In The News This Week … August 3–9, 2008: Kids, Pregnancy, Drugs, Cancer, HIV & TB, & US Healthcare

Kids' Cold Meds & ER Visits

You may recall that in mid-January 2008, the Food & Drug Administration released a recommendation that OTC cough and cold products, including decongestants, expectorants, antihistamines, and antitussives should not be used in those younger than two years. Now, a study of visits by kids under age 2 to an ER at a children's hospital reminds us about the meds' potential dangers. An article published on August 1 in Pediatrics concluded: "A substantial number of children presenting to the emergency department with an apparent life-threatening event had a positive toxicology screen result. In particular, a number of children were found to have been given an over-the-counter cold preparation." Interestingly, they also wrote, "No parent admitted to having given his or her child an over-the-counter cold preparation."

Breakfast & Kids

Also published on August 1 in Pediatrics is the finding that eating breakfast has no effect on students' ability to sustain attention, but students reported feeling more alert after eating breakfast. They also found that male adolescents who skip breakfast report being in a worse mood, and their visuospatial memory is negatively affected, but the same wasn't true of girls. The findings were based on a study of 104 boarding school students between 13 and 20 years of age.

Clean Homes and Irritable Bowel Disease

Are we too clean? A study published in the July issue of the American Journal of Gastroenterology looked at the "hygiene hypothesis," which postulates that individuals raised in a sanitary environment are more likely to develop inflammatory bowel disease (IBD). Researchers looked at almost 400,000 Israeli teens, and determined how "hygienic" the child's upbringing was, including number of siblings, place in the family birth order, and whether the family lived in an urban or rural area. They found that teens with one sibling were between two and three times more likely to have IBD than teens with five or more siblings, and that those in urban areas were 38% more likely to suffer from IBD than those in rural areas. While the findings don't prove the hygiene hypothesis, an association was shown between "surrogate markers" of childhood hygiene and IBD.

Cocoa Butter to Avoid Stretch Marks in Pregnancy?

A double-blind, randomized and placebo-controlled trial has found that application of a cocoa butter lotion does not appear to reduce the likelihood of developing stretch marks during pregnancy. While 45% of women in the cocoa butter group developed stretch marks, compared with 49% in the placebo group, the difference is not considered statistically significant. The findings were published in the August issue of BJOG: An International Journal of Obstetrics & Gynaecology.

Drugs, Not Therapy

An article published in the August issue of Archives of General Psychiatry reports that fewer American psychiatrists offer psychotherapy, and are heading for the prescription pad instead. The authors conclude: "There has been a recent significant decline in the provision of psychotherapy by psychiatrists in the United States. This trend is attributable to a decrease in the number of psychiatrists specializing in psychotherapy and a corresponding increase in those specializing in pharmacotherapy – changes that were likely motivated by financial incentives and growth in psychopharmacological treatments in recent years."

Complementary Therapies & Cancer

A study published online on August 4 in Cancer analyzed the prevalence and the medical and demographic associations of complementary method (CM) use among cancer survivors surveyed 10 to 24 months after diagnosis. Researchers found that of the 19 CMs included in the survey, those most frequently reported were prayer/spiritual practice (61.4%), relaxation (44.3%), faith/spiritual healing (42.4%), nutritional supplements/vitamins (40.1%), meditation (15%), religious counseling (11.3%), massage (11.2%), and support groups (9.7%). Those CMs least likely to be used were hypnosis (0.4%), biofeedback therapy (1.0%), and acupuncture/acupressure (1.2%). Those more likely to use CMs were female, younger, white, higher income, and more educated. The study included 4,139 survivors of one of 10 types of adult cancers.

TB & HIV

A contribution published in the August 6 issue of The Journal of the American Medical Association suggests that patients being treated for TB may not get the full benefit of HIV meds. Specifically, researchers found that nevirapine (a cheap antiretroviral drug used to treat HIV in developing countries) doesn't work as well in patients also on TB treatment. That the same time, a more expensive antiretroviral, efavirenz, didn't seem to be affected by TB treatment.

Chronic Conditions & Health Insurance

Research published in the August issue of Annals of Internal Medicine looked at 12,486 patients aged 18 to 64 in the National Health and Nutritional Examination Survey (1999 to 2004) and found that an estimated 11.4 million working-age Americans with chronic conditions were uninsured, and have poorer access to medical care than their insured counterparts.

Overhaul the System?

A survey commissioned by The Commonwealth Fund, a private foundation that aims to promote a high performing healthcare system, has found that 82% of respondents agreed that the American healthcare system needs either fundamental change or complete rebuilding. Also, the majority of those polled said it is very important for the 2008 presidential candidates to seek reforms to address healthcare quality, access, and costs. The survey was conducted in May, and included 1,004 adult respondents.

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