Monday, March 17th, 2014
The Pap smear test, which women have had annually for decades as a way of screening for cervical cancer, may soon become passe, as a Food and Drug Administration panel has recommended a different test, also performed by vaginal swab, as the first line of defense against the disease. The new test looks for the DNA of the human papillomavirus, or HPV, which is the cause of more than 99% of all cervical cancers, while Pap tests look for abnormal squamous cells that could indicate cervical cancer. More from CNN.com:
Up until now, the Pap was the first test women had to detect the illness, with the HPV test as a second analysis. But if the FDA follows the advisory committee’s recommendations, that would change.
The committee, which voted unanimously to make the switch, would only allow the Roche cobas test to be used alone as the primary evaluation for women 25 years and older. Although there are other HPV tests available, the Roche test detects two strains of the virus that are found in 70% of all cervical cancers.
“Every year, 12,000 women are diagnosed in the U.S. with cervical cancer. This is especially tragic because cervical cancer is a largely preventable disease, and it is well established that HPV is the cause of almost all cervical cancers worldwide. Women need better access to screening tools that include primary HPV screening in order to reduce their risk of developing cervical cancer,” said Dr. Thomas Wright Jr., an expert in gynecology and pathology at Columbia University Medical Center.
“I am pleased that the FDA panel recognized the importance of validated, scientific evidence documenting the use of primary HPV screening to detect women at risk of invasive cervical cancer and allow us to prevent cervical cancer from developing.”
This does not mean the Pap test will go away. It will really be up to the physician and the patient on how best to handle testing. But according to women’s health experts, in most cases, patients who don’t have HPV are less likely to need a Pap, which is why the advisory committee felt it best to recommend the Roche test be administered as the first form of detection.
“I think anytime guidelines are changed, it becomes confusing for both patients and physicians. And we’re going to have to do more research on what’s best,” said Dr. Angela Marshall, director of Comprehensive Women’s Health of Maryland. “But the fact that the FDA is looking to make these changes says we’ve made great strides in detecting and treating cervical cancer.”
Image: Speculum, via Shutterstock
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Thursday, March 13th, 2014
Despite FDA warnings against drinking unpasteurized, “raw” milk, some parents continue to choose it for their families, citing a number of health claims including that it is a gentler alternative for lactose intolerant people. A new study published in the Annals of Family Medicine has found, however, that no such link with lactose intolerance exists. More from Time.com:
Only a small population of people drink unpasteurized milk, also known as “raw” milk, but its increasing popularity has some medical groups concerned. Some raw milk advocates argue that it’s healthier for us since raw milk contains no antibiotics or hormones, while others say it’s better for people with lactose allergies. For its part, the FDA advises against drinking raw milk, which can contain bacteria from fecal matter and sometimes be fatal, and has long stated that it doesn’t help with lactose intolerance.
But a new study published in the Annals of Family Medicine is definitively poking holes in the allergy theory, by reporting that lactose-intolerant people have the same symptoms from raw and pasteurized milk.
Advocates for raw milk claim that it contains good bacteria that can help with lactose absorption. “When I heard that claim it didn’t make sense to me because, regardless of the bacteria, raw milk and pasteurized milk have the same amount of lactose in them,” said study author Christopher Gardner, a professor of medicine at the Stanford Prevention Research Center in a statement. “But I liked the idea of taking this on since it seemed like a relatively straightforward and answerable question because the symptoms of lactose-intolerance are immediate.”
The study was small, with only 16 lactose-intolerant participants. All 16 tried three different types of milk–raw, pasteurized, and soy–over multiple eight-day periods.
For eight days, the participants were randomly assigned to one of the three milks, and they drank an increasing amount of that milk as the study period went on. They then reported their allergy symptoms, which were usually gas, diarrhea, and cramping, and rated them on a scale of 0 to 10. Their breaths were also measured for hydrogen, which can indicate undigested lactose in the colon and intolerance.
After the first eight days of drinking one type of milk, the participants took a week off where they drank no milk, and then started up again with another eight days of a different type of milk. To mask which type of milk participants were drinking, researchers randomized the order and added sugar-free vanilla syrup. Soy, which doesn’t contain lactose, acted as the control.
Researchers found no differences in the hydrogen breath tests between consuming pasteurized or unpasteurized milk. Participants also rated their symptom severity the same, regardless of the type of milk they drank.
Image: Milk, via Shutterstock
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Tuesday, March 11th, 2014
Parents who use smartphones and other devices while also trying to interact with their children report more cranky and frustrated moods than parents who avoid texting and other technology-driven activities in front of their kids, according to a new study by researchers at Boston Medical Center. More from Time.com:
Dr. Jenny Radesky, a fellow in developmental-and-behavioral pediatrics at Boston Medical Center, specializes in counseling parents about developmental and behavioral issues with their children. So she was naturally curious about how the ubiquity of smartphones, and their distracting allure, might affect the quality of time that parents and their children spent together. Previous studies showed that TVs, even if they are only on in the background, can inhibit children’s creativity and siphon their concentrating and focusing powers.
To study the effect of smartphones, Radesky and her colleagues sent in undercover investigators to surreptitiously observe any adult-child grouping with more than one youngster as they ate at a fast-food restaurant. The observers recorded the behavior of both the adults and the children in 55 such groupings, as well as how frequently the adults used their smartphones.
The data provided an unvarnished look at how absorbed many parents were by their devices. One child reached over in an attempt to lift his mother’s face while she looked down at a tablet, but to no avail. Another mother kicked her child under the table in response to the child’s various attempts to get her attention while she looked at her phone. A father responded in curt and irritated tones to his children’s escalating efforts to tear him away from his device.
“What stood out was that in a subset of caregivers using the device almost through the entire meal, how negative their interactions could become with the kids,” she says. While the study did not code or quantify the reactions, Radesky says that there were “a lot of instances where there was very little interaction, harsh interaction or negative interaction” between the adults and the children. “That’s simply unfair to the children,” says Dr. Wendy Sue Swanson of Seattle Children’s Hospital and author of the Seattle Mama Doc blog.
In light of the data, Radesky is working with the American Academy of Pediatrics to develop some guidelines for the smart smartphone use in front of the kids — just as the academy has advice for parents on TV viewing (none for toddlers younger than 2).
Image: Mom on smartphone, via Shutterstock
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Tuesday, March 11th, 2014
Children who are bullied in school may be more than twice as likely to commit or attempt suicide than kids who do not experience bullying, according to a new study conducted in the Netherlands. Cyber-bullying, in which bullying words and threats are communicated via social media and other electronic means, was linked with an even higher suicide rate than bullying that happens in person. More from Reuters:
“We found that suicidal thoughts and attempted suicides are significantly related to bullying, a highly prevalent behavior among adolescents,” Mitch van Geel told Reuters Health in an email.
Van Geel is the study’s lead author from the Institute of Education and Child Studies at Leiden University in the Netherlands.
He said it’s estimated that between 15 and 20 percent of children and teens are involved in bullying as the perpetrator, victim or both.
“Thus efforts should continue to reduce bullying among children and adolescents, and to help those adolescents and children involved in bullying,” he wrote.
While previous studies have found links between bullying and suicidal thoughts and attempted suicides, less is known about whether the association differs between boys and girls. Also, fewer studies have examined the role of cyberbullying.
For the new analysis, published in JAMA Pediatrics, the researchers searched databases for previous studies published on bullying.
They found 34 studies that examined bullying and suicidal thoughts among 284,375 participants between nine and 21 years old. They also found nine studies that examined the relationship between bullying and suicide attempts among 70,102 participants of the same age.
Overall, participants who were bullied were more than twice as likely to think about killing themselves. They were also about two and a half times more likely to attempt killing themselves.
Image: Sad boy, via Shutterstock
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Friday, March 7th, 2014
Young people who start smoking by using e-cigarettes, which contain nicotine but no tobacco tar or smoke, are more likely to eventually smoke real cigarettes–and less likely to quit smoking altogether than those who do not use e-cigarettes, according to a new study published in JAMA Pediatrics. The New York Times has more on the study, which is getting a divided response from experts:
The study’s lead author, Stanton Glantz, a professor of medicine at the University of California, San Francisco, who has been critical of the devices, said the results suggested that e-cigarettes, whose use is growing rapidly among youth and adults, were leading to less quitting, not more.
“The use of e-cigarettes does not discourage, and may encourage, conventional cigarette use among U.S. adolescents,” the study concluded. It was published online in JAMA Pediatrics on Thursday.
But other experts said the data did not support that interpretation. . They said that just because e-cigarettes are being used by youths who smoke more and have a harder time quitting does not mean that the devices themselves are the cause of those problems. It is just as possible, they said, that youths who use the devices were heavier smokers to begin with or would have become heavy smokers.
“The data in this study do not allow many of the broad conclusions that it draws,” said Thomas J. Glynn, a researcher at the American Cancer Society.
The study is likely to further stir the debate over what electronic cigarettes mean for the nation’s 45 million smokers, three million of whom are adolescents. Some experts worry that e-cigarettes is a gateway to smoking real cigarettes for young people, though most say the data is too skimpy to settle the issue. Others hope the devices could be a path to quitting.
So far, the overwhelming majority of young people who use e-cigarettes also smoke real cigarettes, a large federal survey published last year found.
Still, while e-cigarette use among youth doubled from 2011 to 2012, cigarette smoking for youth has continued to decline. The smoking rate hit a record low in 2013 of 9.6 percent, down by two-thirds from its peak in 1997.
The new study drew on broad federal survey data from more than 17,000 middle school and high school students in 2011 and more than 22,000 in 2012. But instead of following the same students over time – which many experts say is crucial to determine whether there has been a progression from e-cigarettes to actual smoking — the study examined two different groups of students, essentially creating two snapshots.
Image: Teen smoking e-cigarette, via Shutterstock
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