Sunday, August 18, 2013
Earlier Acne Outbreaks May Be Caused by Earlier Puberty: Experts
12:36 AM
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Though acne has long been viewed as a teen phenomenon, dermatologists have been tending to an ever-younger patient pool, a new preadolescent reality that many experts link to a trend toward an earlier onset of puberty.
Now, a team of physicians has put together a new list of treatment recommendations that they hope will lead to a better age-appropriate standard of care for children as young as 7.
The guidelines address issues such as when over-the-counter creams should be used versus prescription medicines (including antibiotics, retinoids and, for girls in some cases, hormone therapy). They also discuss how to help young patients stick with their treatments and deal with the emotional effects of acne.
"As the initial start of puberty is occurring earlier than in the past, we needed to define the age ranges and concerns regarding the different groups that make up pediatric acne," said guideline co-author Dr. Andrea Zaenglein, a pediatric dermatologist and professor of dermatology and pediatrics at Penn State/Hershey Medical Center.
She said the goal is "to provide pediatricians and anyone who cares for children with acne with specific guidelines for the care of their patients."
Zaenglein and her colleagues presented their recommendations, which have been endorsed by the American Academy of Pediatrics and published in Pediatrics, at the recent American Academy of Dermatology annual meeting in New York City.
The team defines preadolescent acne as cases occurring among children aged 7 to 12.
The guideline authors pointed out that preadolescent acne is not usually a cause for undue alarm, typically involving the onset of whiteheads and blackheads in the forehead, nose and chin region. More serious inflammatory lesions are not commonly seen among these younger patients, and scarring -- though a concern -- is rare.
The new recommendations advise doctors to first treat cases of preadolescent mild acne with over-the-counter benzoyl peroxide. Only when such products fail to do the trick -- or when children are afflicted with larger-than-usual acne zones -- are age-appropriate oral antibiotics or retinoids to be added to the treatment.
Children should also be instructed to adopt good cleansing protocols, such as washing acne-prone areas twice daily with a nonabrasive pH-balanced cleanser.
Consistent monitoring alongside treatment is also suggested even once acne is brought under control, as the onset of preadolescent acne can be an early sign of more serious acne problems as a child ages into a teen and young adult.
While acknowledging the need to identify the problem and seek appropriate treatment, Zaenglein stressed that "it is important that parents do not panic" because preadolescent acne is readily controllable.
"Acne is very unlikely to be a sign of a hormonal abnormality in that age range," she said, "although your doctor should confirm with a thorough history and physical exam."
But what explains the preadolescent acne phenomenon in the first place?
The jury is still out, said Dr. Lawrence Eichenfield, chief of pediatric and adolescent dermatology at the University of California, San Diego (UCSD), and himself a member of the guideline team.
"There are many ideas as to why this is happening," he said. "It is true that while back in the 1990s it was not that uncommon to see the onset of puberty among 8- or 9-year-olds, there is good data that children are, in fact, going into puberty now about one year earlier than was the case 20 years ago," Eichenfield explained.
"So it could be about hormones, about nutrition, about the obesity epidemic," he suggested. "But I would call these ideas, not even theories. We really just don't know what the reason is. But what we do know is that it's not happening just in the U.S. This is a worldwide phenomenon," he added.
"Which is why I'm very pleased that now, for the first time, we have evidence-based guidelines for the treatment of pediatric care," Eichenfield said. "And that means that parents should feel comfortable that their pediatricians and dermatologists will now have consistent and reliable ways to treat children, and minimize the negative physical and psychological impact that acne can come to have over a patient's lifetime."
For her part, Dr. Sheila Friedlander, a pediatric dermatologist and clinical professor of pediatrics and medicine at UCSD, expressed hope that the new recommendations will help caregivers guide parents away from the "perfect storm of anxiety" that can arise when confronted with preadolescent acne.
"As long as no other signs of a problem exist, such as significant armpit/groin hair or breast development, we consider this 'early acne' a normal event," she said.
"Therefore, health care givers must be prepared to provide parents with an appropriate approach to acne," Friedlander added, agreeing that most cases are eminently treatable when handled properly.
SOURCES: Andrea Zaenglein, M.D., FAAD, pediatric dermatologist, and professor, dermatology and pediatrics, Penn State/Hershey Medical Center; Sheila Friedlander, M.D., pediatric dermatologist, and clinical professor, pediatrics and medicine, department of medicine, University of California, San Diego; Lawrence Eichenfield, M.D., chief, pediatric and adolescent dermatology, University of California, San Diego; July 31-Aug. 4, 2013, American Academy of Dermatology annual meeting, New York City; May 2013 Pediatrics
Mailed Invites May Boost Colon Cancer Screening Rates: Study
12:27 AM
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A targeted mailing campaign improved colorectal cancer screening rates among uninsured people, a new study reveals.
The researchers also found that encouraging people to use an at-home noninvasive screening test, such as a fecal immunochemical test (FIT), might be a better way to increase screening rates than promoting the more time-consuming and invasive colonoscopy.
The study included nearly 6,000 uninsured patients, aged 54 to 64, in a safety-net health system. The participants, who had not had a recent colorectal cancer screening, were mailed invitations to either complete a free FIT that was mailed to them and could be returned to the lab at no cost, or to schedule a free colonoscopy.
The mailing campaign resulted in a threefold increase in the use of FIT and a twofold increase in colonoscopies, compared with the usual care approach for colorectal cancer screenings, according to the study published online Aug. 5 in the journal JAMA Internal Medicine.
The findings suggest that large-scale public health efforts to increase colorectal cancer screening may be more successful if noninvasive tests are offered over colonoscopy, said study leader Dr. Samir Gupta, an associate professor of clinical medicine and gastroenterologist at the University of California, San Diego School of Medicine and Veterans Affairs San Diego Healthcare System.
"Physicians shouldn't necessarily assume that use of colonoscopies is the best and only way to reduce colon cancer rates," Gupta said in a university news release. "What we should ask is, what type of screening is most acceptable to underserved populations? This is because the best predictor of colorectal cancer screening outcomes may be getting any test, rather than which test is done," he explained.
But study senior author Celette Sugg Skinner, an associate director of population research and cancer control for the Simmons Cancer Center at UT Southwestern Medical Center in Dallas, pointed out that "the question to be studied further is whether superior participation can be maintained in the FIT group, because the test must be repeated every year, and how adherence rates will impact overall screening effectiveness and cost."
SOURCE: University of California, San Diego, news release, Aug. 5, 2013.
It would be really good if everyone of us could get a free colonoscopy, Colon cancer is one of the most common cancer, and according to what i know Japan is the only country which has able to make colonoscopy a part of general medical check-up for each and every citizen. :)
Saturday, August 17, 2013
Childhood Abuse Linked to Later Thyroid Problems for Women
1:59 AM
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Stress hormone in 'fight-or-flight' reaction may be involved, researcher suggests
Women who suffered physical abuse during childhood are at increased risk for thyroid problems, according to a new study.
"We found a significant association with thyroid disorders for women who were abused during childhood," lead author Esme Fuller Thomson, professor and chair at the University of Toronto's Faculty of Social Work, said in a university news release.
"We originally thought the link would be explained by factors such as daily stress, smoking or alcohol abuse -- characteristics associated with both childhood physical abuse and thyroid disorders -- but even after adjusting for 14 potential explanatory factors, women who had been physically abused in childhood had 40 percent higher odds of thyroid disorders than their non-abused peers," Fuller Thomson said.
Researchers analyzed data from about 13,000 Canadian adults. More than 1,000 of the women reported being physically abused before they turned 18 and about 900 said they had been diagnosed with a thyroid disorder.
The study was published online July 29 in the Journal of Aggression, Maltreatment & Trauma.
Long-term effects of childhood physical abuse on the thyroid "may be due to the way early traumas change the way an individual reacts to stress throughout life," study co-author Loriena Yancura, an associate professor in the family and consumer sciences department at the University of Hawaii, said in the news release.
"One important avenue for future research is to investigate potential dysfunctions in the production of the 'fight-or-flight' hormone, cortisol, among survivors of abuse," she added.
SOURCE: University of Toronto, news release, July 29, 2013
Health Tip: Know Risk Factors for Gout
1:55 AM
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Gout is characterized by a buildup of uric acid in the body, leading to swollen, painful joints.
The U.S. National Institute on Aging mentions these common risk factors for gout:
- Being male.
- Having a family history of gout.
- Being overweight.
- Eating a poor diet.
- Drinking alcohol.
- Having too much uric acid in the blood, a condition called hyperuricemia. :)