This study compared the effectiveness of extra-fine vs. fine-particle inhaled corticosteroids administered as ICS monotherapy or ICS-long acting beta-agonist combination therapy by conducting a meta-analysis of observational real-life studies. Seven studies with 33,453 subjects aged 5 to 80 years met eligibility criteria for inclusion. Six studies used extra-fine beclomethasone propionate (efBDP) and one study both efBDP and extra-fine ciclesonide as comparators with fine-particle ICS. The overall odds of achieving asthma control were significantly higher for extra-fine ICS compared with fine-particle ICS. Overall exacerbation rate ratios and ICS dose were significantly lower for extra-fine ICS compared to fine-particle ICS. This meta-analysis demonstrates that ef-ICS have significantly higher odds of achieving asthma control with lower exacerbation rates at significantly lower prescribed doses than fine-particle ICS.
From the electronic fetal monitoring patterns studied, deceleration area is the most predictive EFM pattern for acidemia (AUC: 0.76), and combined with tachycardia for significant risk of morbidity (AUC: 0.77).
Young adults insured as dependents on parental insurance plans and their policyholder peers have similar utilization of several reproductive health services, despite the potential for confidentiality breaches that have concerned providers and reproductive health advocates.
This study modeled associations between drug-related mortality at the county level and social determinants of health. Results revealed average mortality rates were significantly higher in counties with greater economic and family distress and economically dependent on mining. Average mortality rates were significantly lower in counties with a greater presence of religious establishments and recent in-migrants, and with economies reliant on public (government) sector employment. Health care supply factors did not contribute to between-county disparities in mortality rates.
Dutch researchers examined functional MRI scans from 332 patients with multiple sclerosis and found that cognitive impairment was associated with white matter damage among those with gray matter atrophy, but was mainly determined by cognitive reserve among those without atrophy. The findings, published in a radiology journal, suggest that evaluating cognitive reserve as part of patient monitoring may help predict when cognitive decline will occur among patients with MS, according to an accompanying editorial.
FDA breakthrough therapy designation was granted to bluebird bio's Lenti-D, which is indicated to treat patients with cerebral adrenoleukodystrophy.
Clinigen and Mitsubishi Tanabe Pharma agreed to collaborate to initiate a managed access program in Europe for its amyotrophic lateral sclerosis treatment edaravone. In studies, patients receiving edaravone demonstrated a 33% reduction in the decline of physical function versus placebo as measured by the ALS Functional Rating Scale-Revised.
The American College of Nurse-Midwives and the American College of Obstetricians and Gynecologists' Committee on Obstetric Practice addressed the treatment of postpartum pain in a Committee Opinion published in Obstetrics & Gynecology. The document said untreated postpartum pain is linked to increased risks for women and recommended that nonpharmacologic and pharmacologic therapies be included in pain management strategies.
A study in The New England Journal of Medicine found that diagnoses of invasive lung cancer among US adults ages 30 to 54 declined from 1995 to 2014, with men seeing a sharper decrease than women, resulting in a higher incidence of the disease in white and Hispanic women.
Men were historically more likely than women to be affected by the disease, and although the reasons behind the shift are not clear, experts said men and women are prone to different forms of lung cancer, and women who quit smoking see their risk decrease more slowly than men.
The FDA asked companies to stop selling over-the-counter teething pain products that contain benzocaine and warned it would take regulatory action if the products are not removed from the market. The agency said there have been more than 400 cases of methemoglobinemia, which compromises the blood's ability to carry oxygen, linked to benzocaine product use, including 11 incidents involving children younger than age 2.