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Health Updates 10 April 2012

  • Treating sleep apnea without the mask: “About 28 million Americans have sleep apnea, which causes repeated awakenings and pauses in breathing during the night, sometimes resulting in loud snoring and gasps for air.  For decades, the standard treatment has been ‘continuous positive airway pressure‘.  A mask worn at night pushes air into the nasal passages, enabling easier breathing.  C.P.A.P. reduces and in some cases completely prevents episodes of apnea.  But the mask is like something from a bad science fiction movie: big, bulky, and obstructive.  Many patients simply refuse to wear it or rip if off while asleep.  Studies show that about half of all people prescribed C.P.A.P. machines stop using them in one to three weeks….Now an alternative form of C.P.A.P. is gaining popularity: a patch that fits over the nostrils. Called Provent, the patch holds two small plugs, one for each nostril, that create just enough air pressure to keep the airways open at night.  It is far less intrusive than the traditional C.P.A.P. machine.  It is also more expensive, and doesn’t work for every patient.”  The device was FDA-approved in 2008; it doesn’t do much to help mouth breathers, nor those with severe nasal allergies. It is also not covered by Medicare or most major insurers, though some doctors expect this to change in the near future.  At this time, a 30-day supply of  patches costs $65 to $80. (NY Times)
  • Smoking menthol cigarettes tied to stroke: “People who smoke menthol cigarettes were more likely to have a history of stroke than smokers who prefer regular cigarettes, an analysis of federal health survey data indicated.  Among 5,167 current smokers participating in the National Health and  Nutrition Examination Survey (NIHANES) from 2001 to 2008, those who reported that they usually smoke menthol cigarettes were more than twice as likely to have had a stroke as those smoking nonmenthol cigarettes, according to Nicholas Vozoris, MD….’These results highlight the need for further review of the last legally allowed tobacco additive in North America, given that mentholated cigarettes may be placing individuals at even greater risk of potentially devastating cerebrovascular disease than regular cigarettes,’  Vozoris wrote….Vozoris indicated that histories of other cardiopulmonary conditions — hypertension, MI, heart failure, and chronic obstructive pulmonary disease — were not significantly related to menthol cigarettes….With additional adjustments for reported histories of multiple cardiopulmonary conditions, menthol cigarette smoking was still significantly associated specifically with stroke…”. (John Gever, MedPage Today)
  • Minorities, Medicare recipients less likely to get antidepressants: “Hispanics and blacks are less likely to be prescribed antidepressants than whites, and Medicare and Medicaid patients are less likely to receive the drugs than those with private insurance, a new study says.  University of Michigan School of Public Health researchers examined data from 1993 to 2007 and found that whites were 1.5 times more likely to receive antidepressants than blacks or Hispanics with major depression.  The study also found that Medicare and Medicaid patients were 31 percent and 38 percent less likely to be prescribed antidepressants than privately insured patients.  Race didn’t  play a role in the type of antidepressants prescribed to patients, but insurance did.  Medicare and Medicaid patients were 58 percent and 61 percent less likely to receive newer antidepressants than privately insured  patients.  Newer types of antidepressants such as serotonin reuptake inhibitors (SSRIs) are considered the first-line drug treatments for major depression.  Older types of antidepressants tend to cause more side effects.  ‘This study confirmed previous findings that sociological factors, such as race and ethnicity, and patient health insurance status, influence physician prescribing behaviors,’ principal investigator Rajesh Balkrishnan, an associate professor in the school of public health, said in a university news release.” (HealthDay)
  • Emotional trauma may hurt toddlers’ later learning: “Suffering emotional trauma such as witnessing domestic violence or being abused early in life may inhibit children’s intellectual development, according to a new study.  The researchers also found that the impact of trauma seems to be most damaging when it occurs during the first two years of life.  The US study included 206 children whose intellectual development was assessed when they were aged 2, about 5 and 8 years old.  The researchers also determined whether children suffered neglect; physical, sexual or emotional abuse; or witnessed domestic violence against their mother.  More than one in three (37 percent) of the children had suffered abuse or witnessed violence by about age 5.  This occurred before age 2 in about 5 percent of children, during preschool (24 to 64 months) in 13 percent of children and during both periods in 19 percent of the children.  Children who suffered abuse or witnessed violence against their mother had lower-than-normal scores on tests of intellectual development.  Those who experienced this type of trauma during the first 2 years of life had the lowest scores.”  Association, once again, does not prove cause-and-effect.  However, mistreated children scored significantly lower on test scores.  “The researchers noted that the brain develops most rapidly during the early years of a child’s life.  ‘Because early brain organization frames later neurological development, changes in early development may have lifelong consequences,’ they wrote.” (MedlinePlus)
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