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An analysis of 19 studies provides additional evidence of increased asthma risk in children and adults given acetaminophen.
The study’s lead author told Reuters Health, while this type of study isn’t the best way to prove that the medication actually causes the illness, it does show that the relationship should be investigated further.
“We know acetaminophen affects inflammatory cells in the airway,” said Dr. J. Mark FitzGerald of the Vancouver Coastal Health Research Institute in British Columbia. But even if the medication does boost asthma risk, he added, it’s likely only one factor in the rise in asthma prevalence seen in recent years.
Asthma has become increasingly common worldwide, and some investigators have suggested that more widespread acetaminophen use could be one contributing factor, given that the drug lowers levels of an antioxidant called glutathione found in lung tissue, FitzGerald and his team note in the journal CHEST.
Also, the researcher pointed out in an interview, a study of about 200,000 patients published in 2008 suggested an increased risk of asthma and wheezing in those who took acetaminophen.
To investigate further, FitzGerald and his associates searched the medical literature for studies that looked at acetaminophen and risk of asthma and wheezing.
When the researchers did a combined analysis of the 19 studies they identified, which included 425,140 patients in all, they found acetaminophen use was associated with a 1.6-fold increased risk of asthma. Children exposed to the drug in the womb were at 1.3-fold greater risk of asthma and 1.5-fold increased risk of wheezing.
The one study that looked at high-dose acetaminophen in children found it more than tripled asthma risk.
At this point, FitzGerald said, parents shouldn’t purge their medicine chests of acetaminophen.
When a pediatrician recommends acetaminophen to treat fever in a child, according to the researcher, parents should follow this advice. The drug “works very well to do what it is supposed to do,” he noted, adding “there’s always a risk benefit in terms of medication.”
Rough buffing of the skin does a better job of removing wrinkles and acne scars and stimulating healing than a gentler rubbing, University of Michigan researchers report.
Known as microdermabrasion, skin buffing has become a popular way to improve the appearance of wrinkles, acne scars, skin discoloration and other signs of aging skin. The procedure involves buffing the skin with grains of diamond or another hard substance such as aluminum oxide crystals, the researchers explain.
Laser resurfacing is considered the “gold standard” for removing wrinkles, acne scars and skin discoloration, but it requires a long healing period after treatment and can sometimes leave the skin damaged, said study leader Dr. Darius J. Karimipour, an assistant professor of dermatology at Michigan.
But with microdermabrasion, he said, the skin heals quickly. Someone could have a treatment at lunchtime and return to work with only a little redness. The researchers’ goal was to make microdermabrasion more effective, he said.
“We came up with the idea of a more aggressive approach,” Karimipour said. “If we treated the skin more aggressively with microdermabrasion, we could generate more collagen.”
The key to improving the appearance of skin is to have the treatment induce the production of collagen, which is an important skin protein, Karimipour explained. Earlier studies had found that aluminum oxide microdermabrasion does not always stimulate collagen production, but he said it was not known if that could be achieved with a more abrasive substance.
To find out, Karimipour’s team took skin samples from the arms of 40 people with sun-damaged skin. Samples were taken before and after the participants had microdermabrasion with either a coarse- or medium-grit, diamond-studded wand.
The researchers found that the course-grit diamond increased the production of compounds associated with wound healing and skin remodeling. These included cytokeratin 16, which helps skin heal after injury.
In addition, the coarse-grit buffing produced antimicrobial peptides that fight infection and substances that break down the skin’s structural proteins to let the skin rebuild. The researchers also found that skin produced other substances that induce collagen production.
These changes were not seen in skin treated with the medium-grit device, they noted.
Their findings are published in the October issue of Archives of Dermatology.
“This research gives us the basis to believe that aggressive microdermabrasion abrasion could potentially result in beneficial effects like we see in other more aggressive procedures, like laser resurfacing,” Karimipour said.
However, he predicted that aggressive microdermabrasion would not replace laser resurfacing. Microdermabrasion is not for the most severe cases but rather for fine-line wrinkles and shallow acne scars, he said.
Dr. Jeffrey Salomon, an assistant clinical professor of plastic surgery at Yale University School of Medicine, said that “the more damage induced to the skin, by whatever mechanism, the stronger the body’s repair response.”
For microdermabrasion-induced injury, coarseness of the grit is only one part of the picture, Salomon said. “The duration of application, pressure applied during the application and the recipient skin thickness are also parameters, just like different grit of sandpaper are used for different types of wood and different types of applications,” he said.
Treating the skin first with chemical peeling agents can reduce the amount of grit needed to get a skin-repair response equivalent to that of a coarser-grit wand, Salomon said.
“So there are a variety of parameters that can be manipulated to achieve equivalent results, independent of the coarseness of the grit,” he said. “In the end, you do need to induce an injury to the skin to get objective evidence of skin rejuvenation.”
Worldwide immunization rates are at their highest-ever levels, a new report shows.
A record number of vaccines — 120 — are now available to prevent deadly diseases, and more than 80 new vaccines are in late-stage clinical testing, according to the report scheduled to be released Wednesday by the World Health Organization, UNICEF and the World Bank.
A record 106 million infants were immunized in 2008, reversing a downward trend. Measles deaths worldwide decreased 74 percent between 2000 and 2007, the report authors noted.
“Such progress must inspire new efforts to immunize children around the globe against life-threatening diseases,” UNICEF executive director Ann M. Veneman, said in a news release.
Along with the good news, the “State of the World’s Vaccines and Immunization” report also said rich nations need to contribute more to eliminate an annual $1 billion funding gap that leaves about 24 million children at risk, particularly in the poorest nations and communities.
Recently developed vaccines include those to protect against meningococcal meningitis, rotavirus diarrhea, pneumococcal disease and human papillomavirus (HPV). Vaccines now in late-stage testing include more than 30 that target diseases for which no vaccine currently exists. Researchers are also working to create vaccines against HIV/AIDS, malaria, tuberculosis and dengue.
The report also said that manufacturers in developing countries now fill 86 percent of the demand for traditional vaccines such as those that protect against measles, whooping cough, tetanus and diphtheria.
“We have seen a dramatic turnaround in the availability of vaccines in even the poorest countries,” Graeme Wheeler, managing director of the World Bank Group, said in the news release. “Yet the international community, together with the countries themselves, must ensure that new and existing technologies actually reach the most vulnerable populations, especially children.”
A new study suggests that the cancer drug Gleevec may benefit people with scleroderma, a chronic connective tissue disease.
No effective treatment currently exists for scleroderma, which affects the skin, blood vessels and often muscles and joints, as well as the gastrointestinal tract, kidneys, heart and lungs. About 300,000 people in the United States have scleroderma, which typically strikes people between the ages of 30 and 50, according to the Scleroderma Foundation.
This study included 30 patients with diffuse scleroderma, a widespread, severe form of the disease. They took 400 milligrams of Gleevec a day and were evaluated monthly for 12 months during treatment and were seen for follow-up three months after they stopped taking the drug.
The researchers assessed the effectiveness of the drug treatment by using a tool called the modified Rodnan skin score, a measure of how much skin is affected by the disease.
“The skin score seems to be a very good marker of disease status and most scleroderma trials use this as an outcome measure,” study leader Dr. Robert Spiera, an associate attending rheumatologist at the Hospital for Special Surgery and an associate professor at Weill Cornell Medical College, said in a hospital news release.
They also used two tests (forced vital capacity and diffusion capacity) to measure patients’ lung function. Lung disease is one of the main causes of death in scleroderma patients.
Interim findings showed a 23 percent improvement in skin scores and improvements in the lung function tests — 9.6 percent in forced vital capacity scores and 11 percent to 18 percent in diffusion capacity scores.
“The lung function data was really exciting,” Spiera said. “In patients with scleroderma, you usually see lung function tests getting worse over time, and if doctors try a therapy for a year and a patient doesn’t get any worse, we get pretty excited. What is amazing to me in this study is that we actually saw improvements in both lung function tests.”
The interim results were presented Sunday at the American College of Rheumatology annual meeting in Philadelphia. The study received funding and donated drugs from Novartis, which makes Gleevec.
The drug is approved in the United States to treat two types of cancer — chronic myeloid leukemia and gastrointestinal stromal tumor.
New research links high blood pressure in children to bones that are more mature than average, suggesting that advanced bone age may predict cardiovascular problems.
The new study, published Oct. 19 in the journal Hypertension, looked at children and found that those without high blood pressure had bones that reflected their chronological age within four months.
But in kids with high blood pressure, there was an average difference of nearly two years between “bone age” (16 years) and chronological age (14 years).
“Accelerated maturation is not the same as precocious puberty, the onset of signs of puberty before age 7 or 8 in girls and age 9 in boys,” study co-author Dr. Mieczyslaw Litwin, scientific director of Children’s Memorial Health Institute in Warsaw, Poland, said in a statement. “Accelerated maturation means that the tempo of biological maturity is greater than average. We found that accelerated skeletal maturation may be the early tell-tale sign of developing hypertension.”
The study authors examined bone age in the 108 Polish white children in the study by examining X-rays of wrists of the left hand. They compared the maturity of the bone structure to a reference atlas.
The researchers report that they found that the bone structures were mature in 20 of 54 children without high blood pressure, but 48 of the 54 with it.
“It is difficult to imagine that the process of biological maturity can be reversed,” Litwin said. “But we think that some lifestyle modifications, such as increased physical activity and diet modification, can influence both metabolic abnormalities and the tempo of biological maturity.”
New insight into how primary lung cancer turns into invasive, or metastatic, cancer could lead to treatments that improve patient survival, U.S. scientists say.
The research team at the University of Texas M.D. Anderson Cancer Center found that lung cancer becomes invasive by suppressing a type of microRNA that normally keeps tumors in a non-metastatic state. Specifically, when microRNA-200 was suppressed in mice prone to metastatic lung cancer, all their primary lung tumors became invasive, the study found.
The study appears in the Sept. 15 issue of the journal Genes & Development.
“Existing treatments have little success against cancer that has spread to other organs, so finding a way to prevent metastasis could have a huge impact on survival,” senior author Dr. Jonathan Kurie, a professor in M.D. Anderson’s Department of Thoracic/Head and Neck Medical Oncology, said in a university news release.
“To do that, we need to understand the cues that initiate metastasis. In this paper, we show that microRNA-200 is one of those central cues,” he explained.
The researchers are now trying to identify regulators of microRNA-200 that might offer targets for treatment.
High exposure to certain now-banned industrial chemicals may lead to fewer female births, a new study suggests.
The findings, reported in the journal Environmental Health, add to evidence that the two groups of related chemicals — polybrominated biphenyls (PBBs) and polychlorinated biphenyls (PCBs) — may affect human reproduction.
PBBs were once widely used as flame retardants in plastics, electronic and textiles, while PCBs were used in everything from appliances and fluorescent lighting to insulation and insecticides.
While the chemicals were banned in the 1970s as potential health hazards, they remain a public-health concern because they linger in the environment and accumulate in the fat of fish, mammals and birds.
For the current study, researchers used data from a group of Michigan residents who, in the early 1970s, had been inadvertently exposed to high levels of PBBs; the chemicals had been accidentally mixed into animal feed, leading to human exposure through contaminated meat, eggs and milk.
The researchers observed that, from 1975 to 1988, women in the study group had a higher-than-average rate of male births, relative to the national average.
There was also a suggestion of increased odds of a male birth when both parents’ combined PBB exposure was particularly high — above the midpoint for the study group — compared with couples whose PBB exposure was lower.
Similarly, couples with high PCB levels had a higher rate of male births.
What this all means for the public at large, however, is unknown, according to lead researcher Metrecia Terrell, of Emory University in Atlanta.
“This was a unique situation, so it’s very difficult to extend the findings to people with everyday exposures,” she said in an interview.
“Exposure in the general population would be much lower,” Terrell pointed out, “and we just don’t know if there are effects on sex ratio.”
Male births have always outnumbered female ones, but some research suggests that the male-to-female birth ratio is declining in the U.S. and elsewhere. One recent study found that in the U.S. in 2001, there were 104.6 boys born for every 100 girls; that compared with a ratio of 105.5 male births for every 100 female ones in 1970.
The researchers speculate that environmental toxins might be playing a role. Certain chemicals may, for example, affect the viability of sperm that bear the Y chromosome — which determines male sex — or the viability of male fetuses.
In this study, however, high exposure to PBBs and PCBs was linked to an increase in male births. Exactly why is unclear, according to Terrell.
Certain PBBs and PCBs have been shown to alter levels of male and female sex hormones, she and her colleagues note. But whether they promote the survival of Y-bearing over X-bearing sperm, or affect the survival of female fetuses is unknown.
Terrell said that continuing research on the chemicals’ potential reproductive effects is needed.
New research has uncovered possible causes of epilepsy related to signals in the brain that go haywire.
It suggests that when a certain protein is missing in the brains of mice, the animals have epileptic seizures. The protein appears to be important to the brain’s ability to calm and fine-tune itself.
The researchers, who report their findings in the Sept. 18 issue of Cell, found that neural connections in the brain were excitable in the mice even though connections appeared normal.
When the protein was restored, the brains of the mice began acting normally again.
The specific protein referred to is one encoded by plasticity related gene-1 (PRG-1) and is found only in the brain, according to the researchers. Its calming effect depends on how the protein interacts with lipids that provide a signaling function in the brain.
Epilepsy occurs when signals in the brain become disrupted. People with the condition can suffer from a long list of symptoms, including seizures, strange behavior and emotions, and loss of consciousness.
There’s no cure for the disorder, but it can be controlled by medicine and surgery in an estimated 80 percent of cases. In recent years, people with epilepsy have turned to a device that stimulates the body’s vagus nerve.
With the H1N1 swine flu virus lurking in every nook and cranny, all Americans should be on guard this coming flu season.
But experts say those living and working in crowded locales — schools, colleges, prisons, cruise ships, airplanes, military barracks — need to be extra careful.
“Any crowded place carries a heightened risk,” said Dr. Melinda Moore, a senior health researcher at the Rand Corp., in Arlington, Va. “It really has to do with people being in close quarters and having disease-transmitting behaviors such as coughing and sneezing.”
“The virus is mainly spread the respiratory route, and it’s also on inanimate objects like doors and knobs and handles and desktops and telephones,” added Dr. Stuart Beeber, attending pediatrician at Northern Westchester Hospital Center, in Mount Kisco, N.Y. “It’s mainly in close quarters where a lot of people are together, such as in classrooms or offices, potentially even movie theaters.”
The danger of transmission lies not only in the fact that hordes of people are together for long periods of time, but that those hordes may not be practicing good hygiene.
“Any environment in which people are crowded together with compromised hygiene carries a heightened risk,” said Dr. Dean Blumberg, an associate professor of pediatric infectious diseases at the University of California, Davis, Children’s Hospital. “It’s when people don’t have access to hand washing or shower facilities.”
Younger children are not naturally very hygienic, Blumberg pointed out.
College students may also engage in behaviors that are friendly to the spread of the H1N1 virus, such as kissing and sharing drinks. If those drinks are alcoholic, judgment may be affected, resulting in even more unsafe behaviors. Smoking can also compromise the respiratory system, making you more vulnerable to infection, Blumberg said.
The added problem in jails and prisons is that stepped-up hygiene needs to be balanced with safety and, in some cases, could actually compromise safety, Blumberg said. For example, “alcohol-based hand gels can be dangerous in that environment,” he said.
Budget cuts may even be contributing to a hygiene crisis. The current fiscal problems plaguing California affect all school facilities, including those related to hygiene, Blumberg said.
“The people involved may not be quite as interested in disease prevention compliance as they are with other things, but that doesn’t make it any less important,” Moore said.
The first line of protection is what experts call “respiratory etiquette.” Coughing and sneezing into your elbow or handkerchief doesn’t require any special facilities. And, as often as you can, wash your hands or cleanse them with hand foam or alcohol gel. “You may also want to wipe down surfaces that you are in frequent contact with, like door knobs,” Beeber said.
These are also messages the airline and cruise-ship industry are emphasizing more than usual right now, although, for the most part, it’s business as usual for travelers.
According to Erik Elvejord, a spokesman for Holland America Line, based in Seattle, the cruise ship industry is already bound by strict public health standards, including not letting sick passengers board a ship and isolating sick passengers who are already on board. Ships do have some flu-testing equipment on board as well as antivirals, he said. Passengers also receive notes on their pillow reminding them to wash their hands, and containers of hand sanitizer are placed all around the ships, although these measures are not new, Elvejord added. “We’ve kind of been doing what we’ve been doing all along,” he said.
Although one passenger on a recent commercial airline flight was told by the flight crew that blankets were no longer available in economy class because of swine flu concerns, David Castelveter, a spokesman for the Air Transport Association (ATA), said he has “not seen that wholesale.”
For the most part, the airline industry is also proceeding with travel-as-usual. “We [already] have pretty sophisticated filtering systems,” he said.
Debunking one persistent myth, Castelveter stressed that cabin air is not recirculated, but comes in the side, moves in a circular motion, then exits the plane into the great beyond. The worst danger comes from the person sitting next to you — not in front or behind, Castelveter said. “The person who sneezes in row 3 will have no impact on someone sitting in row 11,” he said.
Airlines are being more diligent in passing out hand-washing messages, and both water and antibacterial soap are available on most airplanes.
The ATA is also communicating regularly with CDC officials and will follow any recommendations they make, such as screening passengers before boarding an aircraft. So far, nothing has changed, Castelveter said.
As always, people who are sick should stay away from others. “The buzz word is social isolation, so children who have flu-like symptoms should stay home from school and workers who have flu-like symptoms should stay home from work until they have been fever-free for 24 hours without any drugs,” Beeber said.