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Lucas Franki is an associate editor for MDedge News, and has been with the company since 2014. He has a BA in English from Penn State University and is an Eagle Scout.
Asthma, eczema in children unrelated to allergic sensitization
Atopy was not related to development of eczema or asthma in children under age 13 years, according to Ann-Marie Malby Schoos, Ph.D., and her associates at the University of Copenhagen.
Allergic sensitization increased with age in the 399 children tested, rising from 12% at 6 months to 54% at 13 years. The incidence of asthma was highest at age 4 years at 16%, but decreased afterward, falling to 12% at 13 years. The incidence of eczema peaked at 39% in children aged 1.5 years old, but decreased steadily to only 12% in 13-year-olds.
Asthma and allergic sensitization were related only in late childhood, with an odds ratio of 4.49 in 13-year-olds. This pattern was seen throughout allergic sensitization subgroups. There were strong associations between eczema and allergic sensitization at 6 months (OR, 6.02), 1.5 years (OR, 2.06), and 6 years (OR, 2.77), but no association at 13 years. The proportion of children with allergic sensitization who did not have asthma or eczema also increased with age.
“The tradition of using atopy as a particular endotype of asthma and eczema seems unfounded because it depends on the method of testing for sensitization, type of allergens, and age of the patient. This questions the relevance of the terms atopic asthma and atopic eczema as true endotypes,” the investigators concluded.
Find the full study in the Journal of Allergy and Clinical Immunology (doi: 10.1016/j.jaci.2015.10.004).
Atopy was not related to development of eczema or asthma in children under age 13 years, according to Ann-Marie Malby Schoos, Ph.D., and her associates at the University of Copenhagen.
Allergic sensitization increased with age in the 399 children tested, rising from 12% at 6 months to 54% at 13 years. The incidence of asthma was highest at age 4 years at 16%, but decreased afterward, falling to 12% at 13 years. The incidence of eczema peaked at 39% in children aged 1.5 years old, but decreased steadily to only 12% in 13-year-olds.
Asthma and allergic sensitization were related only in late childhood, with an odds ratio of 4.49 in 13-year-olds. This pattern was seen throughout allergic sensitization subgroups. There were strong associations between eczema and allergic sensitization at 6 months (OR, 6.02), 1.5 years (OR, 2.06), and 6 years (OR, 2.77), but no association at 13 years. The proportion of children with allergic sensitization who did not have asthma or eczema also increased with age.
“The tradition of using atopy as a particular endotype of asthma and eczema seems unfounded because it depends on the method of testing for sensitization, type of allergens, and age of the patient. This questions the relevance of the terms atopic asthma and atopic eczema as true endotypes,” the investigators concluded.
Find the full study in the Journal of Allergy and Clinical Immunology (doi: 10.1016/j.jaci.2015.10.004).
Atopy was not related to development of eczema or asthma in children under age 13 years, according to Ann-Marie Malby Schoos, Ph.D., and her associates at the University of Copenhagen.
Allergic sensitization increased with age in the 399 children tested, rising from 12% at 6 months to 54% at 13 years. The incidence of asthma was highest at age 4 years at 16%, but decreased afterward, falling to 12% at 13 years. The incidence of eczema peaked at 39% in children aged 1.5 years old, but decreased steadily to only 12% in 13-year-olds.
Asthma and allergic sensitization were related only in late childhood, with an odds ratio of 4.49 in 13-year-olds. This pattern was seen throughout allergic sensitization subgroups. There were strong associations between eczema and allergic sensitization at 6 months (OR, 6.02), 1.5 years (OR, 2.06), and 6 years (OR, 2.77), but no association at 13 years. The proportion of children with allergic sensitization who did not have asthma or eczema also increased with age.
“The tradition of using atopy as a particular endotype of asthma and eczema seems unfounded because it depends on the method of testing for sensitization, type of allergens, and age of the patient. This questions the relevance of the terms atopic asthma and atopic eczema as true endotypes,” the investigators concluded.
Find the full study in the Journal of Allergy and Clinical Immunology (doi: 10.1016/j.jaci.2015.10.004).
FROM THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
Clazakizumab safe, effective for PsA treatment
Treatment with clazakizumab was well tolerated and effective at treating musculoskeletal stress in patients with psoriatic arthritis (PsA), Dr. Philip Mease and his associates reported in a phase IIB study published in Arthritis & Rheumatology.
After 16 weeks, American College of Rheumatology (ACR) 20 response rates were highest in the group that received 100-mg doses of clazakizumab at 52.4%, compared with 46.3% for the 25-mg group, 39% for the 200-mg group, and 29.3% for the placebo group. ACR 50/ACR 70 response rates were higher for clazakizumab than for placebo after 16 weeks and 24 weeks, without clear evidence of a dose response.
Adverse events were more common for patients taking clazakizumab and occurred most frequently in the 200-mg group. However, serious adverse events were no more common in the 25-mg and 100-mg groups, compared with the placebo group. Discontinuations due to adverse events were highest in the 200-mg group, and were similar in all other groups.
“Clazakizumab may be particularly suited for patients with PsA in whom skin disease is well controlled with topical agents, ultraviolet therapy, and/or oral systemic therapy such as MTX [methotrexate], but whose musculoskeletal manifestations, such as joint signs and symptoms, enthesitis, and dactylitis, require more potent systemic therapy. Furthermore, some PsA patients do not present with skin lesions at diagnosis; those patients may also benefit from clazakizumab treatment,” the investigators noted.
Find the full study in Arthritis & Rheumatology (doi: 10.1002/art.39700).
Treatment with clazakizumab was well tolerated and effective at treating musculoskeletal stress in patients with psoriatic arthritis (PsA), Dr. Philip Mease and his associates reported in a phase IIB study published in Arthritis & Rheumatology.
After 16 weeks, American College of Rheumatology (ACR) 20 response rates were highest in the group that received 100-mg doses of clazakizumab at 52.4%, compared with 46.3% for the 25-mg group, 39% for the 200-mg group, and 29.3% for the placebo group. ACR 50/ACR 70 response rates were higher for clazakizumab than for placebo after 16 weeks and 24 weeks, without clear evidence of a dose response.
Adverse events were more common for patients taking clazakizumab and occurred most frequently in the 200-mg group. However, serious adverse events were no more common in the 25-mg and 100-mg groups, compared with the placebo group. Discontinuations due to adverse events were highest in the 200-mg group, and were similar in all other groups.
“Clazakizumab may be particularly suited for patients with PsA in whom skin disease is well controlled with topical agents, ultraviolet therapy, and/or oral systemic therapy such as MTX [methotrexate], but whose musculoskeletal manifestations, such as joint signs and symptoms, enthesitis, and dactylitis, require more potent systemic therapy. Furthermore, some PsA patients do not present with skin lesions at diagnosis; those patients may also benefit from clazakizumab treatment,” the investigators noted.
Find the full study in Arthritis & Rheumatology (doi: 10.1002/art.39700).
Treatment with clazakizumab was well tolerated and effective at treating musculoskeletal stress in patients with psoriatic arthritis (PsA), Dr. Philip Mease and his associates reported in a phase IIB study published in Arthritis & Rheumatology.
After 16 weeks, American College of Rheumatology (ACR) 20 response rates were highest in the group that received 100-mg doses of clazakizumab at 52.4%, compared with 46.3% for the 25-mg group, 39% for the 200-mg group, and 29.3% for the placebo group. ACR 50/ACR 70 response rates were higher for clazakizumab than for placebo after 16 weeks and 24 weeks, without clear evidence of a dose response.
Adverse events were more common for patients taking clazakizumab and occurred most frequently in the 200-mg group. However, serious adverse events were no more common in the 25-mg and 100-mg groups, compared with the placebo group. Discontinuations due to adverse events were highest in the 200-mg group, and were similar in all other groups.
“Clazakizumab may be particularly suited for patients with PsA in whom skin disease is well controlled with topical agents, ultraviolet therapy, and/or oral systemic therapy such as MTX [methotrexate], but whose musculoskeletal manifestations, such as joint signs and symptoms, enthesitis, and dactylitis, require more potent systemic therapy. Furthermore, some PsA patients do not present with skin lesions at diagnosis; those patients may also benefit from clazakizumab treatment,” the investigators noted.
Find the full study in Arthritis & Rheumatology (doi: 10.1002/art.39700).
FROM ARTHRITIS & RHEUMATOLOGY
Number of U.S. tuberculosis cases increased in 2015
For the first time in 20 years, incidence of tuberculosis in the United States increased slightly in 2015, according to investigators from the Centers for Disease Control and Prevention.
In 2015, 9,563 cases of TB were reported in the United States, up 1.7% from the 9,406 cases reported in 2014. Texas saw the largest total increase in TB cases, going from 1,269 cases in 2014 to 1,334 cases in 2015, followed by South Carolina and Michigan, which both had 25 more TB cases in 2015 than in 2014. Vermont saw the largest relative increase, going from two cases in 2014 to seven cases in 2015, an increase of 250%.
Among U.S.-born patients, the largest number of TB cases were reported in black non-Hispanics, although the incidence rate was highest in Native Hawaiian/other Pacific Islanders at 8.4/100,000 people. For foreign-born patients, Mexico was the most common origin country, followed by the Philippines, India, Vietnam, and China. Incidence rate was significantly higher for patients from Asian countries than from any other region.
“Resuming declines in TB incidence will require more comprehensive public health approaches, both globally and domestically. These include increasing case detection and cure rates globally, reducing TB transmission in institutional settings such as health care settings and correctional facilities, and increasing detection and treatment of preexisting latent TB infection among the U.S. populations most affected by TB,” the CDC investigators said.
Find the full report in the MMWR (doi: 10.15585/mmwr.mm6511a2).
For the first time in 20 years, incidence of tuberculosis in the United States increased slightly in 2015, according to investigators from the Centers for Disease Control and Prevention.
In 2015, 9,563 cases of TB were reported in the United States, up 1.7% from the 9,406 cases reported in 2014. Texas saw the largest total increase in TB cases, going from 1,269 cases in 2014 to 1,334 cases in 2015, followed by South Carolina and Michigan, which both had 25 more TB cases in 2015 than in 2014. Vermont saw the largest relative increase, going from two cases in 2014 to seven cases in 2015, an increase of 250%.
Among U.S.-born patients, the largest number of TB cases were reported in black non-Hispanics, although the incidence rate was highest in Native Hawaiian/other Pacific Islanders at 8.4/100,000 people. For foreign-born patients, Mexico was the most common origin country, followed by the Philippines, India, Vietnam, and China. Incidence rate was significantly higher for patients from Asian countries than from any other region.
“Resuming declines in TB incidence will require more comprehensive public health approaches, both globally and domestically. These include increasing case detection and cure rates globally, reducing TB transmission in institutional settings such as health care settings and correctional facilities, and increasing detection and treatment of preexisting latent TB infection among the U.S. populations most affected by TB,” the CDC investigators said.
Find the full report in the MMWR (doi: 10.15585/mmwr.mm6511a2).
For the first time in 20 years, incidence of tuberculosis in the United States increased slightly in 2015, according to investigators from the Centers for Disease Control and Prevention.
In 2015, 9,563 cases of TB were reported in the United States, up 1.7% from the 9,406 cases reported in 2014. Texas saw the largest total increase in TB cases, going from 1,269 cases in 2014 to 1,334 cases in 2015, followed by South Carolina and Michigan, which both had 25 more TB cases in 2015 than in 2014. Vermont saw the largest relative increase, going from two cases in 2014 to seven cases in 2015, an increase of 250%.
Among U.S.-born patients, the largest number of TB cases were reported in black non-Hispanics, although the incidence rate was highest in Native Hawaiian/other Pacific Islanders at 8.4/100,000 people. For foreign-born patients, Mexico was the most common origin country, followed by the Philippines, India, Vietnam, and China. Incidence rate was significantly higher for patients from Asian countries than from any other region.
“Resuming declines in TB incidence will require more comprehensive public health approaches, both globally and domestically. These include increasing case detection and cure rates globally, reducing TB transmission in institutional settings such as health care settings and correctional facilities, and increasing detection and treatment of preexisting latent TB infection among the U.S. populations most affected by TB,” the CDC investigators said.
Find the full report in the MMWR (doi: 10.15585/mmwr.mm6511a2).
FROM THE MMWR
FDA: Antidepressant meets efficacy tests, after all
The Food and Drug Administration’s Office of New Drugs has ruled in favor of the efficacy of gepirone extended release for treating major depressive disorder. The decision overturns a decision by the agency’s Psychopharmacologic Drugs Advisory Committee that said the drug’s efficacy had not been demonstrated, according to Fabre-Kramer Pharmaceuticals.
The Office of New Drugs took into account two trials involving gepirone ER (Travivo) with more than 5,000 participants. Both trials had highly positive results, with effect sizes similar to other antidepressants approved by the FDA. Travivo was well tolerated and had a favorable safety profile for trial participants. The most frequent side effects were lightheadedness and nausea, which were usually mild and related to a dose increase.
Travivo, manufactured by Fabre-Kramer, is an antidepressant with a unique mechanism of targeted 5-hydroxytryptamine1A agonism. This mechanism treats depression without significant side effects, particularly sexual dysfunction.
“Travivo is a standout drug that offers a truly unique mechanism, compared with current therapies on the market and it’s an important addition to the armamentarium to treat depression. What’s more, the FDA’s decision will have a positive effect on the future development of drugs in this class,” Dr. Stephen M. Stahl, professor of psychiatry, University of California, San Diego, and founder of the Neuroscience Education Institute said in a press release.
Find the press release about the development here.
The Food and Drug Administration’s Office of New Drugs has ruled in favor of the efficacy of gepirone extended release for treating major depressive disorder. The decision overturns a decision by the agency’s Psychopharmacologic Drugs Advisory Committee that said the drug’s efficacy had not been demonstrated, according to Fabre-Kramer Pharmaceuticals.
The Office of New Drugs took into account two trials involving gepirone ER (Travivo) with more than 5,000 participants. Both trials had highly positive results, with effect sizes similar to other antidepressants approved by the FDA. Travivo was well tolerated and had a favorable safety profile for trial participants. The most frequent side effects were lightheadedness and nausea, which were usually mild and related to a dose increase.
Travivo, manufactured by Fabre-Kramer, is an antidepressant with a unique mechanism of targeted 5-hydroxytryptamine1A agonism. This mechanism treats depression without significant side effects, particularly sexual dysfunction.
“Travivo is a standout drug that offers a truly unique mechanism, compared with current therapies on the market and it’s an important addition to the armamentarium to treat depression. What’s more, the FDA’s decision will have a positive effect on the future development of drugs in this class,” Dr. Stephen M. Stahl, professor of psychiatry, University of California, San Diego, and founder of the Neuroscience Education Institute said in a press release.
Find the press release about the development here.
The Food and Drug Administration’s Office of New Drugs has ruled in favor of the efficacy of gepirone extended release for treating major depressive disorder. The decision overturns a decision by the agency’s Psychopharmacologic Drugs Advisory Committee that said the drug’s efficacy had not been demonstrated, according to Fabre-Kramer Pharmaceuticals.
The Office of New Drugs took into account two trials involving gepirone ER (Travivo) with more than 5,000 participants. Both trials had highly positive results, with effect sizes similar to other antidepressants approved by the FDA. Travivo was well tolerated and had a favorable safety profile for trial participants. The most frequent side effects were lightheadedness and nausea, which were usually mild and related to a dose increase.
Travivo, manufactured by Fabre-Kramer, is an antidepressant with a unique mechanism of targeted 5-hydroxytryptamine1A agonism. This mechanism treats depression without significant side effects, particularly sexual dysfunction.
“Travivo is a standout drug that offers a truly unique mechanism, compared with current therapies on the market and it’s an important addition to the armamentarium to treat depression. What’s more, the FDA’s decision will have a positive effect on the future development of drugs in this class,” Dr. Stephen M. Stahl, professor of psychiatry, University of California, San Diego, and founder of the Neuroscience Education Institute said in a press release.
Find the press release about the development here.
Schizophrenia, psychotic disorders more likely in refugees
Refugees are at a significantly higher risk of schizophrenia and other nonaffective psychotic disorders than are nonrefugee migrants from a similar part of the world, according to Dr. Anna-Clara Hollander and her associates.
In a survey of 1.348 million people living in Sweden, 3,704 cases of nonaffective psychotic disorders were diagnosed during an observation period of 8.9 million person-years. Psychotic disorders occurred at a rate of 38.5 per 100,000 person-years in the native population, 80.4 per 100,000 person-years in nonrefugee migrants, and 126.4 per 100,000 person-years in refugees. The hazard ratio for refugees was 2.9 and was 1.7 for nonrefugee migrants.
The incidence rate was higher for refugees than for nonrefugee migrants from Eastern Europe, Asia, the Middle East and North Africa, but not from sub-Saharan Africa, where nonrefugees had an incidence rate of 186.7 per 100,000 years and refugees had an incidence rate of 166 per 100,000 person-years. In addition, disorder incidence was greater in men from all regions except sub-Saharan Africa.
“Clinicians and service planners in high income settings should be aware of the early signs of psychosis in refugees, for whom median presentation to services after arrival to Sweden was more than a year sooner than for other migrant groups. Just as for the general population, refugees and their families will benefit from timely and early intervention and care, particularly in those exposed to severe psychosocial adversity,” the investigators noted.
Find the study in the British Medical Journal (2016 Mar 15. doi: 10.1136/bmj.i1030).
Refugees are at a significantly higher risk of schizophrenia and other nonaffective psychotic disorders than are nonrefugee migrants from a similar part of the world, according to Dr. Anna-Clara Hollander and her associates.
In a survey of 1.348 million people living in Sweden, 3,704 cases of nonaffective psychotic disorders were diagnosed during an observation period of 8.9 million person-years. Psychotic disorders occurred at a rate of 38.5 per 100,000 person-years in the native population, 80.4 per 100,000 person-years in nonrefugee migrants, and 126.4 per 100,000 person-years in refugees. The hazard ratio for refugees was 2.9 and was 1.7 for nonrefugee migrants.
The incidence rate was higher for refugees than for nonrefugee migrants from Eastern Europe, Asia, the Middle East and North Africa, but not from sub-Saharan Africa, where nonrefugees had an incidence rate of 186.7 per 100,000 years and refugees had an incidence rate of 166 per 100,000 person-years. In addition, disorder incidence was greater in men from all regions except sub-Saharan Africa.
“Clinicians and service planners in high income settings should be aware of the early signs of psychosis in refugees, for whom median presentation to services after arrival to Sweden was more than a year sooner than for other migrant groups. Just as for the general population, refugees and their families will benefit from timely and early intervention and care, particularly in those exposed to severe psychosocial adversity,” the investigators noted.
Find the study in the British Medical Journal (2016 Mar 15. doi: 10.1136/bmj.i1030).
Refugees are at a significantly higher risk of schizophrenia and other nonaffective psychotic disorders than are nonrefugee migrants from a similar part of the world, according to Dr. Anna-Clara Hollander and her associates.
In a survey of 1.348 million people living in Sweden, 3,704 cases of nonaffective psychotic disorders were diagnosed during an observation period of 8.9 million person-years. Psychotic disorders occurred at a rate of 38.5 per 100,000 person-years in the native population, 80.4 per 100,000 person-years in nonrefugee migrants, and 126.4 per 100,000 person-years in refugees. The hazard ratio for refugees was 2.9 and was 1.7 for nonrefugee migrants.
The incidence rate was higher for refugees than for nonrefugee migrants from Eastern Europe, Asia, the Middle East and North Africa, but not from sub-Saharan Africa, where nonrefugees had an incidence rate of 186.7 per 100,000 years and refugees had an incidence rate of 166 per 100,000 person-years. In addition, disorder incidence was greater in men from all regions except sub-Saharan Africa.
“Clinicians and service planners in high income settings should be aware of the early signs of psychosis in refugees, for whom median presentation to services after arrival to Sweden was more than a year sooner than for other migrant groups. Just as for the general population, refugees and their families will benefit from timely and early intervention and care, particularly in those exposed to severe psychosocial adversity,” the investigators noted.
Find the study in the British Medical Journal (2016 Mar 15. doi: 10.1136/bmj.i1030).
FROM THE BMJ
Key differences found between patients with bipolar I, bipolar II
Second-generation antipsychotic use is associated with a previous incidence of psychiatric hospitalization in patients with bipolar disorder I but not in those with bipolar II, a study by Dr. Dong Yeon Park and associates shows.
The researchers found that the use of the second-generation agents (SGAs) was twice as common in the bipolar disorder I study group. Forty-four percent of 243 bipolar I patients used at least one of the antipsychotics, compared with 21.2% of 260 patients with bipolar disorder II.
Most bipolar I patients had a history of psychiatric hospitalization; however, hospitalization was significantly more common among patients in an SGA subgroup. In that group, more than 80% of those patients had a history of psychiatric hospitalization, compared with 58.1% of patients with bipolar I who were not taking SGAs. Comparatively, 12.7% of bipolar II patients taking SGAs had a history of psychiatric hospitalization, compared with 9.3% of bipolar II patients who were not taking SGAs.
Patients with bipolar I who were on SGAs also were more likely to be currently depressed, have current complex pharmacotherapy, and have a higher Clinical Global Impression for Bipolar Version Overall Severity score. Meanwhile, bipolar disorder II patients taking SGAs were more likely to be currently using mood stabilizers than were bipolar II patients who were not taking SGAs, reported Dr. Park, of the department of psychiatry at Seoul National Hospital, South Korea.
“More research is needed to assess differential demographic and clinical correlates of current SGA use in patients with bipolar II disorder compared to bipolar I disorder. Challenges related to the variable expense and side effects of SGAs highlight the importance of increasing knowledge of the strengths and limitations of use of these agents in patients with different types of bipolar disorders,” the investigators concluded.
Find the study in the Journal of Psychiatric Research (doi: 10.1016/j.jpsychires.2016.01.016).
Second-generation antipsychotic use is associated with a previous incidence of psychiatric hospitalization in patients with bipolar disorder I but not in those with bipolar II, a study by Dr. Dong Yeon Park and associates shows.
The researchers found that the use of the second-generation agents (SGAs) was twice as common in the bipolar disorder I study group. Forty-four percent of 243 bipolar I patients used at least one of the antipsychotics, compared with 21.2% of 260 patients with bipolar disorder II.
Most bipolar I patients had a history of psychiatric hospitalization; however, hospitalization was significantly more common among patients in an SGA subgroup. In that group, more than 80% of those patients had a history of psychiatric hospitalization, compared with 58.1% of patients with bipolar I who were not taking SGAs. Comparatively, 12.7% of bipolar II patients taking SGAs had a history of psychiatric hospitalization, compared with 9.3% of bipolar II patients who were not taking SGAs.
Patients with bipolar I who were on SGAs also were more likely to be currently depressed, have current complex pharmacotherapy, and have a higher Clinical Global Impression for Bipolar Version Overall Severity score. Meanwhile, bipolar disorder II patients taking SGAs were more likely to be currently using mood stabilizers than were bipolar II patients who were not taking SGAs, reported Dr. Park, of the department of psychiatry at Seoul National Hospital, South Korea.
“More research is needed to assess differential demographic and clinical correlates of current SGA use in patients with bipolar II disorder compared to bipolar I disorder. Challenges related to the variable expense and side effects of SGAs highlight the importance of increasing knowledge of the strengths and limitations of use of these agents in patients with different types of bipolar disorders,” the investigators concluded.
Find the study in the Journal of Psychiatric Research (doi: 10.1016/j.jpsychires.2016.01.016).
Second-generation antipsychotic use is associated with a previous incidence of psychiatric hospitalization in patients with bipolar disorder I but not in those with bipolar II, a study by Dr. Dong Yeon Park and associates shows.
The researchers found that the use of the second-generation agents (SGAs) was twice as common in the bipolar disorder I study group. Forty-four percent of 243 bipolar I patients used at least one of the antipsychotics, compared with 21.2% of 260 patients with bipolar disorder II.
Most bipolar I patients had a history of psychiatric hospitalization; however, hospitalization was significantly more common among patients in an SGA subgroup. In that group, more than 80% of those patients had a history of psychiatric hospitalization, compared with 58.1% of patients with bipolar I who were not taking SGAs. Comparatively, 12.7% of bipolar II patients taking SGAs had a history of psychiatric hospitalization, compared with 9.3% of bipolar II patients who were not taking SGAs.
Patients with bipolar I who were on SGAs also were more likely to be currently depressed, have current complex pharmacotherapy, and have a higher Clinical Global Impression for Bipolar Version Overall Severity score. Meanwhile, bipolar disorder II patients taking SGAs were more likely to be currently using mood stabilizers than were bipolar II patients who were not taking SGAs, reported Dr. Park, of the department of psychiatry at Seoul National Hospital, South Korea.
“More research is needed to assess differential demographic and clinical correlates of current SGA use in patients with bipolar II disorder compared to bipolar I disorder. Challenges related to the variable expense and side effects of SGAs highlight the importance of increasing knowledge of the strengths and limitations of use of these agents in patients with different types of bipolar disorders,” the investigators concluded.
Find the study in the Journal of Psychiatric Research (doi: 10.1016/j.jpsychires.2016.01.016).
FROM THE JOURNAL OF PSYCHIATRIC RESEARCH
Bipolar, low compliance tied to greater cognitive impairment
Patients with bipolar disorder and low levels of pharmacological treatment adherence have greater levels of cognitive impairment, according to Dr. Ileana Fuentes and her associates.
After taking a neurological battery, 12 bipolar disorder patients with low treatment adherence performed worse than did 22 bipolar disorder patients with high treatment adherence in nearly all cognitive functions tested, but the effect was significant in verbal memory testing. The low-adherence group performed significantly worse in verbal memory immediate free recall, immediate cued recall, delayed free recall, and delayed cued recall.
Other factors found to be associated with poorer executive function and processing speed were greater number of manic episodes, history of psychosis, and fewer years of education, reported Dr. Fuentes of the University of Guadalajara, Mexico.
“Despite limitations of the study, our findings are clinically important, and they contribute to better understanding of the cognitive profile in low compliance patients with bipolar disorder. Low compliance, cognitive performance, and asymptomatic phase are important markers in [bipolar disorder] for further studies,” the investigators noted.
Find the study here (J Affect Disord. 2016 May;195:215-20 [doi: 10.1016/j.jad.2016.02.005]).
Patients with bipolar disorder and low levels of pharmacological treatment adherence have greater levels of cognitive impairment, according to Dr. Ileana Fuentes and her associates.
After taking a neurological battery, 12 bipolar disorder patients with low treatment adherence performed worse than did 22 bipolar disorder patients with high treatment adherence in nearly all cognitive functions tested, but the effect was significant in verbal memory testing. The low-adherence group performed significantly worse in verbal memory immediate free recall, immediate cued recall, delayed free recall, and delayed cued recall.
Other factors found to be associated with poorer executive function and processing speed were greater number of manic episodes, history of psychosis, and fewer years of education, reported Dr. Fuentes of the University of Guadalajara, Mexico.
“Despite limitations of the study, our findings are clinically important, and they contribute to better understanding of the cognitive profile in low compliance patients with bipolar disorder. Low compliance, cognitive performance, and asymptomatic phase are important markers in [bipolar disorder] for further studies,” the investigators noted.
Find the study here (J Affect Disord. 2016 May;195:215-20 [doi: 10.1016/j.jad.2016.02.005]).
Patients with bipolar disorder and low levels of pharmacological treatment adherence have greater levels of cognitive impairment, according to Dr. Ileana Fuentes and her associates.
After taking a neurological battery, 12 bipolar disorder patients with low treatment adherence performed worse than did 22 bipolar disorder patients with high treatment adherence in nearly all cognitive functions tested, but the effect was significant in verbal memory testing. The low-adherence group performed significantly worse in verbal memory immediate free recall, immediate cued recall, delayed free recall, and delayed cued recall.
Other factors found to be associated with poorer executive function and processing speed were greater number of manic episodes, history of psychosis, and fewer years of education, reported Dr. Fuentes of the University of Guadalajara, Mexico.
“Despite limitations of the study, our findings are clinically important, and they contribute to better understanding of the cognitive profile in low compliance patients with bipolar disorder. Low compliance, cognitive performance, and asymptomatic phase are important markers in [bipolar disorder] for further studies,” the investigators noted.
Find the study here (J Affect Disord. 2016 May;195:215-20 [doi: 10.1016/j.jad.2016.02.005]).
FROM THE JOURNAL OF AFFECTIVE DISORDERS
U.S. malaria cases up slightly in 2013
Malaria incidence in 2013 in the United States reached its third-highest point since 1973, according to a report from the Centers for Disease Control and Prevention.
The CDC received 1,727 reports of malaria in 2013, up 2% from the 1,687 cases reported in 2012. Since 1973, the only years with a higher incidence of malaria cases were 1980 and 2011 with 1,864 cases and 1,925 cases respectively. Plasmodium falciparum was the most common cause of malaria, accounting for 61% of the total cases. About 270 cases were classified as severe, and 10 people with malaria died, the highest death count since 2001.
Of the 1,720 cases imported into the United States, 1,250 cases originated in Africa, 164 cases came from Asia, 41 cases came from Central America and the Caribbean, 53 cases came from South America, 8 came from Oceania, 1 came from Europe, and 203 cases had unknown origins. Nigeria was the most common malaria source, accounting for 265 cases, with three other countries importing more than 100 cases. Outside of Africa, only India imported more than 100 cases.
“As international travel increases, prevention messages and health communication strategies become even more important for protecting the traveling community from communicable diseases. Prevention messages directed toward Africa-bound travelers, particularly those whose destination is West Africa, should be emphasized in early spring, accompanied with a reminder in late fall through early winter. Malaria prevention messages directed toward Asia-bound travelers, specifically those bound for India, should be intensified in late spring,” the CDC investigators recommended.
Find the full report in the MMWR (doi: 10.15585/mmwr.ss6502a1).
Malaria incidence in 2013 in the United States reached its third-highest point since 1973, according to a report from the Centers for Disease Control and Prevention.
The CDC received 1,727 reports of malaria in 2013, up 2% from the 1,687 cases reported in 2012. Since 1973, the only years with a higher incidence of malaria cases were 1980 and 2011 with 1,864 cases and 1,925 cases respectively. Plasmodium falciparum was the most common cause of malaria, accounting for 61% of the total cases. About 270 cases were classified as severe, and 10 people with malaria died, the highest death count since 2001.
Of the 1,720 cases imported into the United States, 1,250 cases originated in Africa, 164 cases came from Asia, 41 cases came from Central America and the Caribbean, 53 cases came from South America, 8 came from Oceania, 1 came from Europe, and 203 cases had unknown origins. Nigeria was the most common malaria source, accounting for 265 cases, with three other countries importing more than 100 cases. Outside of Africa, only India imported more than 100 cases.
“As international travel increases, prevention messages and health communication strategies become even more important for protecting the traveling community from communicable diseases. Prevention messages directed toward Africa-bound travelers, particularly those whose destination is West Africa, should be emphasized in early spring, accompanied with a reminder in late fall through early winter. Malaria prevention messages directed toward Asia-bound travelers, specifically those bound for India, should be intensified in late spring,” the CDC investigators recommended.
Find the full report in the MMWR (doi: 10.15585/mmwr.ss6502a1).
Malaria incidence in 2013 in the United States reached its third-highest point since 1973, according to a report from the Centers for Disease Control and Prevention.
The CDC received 1,727 reports of malaria in 2013, up 2% from the 1,687 cases reported in 2012. Since 1973, the only years with a higher incidence of malaria cases were 1980 and 2011 with 1,864 cases and 1,925 cases respectively. Plasmodium falciparum was the most common cause of malaria, accounting for 61% of the total cases. About 270 cases were classified as severe, and 10 people with malaria died, the highest death count since 2001.
Of the 1,720 cases imported into the United States, 1,250 cases originated in Africa, 164 cases came from Asia, 41 cases came from Central America and the Caribbean, 53 cases came from South America, 8 came from Oceania, 1 came from Europe, and 203 cases had unknown origins. Nigeria was the most common malaria source, accounting for 265 cases, with three other countries importing more than 100 cases. Outside of Africa, only India imported more than 100 cases.
“As international travel increases, prevention messages and health communication strategies become even more important for protecting the traveling community from communicable diseases. Prevention messages directed toward Africa-bound travelers, particularly those whose destination is West Africa, should be emphasized in early spring, accompanied with a reminder in late fall through early winter. Malaria prevention messages directed toward Asia-bound travelers, specifically those bound for India, should be intensified in late spring,” the CDC investigators recommended.
Find the full report in the MMWR (doi: 10.15585/mmwr.ss6502a1).
FROM MMWR
Asthma hospitalizations linked to prevalence of common cold in children
Daily viral prevalence was the greatest predictor of asthma hospitalizations in children, according to Rosalind M. Eggo and her associates.
Asthma hospitalizations in children occurred most frequently during the school year, and dropped off dramatically when school was out. Increases were not driven by triggers within the school environment, but by increased transmission and prevalence of viruses such as the common cold, the researchers noted. Common cold transmission rates were 45% lower during school holidays and breaks, and asthma hospitalizations decreased accordingly.
In adults, asthma hospitalizations were greatest during the winter and were most influenced by influenza prevalence. Low temperatures were an important risk factor for both groups; however, ozone and particulate matter were not.
“In general, future risk assessments and interventions for asthma, particularly in children, should explicitly consider both the school calendar and the seasonal dynamic of infectious triggers, either through spatiotemporal modeling or when possible, viral surveillance data,” the investigators concluded.
Find the study in PNAS (doi: 10.1073/pnas.1518677113).
Daily viral prevalence was the greatest predictor of asthma hospitalizations in children, according to Rosalind M. Eggo and her associates.
Asthma hospitalizations in children occurred most frequently during the school year, and dropped off dramatically when school was out. Increases were not driven by triggers within the school environment, but by increased transmission and prevalence of viruses such as the common cold, the researchers noted. Common cold transmission rates were 45% lower during school holidays and breaks, and asthma hospitalizations decreased accordingly.
In adults, asthma hospitalizations were greatest during the winter and were most influenced by influenza prevalence. Low temperatures were an important risk factor for both groups; however, ozone and particulate matter were not.
“In general, future risk assessments and interventions for asthma, particularly in children, should explicitly consider both the school calendar and the seasonal dynamic of infectious triggers, either through spatiotemporal modeling or when possible, viral surveillance data,” the investigators concluded.
Find the study in PNAS (doi: 10.1073/pnas.1518677113).
Daily viral prevalence was the greatest predictor of asthma hospitalizations in children, according to Rosalind M. Eggo and her associates.
Asthma hospitalizations in children occurred most frequently during the school year, and dropped off dramatically when school was out. Increases were not driven by triggers within the school environment, but by increased transmission and prevalence of viruses such as the common cold, the researchers noted. Common cold transmission rates were 45% lower during school holidays and breaks, and asthma hospitalizations decreased accordingly.
In adults, asthma hospitalizations were greatest during the winter and were most influenced by influenza prevalence. Low temperatures were an important risk factor for both groups; however, ozone and particulate matter were not.
“In general, future risk assessments and interventions for asthma, particularly in children, should explicitly consider both the school calendar and the seasonal dynamic of infectious triggers, either through spatiotemporal modeling or when possible, viral surveillance data,” the investigators concluded.
Find the study in PNAS (doi: 10.1073/pnas.1518677113).
FROM PNAS
Emotion affects associative memory in first-episode schizophrenia patients
Emotional modulation and alterations of associative memory are significantly worse in first-episode schizophrenia (FES) patients, according to Dr. David Luck and his associates.
In a functional MRI study, FES patients performed worse than did a control group in a standardized card memorization test. Testing consisted of both neutral and emotional components based on the contents of each card memorized. FES patients had worse scores on the emotional component of the test than on the neutral components, while controls had better scores on the emotional component than the neutral component.
Analysis showed that the deficits the FES patients experienced were due to decreased activation and disturbed connectivity in the mnemonic and limbic regions.
“These dysfunctions may be targets for new therapeutic interventions, such as cognitive remediation, known to improve cognitive deficits in schizophrenia,” the investigators concluded.
Find the study in Schizophrenia Research: Cognition (doi: 10.1016/j.scog.2015.11.004).
Emotional modulation and alterations of associative memory are significantly worse in first-episode schizophrenia (FES) patients, according to Dr. David Luck and his associates.
In a functional MRI study, FES patients performed worse than did a control group in a standardized card memorization test. Testing consisted of both neutral and emotional components based on the contents of each card memorized. FES patients had worse scores on the emotional component of the test than on the neutral components, while controls had better scores on the emotional component than the neutral component.
Analysis showed that the deficits the FES patients experienced were due to decreased activation and disturbed connectivity in the mnemonic and limbic regions.
“These dysfunctions may be targets for new therapeutic interventions, such as cognitive remediation, known to improve cognitive deficits in schizophrenia,” the investigators concluded.
Find the study in Schizophrenia Research: Cognition (doi: 10.1016/j.scog.2015.11.004).
Emotional modulation and alterations of associative memory are significantly worse in first-episode schizophrenia (FES) patients, according to Dr. David Luck and his associates.
In a functional MRI study, FES patients performed worse than did a control group in a standardized card memorization test. Testing consisted of both neutral and emotional components based on the contents of each card memorized. FES patients had worse scores on the emotional component of the test than on the neutral components, while controls had better scores on the emotional component than the neutral component.
Analysis showed that the deficits the FES patients experienced were due to decreased activation and disturbed connectivity in the mnemonic and limbic regions.
“These dysfunctions may be targets for new therapeutic interventions, such as cognitive remediation, known to improve cognitive deficits in schizophrenia,” the investigators concluded.
Find the study in Schizophrenia Research: Cognition (doi: 10.1016/j.scog.2015.11.004).
FROM SCHIZOPHRENIA RESEARCH: COGNITION