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Vol. LXIII, No. 9
April 29, 2011
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Digest

Treatment Found for Common Fever in Children

Treatment Found for Common Fever in Children A preliminary study conducted by an NIH team has identified a promising new treatment for the most common periodic fever disease in children. The syndrome is called periodic fever associated with aphthous stomatitis, pharyngitis and cervical adenitis— or PFAPA—and is characterized by monthly flare-ups of fever, accompanied by sore throat, swollen glands and mouth lesions.

The proposed treatment, which will be validated in a larger study before it is recommended, wards off an inappropriate immune system attack without increasing the frequency of flare-ups, a problem caused by the current standard treatment with corticosteroids. Researchers from NHGRI and NIAMS reported their findings in the Apr. 8 early online edition of the Proceedings of the National Academy of Sciences.

“Until now, the basis of PFAPA has been a mystery,” said senior author Dr. Daniel Kastner, NHGRI scientific director. “Advances in genomic analysis have allowed us to define a major role for the innate immune system, the body’s first line of defense against infection. Targeting a specific product of white blood cells at the first sign of fever appears to abort the attacks.”

‘Warm’ Line Helps Tackle Substance Abuse

A free, nationwide service was launched Apr. 8 to help primary care providers identify and advise substance-abusing patients. The service, Physician Clinical Support System for Primary Care (PCSS-P), offers peer-to-peer mentorship and resources on incorporating screening and follow-up into regular patient care. PCSS-P is a project of NIDA and the American Society of Addiction Medicine. NIDA also launched a quick screening tool to help health care providers identify these patients.

The warm line service—“warm” because the response is within 24 hours rather than an immediate response typical of a hotline—is available free to physicians and other health care providers. Providers register with PCSS-P and receive the contact information of a mentor who is a specialist in screening, brief intervention, treatment and referral for patients with substance abuse problems. To use the service, physicians can call (877) 630-8812, or register online at www.PCSSmentor.org.

Americans over age 50 often do not discuss CAM use with their health care providers, a survey indicates.

Americans over age 50 often do not discuss CAM use with their health care providers, a survey indicates.

CAM Talk Lacking Between Patients, Providers

Despite their high use of complementary and alternative medicine (CAM), Americans over age 50 often do not discuss CAM use with their health care providers, a survey indicates. The results, from AARP and NCCAM, were released Apr. 13.

Overall, 53 percent of respondents reported that they had used CAM at some point in their lives. Among those, 58 percent said they had discussed CAM with a health care provider. This dialogue is important because, while CAM is a part of health and wellness for many Americans, some CAM products can interact with conventional medicine. CAM is a group of diverse medical and health care interventions, practices, products or disciplines that are not generally considered part of conventional medicine. CAM includes natural products such as herbal supplements and manual therapies and mind/body practices such as chiropractic care, massage, acupuncture and meditation.

Distribution of Cancers Shifts Dramatically in HIV/AIDS Population

As treatments for HIV/AIDS improve and patients are living longer, the distribution of cancers in this population has undergone a dramatic shift in the U.S. While cases of the types of cancer that have been associated with AIDS progression have decreased, cases of other types of cancer are on the rise. NCI and CDC reported these results online Apr. 11 in the Journal of the National Cancer Institute.

The CDC uses the presence of certain diseases, including three cancers—Kaposi sarcoma, non-Hodgkin lymphoma and invasive cervical cancer—as part of the criteria to determine whether an HIV-infected person has developed AIDS. The introduction of highly active antiretroviral therapy in 1996 resulted in improved immune function, reduced risk of AIDS progression and greatly improved survival for people infected with HIV. As a result, cases of those AIDS-defining cancers decreased threefold, from 34,000 cases between 1991 and 1995 to about 10,000 cases between 2001 and 2005. In contrast, the total number of all other cancers tripled, from around 3,000 in the earlier period to 10,000 in the latter period. Since 2003, annual counts of these other cancers in the HIV/AIDS population have exceeded the number of AIDS-defining malignancies.

People with HIV infection are known to be at increased risk for certain cancers not classified as AIDS-defining malignancies. Of these, the most common are anal, lung and liver cancers and Hodgkin lymphoma. Higher risks for these malignancies stems from co-infections such as human papillomavirus, hepatitis B and C viruses and Epstein-Barr virus, as well as higher smoking rates in the HIV/AIDS population.—compiled by Carla Garnett


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