Category: Drugs and Disease

Most children’s eczema does not have a clear cause, such as an allergy, but most eczema will improve with good skin care. These tips from dermatologists can reduce the severity and frequency of your child’s flare-ups.

Bathing tips

• Bathe your child in warm — not hot — water.
• Limit your child’s time in the bath to 5 or 10 minutes.
• Use cleanser only when needed and make sure the cleanser is mild and fragrance-free. Do not use bubble bath.
  • If your child’s eczema is frequently infected, twice-weekly bleach baths may be beneficial. Discuss this option with your child’s dermatologist.
• After bathing, gently pat your child’s skin partially dry.
• If your child has medicine that you apply to the skin, apply medicine when your child’s skin is almost dry and use the medicine as directed.
• Apply moisturizer on top of the medicine and to the rest of your child’s skin.

Tips for choosing a moisturizer

• When selecting a moisturizer, consider choosing a thick cream or ointment.
• Some children do better with fragrance-free products, so consider petroleum jelly — an inexpensive, fragrance-free product that works well for many children.
• When selecting a product, “trial and error” sampling of different types may help to identify the best moisturizer for your child.

Tips to ease discomfort

• For best results, apply moisturizer at least twice a day. This prevents dryness and cracking. It also can decrease the need for eczema medications.
• If your child has severe itching and scratching, ask your child’s dermatologist about wet wrap therapy. This can reduce swelling and lessen the desire to scratch.
• Keep your child’s fingernails short and smooth. This decreases the likelihood that scratching will puncture the skin. Putting cotton gloves on your child’s hands at night may help prevent scratching during sleep.
• Keep temperature and humidity levels comfortable. Avoid situations in which the air is extremely dry, or where your child may sweat and overheat. This is the most common trigger of the itch/scratch cycle.

Clothes-washing tips

• Using a laundry detergent made for sensitive skin may be beneficial. Scented fabric softener or dryer sheets may contribute to irritation.
• Only use the recommended amount of detergent.
• Use enough water for adequate rinsing.
• Buy clothes without tags because tags can rub against the skin, causing irritation.
• Wash your child’s new clothes before wearing. This will remove excess dyes and fabric finishers, which can irritate the skin.

Good skin care is a key part of gaining control of your child’s eczema. If skin care has not been a regular part of your child’s treatment, you should make an appointment for your child to see a dermatologist.

Food and Drug Administration approved Nucala (mepolizumab) for use with other asthma medicines for the maintenance treatment of asthma in patients age 12 years and older. Nucala is approved for patients who have a history of severe asthma attacks (exacerbations) despite receiving their current asthma medicines.

Asthma is a chronic disease that causes inflammation in the airways of the lungs. During an asthma attack, airways become narrow making it hard to breathe. Severe asthma attacks can lead to asthma-related hospitalizations because these attacks can be serious and even life-threatening. According to the Centers for Disease Control and Prevention, as of 2013, more than 22 million people in the U.S. have asthma, and there are more than 400,000 asthma-related hospitalizations each year.

“This approval offers patients with severe asthma an additional therapy when current treatments cannot maintain adequate control of their asthma,” said Badrul Chowdhury, M.D., Ph.D., director of the Division of Pulmonary, Allergy, and Rheumatology Products in the FDA’s Center for Drug Evaluation and Research.

Nucala is administered once every four weeks by subcutaneous injection by a health care professional into the upper arm, thigh, or abdomen. Nucala is a humanized interleukin-5 antagonist monoclonal antibody produced by recombinant DNA technology in Chinese hamster ovary cells. Nucala reduces severe asthma attacks by reducing the levels of blood eosinophils- a type of white blood cell that contributes to the development of asthma.

The safety and efficacy of Nucala were established in three double-blind, randomized, placebo‑controlled trials in patients with severe asthma on currently available therapies. Nucala or a placebo was administered to patients every four weeks as an add-on asthma treatment. Compared with placebo, patients with severe asthma receiving Nucala had fewer exacerbations requiring hospitalization and/or emergency department visits, and a longer time to the first exacerbation. In addition, patients with severe asthma receiving Nucala experienced greater reductions in their daily maintenance oral corticosteroid dose, while maintaining asthma control compared with patients receiving placebo. Treatment with mepolizumab did not result in a significant improvement in lung function, as measured by the volume of air exhaled by patients in one second.

The most common side effects of Nucala include headache, injection site reactions (pain, redness, swelling, itching, or a burning feeling at the injection site), back pain, and weakness (fatigue). Hypersensitivity reactions can occur within hours or days of being treated with Nucala, including swelling of the face, mouth, and tongue; fainting, dizziness, or lightheadedness; hives; breathing problems and rash. Herpes zoster infections have occurred in patients receiving Nucala. Herpes zoster is the virus that causes shingles.

Nucala is made by GlaxoSmithKline, in Research Triangle Park, North Carolina.

Source: FDA

Can belly fat be a problem even for people who aren’t overweight? New research says yes, excess weight around the middle boosts the risk of premature death even for people considered normal weight.

What’s more, normal weight people with excess stomach fat had an even higher risk of dying early than overweight or obese people did, according to new research published online Nov. 10 in the Annals of Internal Medicine.

“Belly fat is bad fat,” said Dr. Paul Poirier, from the Institute of Cardiology at Laval University in Quebec, Canada, and the author of an accompanying editorial in the same issue of the journal.

Stomach fat has been linked to high cholesterol, inflammation, heart disease, stroke and diabetes, he explained.

“When you have fat around the belly, it’s a lot worse than having the same amount of fat around the hip,” Poirier said. “If your weight is normal, but you have weight around the middle, it’s bad. If you’ve got a belly above 40 inches for men and 34 inches for women, this is obesity [even if your weight measurements seem normal],” Poirier said.

These people may not be obese from a weight perspective, but they are obese from a waist perspective, he said.

For the study, a team led by Dr. Francisco Lopez-Jimenez, a professor of medicine at the Mayo Clinic in Rochester, Minn., used data from a national survey to compare the risk of premature death among more than 15,000 adults. The mean follow-up time was 14 years.

The researchers looked at body mass index (BMI), a rough estimate of body fat based on weight and height measurements. They also looked at waist-to-hip ratios.

The investigators found that normal weight adults with extra stomach fat had the worst long-term survival, regardless of BMI. And, normal weight men with bigger bellies seemed to fare even worse than slender women with more tummy fat.

A normal weight male with more fat around the waist had an 87 percent increased risk of death during the study period compared to a man who was normal weight without extra belly fat. Compared to overweight or obese men (as measured solely by BMI, without specific waist size information), a normal weight man with extra belly fat had more than twice the risk of dying early, the study revealed.

Normal weight women with extra belly fat had nearly a 50 percent increased risk of death during the study period versus a normal weight woman whose weight was more equally distributed throughout her body. Compared to obese women (measured by BMI only), the normal weight women with belly fat had a 32 percent higher risk of early death, the researchers found.

Dr. David Katz, director of the Yale University Prevention Research Center, in New Haven, Conn., and president of the American College of Lifestyle Medicine, said the study findings raise the question: who would have more belly fat and still be at a normal weight according to their BMI?

Some people are more prone to depositing excess fat around the middle, he said. This can lead to fat accumulation in vital organs, especially the liver, he explained.

Another group may be those who have excess body fat and illness, perhaps in early stages, causing loss of lean body mass, Katz said. Although it’s not clear from this study how many people might fall into this category, he added.

Regardless of why someone has gained weight around the middle, Katz said, “We have long known that all varieties of overweight are not created equal with regard to health risk, and that central obesity is the most concerning variety.”

In his editorial, Poirier wrote, “These new data provide evidence that clinicians should look beyond BMI. Although assessing for total fat mass with BMI to identify patients at greater cardiovascular risk is a good start, it is not sufficient

Just a few minutes of easy exercise daily can help lower blood pressure in overweight and obese people with type 2 diabetes, researchers report.

“It appears you don’t have to do very much,” co-author Bronwyn Kingwell, head of metabolic and vascular physiology at the Baker IDI Heart and Diabetes in Melbourne, Australia, said in an American Heart Association news release.

“We saw some marked blood pressure reductions over trial days when people did the equivalent of walking to the water cooler or some simple body-weight movements on the spot,” she noted.

For the study, the researchers monitored blood pressure levels in 24 overweight and obese adults as they sat for eight hours. The average age of the study participant was 62. All had type 2 diabetes.

The study participants took brief breaks from sitting, and either walked slowly for three minutes or did three minutes of simple resistance exercises every half hour. Again, their blood pressure was monitored.

The resistance exercises included activities such as half-squats, calf raises, knee raises, or gluteal muscle squeezes.

Compared to uninterrupted sitting, light walking led to an average 10-point drop in systolic blood pressure (the top number in a blood pressure reading). Simple resistance exercise led to an average 12-point decrease in systolic blood pressure, the study reported.

“Light activity breaks are not meant to replace regular, purposeful exercise. But they may be a practical solution to cut down on sitting time, especially if you’re at your desk all day,” Kingwell said.

The study was to be presented Monday at the American Heart Association’s annual meeting in Orlando. Fla. Until published in a peer-reviewed journal, findings presented at meetings are usually considered preliminary.

Cooking meats at high temperatures, as in barbecuing or pan-frying, may increase the risk for kidney cancer, a new study suggests.

The World Health Organization warned last month that processed meats — including bacon, hot dogs and sausages — can cause colon cancer. Red meats were also associated with higher risk.

The new study looked specifically at kidney cancer, which is increasing in the United States and other developing nations. “This study, and others like it, suggest that the way we cook our meat could potentially impact kidney cancer risk,” said lead researcher Dr. Xifeng Wu, a professor in the department of epidemiology at the University of Texas MD Anderson Cancer Center in Houston.

“Limit the amount of time the meat is cooked at really high temperatures or over an open flame resulting in burning, smoking, or charring of the meat,” Wu suggested.

These new findings support the dietary recommendations for cancer prevention from the American Cancer Society, namely to limit the intake of red and processed meats, she said. Susan Gapstur, vice president for epidemiology at the cancer society, said that when meats are cooked at very high temperatures, certain cancer-causing chemicals are released, some of which are linked to kidney cancer.

“This study offers some clues that meat cooked at high temperature might increase the risk for cancer, especially among people with certain genetic mutations,” Gapstur said.

However, this study only shows an association between consumption of meat cooked at high temperatures and kidney cancer risk, not that it actually causes kidney cancer. To show that, larger prospective studies are needed, she said.

The report was published online Nov. 9 in the journal Cancer.

Many previous studies have suggested that aspects of the so-called Western diet — including high intake of meat, starches and processed foods — are partly responsible for the rise in kidney cancer, Wu said. To study this further, Wu and colleagues collected information from more than 650 kidney cancer patients and compared it with data from nearly 700 cancer-free patients.

• A food questionnaire asked not only about meat intake, but also cooking methods and level of how thoroughly it was cooked, the study authors noted.

• The researchers found that the kidney cancer patients ate more red and white meat than the others. They also ate more meat cooked at high temperatures or over an open flame — such as pan-fried, grilled or barbecued.

• The study found that, in particular, two chemical compounds caused by high-heat cooking seemed to raise kidney cancer risk by more than 50 percent.

• Also, people with certain genetic mutations seemed more susceptible than others to the effects of these chemicals, the researchers said.

However, Gapstur said that the risk for kidney cancer among people with these genetic mutations is not nearly as great as the risk for breast cancer linked to BRCA mutations.

Gapstur said the WHO report should guide meat-eating habits. “Processed meats and red meat, in particular, are carcinogens and are linked to a higher risk of colon cancer — the third most commonly diagnosed cancer in the United States. So, limiting consumption continues to be important,” she said.

In addition, avoid cooking meats at high temperatures, Gapstur suggested. “This study adds to the evidence that cooking methods are perhaps important,” she said.

A widely used class of antibiotics is associated with a small but measurable increased risk of sudden cardiac death, researchers report.

These antibiotics — called macrolides — are used to treat infections such as pneumonia, bronchitis and some sexually transmitted diseases. In the new report, the investigators analyzed 33 studies that were conducted between 1966 and 2015, and included a total of more than 20 million patients. The studies compared patients who took macrolides, other types of antibiotics, or no antibiotics.

Macrolides include the antibiotics erythromycin, azithromycin and clarithromycin

The results revealed a small, but statistically significant, association between taking macrolides and increased risk of sudden cardiac death. But the review did not prove a cause-and-effect relationship between these medications and sudden cardiac death.

The study was published Nov. 9 in the Journal of the American College of Cardiology.

“The absolute risks of sudden cardiac death and cardiac death are small, so it should likely have limited effect on prescribing practice,” study author Dr. Su-Hua Wu, from the department of cardiology at First Affiliated Hospital at Sun Yat-Sen University in Guangzhou, China, said in a journal news release.

“However, given that macrolides are one of the most commonly used antibiotic groups, and millions of patients are prescribed these drugs annually, the total number of sudden cardiac deaths or ventricular tachyarrhythmias and cardiac deaths may not be negligible,” Wu added. An average of 80 cases of rapid heartbeat that can result in sudden cardiac death (or “ventricular tachyarrhythmias”) occurred per 1 million treatment courses among patients who were not taking macrolides, the investigators found.

But, current use of macrolides was associated with an additional 118 ventricular tachyarrhythmias or related sudden cardiac deaths per 1 million treatment courses. And there were 36 additional sudden cardiac deaths from causes other than ventricular tachyarrhythmia, and 38 additional heart-related deaths per one million treatment courses, the findings showed.

Past use of macrolides and use of other antibiotics were not associated with increased heart risk, the researchers found.

To put the findings into perspective, one in 8,500 patients treated with macrolides could develop a serious heart rhythm problem and one in 30,000 might die, Dr. Sami Viskin, from the Tel Aviv Medical Center and Sackler School of Medicine at Tel Aviv University in Israel, explained in an accompanying journal editorial.

“Today, when antimicrobial resistance represents a major threat to global health and new treatment options are frighteningly few, losing an entire class of antibiotics would represent a major setback in the fight against infections. Furthermore, it takes years to fully understand the consequences of a drug’s disappearance,” Viskin wrote.