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Letrozole superior to clomiphene as a treatment for infertility in women with PCOS
Women who received letrozole had more cumulative live births and higher ovulation rates than those who received clomiphene in a small-scale study among infertile women with polycystic ovary syndrome.
In a randomized of 750 women with PCOS, 27.5% of the 374 women who received letrozole had a live birth, compared with 19.1% of the 376 women treated with clomiphene. Eighty-nine percent of women who took letrozole ovulated, compared with 77 % of women who took clomiphene (N. Engl. J. Med. 2014;371:119-29).
There were no significant differences between the groups in congenital anomalies or pregnancy loss, although Dr. Richard S. Legro of Penn State University, Hershey, and his associates noted that further studies with larger numbers of infants will be needed to clarify the safety and teratogenic risks of the drugs. The complete results from the study can be found here.
See our coverage from the conjoint meeting of the International Federation of Fertility Societies and the American Society for Reproductive Medicine.
Dr. Legro reported receiving consulting fees from Ferring Pharmaceuticals, AstraZeneca, and Euroscreen. Dr. Diamond reported receiving consulting fees from EMD Serono and serving on the board of directors of and owning stock in Advanced Reproductive Care. Dr. Santoro reported receiving grant support from Bayer and holding stock options in MenoGeniX.
Women who received letrozole had more cumulative live births and higher ovulation rates than those who received clomiphene in a small-scale study among infertile women with polycystic ovary syndrome.
In a randomized of 750 women with PCOS, 27.5% of the 374 women who received letrozole had a live birth, compared with 19.1% of the 376 women treated with clomiphene. Eighty-nine percent of women who took letrozole ovulated, compared with 77 % of women who took clomiphene (N. Engl. J. Med. 2014;371:119-29).
There were no significant differences between the groups in congenital anomalies or pregnancy loss, although Dr. Richard S. Legro of Penn State University, Hershey, and his associates noted that further studies with larger numbers of infants will be needed to clarify the safety and teratogenic risks of the drugs. The complete results from the study can be found here.
See our coverage from the conjoint meeting of the International Federation of Fertility Societies and the American Society for Reproductive Medicine.
Dr. Legro reported receiving consulting fees from Ferring Pharmaceuticals, AstraZeneca, and Euroscreen. Dr. Diamond reported receiving consulting fees from EMD Serono and serving on the board of directors of and owning stock in Advanced Reproductive Care. Dr. Santoro reported receiving grant support from Bayer and holding stock options in MenoGeniX.
Women who received letrozole had more cumulative live births and higher ovulation rates than those who received clomiphene in a small-scale study among infertile women with polycystic ovary syndrome.
In a randomized of 750 women with PCOS, 27.5% of the 374 women who received letrozole had a live birth, compared with 19.1% of the 376 women treated with clomiphene. Eighty-nine percent of women who took letrozole ovulated, compared with 77 % of women who took clomiphene (N. Engl. J. Med. 2014;371:119-29).
There were no significant differences between the groups in congenital anomalies or pregnancy loss, although Dr. Richard S. Legro of Penn State University, Hershey, and his associates noted that further studies with larger numbers of infants will be needed to clarify the safety and teratogenic risks of the drugs. The complete results from the study can be found here.
See our coverage from the conjoint meeting of the International Federation of Fertility Societies and the American Society for Reproductive Medicine.
Dr. Legro reported receiving consulting fees from Ferring Pharmaceuticals, AstraZeneca, and Euroscreen. Dr. Diamond reported receiving consulting fees from EMD Serono and serving on the board of directors of and owning stock in Advanced Reproductive Care. Dr. Santoro reported receiving grant support from Bayer and holding stock options in MenoGeniX.
FROM THE NEW ENGLAND JOURNAL OF MEDICINE
FDA warns against prescription lidocaine for teething pain
Prescription oral viscous lidocaine should not be used to treat teething pain, as it can lead to serious harm or even death in infants and young children, according to a safety announcement issued June 26 by the Food and Drug Administration.
In 2014, the agency reviewed 22 case reports of serious adverse reactions in children aged from 5 months to 3.5 years who were either given oral viscous lidocaine 2% solution for the treatment of mouth pain or had accidental ingestions. Of the 22 cases identified, 6 resulted in death, 3 were categorized as life-threatening, 11 required hospitalization, and 2 required medical intervention without hospitalization. The symptoms of toxicity from too much viscous lidocaine can include seizures, severe brain injury, or heart problems.
Oral viscous lidocaine solution is not approved to treat teething pain.
The FDA is requiring that a Boxed Warning be added to the product label, indicating that the drug carries a significant risk of serious medical conditions from ingestion. In addition, the FDA announced it will require revisions to the Warnings and Dosage and Administration sections of the drug label to include additional instructions for dosing and a section describing the risk of severe adverse events if ingested.
In 2011 the FDA issued a warning that topical over-the-counter teething preparations containing benzocaine can lead to methemoglobinemia, a rare but occasionally fatal condition that results in a large decrease in the amount of oxygen in the blood. Benzocaine gels and liquids are sold over the counter with brand names such as Anbesol, Hurricaine, Orajel, Baby Orajel, Orabase, and various store brands.
The FDA recommends that parents and caregivers follow the American Academy of Pediatrics’ recommendations for treating teething pain: use a teething ring that has been chilled in the refrigerator or gently rub the child’s gums with your finger.
A link to the FDA warning can be found on their website.
Prescription oral viscous lidocaine should not be used to treat teething pain, as it can lead to serious harm or even death in infants and young children, according to a safety announcement issued June 26 by the Food and Drug Administration.
In 2014, the agency reviewed 22 case reports of serious adverse reactions in children aged from 5 months to 3.5 years who were either given oral viscous lidocaine 2% solution for the treatment of mouth pain or had accidental ingestions. Of the 22 cases identified, 6 resulted in death, 3 were categorized as life-threatening, 11 required hospitalization, and 2 required medical intervention without hospitalization. The symptoms of toxicity from too much viscous lidocaine can include seizures, severe brain injury, or heart problems.
Oral viscous lidocaine solution is not approved to treat teething pain.
The FDA is requiring that a Boxed Warning be added to the product label, indicating that the drug carries a significant risk of serious medical conditions from ingestion. In addition, the FDA announced it will require revisions to the Warnings and Dosage and Administration sections of the drug label to include additional instructions for dosing and a section describing the risk of severe adverse events if ingested.
In 2011 the FDA issued a warning that topical over-the-counter teething preparations containing benzocaine can lead to methemoglobinemia, a rare but occasionally fatal condition that results in a large decrease in the amount of oxygen in the blood. Benzocaine gels and liquids are sold over the counter with brand names such as Anbesol, Hurricaine, Orajel, Baby Orajel, Orabase, and various store brands.
The FDA recommends that parents and caregivers follow the American Academy of Pediatrics’ recommendations for treating teething pain: use a teething ring that has been chilled in the refrigerator or gently rub the child’s gums with your finger.
A link to the FDA warning can be found on their website.
Prescription oral viscous lidocaine should not be used to treat teething pain, as it can lead to serious harm or even death in infants and young children, according to a safety announcement issued June 26 by the Food and Drug Administration.
In 2014, the agency reviewed 22 case reports of serious adverse reactions in children aged from 5 months to 3.5 years who were either given oral viscous lidocaine 2% solution for the treatment of mouth pain or had accidental ingestions. Of the 22 cases identified, 6 resulted in death, 3 were categorized as life-threatening, 11 required hospitalization, and 2 required medical intervention without hospitalization. The symptoms of toxicity from too much viscous lidocaine can include seizures, severe brain injury, or heart problems.
Oral viscous lidocaine solution is not approved to treat teething pain.
The FDA is requiring that a Boxed Warning be added to the product label, indicating that the drug carries a significant risk of serious medical conditions from ingestion. In addition, the FDA announced it will require revisions to the Warnings and Dosage and Administration sections of the drug label to include additional instructions for dosing and a section describing the risk of severe adverse events if ingested.
In 2011 the FDA issued a warning that topical over-the-counter teething preparations containing benzocaine can lead to methemoglobinemia, a rare but occasionally fatal condition that results in a large decrease in the amount of oxygen in the blood. Benzocaine gels and liquids are sold over the counter with brand names such as Anbesol, Hurricaine, Orajel, Baby Orajel, Orabase, and various store brands.
The FDA recommends that parents and caregivers follow the American Academy of Pediatrics’ recommendations for treating teething pain: use a teething ring that has been chilled in the refrigerator or gently rub the child’s gums with your finger.
A link to the FDA warning can be found on their website.
U.S. gestational diabetes prevalence may be as high as 9.4%
The rate of gestational diabetes in the United States is somewhere between 4.6% and 9.4%, according to investigators from the Centers for Disease Control and Prevention.
Researchers compared data from birth certificates collected from 16 states to data from the Pregnancy Risk Assessment Monitoring System (PRAMS) in 21 states. PRAMS is a CDC-led surveillance project that works with state health departments to collect population-based data on maternal experiences before, during, and after pregnancy.
In 2010, the prevalence of gestational diabetes mellitus was 4.6% as listed on birth certificates, 8.7% on the PRAMS scale, and 9.2% as reported on either the PRAMS scale or birth certificates. The percent agreement between the sources was 94.1%, wrote Carla L. DeSisto, M.P.H., and her associates at the CDC (Prev. Chronic Dis. 2014;11:130415 [doi:10.5888/pcd11.130415]).
There was no significant difference in gestational diabetes prevalence between the two study periods examined – 8.1% in 2007-08 and 8.5% in 2009-10, according to an analysis of PRAMS data from 123,373 women. In both time periods, Utah had the lowest prevalence (5.7% and 5.6%, respectively) and Rhode Island had the highest (10.4% and 11.7%).
The rate of gestational diabetes in the United States is somewhere between 4.6% and 9.4%, according to investigators from the Centers for Disease Control and Prevention.
Researchers compared data from birth certificates collected from 16 states to data from the Pregnancy Risk Assessment Monitoring System (PRAMS) in 21 states. PRAMS is a CDC-led surveillance project that works with state health departments to collect population-based data on maternal experiences before, during, and after pregnancy.
In 2010, the prevalence of gestational diabetes mellitus was 4.6% as listed on birth certificates, 8.7% on the PRAMS scale, and 9.2% as reported on either the PRAMS scale or birth certificates. The percent agreement between the sources was 94.1%, wrote Carla L. DeSisto, M.P.H., and her associates at the CDC (Prev. Chronic Dis. 2014;11:130415 [doi:10.5888/pcd11.130415]).
There was no significant difference in gestational diabetes prevalence between the two study periods examined – 8.1% in 2007-08 and 8.5% in 2009-10, according to an analysis of PRAMS data from 123,373 women. In both time periods, Utah had the lowest prevalence (5.7% and 5.6%, respectively) and Rhode Island had the highest (10.4% and 11.7%).
The rate of gestational diabetes in the United States is somewhere between 4.6% and 9.4%, according to investigators from the Centers for Disease Control and Prevention.
Researchers compared data from birth certificates collected from 16 states to data from the Pregnancy Risk Assessment Monitoring System (PRAMS) in 21 states. PRAMS is a CDC-led surveillance project that works with state health departments to collect population-based data on maternal experiences before, during, and after pregnancy.
In 2010, the prevalence of gestational diabetes mellitus was 4.6% as listed on birth certificates, 8.7% on the PRAMS scale, and 9.2% as reported on either the PRAMS scale or birth certificates. The percent agreement between the sources was 94.1%, wrote Carla L. DeSisto, M.P.H., and her associates at the CDC (Prev. Chronic Dis. 2014;11:130415 [doi:10.5888/pcd11.130415]).
There was no significant difference in gestational diabetes prevalence between the two study periods examined – 8.1% in 2007-08 and 8.5% in 2009-10, according to an analysis of PRAMS data from 123,373 women. In both time periods, Utah had the lowest prevalence (5.7% and 5.6%, respectively) and Rhode Island had the highest (10.4% and 11.7%).
FROM PREVENTING CHRONIC DISEASE
Major finding: The prevalence of gestational diabetes mellitus in the United States is between 4.6% and 9.4%.
Data source: Statistical analysis of birth certificate data from 15 states and PRAMS data from 21 states.
Disclosures: No disclosures were reported.
Study identifies factors in adolescent smoking cessation
Investigators have identified 10 significant indicators for smoking cessation by adolescent students and saythat those antismoking efforts should address an array of factors, including dependence, among other factors that affect youth.
"Youth tobacco-control programs that do not consider nicotine dependence symptoms in novice smokers may not be optimally effective," Jennifer O’Loughlin, Ph.D., professor in the department of social and preventive medicine at the University of Montreal, and her colleagues said in a report in Cancer Epidemiology, Biomarkers & Prevention. Their study attempted to gauge smoking habits ofyoung novice smokers, those youngsters who have smoked for only a year or 2.
Data on teenage smoking habits came from participants enrolled in Nicotine Dependence in Teens, a study that collected self-reported data from 1,293 students every 3 months over the course of 5 years. Students were aged 12-13 years at baseline.
As expected, nicotine dependence had a negative effect on smoking. Although the data were presented with a number of covariables accompanying nicotine dependence – including tolerance – the authors found that "nicotine dependence symptoms, such as cravings, emerge as early as 5 months after initiation in some novice smokers, and that tolerance appears at 14 months," the researchers wrote.
Overall, they said, "Male sex, age, susceptibility to cigarette package warnings, participation in team sports, family stress, worrying about weight, overweight, use of illicit drugs, tolerance, and other nicotine dependence symptoms seem to be associated with smoking discontinuation in novice adolescent smokers" ( Cancer Epidemiol Biomarkers Prev. 2014;23[6] June [doi:10.1158/1055-9965.epi-13-0869]).
Conversely, the study found students whose parents smoked, who had stressful family lives, polysubstance abuse, body-weight issues, or adolescents who started smoking earlier in life were less likely to quit than were their peers. The investigators studied 37 potential predictors.
"Tobacco-control programs and policy targeting novice smokers may be more effective if these factors are taken into account in their conceptualization, design, and implementation," Dr. O’Laughlin and her associates wrote.
Data from 620 participants were included in the study. Regular follow-up found that approximately 40% discontinued smoking, defined as not smoking for more than a year. Most who quit were light smokers. Of those who stopped, more than 70% smoked 0-2 cigarettes/per month.
Among the findings:
• Boys were 80% more likely to discontinue smoking than were girls.
• Older adolescents were 30% more likely to discontinue than were younger adolescents.
• Participants who said cigarette package warnings made them afraid to smoke were 44% more likely to quit.
• Adolescents who participated in team sports were more likely to quit than were their nonsmoking peers (44% and 40%, respectively).
Students were recruited from 10 secondary schools in Quebec. Data used in the analysis were self-reported; the researchers said that more in-depth research on each predictor would eventually be needed.
Investigators have identified 10 significant indicators for smoking cessation by adolescent students and saythat those antismoking efforts should address an array of factors, including dependence, among other factors that affect youth.
"Youth tobacco-control programs that do not consider nicotine dependence symptoms in novice smokers may not be optimally effective," Jennifer O’Loughlin, Ph.D., professor in the department of social and preventive medicine at the University of Montreal, and her colleagues said in a report in Cancer Epidemiology, Biomarkers & Prevention. Their study attempted to gauge smoking habits ofyoung novice smokers, those youngsters who have smoked for only a year or 2.
Data on teenage smoking habits came from participants enrolled in Nicotine Dependence in Teens, a study that collected self-reported data from 1,293 students every 3 months over the course of 5 years. Students were aged 12-13 years at baseline.
As expected, nicotine dependence had a negative effect on smoking. Although the data were presented with a number of covariables accompanying nicotine dependence – including tolerance – the authors found that "nicotine dependence symptoms, such as cravings, emerge as early as 5 months after initiation in some novice smokers, and that tolerance appears at 14 months," the researchers wrote.
Overall, they said, "Male sex, age, susceptibility to cigarette package warnings, participation in team sports, family stress, worrying about weight, overweight, use of illicit drugs, tolerance, and other nicotine dependence symptoms seem to be associated with smoking discontinuation in novice adolescent smokers" ( Cancer Epidemiol Biomarkers Prev. 2014;23[6] June [doi:10.1158/1055-9965.epi-13-0869]).
Conversely, the study found students whose parents smoked, who had stressful family lives, polysubstance abuse, body-weight issues, or adolescents who started smoking earlier in life were less likely to quit than were their peers. The investigators studied 37 potential predictors.
"Tobacco-control programs and policy targeting novice smokers may be more effective if these factors are taken into account in their conceptualization, design, and implementation," Dr. O’Laughlin and her associates wrote.
Data from 620 participants were included in the study. Regular follow-up found that approximately 40% discontinued smoking, defined as not smoking for more than a year. Most who quit were light smokers. Of those who stopped, more than 70% smoked 0-2 cigarettes/per month.
Among the findings:
• Boys were 80% more likely to discontinue smoking than were girls.
• Older adolescents were 30% more likely to discontinue than were younger adolescents.
• Participants who said cigarette package warnings made them afraid to smoke were 44% more likely to quit.
• Adolescents who participated in team sports were more likely to quit than were their nonsmoking peers (44% and 40%, respectively).
Students were recruited from 10 secondary schools in Quebec. Data used in the analysis were self-reported; the researchers said that more in-depth research on each predictor would eventually be needed.
Investigators have identified 10 significant indicators for smoking cessation by adolescent students and saythat those antismoking efforts should address an array of factors, including dependence, among other factors that affect youth.
"Youth tobacco-control programs that do not consider nicotine dependence symptoms in novice smokers may not be optimally effective," Jennifer O’Loughlin, Ph.D., professor in the department of social and preventive medicine at the University of Montreal, and her colleagues said in a report in Cancer Epidemiology, Biomarkers & Prevention. Their study attempted to gauge smoking habits ofyoung novice smokers, those youngsters who have smoked for only a year or 2.
Data on teenage smoking habits came from participants enrolled in Nicotine Dependence in Teens, a study that collected self-reported data from 1,293 students every 3 months over the course of 5 years. Students were aged 12-13 years at baseline.
As expected, nicotine dependence had a negative effect on smoking. Although the data were presented with a number of covariables accompanying nicotine dependence – including tolerance – the authors found that "nicotine dependence symptoms, such as cravings, emerge as early as 5 months after initiation in some novice smokers, and that tolerance appears at 14 months," the researchers wrote.
Overall, they said, "Male sex, age, susceptibility to cigarette package warnings, participation in team sports, family stress, worrying about weight, overweight, use of illicit drugs, tolerance, and other nicotine dependence symptoms seem to be associated with smoking discontinuation in novice adolescent smokers" ( Cancer Epidemiol Biomarkers Prev. 2014;23[6] June [doi:10.1158/1055-9965.epi-13-0869]).
Conversely, the study found students whose parents smoked, who had stressful family lives, polysubstance abuse, body-weight issues, or adolescents who started smoking earlier in life were less likely to quit than were their peers. The investigators studied 37 potential predictors.
"Tobacco-control programs and policy targeting novice smokers may be more effective if these factors are taken into account in their conceptualization, design, and implementation," Dr. O’Laughlin and her associates wrote.
Data from 620 participants were included in the study. Regular follow-up found that approximately 40% discontinued smoking, defined as not smoking for more than a year. Most who quit were light smokers. Of those who stopped, more than 70% smoked 0-2 cigarettes/per month.
Among the findings:
• Boys were 80% more likely to discontinue smoking than were girls.
• Older adolescents were 30% more likely to discontinue than were younger adolescents.
• Participants who said cigarette package warnings made them afraid to smoke were 44% more likely to quit.
• Adolescents who participated in team sports were more likely to quit than were their nonsmoking peers (44% and 40%, respectively).
Students were recruited from 10 secondary schools in Quebec. Data used in the analysis were self-reported; the researchers said that more in-depth research on each predictor would eventually be needed.
Key clinical point: Cessation programs should target young adolescents and focus on specific factors, including dependence symptoms.
Major finding: Out of 620 participants, 40% discontinued smoking during follow-up.
Data source: Longitudinal study of 1,293 Canadian adolescents tracked for 5 years.
Disclosures: The study was funded by the Canadian Cancer Society. The authors reported having no relevant financial disclosures.
Study identifies factors in smoking cessation for adolescents
Investigators have identified 10 significant indicators for smoking cessation by adolescent students and say that those antismoking efforts should address an array of factors, including dependence, among other factors that affect youth.
"Youth tobacco-control programs that do not consider nicotine dependence symptoms in novice smokers may not be optimally effective," Jennifer O’Loughlin, Ph.D., professor in the department of social and preventive medicine at the University of Montreal, and her colleagues said in a report in Cancer Epidemiology, Biomarkers & Prevention. Their study attempted to gauge smoking habits of young novice smokers, those who have smoked for only a year or 2.
Data on teenage smoking habits came from participants enrolled in Nicotine Dependence in Teens, a study that collected data from 1,293 students every 3 months over the course of 5 years. Students were aged 12-13 years at baseline.
As expected, nicotine dependence had a negative effect on smoking. Although the data were presented with a number of covariables accompanying nicotine dependence – including tolerance – the authors found that "nicotine dependence symptoms, such as cravings, emerge as early as 5 months after initiation in some novice smokers, and that tolerance appears at 14 months," the researchers wrote.
Overall, they said, "Male sex, age, susceptibility to cigarette package warnings, participation in team sports, family stress, worrying about weight, overweight, use of illicit drugs, tolerance, and other nicotine dependence symptoms seem to be associated with smoking discontinuation in novice adolescent smokers" (Cancer Epidemiol. Biomarkers Prev. 2014;23[6]June [doi:10.1158/1055-9965.epi-13-0869]).
Conversely, the study found students whose parents smoked, who had stressful family lives, polysubstance abuse, body-weight issues, or adolescents who started smoking earlier in life were less likely to quit than were their peers. The investigators studied 37 potential predictors.
"Tobacco-control programs and policy targeting novice smokers may be more effective if these factors are taken into account in their conceptualization, design, and implementation," Ms. O’Laughlin and her associates wrote.
Data from 620 participants were included in the study. Regular follow-up found that approximately 40% discontinued smoking, defined as not smoking for more than a year. Most who quit were light smokers. Of those who stopped, more than 70% smoked 0-2 cigarettes/per month.
Among the findings:
• Boys were 80% more likely to discontinue smoking than were girls.
• Older adolescents were 30% more likely to discontinue than were younger adolescents.
• Participants who said cigarette package warnings made them afraid to smoke were 44% more likely to quit.
• Adolescents who participated in team sports were more likely to quit than were their nonsmoking peers (44% and 40%, respectively).
Students were recruited from 10 secondary schools in Quebec. Data used in the analysis was self-reported; the researchers said that more in-depth research on each predictor would eventually be needed.
The study was funded by the Canadian Cancer Society. The authors did not disclose any potential conflicts of interest.
Investigators have identified 10 significant indicators for smoking cessation by adolescent students and say that those antismoking efforts should address an array of factors, including dependence, among other factors that affect youth.
"Youth tobacco-control programs that do not consider nicotine dependence symptoms in novice smokers may not be optimally effective," Jennifer O’Loughlin, Ph.D., professor in the department of social and preventive medicine at the University of Montreal, and her colleagues said in a report in Cancer Epidemiology, Biomarkers & Prevention. Their study attempted to gauge smoking habits of young novice smokers, those who have smoked for only a year or 2.
Data on teenage smoking habits came from participants enrolled in Nicotine Dependence in Teens, a study that collected data from 1,293 students every 3 months over the course of 5 years. Students were aged 12-13 years at baseline.
As expected, nicotine dependence had a negative effect on smoking. Although the data were presented with a number of covariables accompanying nicotine dependence – including tolerance – the authors found that "nicotine dependence symptoms, such as cravings, emerge as early as 5 months after initiation in some novice smokers, and that tolerance appears at 14 months," the researchers wrote.
Overall, they said, "Male sex, age, susceptibility to cigarette package warnings, participation in team sports, family stress, worrying about weight, overweight, use of illicit drugs, tolerance, and other nicotine dependence symptoms seem to be associated with smoking discontinuation in novice adolescent smokers" (Cancer Epidemiol. Biomarkers Prev. 2014;23[6]June [doi:10.1158/1055-9965.epi-13-0869]).
Conversely, the study found students whose parents smoked, who had stressful family lives, polysubstance abuse, body-weight issues, or adolescents who started smoking earlier in life were less likely to quit than were their peers. The investigators studied 37 potential predictors.
"Tobacco-control programs and policy targeting novice smokers may be more effective if these factors are taken into account in their conceptualization, design, and implementation," Ms. O’Laughlin and her associates wrote.
Data from 620 participants were included in the study. Regular follow-up found that approximately 40% discontinued smoking, defined as not smoking for more than a year. Most who quit were light smokers. Of those who stopped, more than 70% smoked 0-2 cigarettes/per month.
Among the findings:
• Boys were 80% more likely to discontinue smoking than were girls.
• Older adolescents were 30% more likely to discontinue than were younger adolescents.
• Participants who said cigarette package warnings made them afraid to smoke were 44% more likely to quit.
• Adolescents who participated in team sports were more likely to quit than were their nonsmoking peers (44% and 40%, respectively).
Students were recruited from 10 secondary schools in Quebec. Data used in the analysis was self-reported; the researchers said that more in-depth research on each predictor would eventually be needed.
The study was funded by the Canadian Cancer Society. The authors did not disclose any potential conflicts of interest.
Investigators have identified 10 significant indicators for smoking cessation by adolescent students and say that those antismoking efforts should address an array of factors, including dependence, among other factors that affect youth.
"Youth tobacco-control programs that do not consider nicotine dependence symptoms in novice smokers may not be optimally effective," Jennifer O’Loughlin, Ph.D., professor in the department of social and preventive medicine at the University of Montreal, and her colleagues said in a report in Cancer Epidemiology, Biomarkers & Prevention. Their study attempted to gauge smoking habits of young novice smokers, those who have smoked for only a year or 2.
Data on teenage smoking habits came from participants enrolled in Nicotine Dependence in Teens, a study that collected data from 1,293 students every 3 months over the course of 5 years. Students were aged 12-13 years at baseline.
As expected, nicotine dependence had a negative effect on smoking. Although the data were presented with a number of covariables accompanying nicotine dependence – including tolerance – the authors found that "nicotine dependence symptoms, such as cravings, emerge as early as 5 months after initiation in some novice smokers, and that tolerance appears at 14 months," the researchers wrote.
Overall, they said, "Male sex, age, susceptibility to cigarette package warnings, participation in team sports, family stress, worrying about weight, overweight, use of illicit drugs, tolerance, and other nicotine dependence symptoms seem to be associated with smoking discontinuation in novice adolescent smokers" (Cancer Epidemiol. Biomarkers Prev. 2014;23[6]June [doi:10.1158/1055-9965.epi-13-0869]).
Conversely, the study found students whose parents smoked, who had stressful family lives, polysubstance abuse, body-weight issues, or adolescents who started smoking earlier in life were less likely to quit than were their peers. The investigators studied 37 potential predictors.
"Tobacco-control programs and policy targeting novice smokers may be more effective if these factors are taken into account in their conceptualization, design, and implementation," Ms. O’Laughlin and her associates wrote.
Data from 620 participants were included in the study. Regular follow-up found that approximately 40% discontinued smoking, defined as not smoking for more than a year. Most who quit were light smokers. Of those who stopped, more than 70% smoked 0-2 cigarettes/per month.
Among the findings:
• Boys were 80% more likely to discontinue smoking than were girls.
• Older adolescents were 30% more likely to discontinue than were younger adolescents.
• Participants who said cigarette package warnings made them afraid to smoke were 44% more likely to quit.
• Adolescents who participated in team sports were more likely to quit than were their nonsmoking peers (44% and 40%, respectively).
Students were recruited from 10 secondary schools in Quebec. Data used in the analysis was self-reported; the researchers said that more in-depth research on each predictor would eventually be needed.
The study was funded by the Canadian Cancer Society. The authors did not disclose any potential conflicts of interest.
FROM CANCER EPIDEMIOLOGY, BIOMARKERS & PREVENTION
Key clinical point: Cessation programs should target young adolescents and focus on specific factors, including dependence symptoms.
Major finding: Out of 620 participants, 40% discontinued smoking during follow-up.
Data source: Longitudinal study of 1,293 Canadian adolescents tracked for 5 years.
Disclosures: The study was funded by the Canadian Cancer Society. The authors reported having no relevant financial disclosures.
Growth hormone levels predict postsurgical acromegaly remission
Elevated growth hormone levels had a negative impact on remission in acromegaly patients undergoing transsphenoidal adenomectomies, researchers from Emory University in Atlanta concluded after a retrospective, multivariate analysis of case studies.
To determine the impact of preoperative growth hormone (GH), Dr. Jeremy Anthony and his associates examined the case files of 79 acromegaly patients who underwent transsphenoidal adenomectomy between 1994 and 2013 at Emory and assigned them to two groups on the basis of their preoperative GH levels, using 40 ng/mL as the cutoff.
Biochemical remission was defined as normal insulin-like growth factor 1 (IGF-1) during follow-up of more than 3 months in the absence of adjuvant therapy. The results were released at the annual meeting of the American Association of Clinical Endocrinologists on May 15 in Las Vegas.
Group A, with preoperative GH levels greater than 40 ng/mL, comprised 19 patients with a mean age of 43 years and an average follow-up of 38 months. They had larger, more invasive tumors, higher preoperative IGF-1 levels, higher immediate postoperative GH, and more residual tumors at 3 months, compared with the 60 patients in group B, who had preop GH levels of 40 ng/mL or less, a mean age of 47 years, and 43 months of follow-up.
In group A, three patients (15%) had remission at 3 months, but two patients had recurrence within 2 years. In group B, 35 patients (58%) had remission at 3 months with no recurrence during follow-up.
On univariate analysis, lower preoperative GH was a predictor of remission. In a multivariate analysis, however, lack of cavernous sinus invasion was the only predictor of remission.
"The relationship of GH elevation and cavernous sinus invasion should be further defined, as should the molecular fingerprint and the potential role of preoperative medical treatment in this group of patients," Dr. Anthony and his associates wrote.
No disclosures were reported.
Elevated growth hormone levels had a negative impact on remission in acromegaly patients undergoing transsphenoidal adenomectomies, researchers from Emory University in Atlanta concluded after a retrospective, multivariate analysis of case studies.
To determine the impact of preoperative growth hormone (GH), Dr. Jeremy Anthony and his associates examined the case files of 79 acromegaly patients who underwent transsphenoidal adenomectomy between 1994 and 2013 at Emory and assigned them to two groups on the basis of their preoperative GH levels, using 40 ng/mL as the cutoff.
Biochemical remission was defined as normal insulin-like growth factor 1 (IGF-1) during follow-up of more than 3 months in the absence of adjuvant therapy. The results were released at the annual meeting of the American Association of Clinical Endocrinologists on May 15 in Las Vegas.
Group A, with preoperative GH levels greater than 40 ng/mL, comprised 19 patients with a mean age of 43 years and an average follow-up of 38 months. They had larger, more invasive tumors, higher preoperative IGF-1 levels, higher immediate postoperative GH, and more residual tumors at 3 months, compared with the 60 patients in group B, who had preop GH levels of 40 ng/mL or less, a mean age of 47 years, and 43 months of follow-up.
In group A, three patients (15%) had remission at 3 months, but two patients had recurrence within 2 years. In group B, 35 patients (58%) had remission at 3 months with no recurrence during follow-up.
On univariate analysis, lower preoperative GH was a predictor of remission. In a multivariate analysis, however, lack of cavernous sinus invasion was the only predictor of remission.
"The relationship of GH elevation and cavernous sinus invasion should be further defined, as should the molecular fingerprint and the potential role of preoperative medical treatment in this group of patients," Dr. Anthony and his associates wrote.
No disclosures were reported.
Elevated growth hormone levels had a negative impact on remission in acromegaly patients undergoing transsphenoidal adenomectomies, researchers from Emory University in Atlanta concluded after a retrospective, multivariate analysis of case studies.
To determine the impact of preoperative growth hormone (GH), Dr. Jeremy Anthony and his associates examined the case files of 79 acromegaly patients who underwent transsphenoidal adenomectomy between 1994 and 2013 at Emory and assigned them to two groups on the basis of their preoperative GH levels, using 40 ng/mL as the cutoff.
Biochemical remission was defined as normal insulin-like growth factor 1 (IGF-1) during follow-up of more than 3 months in the absence of adjuvant therapy. The results were released at the annual meeting of the American Association of Clinical Endocrinologists on May 15 in Las Vegas.
Group A, with preoperative GH levels greater than 40 ng/mL, comprised 19 patients with a mean age of 43 years and an average follow-up of 38 months. They had larger, more invasive tumors, higher preoperative IGF-1 levels, higher immediate postoperative GH, and more residual tumors at 3 months, compared with the 60 patients in group B, who had preop GH levels of 40 ng/mL or less, a mean age of 47 years, and 43 months of follow-up.
In group A, three patients (15%) had remission at 3 months, but two patients had recurrence within 2 years. In group B, 35 patients (58%) had remission at 3 months with no recurrence during follow-up.
On univariate analysis, lower preoperative GH was a predictor of remission. In a multivariate analysis, however, lack of cavernous sinus invasion was the only predictor of remission.
"The relationship of GH elevation and cavernous sinus invasion should be further defined, as should the molecular fingerprint and the potential role of preoperative medical treatment in this group of patients," Dr. Anthony and his associates wrote.
No disclosures were reported.
FROM AACE 2014
Major finding: Acromegaly patients with preoperative GH levels greater than 40 ng/mL had a 15% remission rate at 3 months, compared with 58% in those with lower preop GH levels.
Data source: A retrospective case series of 79 acromegaly patients who underwent transsphenoidal adenomectomy between 1994 and 2013.
Disclosures: No disclosures were reported.
Speech comprehension worse in bipolar mania
Bipolar disorder patients perform worse than do their counterparts without-bipolar disorder at language comprehension tests at the behavioral level, but not the physiological level, according to findings from a small-scale study.
A team of researchers from CHU Sainte Marguerite and Aix-Marseille Université, Marseille, France, examined behavioral and electrophysiological responses to speech by measuring the "N400 effect," an ERP (event-related brain potential) observed in patients with bipolar disorder and schizophrenia that typically is provoked via the subjects’ response to unexpected or incongruous words at the end of a sentence.
Led by Dr. Michel Cermolacce of CHU Sainte Marguerite, the team compared responses from 38 participants, including 19 bipolar type I patients and 19 healthy comparison subjects. The patients with bipolar disorder were recruited from the Marseille University Department of Psychiatry while presenting a mild to severe manic episode and did not have concurrent neurological disorders (J. Affect. Disord. 2014;158:161-71).
The participants in the study were asked to listen to a series of congruous and incongruous complete sentences and judge whether the last word of each sentence was congruous or incongruous. The subjects’ brain waves were measured throughout the test with an electroencephalogram.
The study participants with bipolar disorder exhibited a lower rate of correct responses for both congruous endings (76.7%, compared to 80% from healthy subjects) and incongruous endings (75% in patients with bipolar disorder, and 80% from healthy subjects). In addition, bipolar patients had longer response times when looking for congruous endings than their peers did (1,120 ms compared to 970 ms for healthy subjects.)
However, EEG readings showed preserved amplitude but delayed latency in difference waves, suggesting no significant disruption of brain waves through the N400. The authors noted that the findings contrast with the only previous N400 study, which showed a disruption of brain waves that is in line with similar results found in patients with schizophrenia (Prog. Neuropsychopharmacol. Biol. Psychiatry 2012;38:194-200). The previous study used visually presented word pairs rather than verbal word pairs, an approach the authors contend does not reflect a natural language setting.
Dr. Cermolacce and his colleagues cited several limitations, including the study’s small sample size and the absence of a group of patients with schizophrenia.
However, the findings suggest that specificity and adherence to natural speech patterns should be taken into account when examining speech disruptions in patients with mental disorders in a research setting, they noted.
"The discrepancy in manic patients between (i) preserved N400 and (ii) delayed [Late Positive Component] and impaired behavioral performances under natural speech conditions can be interpreted as reflecting non-specific cognitive rather than primary language alterations in line with previous behavioral findings," they wrote.
The authors report no conflict of interest.
Bipolar disorder patients perform worse than do their counterparts without-bipolar disorder at language comprehension tests at the behavioral level, but not the physiological level, according to findings from a small-scale study.
A team of researchers from CHU Sainte Marguerite and Aix-Marseille Université, Marseille, France, examined behavioral and electrophysiological responses to speech by measuring the "N400 effect," an ERP (event-related brain potential) observed in patients with bipolar disorder and schizophrenia that typically is provoked via the subjects’ response to unexpected or incongruous words at the end of a sentence.
Led by Dr. Michel Cermolacce of CHU Sainte Marguerite, the team compared responses from 38 participants, including 19 bipolar type I patients and 19 healthy comparison subjects. The patients with bipolar disorder were recruited from the Marseille University Department of Psychiatry while presenting a mild to severe manic episode and did not have concurrent neurological disorders (J. Affect. Disord. 2014;158:161-71).
The participants in the study were asked to listen to a series of congruous and incongruous complete sentences and judge whether the last word of each sentence was congruous or incongruous. The subjects’ brain waves were measured throughout the test with an electroencephalogram.
The study participants with bipolar disorder exhibited a lower rate of correct responses for both congruous endings (76.7%, compared to 80% from healthy subjects) and incongruous endings (75% in patients with bipolar disorder, and 80% from healthy subjects). In addition, bipolar patients had longer response times when looking for congruous endings than their peers did (1,120 ms compared to 970 ms for healthy subjects.)
However, EEG readings showed preserved amplitude but delayed latency in difference waves, suggesting no significant disruption of brain waves through the N400. The authors noted that the findings contrast with the only previous N400 study, which showed a disruption of brain waves that is in line with similar results found in patients with schizophrenia (Prog. Neuropsychopharmacol. Biol. Psychiatry 2012;38:194-200). The previous study used visually presented word pairs rather than verbal word pairs, an approach the authors contend does not reflect a natural language setting.
Dr. Cermolacce and his colleagues cited several limitations, including the study’s small sample size and the absence of a group of patients with schizophrenia.
However, the findings suggest that specificity and adherence to natural speech patterns should be taken into account when examining speech disruptions in patients with mental disorders in a research setting, they noted.
"The discrepancy in manic patients between (i) preserved N400 and (ii) delayed [Late Positive Component] and impaired behavioral performances under natural speech conditions can be interpreted as reflecting non-specific cognitive rather than primary language alterations in line with previous behavioral findings," they wrote.
The authors report no conflict of interest.
Bipolar disorder patients perform worse than do their counterparts without-bipolar disorder at language comprehension tests at the behavioral level, but not the physiological level, according to findings from a small-scale study.
A team of researchers from CHU Sainte Marguerite and Aix-Marseille Université, Marseille, France, examined behavioral and electrophysiological responses to speech by measuring the "N400 effect," an ERP (event-related brain potential) observed in patients with bipolar disorder and schizophrenia that typically is provoked via the subjects’ response to unexpected or incongruous words at the end of a sentence.
Led by Dr. Michel Cermolacce of CHU Sainte Marguerite, the team compared responses from 38 participants, including 19 bipolar type I patients and 19 healthy comparison subjects. The patients with bipolar disorder were recruited from the Marseille University Department of Psychiatry while presenting a mild to severe manic episode and did not have concurrent neurological disorders (J. Affect. Disord. 2014;158:161-71).
The participants in the study were asked to listen to a series of congruous and incongruous complete sentences and judge whether the last word of each sentence was congruous or incongruous. The subjects’ brain waves were measured throughout the test with an electroencephalogram.
The study participants with bipolar disorder exhibited a lower rate of correct responses for both congruous endings (76.7%, compared to 80% from healthy subjects) and incongruous endings (75% in patients with bipolar disorder, and 80% from healthy subjects). In addition, bipolar patients had longer response times when looking for congruous endings than their peers did (1,120 ms compared to 970 ms for healthy subjects.)
However, EEG readings showed preserved amplitude but delayed latency in difference waves, suggesting no significant disruption of brain waves through the N400. The authors noted that the findings contrast with the only previous N400 study, which showed a disruption of brain waves that is in line with similar results found in patients with schizophrenia (Prog. Neuropsychopharmacol. Biol. Psychiatry 2012;38:194-200). The previous study used visually presented word pairs rather than verbal word pairs, an approach the authors contend does not reflect a natural language setting.
Dr. Cermolacce and his colleagues cited several limitations, including the study’s small sample size and the absence of a group of patients with schizophrenia.
However, the findings suggest that specificity and adherence to natural speech patterns should be taken into account when examining speech disruptions in patients with mental disorders in a research setting, they noted.
"The discrepancy in manic patients between (i) preserved N400 and (ii) delayed [Late Positive Component] and impaired behavioral performances under natural speech conditions can be interpreted as reflecting non-specific cognitive rather than primary language alterations in line with previous behavioral findings," they wrote.
The authors report no conflict of interest.
FROM JOURNAL OF AFFECTIVE DISORDERS
Key clinical point: Specificity and adherence to natural speech patterns should be taken into account when examining speech disruptions in patients with bipolar disorder in a research setting.
Major finding: Patients with bipolar disorder showed worst performances in speech cognitions compared with healthy participants on a behavioral level but not necessarily at the electrophysiological level.
Data source: A study of 19 subjects with bipolar 1 disorder and 19 control subjects.
Disclosures: The authors had no relevant disclosures.
E-cigarettes trigger sharp rise in poison control center calls
Calls to U.S. poison control centers because of e-cigarette exposure increased from 1 per month in September 2010 to 215 per month in February 2014, according to a new study published in the April 3 edition of the Morbidity and Mortality Weekly Report.
"Calls about exposures to e-cigarettes, which were first marketed in the United States in 2007, now account for 41.7% of combined monthly e-cigarette and cigarette exposure calls to [poison control centers]," wrote the investigators, led by Dr. Kevin Chatham-Stephens of the CDC (MMWR Morb. Mortal. Wkly Rep. 2014;63:291-2).
Researchers from the Centers for Disease Control and Prevention analyzed data from 2,405 e-cigarette calls to poison control centers in all 50 states, the District of Columbia, and U.S. territories from September 2010 to February 2014. Although calls regarding overexposure are much more common with conventional tobacco products (16,248 calls over the same period of time), the investigators noted that 42% of the e-cigarette exposure calls involved people aged 20 years and older, whereas 94.9% of tobacco exposure calls involve children younger than 5 years.
In addition, health care facilities were responsible for significantly more of the e-cigarette exposure calls than for cigarette exposure calls, 12.8% vs. 5.9%. And callers were significantly more likely to report adverse health effects with e-cigarette exposures (57.8% of calls) than with cigarette exposures (36% of calls).
Poisoning cases can occur either from an exposure to the device itself or to the nicotine liquid contained in a small cartridge that the user inserts into the e-cigarette. Exposure to the liquid can occur through inhalation, ingestion, or absorption, and the most common adverse health effects in e-cigarette exposure calls were vomiting, nausea, and eye irritation.
“New data released today from the federal government confirms pediatricians’ concerns about e-cigarettes and their liquid nicotine refills: they are poisoning children at an alarming rate," Dr. James M. Perrin, president of the American Academy of Pediatrics, said in a statement.
“As pediatricians, we do everything in our power to keep our young patients safe from poisonous products, like household cleaners and prescription medications. Why should we act differently when it comes to liquid nicotine? The e-cigarette industry specifically targets children and teens with appealing flavors like cotton candy and gummy bear, and neither these products nor their liquid nicotine refills are currently regulated by the federal government," he said.
"Pediatricians call on the U.S. Department of Health and Human Services to convene Centers for Disease Control and Prevention, Food and Drug Administration, and other federal agencies and develop a national plan of action to keep children safe from e-cigarette poisoning. With more and more children being exposed to these dangerous products each month, we cannot afford to wait another day,” concluded Dr. Perrin, professor of pediatrics at Harvard Medical School, Boston.
Currently, e-cigarettes and their components that are marketed for therapeutic purposes such as smoking cessation are not regulated by the FDA Center for Tobacco Products, but are instead regulated by FDA Center for Drug Evaluation and Research.
*This article was updated 4/3/2014.
Calls to U.S. poison control centers because of e-cigarette exposure increased from 1 per month in September 2010 to 215 per month in February 2014, according to a new study published in the April 3 edition of the Morbidity and Mortality Weekly Report.
"Calls about exposures to e-cigarettes, which were first marketed in the United States in 2007, now account for 41.7% of combined monthly e-cigarette and cigarette exposure calls to [poison control centers]," wrote the investigators, led by Dr. Kevin Chatham-Stephens of the CDC (MMWR Morb. Mortal. Wkly Rep. 2014;63:291-2).
Researchers from the Centers for Disease Control and Prevention analyzed data from 2,405 e-cigarette calls to poison control centers in all 50 states, the District of Columbia, and U.S. territories from September 2010 to February 2014. Although calls regarding overexposure are much more common with conventional tobacco products (16,248 calls over the same period of time), the investigators noted that 42% of the e-cigarette exposure calls involved people aged 20 years and older, whereas 94.9% of tobacco exposure calls involve children younger than 5 years.
In addition, health care facilities were responsible for significantly more of the e-cigarette exposure calls than for cigarette exposure calls, 12.8% vs. 5.9%. And callers were significantly more likely to report adverse health effects with e-cigarette exposures (57.8% of calls) than with cigarette exposures (36% of calls).
Poisoning cases can occur either from an exposure to the device itself or to the nicotine liquid contained in a small cartridge that the user inserts into the e-cigarette. Exposure to the liquid can occur through inhalation, ingestion, or absorption, and the most common adverse health effects in e-cigarette exposure calls were vomiting, nausea, and eye irritation.
“New data released today from the federal government confirms pediatricians’ concerns about e-cigarettes and their liquid nicotine refills: they are poisoning children at an alarming rate," Dr. James M. Perrin, president of the American Academy of Pediatrics, said in a statement.
“As pediatricians, we do everything in our power to keep our young patients safe from poisonous products, like household cleaners and prescription medications. Why should we act differently when it comes to liquid nicotine? The e-cigarette industry specifically targets children and teens with appealing flavors like cotton candy and gummy bear, and neither these products nor their liquid nicotine refills are currently regulated by the federal government," he said.
"Pediatricians call on the U.S. Department of Health and Human Services to convene Centers for Disease Control and Prevention, Food and Drug Administration, and other federal agencies and develop a national plan of action to keep children safe from e-cigarette poisoning. With more and more children being exposed to these dangerous products each month, we cannot afford to wait another day,” concluded Dr. Perrin, professor of pediatrics at Harvard Medical School, Boston.
Currently, e-cigarettes and their components that are marketed for therapeutic purposes such as smoking cessation are not regulated by the FDA Center for Tobacco Products, but are instead regulated by FDA Center for Drug Evaluation and Research.
*This article was updated 4/3/2014.
Calls to U.S. poison control centers because of e-cigarette exposure increased from 1 per month in September 2010 to 215 per month in February 2014, according to a new study published in the April 3 edition of the Morbidity and Mortality Weekly Report.
"Calls about exposures to e-cigarettes, which were first marketed in the United States in 2007, now account for 41.7% of combined monthly e-cigarette and cigarette exposure calls to [poison control centers]," wrote the investigators, led by Dr. Kevin Chatham-Stephens of the CDC (MMWR Morb. Mortal. Wkly Rep. 2014;63:291-2).
Researchers from the Centers for Disease Control and Prevention analyzed data from 2,405 e-cigarette calls to poison control centers in all 50 states, the District of Columbia, and U.S. territories from September 2010 to February 2014. Although calls regarding overexposure are much more common with conventional tobacco products (16,248 calls over the same period of time), the investigators noted that 42% of the e-cigarette exposure calls involved people aged 20 years and older, whereas 94.9% of tobacco exposure calls involve children younger than 5 years.
In addition, health care facilities were responsible for significantly more of the e-cigarette exposure calls than for cigarette exposure calls, 12.8% vs. 5.9%. And callers were significantly more likely to report adverse health effects with e-cigarette exposures (57.8% of calls) than with cigarette exposures (36% of calls).
Poisoning cases can occur either from an exposure to the device itself or to the nicotine liquid contained in a small cartridge that the user inserts into the e-cigarette. Exposure to the liquid can occur through inhalation, ingestion, or absorption, and the most common adverse health effects in e-cigarette exposure calls were vomiting, nausea, and eye irritation.
“New data released today from the federal government confirms pediatricians’ concerns about e-cigarettes and their liquid nicotine refills: they are poisoning children at an alarming rate," Dr. James M. Perrin, president of the American Academy of Pediatrics, said in a statement.
“As pediatricians, we do everything in our power to keep our young patients safe from poisonous products, like household cleaners and prescription medications. Why should we act differently when it comes to liquid nicotine? The e-cigarette industry specifically targets children and teens with appealing flavors like cotton candy and gummy bear, and neither these products nor their liquid nicotine refills are currently regulated by the federal government," he said.
"Pediatricians call on the U.S. Department of Health and Human Services to convene Centers for Disease Control and Prevention, Food and Drug Administration, and other federal agencies and develop a national plan of action to keep children safe from e-cigarette poisoning. With more and more children being exposed to these dangerous products each month, we cannot afford to wait another day,” concluded Dr. Perrin, professor of pediatrics at Harvard Medical School, Boston.
Currently, e-cigarettes and their components that are marketed for therapeutic purposes such as smoking cessation are not regulated by the FDA Center for Tobacco Products, but are instead regulated by FDA Center for Drug Evaluation and Research.
*This article was updated 4/3/2014.
FROM MMWR
Too much or too little sodium may boost cardiovascular risk
Patients who had notably high or notably low sodium intake levels were at an increased risk of both all-cause mortality and cardiovascular disease, compared with patients who had usual sodium intake levels, a new meta-analysis suggests.
In fact, the sodium "sweet spot" may be between 2,645 mg/day and 4,945 mg/day, a range that the report’s investigators noted was "associated with the most favorable health outcomes, within which variation in sodium intake is not associated with variation in mortality."
Researchers explored the association between sodium intake and health outcomes, basing measurements on the average sodium levels of participants from surveys included in the meta-analysis. Data for the analysis included surveys that tracked sodium intake in population samples from prospective cohort studies and randomized controlled studies. The investigators categorized the measurements as low (less than 2,645 mg/day), usual (between 2,645 mg/day and 4,945 mg/day), and high sodium (more than 4,945 mg/day) intake levels.
"In none of the primary or supplementary analyses was a low sodium intake associated with beneficial effects on [all-cause mortality] or [cardiovascular disease]," the investigators wrote.
When tracking populations with sodium levels outside the usual range, the investigators noticed a U-shaped correlation between sodium intake and health outcomes. The distribution is "in accordance with the generally accepted relationship between a low level of nutrient intake and risk of inadequacy, and a high level of nutrient intake and risk of adverse event," the authors wrote.
Notably, this estimate is higher than the 2004 Institute of Medicine (IOM) recommendations that are currently used by the Centers for Disease Control and Prevention, which set tolerable sodium intake levels at no more than 2,300 mg/day for healthy individuals younger than 50 years, and to 1,500 mg/day for those older than 50 years and other groups at greater risk. However, a study from the IOM in 2013 concluded that the effect of lowered sodium intake on direct health outcomes does not support recommendations to lower sodium intake within these subgroups to or even below 1,500 mg/day.
The results come from a meta-analysis of 274,683 patients in 25 studies. Dr. Niels Graudal of Copenhagen University Hospital led the study. The survey sample included several subsets of data, as well as participants from a wide variety of demographics. The report was published April 2 in the American Journal of Hypertension (doi: 10.1093/ajh/hpu028).
When comparing usual-intake vs. low-intake groups, the researchers found that risk of all-cause mortality was significantly lower in the usual-intake group, but stroke and heart disease risks were the same for both groups.
Compared with high-intake groups, usual-intake groups had significantly lower risks of all-cause mortality, cardiovascular disease, stroke, and heart disease. In addition, there was no significant difference in risk between the high end and low end of the usual-sodium group, suggesting that both ends of the middle category were equally healthful.
The investigators cautioned that the meta-analysis included only two randomized controlled trials, and thus their results were based primarily on observational studies.
The authors of the study declared no conflicts of interest. The A.P. Møller Foundation for the Advancement of Medical Science supported the study.
Patients who had notably high or notably low sodium intake levels were at an increased risk of both all-cause mortality and cardiovascular disease, compared with patients who had usual sodium intake levels, a new meta-analysis suggests.
In fact, the sodium "sweet spot" may be between 2,645 mg/day and 4,945 mg/day, a range that the report’s investigators noted was "associated with the most favorable health outcomes, within which variation in sodium intake is not associated with variation in mortality."
Researchers explored the association between sodium intake and health outcomes, basing measurements on the average sodium levels of participants from surveys included in the meta-analysis. Data for the analysis included surveys that tracked sodium intake in population samples from prospective cohort studies and randomized controlled studies. The investigators categorized the measurements as low (less than 2,645 mg/day), usual (between 2,645 mg/day and 4,945 mg/day), and high sodium (more than 4,945 mg/day) intake levels.
"In none of the primary or supplementary analyses was a low sodium intake associated with beneficial effects on [all-cause mortality] or [cardiovascular disease]," the investigators wrote.
When tracking populations with sodium levels outside the usual range, the investigators noticed a U-shaped correlation between sodium intake and health outcomes. The distribution is "in accordance with the generally accepted relationship between a low level of nutrient intake and risk of inadequacy, and a high level of nutrient intake and risk of adverse event," the authors wrote.
Notably, this estimate is higher than the 2004 Institute of Medicine (IOM) recommendations that are currently used by the Centers for Disease Control and Prevention, which set tolerable sodium intake levels at no more than 2,300 mg/day for healthy individuals younger than 50 years, and to 1,500 mg/day for those older than 50 years and other groups at greater risk. However, a study from the IOM in 2013 concluded that the effect of lowered sodium intake on direct health outcomes does not support recommendations to lower sodium intake within these subgroups to or even below 1,500 mg/day.
The results come from a meta-analysis of 274,683 patients in 25 studies. Dr. Niels Graudal of Copenhagen University Hospital led the study. The survey sample included several subsets of data, as well as participants from a wide variety of demographics. The report was published April 2 in the American Journal of Hypertension (doi: 10.1093/ajh/hpu028).
When comparing usual-intake vs. low-intake groups, the researchers found that risk of all-cause mortality was significantly lower in the usual-intake group, but stroke and heart disease risks were the same for both groups.
Compared with high-intake groups, usual-intake groups had significantly lower risks of all-cause mortality, cardiovascular disease, stroke, and heart disease. In addition, there was no significant difference in risk between the high end and low end of the usual-sodium group, suggesting that both ends of the middle category were equally healthful.
The investigators cautioned that the meta-analysis included only two randomized controlled trials, and thus their results were based primarily on observational studies.
The authors of the study declared no conflicts of interest. The A.P. Møller Foundation for the Advancement of Medical Science supported the study.
Patients who had notably high or notably low sodium intake levels were at an increased risk of both all-cause mortality and cardiovascular disease, compared with patients who had usual sodium intake levels, a new meta-analysis suggests.
In fact, the sodium "sweet spot" may be between 2,645 mg/day and 4,945 mg/day, a range that the report’s investigators noted was "associated with the most favorable health outcomes, within which variation in sodium intake is not associated with variation in mortality."
Researchers explored the association between sodium intake and health outcomes, basing measurements on the average sodium levels of participants from surveys included in the meta-analysis. Data for the analysis included surveys that tracked sodium intake in population samples from prospective cohort studies and randomized controlled studies. The investigators categorized the measurements as low (less than 2,645 mg/day), usual (between 2,645 mg/day and 4,945 mg/day), and high sodium (more than 4,945 mg/day) intake levels.
"In none of the primary or supplementary analyses was a low sodium intake associated with beneficial effects on [all-cause mortality] or [cardiovascular disease]," the investigators wrote.
When tracking populations with sodium levels outside the usual range, the investigators noticed a U-shaped correlation between sodium intake and health outcomes. The distribution is "in accordance with the generally accepted relationship between a low level of nutrient intake and risk of inadequacy, and a high level of nutrient intake and risk of adverse event," the authors wrote.
Notably, this estimate is higher than the 2004 Institute of Medicine (IOM) recommendations that are currently used by the Centers for Disease Control and Prevention, which set tolerable sodium intake levels at no more than 2,300 mg/day for healthy individuals younger than 50 years, and to 1,500 mg/day for those older than 50 years and other groups at greater risk. However, a study from the IOM in 2013 concluded that the effect of lowered sodium intake on direct health outcomes does not support recommendations to lower sodium intake within these subgroups to or even below 1,500 mg/day.
The results come from a meta-analysis of 274,683 patients in 25 studies. Dr. Niels Graudal of Copenhagen University Hospital led the study. The survey sample included several subsets of data, as well as participants from a wide variety of demographics. The report was published April 2 in the American Journal of Hypertension (doi: 10.1093/ajh/hpu028).
When comparing usual-intake vs. low-intake groups, the researchers found that risk of all-cause mortality was significantly lower in the usual-intake group, but stroke and heart disease risks were the same for both groups.
Compared with high-intake groups, usual-intake groups had significantly lower risks of all-cause mortality, cardiovascular disease, stroke, and heart disease. In addition, there was no significant difference in risk between the high end and low end of the usual-sodium group, suggesting that both ends of the middle category were equally healthful.
The investigators cautioned that the meta-analysis included only two randomized controlled trials, and thus their results were based primarily on observational studies.
The authors of the study declared no conflicts of interest. The A.P. Møller Foundation for the Advancement of Medical Science supported the study.
FROM THE AMERICAN JOURNAL OF HYPERTENSION
Major finding: Compared with patients with low sodium intake (less than 2,645 mg/day) or high sodium intake (greater than 4,945 mg/day), patients with usual sodium intake levels (2,645-4,945 mg/day) had significantly lower risks of all-cause mortality.
Data source: A meta-analysis of 23 observational studies and 2 randomized controlled trials involving 274,683 patients.
Disclosures: The authors of the study declared no conflicts of interest. The A. P. Møller Foundation for the Advancement of Medical Science supported the study.
Youth tanning curbed in states with restrictions
States with stronger laws to restrict tanning bed access for minors reported significantly lower instances of tanning among teens than states without restrictions, according to a large-scale review published by the American Journal of Public Health.
Overall, female minors in states with tanning access laws used the beds 30% less than teens in states without any restrictions. The laws include warning signs on indoor tanning devices, limited advertising, and mandatory protective eyewear.
"State indoor tanning laws, especially age restrictions, may be effective in reducing indoor tanning among our nation’s youth," wrote Gery P. Guy Jr., Ph.D., of the Centers for Disease Control and Prevention and his colleagues.
Six states (California, Illinois, Nevada, Oregon, Texas, and Vermont), currently restrict indoor tanning among minors younger than 18 years, the researchers noted.
In addition, data from states with youth access laws – laws that require parental permission or place an outright ban on teen use of tanning beds – indicated that female students use tanning beds 42% less than those in states without the laws (Am. J. Public Health 2014 [doi: 10.2105/AJPH.2013.301850]).
The researchers used nationally representative data from 31,835 adolescents from 2009 and 2011 collected as part of the national Youth Risk Behavior Surveys of U.S. high school students in grades 9-12. They conducted a multivariable logistic regression analysis to examine the associations between the indoor tanning laws of different states and the reports of indoor tanning among high school students in those states. The survey found that 23.4 % of the young women surveyed said they used indoor tanning, and 6.5% of young men admitted to using the devices.
The researchers had no financial conflicts to disclose.
States with stronger laws to restrict tanning bed access for minors reported significantly lower instances of tanning among teens than states without restrictions, according to a large-scale review published by the American Journal of Public Health.
Overall, female minors in states with tanning access laws used the beds 30% less than teens in states without any restrictions. The laws include warning signs on indoor tanning devices, limited advertising, and mandatory protective eyewear.
"State indoor tanning laws, especially age restrictions, may be effective in reducing indoor tanning among our nation’s youth," wrote Gery P. Guy Jr., Ph.D., of the Centers for Disease Control and Prevention and his colleagues.
Six states (California, Illinois, Nevada, Oregon, Texas, and Vermont), currently restrict indoor tanning among minors younger than 18 years, the researchers noted.
In addition, data from states with youth access laws – laws that require parental permission or place an outright ban on teen use of tanning beds – indicated that female students use tanning beds 42% less than those in states without the laws (Am. J. Public Health 2014 [doi: 10.2105/AJPH.2013.301850]).
The researchers used nationally representative data from 31,835 adolescents from 2009 and 2011 collected as part of the national Youth Risk Behavior Surveys of U.S. high school students in grades 9-12. They conducted a multivariable logistic regression analysis to examine the associations between the indoor tanning laws of different states and the reports of indoor tanning among high school students in those states. The survey found that 23.4 % of the young women surveyed said they used indoor tanning, and 6.5% of young men admitted to using the devices.
The researchers had no financial conflicts to disclose.
States with stronger laws to restrict tanning bed access for minors reported significantly lower instances of tanning among teens than states without restrictions, according to a large-scale review published by the American Journal of Public Health.
Overall, female minors in states with tanning access laws used the beds 30% less than teens in states without any restrictions. The laws include warning signs on indoor tanning devices, limited advertising, and mandatory protective eyewear.
"State indoor tanning laws, especially age restrictions, may be effective in reducing indoor tanning among our nation’s youth," wrote Gery P. Guy Jr., Ph.D., of the Centers for Disease Control and Prevention and his colleagues.
Six states (California, Illinois, Nevada, Oregon, Texas, and Vermont), currently restrict indoor tanning among minors younger than 18 years, the researchers noted.
In addition, data from states with youth access laws – laws that require parental permission or place an outright ban on teen use of tanning beds – indicated that female students use tanning beds 42% less than those in states without the laws (Am. J. Public Health 2014 [doi: 10.2105/AJPH.2013.301850]).
The researchers used nationally representative data from 31,835 adolescents from 2009 and 2011 collected as part of the national Youth Risk Behavior Surveys of U.S. high school students in grades 9-12. They conducted a multivariable logistic regression analysis to examine the associations between the indoor tanning laws of different states and the reports of indoor tanning among high school students in those states. The survey found that 23.4 % of the young women surveyed said they used indoor tanning, and 6.5% of young men admitted to using the devices.
The researchers had no financial conflicts to disclose.
FROM THE AMERICAN JOURNAL OF PUBLIC HEALTH
Major finding: Youth access laws reduce indoor tanning use by 42% in teenage girls.
Data source: Data review performed by the CDC based on National Youth Risk Behavior Surveys from 2009 and 2011.
