity nearly doubled a woman’s chances of having a child who developed asthma by age 4. Extreme-low weight gain (<5 kg) and extreme-high weight gain (≥25 kg) were both associated with increased risk of asthma.

At 9 months, 2 years, and 4 years, 5%, 8%, and 12% of children, respectively, were diagnosed with asthma. Overall, 15% of children were diagnosed with asthma by age 4. Every 1.0 unit increase in maternal body mass index was associated with increased odds of asthma in children.

Childhood asthma already is believed to have inutero origins, the researchers say. They cite a study that found 40% of children with a diagnosis of asthma by age 7 had reduced airflow and bronchial responsiveness as neonates. Research suggests that maternal weight and gestational weight gain may change the intrauterine environment and affect the development of asthma.

The researchers say, to their knowledge, no studies have examined the association between gestational weight gain and asthma in offspring in a nationally representative sample of children in the U.S. Moreover, previous studies did not account for gestational age, which can affect the amount of weight gained.

Although the researchers note that no single risk factor can entirely account for childhood asthma, maternal obesity is one that is modifiable.

Extreme weight gain during pregnancy may contribute to  risk factors for early childhood asthma, say researchers from University of South Carolina. They found obesity nearly doubled a woman’s chances of having a child who developed asthma by age 4. Extreme-low weight gain (<5 kg) and extreme-high weight gain (≥25 kg) were both associated with increased risk of asthma.

At 9 months, 2 years, and 4 years, 5%, 8%, and 12% of children, respectively, were diagnosed with asthma. Overall, 15% of children were diagnosed with asthma by age 4. Every 1.0 unit increase in maternal body mass index was associated with increased odds of asthma in children.

Childhood asthma already is believed to have inutero origins, the researchers say. They cite a study that found 40% of children with a diagnosis of asthma by age 7 had reduced airflow and bronchial responsiveness as neonates. Research suggests that maternal weight and gestational weight gain may change the intrauterine environment and affect the development of asthma.

The researchers say, to their knowledge, no studies have examined the association between gestational weight gain and asthma in offspring in a nationally representative sample of children in the U.S. Moreover, previous studies did not account for gestational age, which can affect the amount of weight gained.

Although the researchers note that no single risk factor can entirely account for childhood asthma, maternal obesity is one that is modifiable.

Extreme weight gain during pregnancy may contribute to  risk factors for early childhood asthma, say researchers from University of South Carolina. They found obesity nearly doubled a woman’s chances of having a child who developed asthma by age 4. Extreme-low weight gain (<5 kg) and extreme-high weight gain (≥25 kg) were both associated with increased risk of asthma.

At 9 months, 2 years, and 4 years, 5%, 8%, and 12% of children, respectively, were diagnosed with asthma. Overall, 15% of children were diagnosed with asthma by age 4. Every 1.0 unit increase in maternal body mass index was associated with increased odds of asthma in children.

Childhood asthma already is believed to have inutero origins, the researchers say. They cite a study that found 40% of children with a diagnosis of asthma by age 7 had reduced airflow and bronchial responsiveness as neonates. Research suggests that maternal weight and gestational weight gain may change the intrauterine environment and affect the development of asthma.

The researchers say, to their knowledge, no studies have examined the association between gestational weight gain and asthma in offspring in a nationally representative sample of children in the U.S. Moreover, previous studies did not account for gestational age, which can affect the amount of weight gained.

Although the researchers note that no single risk factor can entirely account for childhood asthma, maternal obesity is one that is modifiable.

About 1 in 5 U.S. adults used tobacco in 2015 every day or on some days, according to the CDC and the FDA. The most common tobacco product was cigarettes (15%). About 9.5 million adults used ≥ 2 tobacco products.

This is the first time the CDC and FDA have used the National Health Interview Survey to assess the range of tobacco products used. Survey questions asked about current cigarette smoking since 1965, but only recently began to track other tobacco products.

About 42 million adults, or > 87% of the nearly 49 million tobacco product users in the U.S., reported using cigarettes, cigars, or pipes; the remaining tobacco users reported using e-cigarettes or smokeless tobacco products (eg, chewing tobacco and snuff).

The survey also found that men were more likely than women to use tobacco products (25% vs 15%). Adults aged 25 to 44 years were more likely than those aged ≥ 65 years to use tobacco products (23% vs 11%). By race and ethnicity, tobacco product use ranged from 9% among Asians to 27% among American Indians/Alaska Natives.

Using tobacco products was more common among adults in the Midwest; people with annual incomes less than $35,000; the uninsured or Medicaid insured; those with a disability; and those who are lesbian, gay, or bisexual. Adults with serious psychological distress were more than 2 times as likely to use tobacco as those who reported no serious psychological distress (47% vs 19%).

Cigarette smoking remains the leading preventable cause of death and disease in the U.S. The CDC urges full implementation of comprehensive state tobacco control programs along with FDA regulation of tobacco products and targeted interventions to reach subpopulations with the greatest burden of use.

About 1 in 5 U.S. adults used tobacco in 2015 every day or on some days, according to the CDC and the FDA. The most common tobacco product was cigarettes (15%). About 9.5 million adults used ≥ 2 tobacco products.

This is the first time the CDC and FDA have used the National Health Interview Survey to assess the range of tobacco products used. Survey questions asked about current cigarette smoking since 1965, but only recently began to track other tobacco products.

About 42 million adults, or > 87% of the nearly 49 million tobacco product users in the U.S., reported using cigarettes, cigars, or pipes; the remaining tobacco users reported using e-cigarettes or smokeless tobacco products (eg, chewing tobacco and snuff).

The survey also found that men were more likely than women to use tobacco products (25% vs 15%). Adults aged 25 to 44 years were more likely than those aged ≥ 65 years to use tobacco products (23% vs 11%). By race and ethnicity, tobacco product use ranged from 9% among Asians to 27% among American Indians/Alaska Natives.

Using tobacco products was more common among adults in the Midwest; people with annual incomes less than $35,000; the uninsured or Medicaid insured; those with a disability; and those who are lesbian, gay, or bisexual. Adults with serious psychological distress were more than 2 times as likely to use tobacco as those who reported no serious psychological distress (47% vs 19%).

Cigarette smoking remains the leading preventable cause of death and disease in the U.S. The CDC urges full implementation of comprehensive state tobacco control programs along with FDA regulation of tobacco products and targeted interventions to reach subpopulations with the greatest burden of use.

About 1 in 5 U.S. adults used tobacco in 2015 every day or on some days, according to the CDC and the FDA. The most common tobacco product was cigarettes (15%). About 9.5 million adults used ≥ 2 tobacco products.

This is the first time the CDC and FDA have used the National Health Interview Survey to assess the range of tobacco products used. Survey questions asked about current cigarette smoking since 1965, but only recently began to track other tobacco products.

About 42 million adults, or > 87% of the nearly 49 million tobacco product users in the U.S., reported using cigarettes, cigars, or pipes; the remaining tobacco users reported using e-cigarettes or smokeless tobacco products (eg, chewing tobacco and snuff).

The survey also found that men were more likely than women to use tobacco products (25% vs 15%). Adults aged 25 to 44 years were more likely than those aged ≥ 65 years to use tobacco products (23% vs 11%). By race and ethnicity, tobacco product use ranged from 9% among Asians to 27% among American Indians/Alaska Natives.

Using tobacco products was more common among adults in the Midwest; people with annual incomes less than $35,000; the uninsured or Medicaid insured; those with a disability; and those who are lesbian, gay, or bisexual. Adults with serious psychological distress were more than 2 times as likely to use tobacco as those who reported no serious psychological distress (47% vs 19%).

Cigarette smoking remains the leading preventable cause of death and disease in the U.S. The CDC urges full implementation of comprehensive state tobacco control programs along with FDA regulation of tobacco products and targeted interventions to reach subpopulations with the greatest burden of use.

Adult patients with mycosis fungoides (MF) have a higher risk of secondary malignancies, according to a 20-year population-based cohort study. The researchers, from Bezmialem Vakif University in Istanbul, Turkey, say their findings support earlier research about a higher risk of, for instance, Hodgkin lymphoma, chronic leukemia, and lung cancer.

Between 1998 and 2015, the researchers documented 143 cases of cutaneous T-cell lymphoma (CTCL). The majority of patients had early-stage disease.

The researchers also documented 13 cases (9%) of secondary malignancy diagnosed at least 3 months after the diagnosis of CTCL. The cancers included bladder cancer, nasopharynx cancer, renal cell carcinoma, lung cancer, and superficial spreading malignant melanoma.

Older age, stage IV disease, lymphomatoid papulosis, and having CTCL for > 10 years raised the chances of developing secondary solid tumors. In 60% of patients, the secondary malignancies occurred during the first year of diagnosis.

Research has suggested that antilymphoma drugs, particularly alkylating agents, may lead to leukemia, the researchers note. In this study, 6 patients with secondary cancers were getting systemic treatment with interferon or acitretin; 7 were getting no systemic treatment.

The researchers add that MF and hematologic malignancies may share genetic origin, carcinogens, or viruses that affect lymphocyte precursors. They also note that the first neoplasm may produce cytokines that induce development of the secondary neoplasm. The researchers cite research that found MF is a T helper cell 2–mediated disease associated with human leukocyte antigen 2 alleles. Viruses such as Epstein-Barr and herpes simplex also have been implicated.

“Extensive evaluation” for secondary malignancies in adult patients with MF is wise, the researchers advise, particularly if the patient has lymphomatoid papulosis.

Source:

Cengiz FP, Emiroğlu N, Onsun N. Turk J Haematol. 2017;34(4):378-379.

doi: 10.4274/tjh.2017.0234.

Adult patients with mycosis fungoides (MF) have a higher risk of secondary malignancies, according to a 20-year population-based cohort study. The researchers, from Bezmialem Vakif University in Istanbul, Turkey, say their findings support earlier research about a higher risk of, for instance, Hodgkin lymphoma, chronic leukemia, and lung cancer.

Between 1998 and 2015, the researchers documented 143 cases of cutaneous T-cell lymphoma (CTCL). The majority of patients had early-stage disease.

The researchers also documented 13 cases (9%) of secondary malignancy diagnosed at least 3 months after the diagnosis of CTCL. The cancers included bladder cancer, nasopharynx cancer, renal cell carcinoma, lung cancer, and superficial spreading malignant melanoma.

Older age, stage IV disease, lymphomatoid papulosis, and having CTCL for > 10 years raised the chances of developing secondary solid tumors. In 60% of patients, the secondary malignancies occurred during the first year of diagnosis.

Research has suggested that antilymphoma drugs, particularly alkylating agents, may lead to leukemia, the researchers note. In this study, 6 patients with secondary cancers were getting systemic treatment with interferon or acitretin; 7 were getting no systemic treatment.

The researchers add that MF and hematologic malignancies may share genetic origin, carcinogens, or viruses that affect lymphocyte precursors. They also note that the first neoplasm may produce cytokines that induce development of the secondary neoplasm. The researchers cite research that found MF is a T helper cell 2–mediated disease associated with human leukocyte antigen 2 alleles. Viruses such as Epstein-Barr and herpes simplex also have been implicated.

“Extensive evaluation” for secondary malignancies in adult patients with MF is wise, the researchers advise, particularly if the patient has lymphomatoid papulosis.

Source:

Cengiz FP, Emiroğlu N, Onsun N. Turk J Haematol. 2017;34(4):378-379.

doi: 10.4274/tjh.2017.0234.

Adult patients with mycosis fungoides (MF) have a higher risk of secondary malignancies, according to a 20-year population-based cohort study. The researchers, from Bezmialem Vakif University in Istanbul, Turkey, say their findings support earlier research about a higher risk of, for instance, Hodgkin lymphoma, chronic leukemia, and lung cancer.

Between 1998 and 2015, the researchers documented 143 cases of cutaneous T-cell lymphoma (CTCL). The majority of patients had early-stage disease.

The researchers also documented 13 cases (9%) of secondary malignancy diagnosed at least 3 months after the diagnosis of CTCL. The cancers included bladder cancer, nasopharynx cancer, renal cell carcinoma, lung cancer, and superficial spreading malignant melanoma.

Older age, stage IV disease, lymphomatoid papulosis, and having CTCL for > 10 years raised the chances of developing secondary solid tumors. In 60% of patients, the secondary malignancies occurred during the first year of diagnosis.

Research has suggested that antilymphoma drugs, particularly alkylating agents, may lead to leukemia, the researchers note. In this study, 6 patients with secondary cancers were getting systemic treatment with interferon or acitretin; 7 were getting no systemic treatment.

The researchers add that MF and hematologic malignancies may share genetic origin, carcinogens, or viruses that affect lymphocyte precursors. They also note that the first neoplasm may produce cytokines that induce development of the secondary neoplasm. The researchers cite research that found MF is a T helper cell 2–mediated disease associated with human leukocyte antigen 2 alleles. Viruses such as Epstein-Barr and herpes simplex also have been implicated.

“Extensive evaluation” for secondary malignancies in adult patients with MF is wise, the researchers advise, particularly if the patient has lymphomatoid papulosis.

Source:

Cengiz FP, Emiroğlu N, Onsun N. Turk J Haematol. 2017;34(4):378-379.

doi: 10.4274/tjh.2017.0234.

The FDA has given the nod to a new indication for the NSS-2 Bridge, an electronic device that was cleared for use in acupuncture in 2014. Now it is approved for reducing the symptoms of opioid withdrawal.

The NSS-2 Bridge is a small electrical nerve stimulator placed behind a patient’s ear. A battery-powered chip sends electrical pulses to stimulate branches of certain cranial nerves. Patients can use the device for up to 5 days during the acute phase of physical withdrawal.

The approval was based on results from a clinical study of 73 patients in withdrawal, evaluating their symptoms on the Clinical Opiate Withdrawal Scale (COWS), which measures signs and symptoms such as resting pulse rate, sweating, pupil size, gastrointestinal issues, bone and joint aches, tremors, and anxiety. The COWS scores range from 0 to > 36. The higher the score, the more severe the symptoms.

Before patients used the device, their average COWS score was 20.1. Within 30 minutes, all patient scores dropped by at least 31%. Nearly all (88%) the patients transitioned to medication-assisted therapy after 5 days of using the device.

The FDA has given the nod to a new indication for the NSS-2 Bridge, an electronic device that was cleared for use in acupuncture in 2014. Now it is approved for reducing the symptoms of opioid withdrawal.

The NSS-2 Bridge is a small electrical nerve stimulator placed behind a patient’s ear. A battery-powered chip sends electrical pulses to stimulate branches of certain cranial nerves. Patients can use the device for up to 5 days during the acute phase of physical withdrawal.

The approval was based on results from a clinical study of 73 patients in withdrawal, evaluating their symptoms on the Clinical Opiate Withdrawal Scale (COWS), which measures signs and symptoms such as resting pulse rate, sweating, pupil size, gastrointestinal issues, bone and joint aches, tremors, and anxiety. The COWS scores range from 0 to > 36. The higher the score, the more severe the symptoms.

Before patients used the device, their average COWS score was 20.1. Within 30 minutes, all patient scores dropped by at least 31%. Nearly all (88%) the patients transitioned to medication-assisted therapy after 5 days of using the device.

The FDA has given the nod to a new indication for the NSS-2 Bridge, an electronic device that was cleared for use in acupuncture in 2014. Now it is approved for reducing the symptoms of opioid withdrawal.

The NSS-2 Bridge is a small electrical nerve stimulator placed behind a patient’s ear. A battery-powered chip sends electrical pulses to stimulate branches of certain cranial nerves. Patients can use the device for up to 5 days during the acute phase of physical withdrawal.

The approval was based on results from a clinical study of 73 patients in withdrawal, evaluating their symptoms on the Clinical Opiate Withdrawal Scale (COWS), which measures signs and symptoms such as resting pulse rate, sweating, pupil size, gastrointestinal issues, bone and joint aches, tremors, and anxiety. The COWS scores range from 0 to > 36. The higher the score, the more severe the symptoms.

Before patients used the device, their average COWS score was 20.1. Within 30 minutes, all patient scores dropped by at least 31%. Nearly all (88%) the patients transitioned to medication-assisted therapy after 5 days of using the device.

Does antibiotic prophylaxis protect patients with cardiac conditions against endocarditis from invasive dental procedures? Studies have long suggested both “yes” and “no.” Researchers from Université Paris Diderot and others note that clinical trials and cohort studies have not proved efficacy. Only 2 case-control studies done in the past 30 years have established an association between dental procedures and streptococcal infective endocarditis; neither was sufficiently powered to establish the efficacy of antibiotic prophylaxis.

Current U.S. and European guidelines vary in who must be covered: all patients, certain patients, or no patients at all. But a rise in the incidence of infective endocarditis among patients with prosthetic heart valves, implicating invasive dental procedures, “raised the question of whether the indications for antibiotic prophylaxis may be broadened again,” the researchers say. They cite 2016 NICE guidelines that “clearly specify” that it may be appropriate in individual cases.

Given that endocarditis can be fatal or expensive to treat—hospitals stays are long and valve surgery may be needed—the researchers decided to evaluate the association between invasive dental procedures and oral streptococcal infective endocarditis in a population-based cohort and a case crossover study.

In the first study of 138,876 patients with prosthetic heart valves, 69,303 underwent at least 1 dental procedure. Of 396,615 dental procedures, 26% were invasive. Patients received prophylactic antibiotics before half of the procedures.   

Over a median 1.7 years of follow-up, 267 people developed infective endocarditis associated with oral streptococci. However, the rate of oral streptococcal infective endocarditis did not rise significantly in the 3 months after an invasive dental procedure, with or without antibiotic prophylaxis. 

The case crossover study of patients with endocarditis indicated “the same direction of effect”: Although invasive dental procedures may be associated with oral streptococcal infective endocarditis, the magnitude of the association “remains uncertain.”

Source:

Tubiana S, Blotière PO, Hoen B, et al. BMJ. 2017;358: j3776.

doi: 10.1136/bmj.j3776.

Does antibiotic prophylaxis protect patients with cardiac conditions against endocarditis from invasive dental procedures? Studies have long suggested both “yes” and “no.” Researchers from Université Paris Diderot and others note that clinical trials and cohort studies have not proved efficacy. Only 2 case-control studies done in the past 30 years have established an association between dental procedures and streptococcal infective endocarditis; neither was sufficiently powered to establish the efficacy of antibiotic prophylaxis.

Current U.S. and European guidelines vary in who must be covered: all patients, certain patients, or no patients at all. But a rise in the incidence of infective endocarditis among patients with prosthetic heart valves, implicating invasive dental procedures, “raised the question of whether the indications for antibiotic prophylaxis may be broadened again,” the researchers say. They cite 2016 NICE guidelines that “clearly specify” that it may be appropriate in individual cases.

Given that endocarditis can be fatal or expensive to treat—hospitals stays are long and valve surgery may be needed—the researchers decided to evaluate the association between invasive dental procedures and oral streptococcal infective endocarditis in a population-based cohort and a case crossover study.

In the first study of 138,876 patients with prosthetic heart valves, 69,303 underwent at least 1 dental procedure. Of 396,615 dental procedures, 26% were invasive. Patients received prophylactic antibiotics before half of the procedures.   

Over a median 1.7 years of follow-up, 267 people developed infective endocarditis associated with oral streptococci. However, the rate of oral streptococcal infective endocarditis did not rise significantly in the 3 months after an invasive dental procedure, with or without antibiotic prophylaxis. 

The case crossover study of patients with endocarditis indicated “the same direction of effect”: Although invasive dental procedures may be associated with oral streptococcal infective endocarditis, the magnitude of the association “remains uncertain.”

Source:

Tubiana S, Blotière PO, Hoen B, et al. BMJ. 2017;358: j3776.

doi: 10.1136/bmj.j3776.

Does antibiotic prophylaxis protect patients with cardiac conditions against endocarditis from invasive dental procedures? Studies have long suggested both “yes” and “no.” Researchers from Université Paris Diderot and others note that clinical trials and cohort studies have not proved efficacy. Only 2 case-control studies done in the past 30 years have established an association between dental procedures and streptococcal infective endocarditis; neither was sufficiently powered to establish the efficacy of antibiotic prophylaxis.

Current U.S. and European guidelines vary in who must be covered: all patients, certain patients, or no patients at all. But a rise in the incidence of infective endocarditis among patients with prosthetic heart valves, implicating invasive dental procedures, “raised the question of whether the indications for antibiotic prophylaxis may be broadened again,” the researchers say. They cite 2016 NICE guidelines that “clearly specify” that it may be appropriate in individual cases.

Given that endocarditis can be fatal or expensive to treat—hospitals stays are long and valve surgery may be needed—the researchers decided to evaluate the association between invasive dental procedures and oral streptococcal infective endocarditis in a population-based cohort and a case crossover study.

In the first study of 138,876 patients with prosthetic heart valves, 69,303 underwent at least 1 dental procedure. Of 396,615 dental procedures, 26% were invasive. Patients received prophylactic antibiotics before half of the procedures.   

Over a median 1.7 years of follow-up, 267 people developed infective endocarditis associated with oral streptococci. However, the rate of oral streptococcal infective endocarditis did not rise significantly in the 3 months after an invasive dental procedure, with or without antibiotic prophylaxis. 

The case crossover study of patients with endocarditis indicated “the same direction of effect”: Although invasive dental procedures may be associated with oral streptococcal infective endocarditis, the magnitude of the association “remains uncertain.”

Source:

Tubiana S, Blotière PO, Hoen B, et al. BMJ. 2017;358: j3776.

doi: 10.1136/bmj.j3776.

Making sure some patients are taking their medication correctly may be a little easier now. The FDA has approved Abilify MyCite (apiprazole), which has an ingestible sensor.

Abilify MyCite is approved for treatment of schizophrenia, acute treatment of manic and mixed episodes associated with bipolar 1 disorder, and as an add-on treatment for depression in adults.

The sensor, embedded in the pill, records when the medicine was taken, and sends a message to a wearable patch, which then transmits information to a mobile application. Patients can track the ingestion of the medication on their smartphone and can allow their caregivers and physicians to access information through a web-based portal.

However, the FDA notes that Abilify MyCite’s prescribing information includes a caution that the product has not been shown to improve patient adherence with a treatment regimen. Moreover, Ability MyCite should not be used to track drug ingestion in real time or during an emergency, because detection may be delayed or may not occur. Before prescribing it for a patient, health care professionals should make sure the patient is capable and willing to use the drug, patch, and app.

Making sure some patients are taking their medication correctly may be a little easier now. The FDA has approved Abilify MyCite (apiprazole), which has an ingestible sensor.

Abilify MyCite is approved for treatment of schizophrenia, acute treatment of manic and mixed episodes associated with bipolar 1 disorder, and as an add-on treatment for depression in adults.

The sensor, embedded in the pill, records when the medicine was taken, and sends a message to a wearable patch, which then transmits information to a mobile application. Patients can track the ingestion of the medication on their smartphone and can allow their caregivers and physicians to access information through a web-based portal.

However, the FDA notes that Abilify MyCite’s prescribing information includes a caution that the product has not been shown to improve patient adherence with a treatment regimen. Moreover, Ability MyCite should not be used to track drug ingestion in real time or during an emergency, because detection may be delayed or may not occur. Before prescribing it for a patient, health care professionals should make sure the patient is capable and willing to use the drug, patch, and app.

Making sure some patients are taking their medication correctly may be a little easier now. The FDA has approved Abilify MyCite (apiprazole), which has an ingestible sensor.

Abilify MyCite is approved for treatment of schizophrenia, acute treatment of manic and mixed episodes associated with bipolar 1 disorder, and as an add-on treatment for depression in adults.

The sensor, embedded in the pill, records when the medicine was taken, and sends a message to a wearable patch, which then transmits information to a mobile application. Patients can track the ingestion of the medication on their smartphone and can allow their caregivers and physicians to access information through a web-based portal.

However, the FDA notes that Abilify MyCite’s prescribing information includes a caution that the product has not been shown to improve patient adherence with a treatment regimen. Moreover, Ability MyCite should not be used to track drug ingestion in real time or during an emergency, because detection may be delayed or may not occur. Before prescribing it for a patient, health care professionals should make sure the patient is capable and willing to use the drug, patch, and app.

Adolescents are one of the highest risk groups for HIV, but they often don’t want to talk about it. They also don’t want to get tested—of 40% of high school students who had had intercourse, only 10% had been tested, according to a CDC study.

Are online forums the solution? They offer anonymity along with information, and many adolescents—if not most—are used to getting information from social media. Researchers from University of California in Davis, say there’s a real need for a reliable source of advice on the subject for that audience. Most online forums for adolescent message boards and websites revolve around pregnancy and birth control rather than STDs.

The researchers noted that higher levels of stigma surrounding HIV correlate with lower levels of HIV testing. Even the testing is stigmatized, because many people feel just getting the test creates the impression that they are promiscuous, for instance. They also fear what the test may tell them and that it might be used against them in employment or health insurance.

The researchers analyzed 201 threads and 319 posts. Among 7 forums, 2 (POZ, MedHelp) were monitored by counselors, and 4 (DailyStrength, eHealth Forum, HealingWell, and HealthBoards) were monitored by members. One (The Body) was monitored by counselors and members.

In 13 threads, users displayed a “self-stigmatizing attitude” toward HIV testing, mainly because of the fear of being diagnosed. Others feared losing employment or having relationships affected. Notably, no adolescents asked about HIV testing in the forums targeted at their age groups. It is important to increase the visibility of HIV-related resources in adolescents’ forums, the researchers say; the lack of available information online may “perpetuate the taboo among this population by conveying a deeper stigma toward HIV.”

The study showed that the level of stigmatization differed significantly based on who monitored the session: The threads maintained by members had fewer stigmatized posts. The researchers suggest that if health care professionals get more involved by collaborating with forums to provide more content and framing HIV testing as a regular preventive checkup, they may reduce the stigma. Health care professionals also may be able to identify those who suspect they have HIV and encourage them to get tested. Health care professionals also can initiate threads that invite open discussion of HIV-related topics in sexual education forums devoted to adolescents. The researchers say breaking the online silence will lead more people to timely testing.

Source:

Ho CL, Pan W, Taylor LD. J Psychosoc Nurs Ment Health Serv. 2017;55(12):34-43.

doi: 10.3928/02793695-20170905-01.

Adolescents are one of the highest risk groups for HIV, but they often don’t want to talk about it. They also don’t want to get tested—of 40% of high school students who had had intercourse, only 10% had been tested, according to a CDC study.

Are online forums the solution? They offer anonymity along with information, and many adolescents—if not most—are used to getting information from social media. Researchers from University of California in Davis, say there’s a real need for a reliable source of advice on the subject for that audience. Most online forums for adolescent message boards and websites revolve around pregnancy and birth control rather than STDs.

The researchers noted that higher levels of stigma surrounding HIV correlate with lower levels of HIV testing. Even the testing is stigmatized, because many people feel just getting the test creates the impression that they are promiscuous, for instance. They also fear what the test may tell them and that it might be used against them in employment or health insurance.

The researchers analyzed 201 threads and 319 posts. Among 7 forums, 2 (POZ, MedHelp) were monitored by counselors, and 4 (DailyStrength, eHealth Forum, HealingWell, and HealthBoards) were monitored by members. One (The Body) was monitored by counselors and members.

In 13 threads, users displayed a “self-stigmatizing attitude” toward HIV testing, mainly because of the fear of being diagnosed. Others feared losing employment or having relationships affected. Notably, no adolescents asked about HIV testing in the forums targeted at their age groups. It is important to increase the visibility of HIV-related resources in adolescents’ forums, the researchers say; the lack of available information online may “perpetuate the taboo among this population by conveying a deeper stigma toward HIV.”

The study showed that the level of stigmatization differed significantly based on who monitored the session: The threads maintained by members had fewer stigmatized posts. The researchers suggest that if health care professionals get more involved by collaborating with forums to provide more content and framing HIV testing as a regular preventive checkup, they may reduce the stigma. Health care professionals also may be able to identify those who suspect they have HIV and encourage them to get tested. Health care professionals also can initiate threads that invite open discussion of HIV-related topics in sexual education forums devoted to adolescents. The researchers say breaking the online silence will lead more people to timely testing.

Source:

Ho CL, Pan W, Taylor LD. J Psychosoc Nurs Ment Health Serv. 2017;55(12):34-43.

doi: 10.3928/02793695-20170905-01.

Adolescents are one of the highest risk groups for HIV, but they often don’t want to talk about it. They also don’t want to get tested—of 40% of high school students who had had intercourse, only 10% had been tested, according to a CDC study.

Are online forums the solution? They offer anonymity along with information, and many adolescents—if not most—are used to getting information from social media. Researchers from University of California in Davis, say there’s a real need for a reliable source of advice on the subject for that audience. Most online forums for adolescent message boards and websites revolve around pregnancy and birth control rather than STDs.

The researchers noted that higher levels of stigma surrounding HIV correlate with lower levels of HIV testing. Even the testing is stigmatized, because many people feel just getting the test creates the impression that they are promiscuous, for instance. They also fear what the test may tell them and that it might be used against them in employment or health insurance.

The researchers analyzed 201 threads and 319 posts. Among 7 forums, 2 (POZ, MedHelp) were monitored by counselors, and 4 (DailyStrength, eHealth Forum, HealingWell, and HealthBoards) were monitored by members. One (The Body) was monitored by counselors and members.

In 13 threads, users displayed a “self-stigmatizing attitude” toward HIV testing, mainly because of the fear of being diagnosed. Others feared losing employment or having relationships affected. Notably, no adolescents asked about HIV testing in the forums targeted at their age groups. It is important to increase the visibility of HIV-related resources in adolescents’ forums, the researchers say; the lack of available information online may “perpetuate the taboo among this population by conveying a deeper stigma toward HIV.”

The study showed that the level of stigmatization differed significantly based on who monitored the session: The threads maintained by members had fewer stigmatized posts. The researchers suggest that if health care professionals get more involved by collaborating with forums to provide more content and framing HIV testing as a regular preventive checkup, they may reduce the stigma. Health care professionals also may be able to identify those who suspect they have HIV and encourage them to get tested. Health care professionals also can initiate threads that invite open discussion of HIV-related topics in sexual education forums devoted to adolescents. The researchers say breaking the online silence will lead more people to timely testing.

Source:

Ho CL, Pan W, Taylor LD. J Psychosoc Nurs Ment Health Serv. 2017;55(12):34-43.

doi: 10.3928/02793695-20170905-01.

Two medicines used to treat opioid use disorder—buprenorphine/naloxone (Suboxone) and extended-release naltrexone (Vivitrol)—have similar outcomes if the patient adheres to the treatment, according to a 24-week study of 570 opioid-dependent adults.

The researchers expected that it would be more difficult to initiate treatment with naltrexone because it requires full detoxification, and patients often drop out of the process. And indeed, fewer patients successfully initiated naltrexone, compared with buprenorphine/naloxone (72% vs 94%). The 24-week relapse rates were slightly higher for naltrexone: 65%, compared with 57% for buprenorphine/naloxone, mainly due to early relapse in the naltrexone group.

But among the 474 patients who successfully started on medication, the relapse rates were similar: 52% for naltrexone vs 56% for buprenorphine/naloxone.

Other outcomes among patients who began treatment—days abstinent, negative urine tests, and time to relapse—generally favored buprenorphine/naloxone in the full group, the researchers say. When only those who initiated treatment were considered, the outcomes slightly favored naltrexone.

During the study, 5 people had fatal overdoses: 3 in the buprenorphine/naloxone group and 2 in the naltrexone group. However, overall overdose rates, including nonfatal overdose, were low compared with what would be expected in this population, the researchers say. Their findings “strongly support” the conclusion that medication protects against overdose.

“Studies show that people with opioid dependence who follow detoxification with no medication are very likely to return to drug use,” said Nora Volkow, MD, director of the National Institute on Drug Abuse. “Yet many treatment programs have been slow to accept medications that have proven to be safe and effective. These findings should encourage clinicians to use medication protocols.”

Two medicines used to treat opioid use disorder—buprenorphine/naloxone (Suboxone) and extended-release naltrexone (Vivitrol)—have similar outcomes if the patient adheres to the treatment, according to a 24-week study of 570 opioid-dependent adults.

The researchers expected that it would be more difficult to initiate treatment with naltrexone because it requires full detoxification, and patients often drop out of the process. And indeed, fewer patients successfully initiated naltrexone, compared with buprenorphine/naloxone (72% vs 94%). The 24-week relapse rates were slightly higher for naltrexone: 65%, compared with 57% for buprenorphine/naloxone, mainly due to early relapse in the naltrexone group.

But among the 474 patients who successfully started on medication, the relapse rates were similar: 52% for naltrexone vs 56% for buprenorphine/naloxone.

Other outcomes among patients who began treatment—days abstinent, negative urine tests, and time to relapse—generally favored buprenorphine/naloxone in the full group, the researchers say. When only those who initiated treatment were considered, the outcomes slightly favored naltrexone.

During the study, 5 people had fatal overdoses: 3 in the buprenorphine/naloxone group and 2 in the naltrexone group. However, overall overdose rates, including nonfatal overdose, were low compared with what would be expected in this population, the researchers say. Their findings “strongly support” the conclusion that medication protects against overdose.

“Studies show that people with opioid dependence who follow detoxification with no medication are very likely to return to drug use,” said Nora Volkow, MD, director of the National Institute on Drug Abuse. “Yet many treatment programs have been slow to accept medications that have proven to be safe and effective. These findings should encourage clinicians to use medication protocols.”

Two medicines used to treat opioid use disorder—buprenorphine/naloxone (Suboxone) and extended-release naltrexone (Vivitrol)—have similar outcomes if the patient adheres to the treatment, according to a 24-week study of 570 opioid-dependent adults.

The researchers expected that it would be more difficult to initiate treatment with naltrexone because it requires full detoxification, and patients often drop out of the process. And indeed, fewer patients successfully initiated naltrexone, compared with buprenorphine/naloxone (72% vs 94%). The 24-week relapse rates were slightly higher for naltrexone: 65%, compared with 57% for buprenorphine/naloxone, mainly due to early relapse in the naltrexone group.

But among the 474 patients who successfully started on medication, the relapse rates were similar: 52% for naltrexone vs 56% for buprenorphine/naloxone.

Other outcomes among patients who began treatment—days abstinent, negative urine tests, and time to relapse—generally favored buprenorphine/naloxone in the full group, the researchers say. When only those who initiated treatment were considered, the outcomes slightly favored naltrexone.

During the study, 5 people had fatal overdoses: 3 in the buprenorphine/naloxone group and 2 in the naltrexone group. However, overall overdose rates, including nonfatal overdose, were low compared with what would be expected in this population, the researchers say. Their findings “strongly support” the conclusion that medication protects against overdose.

“Studies show that people with opioid dependence who follow detoxification with no medication are very likely to return to drug use,” said Nora Volkow, MD, director of the National Institute on Drug Abuse. “Yet many treatment programs have been slow to accept medications that have proven to be safe and effective. These findings should encourage clinicians to use medication protocols.”

Malaria is a major challenge in more than 100 countries. In 2015, nearly half the countries in the world had ongoing malaria transmission, according to Dr. Eileen Villasante, head of the Malaria Department at the Naval Medical Research Center (NMRC). But NMRC researchers may have found a new way to meet that challenge. They identified a novel highly protective malaria antigen, Plasmodium yoelii E140.

E140 is found in multiple stages of the life cycle of the malaria parasite, including sporozoites, liver stages, and blood stages, Villasante said. The researchers found that E140 induced up to 100% sterile protection, persisting for at least 3 months. They are now at work on a vaccine with the antigen.

Malaria is a major challenge in more than 100 countries. In 2015, nearly half the countries in the world had ongoing malaria transmission, according to Dr. Eileen Villasante, head of the Malaria Department at the Naval Medical Research Center (NMRC). But NMRC researchers may have found a new way to meet that challenge. They identified a novel highly protective malaria antigen, Plasmodium yoelii E140.

E140 is found in multiple stages of the life cycle of the malaria parasite, including sporozoites, liver stages, and blood stages, Villasante said. The researchers found that E140 induced up to 100% sterile protection, persisting for at least 3 months. They are now at work on a vaccine with the antigen.

Malaria is a major challenge in more than 100 countries. In 2015, nearly half the countries in the world had ongoing malaria transmission, according to Dr. Eileen Villasante, head of the Malaria Department at the Naval Medical Research Center (NMRC). But NMRC researchers may have found a new way to meet that challenge. They identified a novel highly protective malaria antigen, Plasmodium yoelii E140.

E140 is found in multiple stages of the life cycle of the malaria parasite, including sporozoites, liver stages, and blood stages, Villasante said. The researchers found that E140 induced up to 100% sterile protection, persisting for at least 3 months. They are now at work on a vaccine with the antigen.

High blood pressure should be treated at 130/80 mm Hg, rather than 140/90, according to findings from a landmark study that support a key change in the 2017 Hypertension Clinical Practice Guidelines.

The American Heart Association and American College of Cardiology announced the update along with the new guidelines, the first comprehensive high blood pressure guidelines in more than a decade.

The changes were informed by results from the NIH-funded Systolic Blood Pressure Intervention Trial (SPRINT), which was designed to determine the best way to treat high blood pressure in adults aged ≥ 50 years who are at high risk for heart disease. The study included > 9,300 participants and remains the largest of its kind to date to examine the effects on cardiovascular and kidney disease of maintaining systolic blood pressure at a lower than previously recommended level.

High blood pressure should be treated at 130/80 mm Hg, rather than 140/90, according to findings from a landmark study that support a key change in the 2017 Hypertension Clinical Practice Guidelines.

The American Heart Association and American College of Cardiology announced the update along with the new guidelines, the first comprehensive high blood pressure guidelines in more than a decade.

The changes were informed by results from the NIH-funded Systolic Blood Pressure Intervention Trial (SPRINT), which was designed to determine the best way to treat high blood pressure in adults aged ≥ 50 years who are at high risk for heart disease. The study included > 9,300 participants and remains the largest of its kind to date to examine the effects on cardiovascular and kidney disease of maintaining systolic blood pressure at a lower than previously recommended level.

High blood pressure should be treated at 130/80 mm Hg, rather than 140/90, according to findings from a landmark study that support a key change in the 2017 Hypertension Clinical Practice Guidelines.

The American Heart Association and American College of Cardiology announced the update along with the new guidelines, the first comprehensive high blood pressure guidelines in more than a decade.

The changes were informed by results from the NIH-funded Systolic Blood Pressure Intervention Trial (SPRINT), which was designed to determine the best way to treat high blood pressure in adults aged ≥ 50 years who are at high risk for heart disease. The study included > 9,300 participants and remains the largest of its kind to date to examine the effects on cardiovascular and kidney disease of maintaining systolic blood pressure at a lower than previously recommended level.