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Respiratory Diagnoses Missed, Alzheimer Biomarkers, and More

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In the news: respiratory disease underdiagnosed, Alzheimer biomarkers, Crohn disease microbiome, migraine device, sleep apnea and diabetes.

Opportunities to diagnose chronic obstructive pulmonary disease (COPD) at an early stage are missed most of the time in both primary care and secondary care, according to a UK study. Opportunities for diagnosis were missed in 85% of close to 39,000 patients in the 5 years immediately preceding diagnosis of COPD. The prevalence of all comorbidities present at COPD diagnosis increased except for asthma and bronchiectasis. The lead author called the numbers of study patients misdiagnosed and underdiagnosed “a cause for concern.”

• Biomarkers to Predict Alzheimer: Researchers discovered and validated a set of 10 lipids from peripheral blood that predicted phenoconversion to amnestic mild cognitive impairment or Alzheimer disease within a 2- to 3-year timeframe with over 90% accuracy. The biomarker panel, reflecting cell membrane integrity, may be sensitive to early neurodegeneration of preclinical Alzheimer disease.

• Crohn Disease Microbiome Identified: Several important new study findings have identified the microbiome in early-onset Crohn disease (CD) and highlight particular microbes that are increased or decreased in abundance in the disease. The researchers found that microbiota co-occur in 2 groups of organisms, increased or decreased in CD; rectal biopsies are a robust disease predictor, irrespective of disease location; fecal samples collected at onset of disease do not reflect alterations of intestinal lining bacterial communities; and antibiotics contribute to an imbalance of intestinal bacteria.

• Migraine Device FDA-approved: The FDA has allowed marketing of Cefaly, the first device as a preventative treatment for migraine headaches. This is also the first transcutaneous electrical nerve stimulation device specifically authorized for use before the onset of pain. Cefaly, a small, portable, battery-powered, prescription device that resembles a plastic headband worn across the forehead and over the ears, may help patients who cannot tolerate current migraine medications for preventing migraines or treating attacks, it was noted.

• Sleep Apnea Worsens Diabetes Control: Obstructive sleep apnea (OSA) may worsen diabetes mellitus (DM) control by disrupting the deepest stages of sleep, according to a new study. Severe OSA has long been known to lead to poorer glycemic control among patients with type 2 DM. But it is unknown whether obstructive events during REM sleep have a different metabolic impact compared with those during non-REM sleep.

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