The Vitals - April 2015

Examining the News Affecting Pharmacy & Clinics
April 2015, Vol 3, No 4 - The Vitals

In This Article

Adverse Childhood Experiences Linked To Pediatric Asthma

Recent research findings report a link between adverse childhood experiences (ACEs) and pediatric asthma among children who experience violence, or substance abuse at home.

To evaluate the relationship between single and cumulative ACEs, household dysfunction, and parental reports of lifetime asthma in children, Robyn Wing, MD, Emergency Medicine Physician, Hasbro Children’s Hospital, Providence, RI, and colleagues conducted a cross-sectional study using data from the 2011-2012 National Survey of Children’s Health, a nationally representative sample of children 0 to 17 years of age.

The prevalence of asthma in the sample evaluated was 14.6%, and the prevalence of exposure to any ACEs was 29.2%. The authors found that an increased number of ACE exposures was associated with increased odds for developing asthma. In particular, the odds of reporting asthma were 1.28 in patients reporting exposure to 1 ACE, 1.73 in patients reporting exposures to 4 ACEs, and 1.61 in those reporting exposures to 5 or 6 ACEs, compared with patients who were not exposed to any ACEs.

“This study supports the growing evidence for the biopsychological model of asthma onset,” the study authors concluded. Future research is warranted to examine the association between ACEs and specific asthma-related health outcomes.

Source: Wing R, Gjelsvik A, Nocera M, McQuaid EL. Ann Allergy Asthma Immunol. 2015 Mar 31. [Epub ahead of print]

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Smoking Cessation Beneficial, Even At 60

It’s never too late to discuss smoking cessation with patients. According to a recent study from the German Cancer Research Center, quitting smoking at age ≥60 years lowers the risk for developing cardiovascular disease within the first 5 years of cessation.

“Our study corroborates and expands evidence from previous studies in showing that smoking is a strong independent risk factor of cardiovascular events and mortality, even at [an] older age, advancing cardiovascular mortality by >5 years, and demonstrating that smoking cessation in these age groups is still beneficial [to] reducing the excess risk,” explained Ute Mons, PhD, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany, and colleagues.

As part of a meta-analysis of 25 cohorts participating in CHANCES (Consortium on Health and Ageing: Network of Cohorts in Europe and the United States), the investigators sought to determine the impact of smoking and smoking cessation on cardiovascular mortality, and acute coronary and stroke events among patients age ≥60 years. They also evaluated the risk advancement periods for cardiovascular mortality, and traditional epidemiological relative risk measures.

Of the 503,905 patients included in the analysis, 37,952 died from cardiovascular disease. Smoking status was associated with cardiovascular mortality for current smokers (hazard ratio [HR], 2.07) and former smokers (HR, 1.37), compared with participants who had never smoked. The excess risk in smokers increased with cigarette consumption in a dose-dependent manner, the authors found, and decreased continuously with time since smoking cessation in former smokers.

Source: Mons U, Muezzinler A, Schotter B, et al. BMJ. 2015 Apr 20;350:h1551. [Epub ahead of print]

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High-Fructose Corn Syrup Linked To CVD In Young Adults

The consumption of beverages containing high-fructose corn syrup, even in small amounts, significantly increases risk factors for cardiovascular disease (CVD) when consumed for just 2 weeks by young, healthy men and women.

“These results provide mechanistic support for the epidemiologic evidence that the risk of cardiovascular mortality is positively associated with consumption of increasing amounts of added sugars,” according to Kimber L. Stanhope, PhD, Associate Researcher, Department of Molecular Biosciences, University of California, Davis, and colleagues.

As part of a parallel-arm, nonrandomized, double-blind, intervention study, the investigators included 85 patients (age range, 18-40 years) who participated in 3.5 inpatient days of baseline testing, followed by 13 days of outpatient testing where patients consumed beverages sweetened with high-fructose corn syrup at 0% (n = 23), 10% (n = 18), 17.5% (n = 16), or 25% (n = 28) of their energy requirement. The beverages were also consumed during 3.5 days of intervention testing.

Data indicate that consumption of beverages with high-fructose corn syrup (10%, 17.5%, and 25%) was associated with significant linear dose-response increases in lipid/lipoprotein risk factors for CVD and uric acid. In addition, the authors found that all 3 doses of high-fructose corn syrup increased concentrations of postprandial triglycerides, with the 2 higher doses increasing fasting and/or postprandial concentrations of non–high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apolipoprotein B, apolipoprotein CIII, and uric acid.

This is the first study to show a direct, dose-dependent relationship between the amount of added sugar consumed in sweetened beverages and increased risk factors for CVD, according to the authors.

Source: Stanhope KL, Medici V, Bremer AA, et al. Am J Clin Nutr. 2015 Apr 22. [Epub ahead of print]

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Infectious Disease

5 Facts To Consider With Ebola Survivors

In a recent observational study published in The Lancet Infectious Diseases, investigators included 49 probable and confirmed survivors of the 2007 Bundibugyo ebolavirus outbreak in Uganda, and 157 of their seronegative contacts. Conducted approximately 29 months after the outbreak, information was collected about their health status, functional limitations, and demographics. Blood samples were also collected for clinical chemistry, hematology, and filovirus antibodies.
  1. Ebola survivors had a significantly increased risk for ocular deficits, blurred vision, hearing loss, difficulty swallowing, difficulty sleeping, arthralgias, and various constitutional symptoms.
  2. Survivors were also twice as likely to report chronic health problems for >1 year, including back pain, pain in the abdomen and large joints, as well as impotence, fatigue, and severe headaches.
  3. The investigators also found that limitations associated with memory loss or confusion were approximately 6 times more prevalent among Ebola survivors.
  4. Long-term sequelae persist for >2 years after the Ebola virus, the authors concluded, adding that defining health consequences related to the Ebola virus could improve patient care for survivors and contribute to understanding the disease pathogenesis.
  5. More data are needed to evaluate the long-term effect of Ebola on children, as the effects of severe disease most likely differ from those seen in adults.

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House Passes HR 471

The Ensuring Patient Access and Effective Drug Enforcement Act of 2015 (HR 471) has been passed by the House of Representatives, bringing it one step closer to becoming a law, and bringing healthcare professionals together. HR 471 would help curb prescription drug abuse and protect patients in need of medications. The Bill would direct the US Department of Health & Human Services to work with the Drug Enforcement Administration and the Office of National Drug Control Policy. Their task would be to identify obstacles of legitimate patient access to controlled substances; issues with diversion of controlled substances; and how collaboration between federal, state, local, and tribal law enforcement agencies and the pharmaceutical industry can benefit patients and prevent diversion and abuse of controlled substances. The bill was originally introduced to the House by Rep Tom Marino (R-PA) in January of this year.

Source: All Bill Information (Except Text) for H.R.471 - Ensuring Patient Access and Effective Drug Enforcement Act of 2015. Updated April 22, 2015. Accessed April 23, 2015.

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Last modified: May 27, 2015
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