Medical News You May Have Missed - Week of February 18th

February 23, 2013

Diabetes progress; folic acid and autism; acupuncture and allergic rhinitis; depression and shingles vaccine; HMP virus alert.

NIH: More Diabetes Patients Meeting Metabolic Goals

An increased number of patients with diabetes have been able to meet or exceed goals for HbA1C, blood pressure, and cholesterol, according to data from the National Institutes of Health published in a recent issue of Diabetes Care. The study compared data on goals for the 3 measures gathered by the National Health and Nutrition Examination Survey from the time periods 1999 to 2010 and 1988 to 1994. Improvements between the former and the latter surveys, respectively, were:
• HbA1c goals: 53% vs 43%
• Blood pressure goals: 51% vs 33%
• LDL-C goals: 56% vs 10%

Despite these encouraging results, the authors conclude that control of these 3 primary measures remains suboptimal among adults with diabetes-particularly among some minority groups.

View the abstract here

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Prenatal Use of Folic Acid Reduced Autism Likelihood by 40%

Women who used prenatal folic acid supplements from 4 weeks before pregnancy to 8 weeks after the start of pregnancy had a 40% reduced risk of having a child with an autistic disorder, according to the results of a population-based Norwegian study that examined more than 85,000 children. Results were published in the February 13, 2013 issue of Journal of the American Medical Association.

Autistic disorder was found in 0.21% of the children born to mothers who did not take folic acid, compared with 0.10% of children born to mother who did, resulting in an adjusted odds ratio for an autistic disorder of 0.61 (95% CI, 0.41-0.90).

Children in the study were born between 2002 and 2008. The study ended in March 2012. During that time, 270 children (0.32% of the population) were diagnosed with an autism spectrum disorder.        

The researchers pointed out that "this finding does not establish a causal relation between folic acid use and autistic disorder but provides a rationale for replicating the analyses in other study samples."

Read the full results of the study here.

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Acupuncture and Seasonal Allergic Rhinitis: Positive Results, Questionable Durability

Among patients with seasonal allergic rhinitis (SAR), an 8-week course of acupuncture resulted in statistically significant improvements in measures of disease-specific quality-of-life and antihistamine use, compared with sham acupuncture and with antihistamine use alone.

The study, published in Annals of Internal Medicine, randomly assigned 422 people with SAR to acupuncture plus rescue medication (n=212), sham acupuncture plus rescue medication (n=102), or to rescue mediation alone (n=108). Researchers measured changes in Rhinitis Quality of Life Questionnaire score and in the rescue medication score over 12 weeks of treatment during 2 allergy seasons, 1 year apart.

No differences were observed between the groups after 16 weeks in the first year. After 8 weeks in the second year, small improvements were durable in the group receiving real acupuncture compared with the sham acupuncture group.

In an editorial that accompanied the study, two researchers said the study provides evidence of the effectiveness of "real-world acupuncture."

The abstract of the study is available here.

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Untreated Depression Decreased Efficacy of Shingles Vaccine

The varicella zoster virus vaccine is less effective in older adults with depression who are not receiving antidepressant medication than adults with depression who are, according to the results of a study published in Clinical Infectious Diseases.

Adults aged 60 years or older had lower levels of varicella zoster virus (VZV) specific responder cell frequency (RCF) at baseline compared with adults who were not depressed, and their levels of VZV-RCF remained significantly lower up to 2 years after vaccination.

In contrast, adults who were depressed, but who were receiving antidepressants, had significantly higher levels of VZV-RCF after vaccination compared with untreated adults, and were able to reach levels of VZV-RCF equivalent to undepressed participants by 6 weeks post-vaccination.

Based on these results, treatment with a selective serotonin-reuptake inhibitor among adults with depression may "increase the efficacy of zoster vaccine, and, possibly, vaccines against other important pathogens."

The abstract of the study is available here.

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Little Known Virus Second Common Cause of Bronchitis in Children

Researchers have identified human metapneumovirus (HMPV) as a relatively unknown, but frequent cause of hospitalizations in children with respiratory infection, according to the results of a study published in the New England Journal of Medicine.

"We found MPV is as important a cause of respiratory illness as influenza, and caused more illness than the three common types of parainfluenza virus combined. In fact, in young children, the burden of MPV was second only to RSV (respiratory syncytial virus) as a cause of bronchiolitis," John Williams, MD, associate professor of pediatric infectious diseases at Vanderbilt University medical Centers said in a press release.

Between 2003 and 2009, the researchers conducted a surveillance study for acute respiratory illness or fever in inpatient and outpatient children aged 5 years or less in three U.S. counties. The overall annual rate of hospitalizations associated with the virus were 1 per 1,000 in children less than 5 years, 3 per 1,000 in infants less than 6 months and 2 per 1,000 in children 6 months to 11 months in age.

Read the full study here.

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