Katie Lennon

Marijuana use was higher in states that legalized treatment of medical conditions with marijuana, but the increased use was present both before and after such laws were passed, according to annual, repeated cross-sectional surveys.

“[T]he overall effect of medical marijuana laws on adolescent use before versus after passage of the law remained nonsignificant, although (as for the overall results), use was significantly reduced in 8th- but not for 10th- or 12th-graders,” noted Dr. Deborah S. Hasin, professor of epidemiology (in psychiatry) at Columbia University Medical Center, New York, and her colleagues.

©ron hilton/iStockphoto.com

The findings were based on responses to surveys from 1,098,270 students in the 8th, 10th, and 12th grades between 1991 and 2014. Respondents were from the 48 contiguous states, 21 of which had passed medical marijuana laws by 2014. Mean response rates for 1991-2013 were 81%-91% for almost all years and grades.

Students were asked if they had used marijuana in the previous 30 days; 15.87% of them said they had, in states that had passed a medical marijuana law between 1991 and 2014. In states that had not passed that type of a law, the prevalence of marijuana use was 13.27%.

The study showed no evidence for an increase in adolescent use of marijuana in the year of passage of a medical marijuana law, or in the first or second years after passage.

Prior to passage of a law permitting the use of marijuana for medicinal purposes, 16.25% of the survey’s participants said they had used marijuana within the previous 30 days. Following such legislative changes, the prevalence of use was 15.45%.

“Our two main findings, in conjunction with other evidence, suggest that state-level factors other than medical marijuana laws influence adolescent marijuana use,” the researchers wrote.

Dr. Hasin and her colleagues declared no conflicts of interest.

Read the full study here.

[email protected]

Marijuana use was higher in states that legalized treatment of medical conditions with marijuana, but the increased use was present both before and after such laws were passed, according to annual, repeated cross-sectional surveys.

“[T]he overall effect of medical marijuana laws on adolescent use before versus after passage of the law remained nonsignificant, although (as for the overall results), use was significantly reduced in 8th- but not for 10th- or 12th-graders,” noted Dr. Deborah S. Hasin, professor of epidemiology (in psychiatry) at Columbia University Medical Center, New York, and her colleagues.

©ron hilton/iStockphoto.com

The findings were based on responses to surveys from 1,098,270 students in the 8th, 10th, and 12th grades between 1991 and 2014. Respondents were from the 48 contiguous states, 21 of which had passed medical marijuana laws by 2014. Mean response rates for 1991-2013 were 81%-91% for almost all years and grades.

Students were asked if they had used marijuana in the previous 30 days; 15.87% of them said they had, in states that had passed a medical marijuana law between 1991 and 2014. In states that had not passed that type of a law, the prevalence of marijuana use was 13.27%.

The study showed no evidence for an increase in adolescent use of marijuana in the year of passage of a medical marijuana law, or in the first or second years after passage.

Prior to passage of a law permitting the use of marijuana for medicinal purposes, 16.25% of the survey’s participants said they had used marijuana within the previous 30 days. Following such legislative changes, the prevalence of use was 15.45%.

“Our two main findings, in conjunction with other evidence, suggest that state-level factors other than medical marijuana laws influence adolescent marijuana use,” the researchers wrote.

Dr. Hasin and her colleagues declared no conflicts of interest.

Read the full study here.

[email protected]

Marijuana use was higher in states that legalized treatment of medical conditions with marijuana, but the increased use was present both before and after such laws were passed, according to annual, repeated cross-sectional surveys.

“[T]he overall effect of medical marijuana laws on adolescent use before versus after passage of the law remained nonsignificant, although (as for the overall results), use was significantly reduced in 8th- but not for 10th- or 12th-graders,” noted Dr. Deborah S. Hasin, professor of epidemiology (in psychiatry) at Columbia University Medical Center, New York, and her colleagues.

©ron hilton/iStockphoto.com

The findings were based on responses to surveys from 1,098,270 students in the 8th, 10th, and 12th grades between 1991 and 2014. Respondents were from the 48 contiguous states, 21 of which had passed medical marijuana laws by 2014. Mean response rates for 1991-2013 were 81%-91% for almost all years and grades.

Students were asked if they had used marijuana in the previous 30 days; 15.87% of them said they had, in states that had passed a medical marijuana law between 1991 and 2014. In states that had not passed that type of a law, the prevalence of marijuana use was 13.27%.

The study showed no evidence for an increase in adolescent use of marijuana in the year of passage of a medical marijuana law, or in the first or second years after passage.

Prior to passage of a law permitting the use of marijuana for medicinal purposes, 16.25% of the survey’s participants said they had used marijuana within the previous 30 days. Following such legislative changes, the prevalence of use was 15.45%.

“Our two main findings, in conjunction with other evidence, suggest that state-level factors other than medical marijuana laws influence adolescent marijuana use,” the researchers wrote.

Dr. Hasin and her colleagues declared no conflicts of interest.

Read the full study here.

[email protected]

In bronchiectasis patients who develop rheumatoid arthritis, the responses of anticitrullinated peptide antibodies become more citrulline specific, according to results of a British study.

The study investigators measured anticitrullinated peptide antibodies (ACPA) and rheumatoid factors (RF) in 122 patients with bronchiectasis (BR) alone, 50 patients with BR and RA (BRRA), 50 patients with RA without lung disease, 87 patients with asthma, and 79 healthy patients.

The citrulline specificity of ACPA in patients with BRRA was increased, compared with patients with BR alone and RA without any lung disease. While the study showed significantly elevated levels of ACPA in patients with BR alone, the ACPA response was not citrulline specific.

“Bronchiectasis is an unusual but potent model for the induction of autoimmunity in RA by bacterial infection in the lung,” according to Anne-Marie Quirke, Ph.D., and her colleagues. “Our study suggests that in the early stages of tolerance breakdown, the ACPA response is not citrulline specific, but becomes more so in those patients with BR that develop BRRA.”

In contrast to patients with BR alone, patients with BRRA showed no correlation between antibody responses to citrullinated peptides and arginine-containing peptides, with the exception of the citrullinated peptide cVim and the arginine-containing peptide Vim.

Rheumatoid factors were found significantly more often in BRRA patients, compared with patients with RA without any lung disease, with percent serum antibody positivity for RF vs. controls having been 82 and 52, respectively. For patients with BR alone, the percent serum positivity of RF, compared with controls, was 25.

“Further prospective investigations will need to be carried out of BR patients at risk for RA in order to confirm the evolution of citrulline specificity of ACPA in patients with BR who subsequently develop [RA],” according to the researchers.

Read the full study in Arthritis & Rheumatology (doi:10.1002/art.39226).

[email protected]

In bronchiectasis patients who develop rheumatoid arthritis, the responses of anticitrullinated peptide antibodies become more citrulline specific, according to results of a British study.

The study investigators measured anticitrullinated peptide antibodies (ACPA) and rheumatoid factors (RF) in 122 patients with bronchiectasis (BR) alone, 50 patients with BR and RA (BRRA), 50 patients with RA without lung disease, 87 patients with asthma, and 79 healthy patients.

The citrulline specificity of ACPA in patients with BRRA was increased, compared with patients with BR alone and RA without any lung disease. While the study showed significantly elevated levels of ACPA in patients with BR alone, the ACPA response was not citrulline specific.

“Bronchiectasis is an unusual but potent model for the induction of autoimmunity in RA by bacterial infection in the lung,” according to Anne-Marie Quirke, Ph.D., and her colleagues. “Our study suggests that in the early stages of tolerance breakdown, the ACPA response is not citrulline specific, but becomes more so in those patients with BR that develop BRRA.”

In contrast to patients with BR alone, patients with BRRA showed no correlation between antibody responses to citrullinated peptides and arginine-containing peptides, with the exception of the citrullinated peptide cVim and the arginine-containing peptide Vim.

Rheumatoid factors were found significantly more often in BRRA patients, compared with patients with RA without any lung disease, with percent serum antibody positivity for RF vs. controls having been 82 and 52, respectively. For patients with BR alone, the percent serum positivity of RF, compared with controls, was 25.

“Further prospective investigations will need to be carried out of BR patients at risk for RA in order to confirm the evolution of citrulline specificity of ACPA in patients with BR who subsequently develop [RA],” according to the researchers.

Read the full study in Arthritis & Rheumatology (doi:10.1002/art.39226).

[email protected]

In bronchiectasis patients who develop rheumatoid arthritis, the responses of anticitrullinated peptide antibodies become more citrulline specific, according to results of a British study.

The study investigators measured anticitrullinated peptide antibodies (ACPA) and rheumatoid factors (RF) in 122 patients with bronchiectasis (BR) alone, 50 patients with BR and RA (BRRA), 50 patients with RA without lung disease, 87 patients with asthma, and 79 healthy patients.

The citrulline specificity of ACPA in patients with BRRA was increased, compared with patients with BR alone and RA without any lung disease. While the study showed significantly elevated levels of ACPA in patients with BR alone, the ACPA response was not citrulline specific.

“Bronchiectasis is an unusual but potent model for the induction of autoimmunity in RA by bacterial infection in the lung,” according to Anne-Marie Quirke, Ph.D., and her colleagues. “Our study suggests that in the early stages of tolerance breakdown, the ACPA response is not citrulline specific, but becomes more so in those patients with BR that develop BRRA.”

In contrast to patients with BR alone, patients with BRRA showed no correlation between antibody responses to citrullinated peptides and arginine-containing peptides, with the exception of the citrullinated peptide cVim and the arginine-containing peptide Vim.

Rheumatoid factors were found significantly more often in BRRA patients, compared with patients with RA without any lung disease, with percent serum antibody positivity for RF vs. controls having been 82 and 52, respectively. For patients with BR alone, the percent serum positivity of RF, compared with controls, was 25.

“Further prospective investigations will need to be carried out of BR patients at risk for RA in order to confirm the evolution of citrulline specificity of ACPA in patients with BR who subsequently develop [RA],” according to the researchers.

Read the full study in Arthritis & Rheumatology (doi:10.1002/art.39226).

[email protected]

The Centers for Medicare & Medicaid Services Innovation Center has decided to give payers and practices more time to apply for participation in the Oncology Care Model (OCM).

The OCM’s new application submission deadline is June 30, at 5 pm Eastern Daylight Time. The deadline extension is exclusively for web-based applications.

Only those who submitted timely, complete Letters of Intent (LOIs) are eligible to apply for acceptance into the program, says a written statement by the CMS Innovation Center. Applications must be completed online using an authenticated weblink and password that was e-mailed to each applicant upon submission of a complete LOI. PDF versions of the applications will not be accepted.

Visit the OCM web page for more information, including the updated Frequently Asked Questions document.

To reach the OCM team directly, send an e-mail to [email protected].

[email protected]

The Centers for Medicare & Medicaid Services Innovation Center has decided to give payers and practices more time to apply for participation in the Oncology Care Model (OCM).

The OCM’s new application submission deadline is June 30, at 5 pm Eastern Daylight Time. The deadline extension is exclusively for web-based applications.

Only those who submitted timely, complete Letters of Intent (LOIs) are eligible to apply for acceptance into the program, says a written statement by the CMS Innovation Center. Applications must be completed online using an authenticated weblink and password that was e-mailed to each applicant upon submission of a complete LOI. PDF versions of the applications will not be accepted.

Visit the OCM web page for more information, including the updated Frequently Asked Questions document.

To reach the OCM team directly, send an e-mail to [email protected].

[email protected]

The Centers for Medicare & Medicaid Services Innovation Center has decided to give payers and practices more time to apply for participation in the Oncology Care Model (OCM).

The OCM’s new application submission deadline is June 30, at 5 pm Eastern Daylight Time. The deadline extension is exclusively for web-based applications.

Only those who submitted timely, complete Letters of Intent (LOIs) are eligible to apply for acceptance into the program, says a written statement by the CMS Innovation Center. Applications must be completed online using an authenticated weblink and password that was e-mailed to each applicant upon submission of a complete LOI. PDF versions of the applications will not be accepted.

Visit the OCM web page for more information, including the updated Frequently Asked Questions document.

To reach the OCM team directly, send an e-mail to [email protected].

[email protected]

Mycophenolate mofetil was superior to azathioprine in preventing treatment failure in 227 lupus nephritis patients who initially responded to induction therapy, according to a randomized, double-blind comparison of the drugs’ efficacy during a 36-month maintenance phase of treatment.

The study’s participants were selected from a group of 370 lupus nephritis patients that received induction therapy in the form of mycophenolate mofetil (MMF) or intravenous cyclophosphamide (IVC) for 24 weeks; there was no difference in the efficacy of these two drugs.

All patients entered the study with biopsy-proven class III-V lupus nephritis and laboratory tests consistent with active nephritis, including evidence of an active urine sediment, proteinuria greater than or equal to 1 g/day or elevated serum creatinine (greater than 1.3 mg/dL). Patients with class III or V lupus nephritis were required to have higher levels of proteinuria (greater than or equal to 2 g/day) or serum creatinine greater than 1.3 mg/dL. Only patients who met prespecified criteria for a complete or partial renal response after 24 weeks of induction therapy and were adjudicated as responders by the clinical endpoints committee were advanced into the maintenance phase of the trial. The primary outcome measure in the maintenance phase was the time to treatment failure (TF), defined by any of the following criteria: death, end-stage renal disease, sustained doubling of serum creatinine, or renal flare and requirement for rescue therapy.

Among the patients who participated in the induction phase of the trial, non-Hispanic ethnicity was associated with a higher likelihood of complete remission.

Various characteristics of the study’s participants were associated with greater likelihood of treatment failure. These included: anti–double-stranded DNA (anti-dsDNA) at trial entry, failure to reduce anti-dsDNA within 8 weeks, and failure to reduce urine protein:creatinine ratio (UP/C) by greater than or equal to 25% within 8 weeks (Lupus Sci. Med. 2015 [doi:10.1136/lupus-2015-000089]).

For patients who participated in the maintenance phase, baseline estimated glomerular filtration rate (eGFR) greater than or equal to 90 mL/min/1.73 m², and UP/C greater than or equal to 1 at the end of induction were independently associated with complete remission during the maintenance phase.

Among the study’s other findings for patients who participated in maintenance therapy were that lack of treatment with antimalarials, failure to reduce anti-dsDNA or UP/C within the first 8 weeks of induction therapy, and anti-dsDNA positivity at the end of induction were independently associated with TF.

“Although our findings contribute to the understanding of predictors of renal outcomes in lupus nephritis, we believe that the associations described in this study are not strong enough to directly impact therapeutic decision making in individual patients in the clinic,” noted Dr. Maria Dall’Era of the University of California, San Francisco, and her colleagues. “Better biomarkers are needed to achieve this important goal. Lastly, in future controlled trials of lupus nephritis, studying the factors identified in our present analysis in a prespecified fashion might serve to further elucidate their association with renal response to treatment.”

The researchers declared no conflicts of interest.

[email protected]

Mycophenolate mofetil was superior to azathioprine in preventing treatment failure in 227 lupus nephritis patients who initially responded to induction therapy, according to a randomized, double-blind comparison of the drugs’ efficacy during a 36-month maintenance phase of treatment.

The study’s participants were selected from a group of 370 lupus nephritis patients that received induction therapy in the form of mycophenolate mofetil (MMF) or intravenous cyclophosphamide (IVC) for 24 weeks; there was no difference in the efficacy of these two drugs.

All patients entered the study with biopsy-proven class III-V lupus nephritis and laboratory tests consistent with active nephritis, including evidence of an active urine sediment, proteinuria greater than or equal to 1 g/day or elevated serum creatinine (greater than 1.3 mg/dL). Patients with class III or V lupus nephritis were required to have higher levels of proteinuria (greater than or equal to 2 g/day) or serum creatinine greater than 1.3 mg/dL. Only patients who met prespecified criteria for a complete or partial renal response after 24 weeks of induction therapy and were adjudicated as responders by the clinical endpoints committee were advanced into the maintenance phase of the trial. The primary outcome measure in the maintenance phase was the time to treatment failure (TF), defined by any of the following criteria: death, end-stage renal disease, sustained doubling of serum creatinine, or renal flare and requirement for rescue therapy.

Among the patients who participated in the induction phase of the trial, non-Hispanic ethnicity was associated with a higher likelihood of complete remission.

Various characteristics of the study’s participants were associated with greater likelihood of treatment failure. These included: anti–double-stranded DNA (anti-dsDNA) at trial entry, failure to reduce anti-dsDNA within 8 weeks, and failure to reduce urine protein:creatinine ratio (UP/C) by greater than or equal to 25% within 8 weeks (Lupus Sci. Med. 2015 [doi:10.1136/lupus-2015-000089]).

For patients who participated in the maintenance phase, baseline estimated glomerular filtration rate (eGFR) greater than or equal to 90 mL/min/1.73 m², and UP/C greater than or equal to 1 at the end of induction were independently associated with complete remission during the maintenance phase.

Among the study’s other findings for patients who participated in maintenance therapy were that lack of treatment with antimalarials, failure to reduce anti-dsDNA or UP/C within the first 8 weeks of induction therapy, and anti-dsDNA positivity at the end of induction were independently associated with TF.

“Although our findings contribute to the understanding of predictors of renal outcomes in lupus nephritis, we believe that the associations described in this study are not strong enough to directly impact therapeutic decision making in individual patients in the clinic,” noted Dr. Maria Dall’Era of the University of California, San Francisco, and her colleagues. “Better biomarkers are needed to achieve this important goal. Lastly, in future controlled trials of lupus nephritis, studying the factors identified in our present analysis in a prespecified fashion might serve to further elucidate their association with renal response to treatment.”

The researchers declared no conflicts of interest.

[email protected]

Mycophenolate mofetil was superior to azathioprine in preventing treatment failure in 227 lupus nephritis patients who initially responded to induction therapy, according to a randomized, double-blind comparison of the drugs’ efficacy during a 36-month maintenance phase of treatment.

The study’s participants were selected from a group of 370 lupus nephritis patients that received induction therapy in the form of mycophenolate mofetil (MMF) or intravenous cyclophosphamide (IVC) for 24 weeks; there was no difference in the efficacy of these two drugs.

All patients entered the study with biopsy-proven class III-V lupus nephritis and laboratory tests consistent with active nephritis, including evidence of an active urine sediment, proteinuria greater than or equal to 1 g/day or elevated serum creatinine (greater than 1.3 mg/dL). Patients with class III or V lupus nephritis were required to have higher levels of proteinuria (greater than or equal to 2 g/day) or serum creatinine greater than 1.3 mg/dL. Only patients who met prespecified criteria for a complete or partial renal response after 24 weeks of induction therapy and were adjudicated as responders by the clinical endpoints committee were advanced into the maintenance phase of the trial. The primary outcome measure in the maintenance phase was the time to treatment failure (TF), defined by any of the following criteria: death, end-stage renal disease, sustained doubling of serum creatinine, or renal flare and requirement for rescue therapy.

Among the patients who participated in the induction phase of the trial, non-Hispanic ethnicity was associated with a higher likelihood of complete remission.

Various characteristics of the study’s participants were associated with greater likelihood of treatment failure. These included: anti–double-stranded DNA (anti-dsDNA) at trial entry, failure to reduce anti-dsDNA within 8 weeks, and failure to reduce urine protein:creatinine ratio (UP/C) by greater than or equal to 25% within 8 weeks (Lupus Sci. Med. 2015 [doi:10.1136/lupus-2015-000089]).

For patients who participated in the maintenance phase, baseline estimated glomerular filtration rate (eGFR) greater than or equal to 90 mL/min/1.73 m², and UP/C greater than or equal to 1 at the end of induction were independently associated with complete remission during the maintenance phase.

Among the study’s other findings for patients who participated in maintenance therapy were that lack of treatment with antimalarials, failure to reduce anti-dsDNA or UP/C within the first 8 weeks of induction therapy, and anti-dsDNA positivity at the end of induction were independently associated with TF.

“Although our findings contribute to the understanding of predictors of renal outcomes in lupus nephritis, we believe that the associations described in this study are not strong enough to directly impact therapeutic decision making in individual patients in the clinic,” noted Dr. Maria Dall’Era of the University of California, San Francisco, and her colleagues. “Better biomarkers are needed to achieve this important goal. Lastly, in future controlled trials of lupus nephritis, studying the factors identified in our present analysis in a prespecified fashion might serve to further elucidate their association with renal response to treatment.”

The researchers declared no conflicts of interest.

[email protected]

About one-third of people with bipolar disorder are affected by comorbid migraine, and migraine is significantly more common among bipolar II disorder patients than among those with bipolar I disorder, a meta-analysis shows.

The meta-analysis covered 14 studies of 3,976 patients with some type of bipolar disorder from North America, Europe, and South America. Of the sample, 2,161 had bipolar I disorder and 647 had bipolar II disorder. The type of bipolar disorder the other patients had was either mixed or unknown. On average, each of the studies included 283.69 participants, and the mean age of a participant was 35.5 years. Studies that reported the prevalence of bipolar disorder among people with migraines were excluded.

Fifty-four percent of bipolar II disorder patients had migraines, compared with 32.7% of bipolar I disorder patients. An additional finding of the meta-analysis is that migraine was found significantly more often in studies that used standardized criteria to determine whether a bipolar patient had comorbid migraine than in studies that used nonstandardized criteria, such as self-report.

A meta-regression analysis of data from the studies showed that mean age moderated how frequently migraine occurred among the entire sample.

“The findings of this meta-analysis suggest that the prevalence of comorbid migraine among people with [bipolar disorder] is remarkably high, particularly among people with [bipolar II disorder],” according to Dr. Michele Fornaro and Brendon Stubbs.

The results of this meta-analysis “highlighted the need for further studies focusing on [migraine-bipolar II disorder] comobidity including well-matched control cases with or without rapid cycling features too,” according to the researchers.

Read the full study in Journal of Affective Disorders (doi:http://dx.doi.org/10.1016/j.jad.2015.02.032).

[email protected]

About one-third of people with bipolar disorder are affected by comorbid migraine, and migraine is significantly more common among bipolar II disorder patients than among those with bipolar I disorder, a meta-analysis shows.

The meta-analysis covered 14 studies of 3,976 patients with some type of bipolar disorder from North America, Europe, and South America. Of the sample, 2,161 had bipolar I disorder and 647 had bipolar II disorder. The type of bipolar disorder the other patients had was either mixed or unknown. On average, each of the studies included 283.69 participants, and the mean age of a participant was 35.5 years. Studies that reported the prevalence of bipolar disorder among people with migraines were excluded.

Fifty-four percent of bipolar II disorder patients had migraines, compared with 32.7% of bipolar I disorder patients. An additional finding of the meta-analysis is that migraine was found significantly more often in studies that used standardized criteria to determine whether a bipolar patient had comorbid migraine than in studies that used nonstandardized criteria, such as self-report.

A meta-regression analysis of data from the studies showed that mean age moderated how frequently migraine occurred among the entire sample.

“The findings of this meta-analysis suggest that the prevalence of comorbid migraine among people with [bipolar disorder] is remarkably high, particularly among people with [bipolar II disorder],” according to Dr. Michele Fornaro and Brendon Stubbs.

The results of this meta-analysis “highlighted the need for further studies focusing on [migraine-bipolar II disorder] comobidity including well-matched control cases with or without rapid cycling features too,” according to the researchers.

Read the full study in Journal of Affective Disorders (doi:http://dx.doi.org/10.1016/j.jad.2015.02.032).

[email protected]

About one-third of people with bipolar disorder are affected by comorbid migraine, and migraine is significantly more common among bipolar II disorder patients than among those with bipolar I disorder, a meta-analysis shows.

The meta-analysis covered 14 studies of 3,976 patients with some type of bipolar disorder from North America, Europe, and South America. Of the sample, 2,161 had bipolar I disorder and 647 had bipolar II disorder. The type of bipolar disorder the other patients had was either mixed or unknown. On average, each of the studies included 283.69 participants, and the mean age of a participant was 35.5 years. Studies that reported the prevalence of bipolar disorder among people with migraines were excluded.

Fifty-four percent of bipolar II disorder patients had migraines, compared with 32.7% of bipolar I disorder patients. An additional finding of the meta-analysis is that migraine was found significantly more often in studies that used standardized criteria to determine whether a bipolar patient had comorbid migraine than in studies that used nonstandardized criteria, such as self-report.

A meta-regression analysis of data from the studies showed that mean age moderated how frequently migraine occurred among the entire sample.

“The findings of this meta-analysis suggest that the prevalence of comorbid migraine among people with [bipolar disorder] is remarkably high, particularly among people with [bipolar II disorder],” according to Dr. Michele Fornaro and Brendon Stubbs.

The results of this meta-analysis “highlighted the need for further studies focusing on [migraine-bipolar II disorder] comobidity including well-matched control cases with or without rapid cycling features too,” according to the researchers.

Read the full study in Journal of Affective Disorders (doi:http://dx.doi.org/10.1016/j.jad.2015.02.032).

[email protected]

Psoriasis may play a role in temporomandibular joint disorders, according to an observational study that compared psoriasis patients to individuals without the disorder.

The Italian study, conducted from January 2014 to December 2014, included 112 patients with psoriasis and a 112-person control group. Of the patients with psoriasis, 25 (22%) had psoriatic arthritis (PsA). Patients were examined for temporomandibular disorder (TMD) signs and symptoms based on the standardized Research Diagnostic Criteria for Temporomandibular Disorders. TMD was assessed through a questionnaire and a clinical examination.

Overall, patients with psoriasis experienced TMD symptoms significantly more frequently than did members of the control group, with 69% of the psoriasis group reporting one or more symptoms, compared with 24% of the controls. Most often, the patients with psoriasis reported suffering from tenderness or stiffness in the neck and shoulders, muscle pain on chewing, and the sensation of a stuck or locked jaw. The control group’s major complaint was tenderness or stiffness in the neck and shoulders.

Temporomandibular joint sounds and opening derangement, which are signs of TMD, also were more common in the patients with psoriasis than in the control group.

TMD symptoms and signs were even more common in the subset of patients with PsA, with 80% of these patients reporting symptoms. Additionally, a statistically significant increase in opening derangement, bruxism, and temporomandibular joint sounds occurred in patients with PsA, compared with psoriasis patents without arthritis and controls.

Temporomandibular joint sounds and opening derangement “were found to be more frequent and severe in patients with psoriasis and PsA than in the healthy subjects, this result being highly significant,” wrote Dr. Vito Crincoli and colleagues at the University of Bari (Italy). “Therefore, in addition to dermatological and rheumatological implications, psoriasis seems to play a role in TMJ disorders, causing an increase in orofacial pain and an altered chewing function.”

Read the full study in the International Journal of Medical Sciences (2015;12:341-8 [doi:10.7150/ijms.11288]).

[email protected]

Psoriasis may play a role in temporomandibular joint disorders, according to an observational study that compared psoriasis patients to individuals without the disorder.

The Italian study, conducted from January 2014 to December 2014, included 112 patients with psoriasis and a 112-person control group. Of the patients with psoriasis, 25 (22%) had psoriatic arthritis (PsA). Patients were examined for temporomandibular disorder (TMD) signs and symptoms based on the standardized Research Diagnostic Criteria for Temporomandibular Disorders. TMD was assessed through a questionnaire and a clinical examination.

Overall, patients with psoriasis experienced TMD symptoms significantly more frequently than did members of the control group, with 69% of the psoriasis group reporting one or more symptoms, compared with 24% of the controls. Most often, the patients with psoriasis reported suffering from tenderness or stiffness in the neck and shoulders, muscle pain on chewing, and the sensation of a stuck or locked jaw. The control group’s major complaint was tenderness or stiffness in the neck and shoulders.

Temporomandibular joint sounds and opening derangement, which are signs of TMD, also were more common in the patients with psoriasis than in the control group.

TMD symptoms and signs were even more common in the subset of patients with PsA, with 80% of these patients reporting symptoms. Additionally, a statistically significant increase in opening derangement, bruxism, and temporomandibular joint sounds occurred in patients with PsA, compared with psoriasis patents without arthritis and controls.

Temporomandibular joint sounds and opening derangement “were found to be more frequent and severe in patients with psoriasis and PsA than in the healthy subjects, this result being highly significant,” wrote Dr. Vito Crincoli and colleagues at the University of Bari (Italy). “Therefore, in addition to dermatological and rheumatological implications, psoriasis seems to play a role in TMJ disorders, causing an increase in orofacial pain and an altered chewing function.”

Read the full study in the International Journal of Medical Sciences (2015;12:341-8 [doi:10.7150/ijms.11288]).

[email protected]

Psoriasis may play a role in temporomandibular joint disorders, according to an observational study that compared psoriasis patients to individuals without the disorder.

The Italian study, conducted from January 2014 to December 2014, included 112 patients with psoriasis and a 112-person control group. Of the patients with psoriasis, 25 (22%) had psoriatic arthritis (PsA). Patients were examined for temporomandibular disorder (TMD) signs and symptoms based on the standardized Research Diagnostic Criteria for Temporomandibular Disorders. TMD was assessed through a questionnaire and a clinical examination.

Overall, patients with psoriasis experienced TMD symptoms significantly more frequently than did members of the control group, with 69% of the psoriasis group reporting one or more symptoms, compared with 24% of the controls. Most often, the patients with psoriasis reported suffering from tenderness or stiffness in the neck and shoulders, muscle pain on chewing, and the sensation of a stuck or locked jaw. The control group’s major complaint was tenderness or stiffness in the neck and shoulders.

Temporomandibular joint sounds and opening derangement, which are signs of TMD, also were more common in the patients with psoriasis than in the control group.

TMD symptoms and signs were even more common in the subset of patients with PsA, with 80% of these patients reporting symptoms. Additionally, a statistically significant increase in opening derangement, bruxism, and temporomandibular joint sounds occurred in patients with PsA, compared with psoriasis patents without arthritis and controls.

Temporomandibular joint sounds and opening derangement “were found to be more frequent and severe in patients with psoriasis and PsA than in the healthy subjects, this result being highly significant,” wrote Dr. Vito Crincoli and colleagues at the University of Bari (Italy). “Therefore, in addition to dermatological and rheumatological implications, psoriasis seems to play a role in TMJ disorders, causing an increase in orofacial pain and an altered chewing function.”

Read the full study in the International Journal of Medical Sciences (2015;12:341-8 [doi:10.7150/ijms.11288]).

[email protected]

At least 25% of females from six out of seven countries studied and 10% of males in four of the countries reported suffering from sexual violence before age 18 years.

Researchers surveyed adults aged 18-24 years in Cambodia, Haiti, Kenya, Malawi, Swaziland, Tanzania, and Zimbabwe. Data were collected through household surveys from 2007 to 2013 by the Centers for Disease Control and Prevention (CDC) and the United Nations Children’s Fund (UNICEF) in partnership with host country governments, communities, and academic institutions.

The definition of sexual violence used in this survey included unwanted touching, unwanted attempted sex, pressured/coerced sex, and forced sex. For all countries that participated in the survey other than Swaziland and Malawi, sex was defined as vaginal/anal penetration by the penis, hands, fingers, mouth, or objects, or oral penetration by the penis, except in Swaziland (penetration of vagina or anus by penis only) and Malawi (oral, vaginal, or anal sex, or vaginal/anal object insertion).

Of the countries studied, Swaziland and Zimbabwe had the highest percentages of females that suffered from childhood sexual violence; the rates were 37.6% in Swaziland and 32.5% in Zimbabwe. In Haiti, the largest percentage of males reported having been victims of sexual violence under the age of 18; while the rate was 21.2% for males, an even higher rate – 25.7% – of females in Haiti reported suffering from childhood sexual violence.

Cambodia reported the lowest rates of childhood sexual violence for both females and males, at 4.4% and 5.6%. respectively.

Despite the high percentage of the study’s sample that suffered from childhood sexual violence, only 10% or less of male and female victims in most of the countries studied received services such as health care, legal/security aid, counseling support, or child protective services. Female victims in Haiti, Swaziland, and Tanzania were most often provided with services, with rates ranging from 10% in Haiti to 24% in Swaziland.

“Despite myriad adverse effects of sexual violence, in this study, most persons who reported experiencing it during childhood did not receive services for their abuse,” according to Dr. Steven A. Sumner of the National Center for Injury Prevention and Control, Atlanta, and his colleagues. “Although the control and response to violence traditionally has been seen as the responsibility of law enforcement and social welfare, health sectors can integrate violence prevention and care into routine programmatic activities, building clear links to social services to achieve maximal benefit for various health measures.”

Read the full study in MMWR.

[email protected]

At least 25% of females from six out of seven countries studied and 10% of males in four of the countries reported suffering from sexual violence before age 18 years.

Researchers surveyed adults aged 18-24 years in Cambodia, Haiti, Kenya, Malawi, Swaziland, Tanzania, and Zimbabwe. Data were collected through household surveys from 2007 to 2013 by the Centers for Disease Control and Prevention (CDC) and the United Nations Children’s Fund (UNICEF) in partnership with host country governments, communities, and academic institutions.

The definition of sexual violence used in this survey included unwanted touching, unwanted attempted sex, pressured/coerced sex, and forced sex. For all countries that participated in the survey other than Swaziland and Malawi, sex was defined as vaginal/anal penetration by the penis, hands, fingers, mouth, or objects, or oral penetration by the penis, except in Swaziland (penetration of vagina or anus by penis only) and Malawi (oral, vaginal, or anal sex, or vaginal/anal object insertion).

Of the countries studied, Swaziland and Zimbabwe had the highest percentages of females that suffered from childhood sexual violence; the rates were 37.6% in Swaziland and 32.5% in Zimbabwe. In Haiti, the largest percentage of males reported having been victims of sexual violence under the age of 18; while the rate was 21.2% for males, an even higher rate – 25.7% – of females in Haiti reported suffering from childhood sexual violence.

Cambodia reported the lowest rates of childhood sexual violence for both females and males, at 4.4% and 5.6%. respectively.

Despite the high percentage of the study’s sample that suffered from childhood sexual violence, only 10% or less of male and female victims in most of the countries studied received services such as health care, legal/security aid, counseling support, or child protective services. Female victims in Haiti, Swaziland, and Tanzania were most often provided with services, with rates ranging from 10% in Haiti to 24% in Swaziland.

“Despite myriad adverse effects of sexual violence, in this study, most persons who reported experiencing it during childhood did not receive services for their abuse,” according to Dr. Steven A. Sumner of the National Center for Injury Prevention and Control, Atlanta, and his colleagues. “Although the control and response to violence traditionally has been seen as the responsibility of law enforcement and social welfare, health sectors can integrate violence prevention and care into routine programmatic activities, building clear links to social services to achieve maximal benefit for various health measures.”

Read the full study in MMWR.

[email protected]

At least 25% of females from six out of seven countries studied and 10% of males in four of the countries reported suffering from sexual violence before age 18 years.

Researchers surveyed adults aged 18-24 years in Cambodia, Haiti, Kenya, Malawi, Swaziland, Tanzania, and Zimbabwe. Data were collected through household surveys from 2007 to 2013 by the Centers for Disease Control and Prevention (CDC) and the United Nations Children’s Fund (UNICEF) in partnership with host country governments, communities, and academic institutions.

The definition of sexual violence used in this survey included unwanted touching, unwanted attempted sex, pressured/coerced sex, and forced sex. For all countries that participated in the survey other than Swaziland and Malawi, sex was defined as vaginal/anal penetration by the penis, hands, fingers, mouth, or objects, or oral penetration by the penis, except in Swaziland (penetration of vagina or anus by penis only) and Malawi (oral, vaginal, or anal sex, or vaginal/anal object insertion).

Of the countries studied, Swaziland and Zimbabwe had the highest percentages of females that suffered from childhood sexual violence; the rates were 37.6% in Swaziland and 32.5% in Zimbabwe. In Haiti, the largest percentage of males reported having been victims of sexual violence under the age of 18; while the rate was 21.2% for males, an even higher rate – 25.7% – of females in Haiti reported suffering from childhood sexual violence.

Cambodia reported the lowest rates of childhood sexual violence for both females and males, at 4.4% and 5.6%. respectively.

Despite the high percentage of the study’s sample that suffered from childhood sexual violence, only 10% or less of male and female victims in most of the countries studied received services such as health care, legal/security aid, counseling support, or child protective services. Female victims in Haiti, Swaziland, and Tanzania were most often provided with services, with rates ranging from 10% in Haiti to 24% in Swaziland.

“Despite myriad adverse effects of sexual violence, in this study, most persons who reported experiencing it during childhood did not receive services for their abuse,” according to Dr. Steven A. Sumner of the National Center for Injury Prevention and Control, Atlanta, and his colleagues. “Although the control and response to violence traditionally has been seen as the responsibility of law enforcement and social welfare, health sectors can integrate violence prevention and care into routine programmatic activities, building clear links to social services to achieve maximal benefit for various health measures.”

Read the full study in MMWR.

[email protected]

Children with urinary levels of 3-phenoxybenzoic acid (3-PBA) above the limit of detection were twice as likely to have attention-deficit/hyperactivity disorder as those with lower levels of the metabolite of several pyrethroid pesticides, according to a study.

Such data came from the National Health and Nutrition Examination Survey (NHANES) results for 687 children aged 8-15 years. Of the sample, 15% had ADHD, which the researchers defined as meeting Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for ADHD and/or having a prior ADHD diagnosis. The limit of detection for 3-PBA was 0.1 mcg/L. It was below that level for 21% or 131 of the study’s participants. The average BPA level in the sample was 1.14 mcg/L.

Each tenfold increase in urinary 3-BPA level was associated with a 57% increase in the prevalence of ADHD. Higher 3-BPA levels also were associated with an increasing number of hyperactive-impulsive symptoms; the number of these symptoms found in children with detectable levels of 3-BPA was 77% higher than in children with nondetectable levels.

The researchers found some differences in 3-BPA levels’ associations with ADHD and the disorder’s symptoms in boys and girls. Stronger associations between urinary 3-BPA levels and ADHD were found in boys; boys with detectable levels of 3-BPA were almost three times as likely to have ADHD than other boys in the sample. In girls, the adjusted odds ratio was only 1.54.

“Our results suggest an association between childhood urinary pyrethroid pesticide biomarkers and ADHD, particularly hyperactive-impulsive symptoms, and these associations may be stronger in boys than girls,” according to Melissa Wagner-Schuman of the Cincinnati Children’s Hospital Center and her colleagues. “Given the growing use of pyrethroid pesticides and the perception that they represent a safer pesticide alternative, these results may be of considerable public importance. However, replication of findings is warranted in prospective, longitudinal studies with serial measurements of pyrethroid pesticide exposure.”

Read the full study in Environmental Health (doi: 10.1186/s12940-015-0030-y).

[email protected]

Children with urinary levels of 3-phenoxybenzoic acid (3-PBA) above the limit of detection were twice as likely to have attention-deficit/hyperactivity disorder as those with lower levels of the metabolite of several pyrethroid pesticides, according to a study.

Such data came from the National Health and Nutrition Examination Survey (NHANES) results for 687 children aged 8-15 years. Of the sample, 15% had ADHD, which the researchers defined as meeting Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for ADHD and/or having a prior ADHD diagnosis. The limit of detection for 3-PBA was 0.1 mcg/L. It was below that level for 21% or 131 of the study’s participants. The average BPA level in the sample was 1.14 mcg/L.

Each tenfold increase in urinary 3-BPA level was associated with a 57% increase in the prevalence of ADHD. Higher 3-BPA levels also were associated with an increasing number of hyperactive-impulsive symptoms; the number of these symptoms found in children with detectable levels of 3-BPA was 77% higher than in children with nondetectable levels.

The researchers found some differences in 3-BPA levels’ associations with ADHD and the disorder’s symptoms in boys and girls. Stronger associations between urinary 3-BPA levels and ADHD were found in boys; boys with detectable levels of 3-BPA were almost three times as likely to have ADHD than other boys in the sample. In girls, the adjusted odds ratio was only 1.54.

“Our results suggest an association between childhood urinary pyrethroid pesticide biomarkers and ADHD, particularly hyperactive-impulsive symptoms, and these associations may be stronger in boys than girls,” according to Melissa Wagner-Schuman of the Cincinnati Children’s Hospital Center and her colleagues. “Given the growing use of pyrethroid pesticides and the perception that they represent a safer pesticide alternative, these results may be of considerable public importance. However, replication of findings is warranted in prospective, longitudinal studies with serial measurements of pyrethroid pesticide exposure.”

Read the full study in Environmental Health (doi: 10.1186/s12940-015-0030-y).

[email protected]

Children with urinary levels of 3-phenoxybenzoic acid (3-PBA) above the limit of detection were twice as likely to have attention-deficit/hyperactivity disorder as those with lower levels of the metabolite of several pyrethroid pesticides, according to a study.

Such data came from the National Health and Nutrition Examination Survey (NHANES) results for 687 children aged 8-15 years. Of the sample, 15% had ADHD, which the researchers defined as meeting Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for ADHD and/or having a prior ADHD diagnosis. The limit of detection for 3-PBA was 0.1 mcg/L. It was below that level for 21% or 131 of the study’s participants. The average BPA level in the sample was 1.14 mcg/L.

Each tenfold increase in urinary 3-BPA level was associated with a 57% increase in the prevalence of ADHD. Higher 3-BPA levels also were associated with an increasing number of hyperactive-impulsive symptoms; the number of these symptoms found in children with detectable levels of 3-BPA was 77% higher than in children with nondetectable levels.

The researchers found some differences in 3-BPA levels’ associations with ADHD and the disorder’s symptoms in boys and girls. Stronger associations between urinary 3-BPA levels and ADHD were found in boys; boys with detectable levels of 3-BPA were almost three times as likely to have ADHD than other boys in the sample. In girls, the adjusted odds ratio was only 1.54.

“Our results suggest an association between childhood urinary pyrethroid pesticide biomarkers and ADHD, particularly hyperactive-impulsive symptoms, and these associations may be stronger in boys than girls,” according to Melissa Wagner-Schuman of the Cincinnati Children’s Hospital Center and her colleagues. “Given the growing use of pyrethroid pesticides and the perception that they represent a safer pesticide alternative, these results may be of considerable public importance. However, replication of findings is warranted in prospective, longitudinal studies with serial measurements of pyrethroid pesticide exposure.”

Read the full study in Environmental Health (doi: 10.1186/s12940-015-0030-y).

[email protected]

Patients with bipolar disorder with psychotic symptoms with a longer duration of untreated illness are worse off than patients diagnosed with the condition earlier, a retrospective study shows.

The duration of untreated psychosis (DUP), duration of untreated illness (DUI), and initial diagnosis of 240 bipolar disorder (BD) patients with psychotic symptoms were extrapolated through a retrospective review of clinical charts, Lombardy database, and, if necessary, through clinical interviews with patients and their relatives. DUP was defined as the time between the onset of psychotic symptoms and the start of antipsychotic treatment, while DUI was defined as the time between the onset of any symptoms of BD and the start of the appropriate mood-stabilizing therapy.

Most (61.5%) of the study’s participants initially were diagnosed with illnesses other than bipolar disorder with psychotic symptoms; the top most common misdiagnosis was delusional disorder.

For patients with DUIs of less than or equal to 8 years, Global Assessment of Functioning (GAF) scores were significantly higher than for patients with DUIs of greater than 8 years. Another significant difference that was found between these two groups was in the number of hospitalizations; participants in the group with longer DUIs faced significantly more of these.

The results of the study suggest that DUI, but not DUP, “seem to affect [at least partly] long-term prognosis” in patients with [bipolar disorder] with psychotic symptoms, according to Dr. A. Carlo Altamura and his colleagues.

Among the study’s conclusions is that “early-onset [bipolar disorder] patients with psychotic features have a long-term poorer working functioning” than late-onset BD patients with psychotic symptoms, according to the researchers.

Read the full study in the Journal of Affective Disorders (doi:10.1016/j.jd2015.04.024).

[email protected]

Patients with bipolar disorder with psychotic symptoms with a longer duration of untreated illness are worse off than patients diagnosed with the condition earlier, a retrospective study shows.

The duration of untreated psychosis (DUP), duration of untreated illness (DUI), and initial diagnosis of 240 bipolar disorder (BD) patients with psychotic symptoms were extrapolated through a retrospective review of clinical charts, Lombardy database, and, if necessary, through clinical interviews with patients and their relatives. DUP was defined as the time between the onset of psychotic symptoms and the start of antipsychotic treatment, while DUI was defined as the time between the onset of any symptoms of BD and the start of the appropriate mood-stabilizing therapy.

Most (61.5%) of the study’s participants initially were diagnosed with illnesses other than bipolar disorder with psychotic symptoms; the top most common misdiagnosis was delusional disorder.

For patients with DUIs of less than or equal to 8 years, Global Assessment of Functioning (GAF) scores were significantly higher than for patients with DUIs of greater than 8 years. Another significant difference that was found between these two groups was in the number of hospitalizations; participants in the group with longer DUIs faced significantly more of these.

The results of the study suggest that DUI, but not DUP, “seem to affect [at least partly] long-term prognosis” in patients with [bipolar disorder] with psychotic symptoms, according to Dr. A. Carlo Altamura and his colleagues.

Among the study’s conclusions is that “early-onset [bipolar disorder] patients with psychotic features have a long-term poorer working functioning” than late-onset BD patients with psychotic symptoms, according to the researchers.

Read the full study in the Journal of Affective Disorders (doi:10.1016/j.jd2015.04.024).

[email protected]

Patients with bipolar disorder with psychotic symptoms with a longer duration of untreated illness are worse off than patients diagnosed with the condition earlier, a retrospective study shows.

The duration of untreated psychosis (DUP), duration of untreated illness (DUI), and initial diagnosis of 240 bipolar disorder (BD) patients with psychotic symptoms were extrapolated through a retrospective review of clinical charts, Lombardy database, and, if necessary, through clinical interviews with patients and their relatives. DUP was defined as the time between the onset of psychotic symptoms and the start of antipsychotic treatment, while DUI was defined as the time between the onset of any symptoms of BD and the start of the appropriate mood-stabilizing therapy.

Most (61.5%) of the study’s participants initially were diagnosed with illnesses other than bipolar disorder with psychotic symptoms; the top most common misdiagnosis was delusional disorder.

For patients with DUIs of less than or equal to 8 years, Global Assessment of Functioning (GAF) scores were significantly higher than for patients with DUIs of greater than 8 years. Another significant difference that was found between these two groups was in the number of hospitalizations; participants in the group with longer DUIs faced significantly more of these.

The results of the study suggest that DUI, but not DUP, “seem to affect [at least partly] long-term prognosis” in patients with [bipolar disorder] with psychotic symptoms, according to Dr. A. Carlo Altamura and his colleagues.

Among the study’s conclusions is that “early-onset [bipolar disorder] patients with psychotic features have a long-term poorer working functioning” than late-onset BD patients with psychotic symptoms, according to the researchers.

Read the full study in the Journal of Affective Disorders (doi:10.1016/j.jd2015.04.024).

[email protected]

Three North American nonprofit organizations that invest in scleroderma research are jointly trying to raise awareness about the autoimmune disorder.

Their efforts include posting information and urging people to pledge to raise awareness about the disease on Facebook and Twitter channels throughout June, which is Scleroderma Awareness Month. The partners in this campaign – Scleroderma Foundation, Scleroderma Research Foundation, and Scleroderma Society of Canada – have named their project, “Hard word. Harder disease.”

The campaign includes blogger outreach and sclerodermaaware.org, which serves as the landing page for the pledge and includes links to facts about the disease, organizers of the campaign, and scleroderma patients’ stories.

“Our strategy is to compel those who are not immediately impacted by scleroderma to relate to the disease, and therefore be more likely to empathize,” Robert J. Riggs, chief executive officer for the Scleroderma Foundation,said in a written statement.

[email protected]

Three North American nonprofit organizations that invest in scleroderma research are jointly trying to raise awareness about the autoimmune disorder.

Their efforts include posting information and urging people to pledge to raise awareness about the disease on Facebook and Twitter channels throughout June, which is Scleroderma Awareness Month. The partners in this campaign – Scleroderma Foundation, Scleroderma Research Foundation, and Scleroderma Society of Canada – have named their project, “Hard word. Harder disease.”

The campaign includes blogger outreach and sclerodermaaware.org, which serves as the landing page for the pledge and includes links to facts about the disease, organizers of the campaign, and scleroderma patients’ stories.

“Our strategy is to compel those who are not immediately impacted by scleroderma to relate to the disease, and therefore be more likely to empathize,” Robert J. Riggs, chief executive officer for the Scleroderma Foundation,said in a written statement.

[email protected]

Three North American nonprofit organizations that invest in scleroderma research are jointly trying to raise awareness about the autoimmune disorder.

Their efforts include posting information and urging people to pledge to raise awareness about the disease on Facebook and Twitter channels throughout June, which is Scleroderma Awareness Month. The partners in this campaign – Scleroderma Foundation, Scleroderma Research Foundation, and Scleroderma Society of Canada – have named their project, “Hard word. Harder disease.”

The campaign includes blogger outreach and sclerodermaaware.org, which serves as the landing page for the pledge and includes links to facts about the disease, organizers of the campaign, and scleroderma patients’ stories.

“Our strategy is to compel those who are not immediately impacted by scleroderma to relate to the disease, and therefore be more likely to empathize,” Robert J. Riggs, chief executive officer for the Scleroderma Foundation,said in a written statement.

[email protected]