FDA approves first treatment for frequent urination

The U.S. Food and Drug Administration has approved treatment for nocturnal polyuria, or overproduction of urine during the night. This condition causes adults to wake up at least two times during the night to urinate, a symptom called nocturia. The treatment is a nasal spray called Noctiva.

Noctiva helps reduce the number of times that adults need to wake up to urinate, according to Hylton V. Joff, director of the Division of Bone, Reproductive and Urologic Products in the FDA’s Center for Drug Evaluation and Research.

Researchers studied 1,045 patients 50 years of age and older with nocturia caused by nocturnal polyuria in two 12-week trials. In both trials, some patients were given placebo drugs while others received Noctiva. More patients that were given Noctiva at least halved their number of urinations during the night and had more nights with one or fewer night-time urinations.

Nocturia can be caused by conditions such as congestive heart failure, medications, or diseases of the bladder or prostate. Health care providers should consider these conditions before recommending Noctiva, since Noctiva is approved only for adults that have nocturia caused by nocturnal polyuria. The medicine can have serious side effects and needs careful physician supervision.

Written by: Katherine Heighway | Medically Reviewed by Dr. Robert Carlson, M.D.

How Birth Order Affects Asthma

Swedish study confirmed link between birth order and risk of childhood disease. Is it better to be the first-born or the younger child? The answer– at least when it comes to certain diseases– is something Swedish researchers may now know.

A study from the Karolinska Institute in Sweden found that birth order and the presence or absence of siblings affected a child’s risk of developing asthma, diabetes, ADHD and respiratory infections.

“Our study confirms a link between sibship and childhood disease,” principal researcher, Catarina Almqvist Malmros, MD, said in a press release. “We found that single children had a higher risk of asthma, diabetes and ADHD than firstborns who had younger siblings, but showed no difference in the risk of developing respiratory infections.”

Dr. Malmros is a professor at Karolinska Institute’s Department of Medical Epidemiology and Biostatistics and a pediatrician at Astrid Lindgren’s Children’s Hospital.

Previous research showed that younger siblings are less likely to develop asthma, allergies such as hay fever and atopic eczema–a skin condition. A link between younger siblings and lower risks of type 1 diabetes and ADHD has also been confirmed in the past.

This study was an attempt to develop a more global understanding of the relationship between sibship and diseases. Professor Almqvist Malmros and colleagues analyzed sibship data from the Swedish Multigenerational Registry.

Children were divided into three groups: children with no siblings, first-born children with at least one sibling and second-born children. The researchers also looked at the interval between first and second-born children and divided this group into children born less than two years, two to four years or five years or more after their older sibling.

Single children made up 13 percent of the group, while 43 percent were first-born and 44 percent were second-born. Younger siblings were less likely to develop asthma and respiratory infections than first-born children with younger siblings.

The researchers were unable to determine exactly which birth order affected disease patterns. They theorized that the children might have been exposed to different bacteria or viruses or that the environment in the uterus during pregnancy could have had an effect.

The study was published in the June 2016 issue of the Journal of Allergy and Clinical Immunology. Funding for the study was provided by the Swedish Research Council, the Swedish initiative for Research on Microdata in the Social and Medical Sciences, the Swedish Heart Lung Foundation, the Åke Wiberg foundation, Sällskapet Barnavård, the Stockholm County Council (ALF project) and the Strategic Research Program in Epidemiology at Karolinska Institutet.

Coauthor C. Almgvist reported receiving funding from the Swedish Research Council, Swedish Heart Lung Foundation, Åke Wiberg foundation, and Sällskapet Barnavård and grants provided by the Stockholm County Council (ALF project) and Strategic Research Program in Epidemiology at Karolinska Institutet. None of the remaining authors expressed a conflict of interest.

Journal of Allergy and Clinical Immunology, “Sibship and risk of asthma in a total population: A disease comparative approach, (2016)” http://www.jacionline.org/article/S0091-6749(16)30287- 1/abstract Medical Express, “Sibling order affects risk of asthma and other diseases”

http://medicalxpress.com/news/2016-08- sibling-affects- asthma-diseases.html

By Beth Greenwood | Medically Reviewed by Dr. Robert Carlson, M.D.

Simple carbs may be giving you zits

Acne vulgaris has been found to be associated with high glycemic index. Research has long suggested a connection between diet and acne. Though some people assume that a pizza fanatic may have a lot of acne because of the junk food’s grease, that’s not necessarily the culprit. Think simple– simple carbs.

According to a study published in the Journal of the American Academy of Dermatology, acne vulgaris is associated with a high glycemic index and high glycemic load levels. The study also found an inverse correlation between serum adiponectin concentration and glycemic index.

Acne vulgaris is a common skin condition that occurs when hair follicles plug with oil and dead skin cells. Although most people experience some form of acne in their lives, the severity of acne varies greatly. The most severe form of acne can cause infections larger than five millimeters and produce lifelong scarring.

To conduct the study, researchers from the Marmara University Faculty of Medicine in Istanbul, Turkey examined 50 people with acne vulgaris. The research team compared the acne patients’ glycemic indexes and glycemic loads with 36 healthy control participants and looked at possible acne associations with milk consumption, insulin resistance and adiponectin levels. None of the patients were obese.

The glycemic index is a system of assigning carbohydrate-containing foods with a number according to how much that food increases blood sugar, according to the Mayo Clinic. In this system foods like carrots are assigned a low number while foods like white bread are assigned a high number.

“A high glycemic index/load diet was positively associated with acne vulgaris”, the authors said in the study. “Adiponectin may be a pathogenetic cofactor contributing to the development of the disease. Further research on adiponectin levels in patients with acne in terms of development of insulin resistance might be important in this possible relationship.”

The study was led by Asli Aksu Çerman, MD, who works at the Marmara University Faculty of Medicine in Istanbul. The study was published in the July 2016 issue of the Journal of the American Academy of Dermatology.

The authors disclosed no financial information or conflicts of interest.


http://www.jaad.org/article/S0190-9622(16)01485- 7/abstract
http://medicalxpress.com/news/2016-06- high-glycemic- indexload-diet- linked.html
http://www.mayoclinic.org/healthy-lifestyle/nutrition- and-healthy- eating/in-depth/glycemic- index-diet/art-20048478

By Emma Fortel | Medically Reviewed by Dr. Bob Carlson, M.D.


Air Pollution and Your Skin

Research shows air pollution damages and prematurely ages skin. Lung and heart diseases have long been linked to air pollution, but the effects on the skin are now beginning to be understood.

Air pollution, especially in large and heavily polluted cities, is causing skin damage, according to emerging research. In urban areas most air pollution comes from vehicle exhaust. Among the pollutants in this exhaust are tiny particles called PMs, nitrogen dioxide (NO2) and chemicals like polycyclic aromatic hydrocarbons (PAHs).

From eczema and hives to accelerating wrinkles and age spots, air pollution is being linked to damage to the body’s largest organ. However, scientists also say that some common skin routines may also be making the problem worse.

“With traffic pollution emerging as the single most toxic substance for skin, the dream of perfect skin is over for those living and working in traffic-polluted areas unless they take steps to protect their skin right now,” Dr. Mervyn Patterson, a cosmetic doctor at Woodford Medical clinics in the UK, said in an interview with The Guardian.

Jean Krutmann, MD, is the director at the Leibniz Research Institute for Environmental Medicine in Germany. He and colleagues completed a study of over 1,800 people in Germany and China that showed when air pollution increased so did age spots on the patients cheeks.

“It is not a problem that is limited to China or India–we have it in Paris, in London, wherever you have larger urban agglomerations you have it,” Dr. Krutman said in a press release. “In Europe everywhere is so densely populated and the particles are being distributed by the wind, so it is very difficult to escape from the problem.”

The study was reported in May, 2015 in the Journal of Investigative Dermatology. Pollutants are able to pass through the skin and once in the body they cause inflammation. These pollutants can increase melanocytes, the cells that create pigment in the skin, make blood vessels grow larger and trigger the enzymes that reabsorb damaged collagen. Collagen is one of the supporting structures of the skin. The enzymes can remove so much that skin begins to sag and wrinkle.

Researchers are now looking for ways to protect the skin from air pollution. Some have added vitamin B3 to skin care products as it can help heal damaged skin. Others are looking at different molecules or chemicals that may protect the skin from damage in the first place.

Researchers also noted that some of the things people do in their quest for smoother skin add to air pollution’s effects, like retinoids, glycolic acid and skin scrubs. “You can also put on a very nice physical shield in the form of good quality mineral makeup. That produces an effect like a protective mesh and probably has some trapping effect, protecting against the initial penetration of particles,” Dr. Patterson said. “But you also need always to try to remove that shield in the evening, washing the slate clean every night.”


The Guardian, “Air pollution causes wrinkles and premature ageing, new research shows”

https://www.theguardian.com/environment/2016/jul/15/air-pollution- causes-wrinkles-and- premature-ageing- new-research- shows

Journal of Investigative Dermatology, “Traffic-Related Air Pollution Contributes to Development of Facial Lentigines: Further Epidemiological Evidence from Caucasians and Asians,”

http://www.jidonline.org/article/S0022-202X(16)00453- X/abstract

Written by Beth Greenwood | Medically Reviewed by Dr. Bob Carlson, M.D.

Gluten-Free diets may increase risk of exposure to arsenic and mercury

As gluten-free diets gain popularity in the U.S., the health effects of such a diet have come into question. One study, published March 1 in the journal Epidemiology, said that gluten-free diets could increase exposure to toxic metals such as mercury and arsenic.

In 2015, a quarter of Americans said they ate gluten-free diets. This is a 67 percent increase from 2013.

Gluten-free diets are recommended to people with celiac disease, a serious genetic autoimmune disease triggered by gluten. But, even though less than one percent of people in the U.S. have been diagnosed with the disease, gluten-free diets have become increasingly popular with Americans.

Researchers looked at data from the National Health and Nutrition Examination Survey of 7,471 people between 2009 and 2014, including 73 who reported eating gluten-free diets. Participants that ate gluten-free diets had levels of arsenic twice as high and levels of mercury 70 percent higher compared to the participants who didn’t eat gluten-free. The problem could have to do with rice, which is common in gluten-free products to substitute for wheat. Rice is known to contain toxic metals including arsenic and mercury.

“These results indicate that there could be unintended consequences of eating a gluten-free diet,” study author Maria Argos said.

However, she said that more research is needed before determining gluten-free diets dangerous.

Funding was provided by National Institutes of Health grants.


Soy may lengthen life for breast cancer patients

New research linked a higher intake of isoflavone, a component of soy, to a reduced rate of mortality in breast cancer patients.

Isoflavone is a part of soy that has “estrogen-like properties,” according to the study. It has been unclear whether isoflavones should be encouraged or not for breast cancer patients because of conflicting research. Some studies have shown that isoflavones slow the growth of breast cancer cells while other studies show they reduce the effectiveness of hormone therapies.

A new study, published March 6 in the journal CANCER, aimed to continue research on the effect of isoflavone on breast cancer patients.

Researchers studied 6,235 American and Canadian women diagnosed with breast cancer to determine any relationship between intake of isoflavones and rate of death. After nine years, researchers saw that women who ate more isoflavone had a 21 percent lower risk of dying compared to women who ate lower amounts. The study relied on a dietary survey.

“For women with hormone receptor-negative breast cancer, soy food products may potentially have a protective effect,” said study author Dr. Zhang.

More research is needed to fully conclude the relationship between soy and its impact on breast cancer patients.

Funding was provided by the U.S. National Cancer Institute.


U.S. sunscreens fail to meet standards of European sunscreens

sunscreen-1461335_1280American sunscreens may not meet standards of the European Union, according to a new study published Feb. 24 in the Journal of the American Academy of Dermatology.

Researchers analyzed 20 best-selling U.S. sunscreens with an SPF 15 to 100 and labeled “broad spectrum,” meaning protection against ultraviolet A and ultraviolet B rays. Nineteen met U.S. standards and 11 met European Union standards.

The problem may reside in the fact that U.S. sunscreens measure SPF that protects against UVA rays, which cause sunburn, but not necessarily against UVB rays, which could cause skin cancer and early signs of aging.

Study authors said that these findings show that U.S. sunscreens may need better standards to protect against UVA rays. However, they acknowledged that their evaluation of only a few sunscreen products are a limitation on their research.

There was no funding for this study.


Prenatal Opioid Abuse

The American Academy of Pediatrics Recommends a Different Approach to Prenatal Opioid Abuse.

The number of pregnant women that abuse opioids, a type of drug that alleviates pain, has increased greatly in the past twenty years. This has resulted in more infants born with neonatal abstinence syndrome, a condition when infants have withdrawal symptoms. In 2012, every 25 minutes an infant was born in the U.S. with this syndrome.

As opioid abuse in the U.S. continues to get worse, more states have approved criminal prosecution laws against pregnant women with problems with substance abuse.

The American Academy of Pediatrics released a policy statement online Feb. 20 in Pediatrics advising a public health response instead of punishing these women.

“Pregnant women must be able to discuss their substance use openly with their medical providers without fear of punishment,” said co-author Davida M. Schiff. “Punitive policies towards pregnant women with substance use disorder are detrimental to the health of mother and baby.”

The Academy recommends measures such as substance treatment programs for pregnant women, more funding for social services and child welfare, routine screening for alcohol and drug use in women of childbearing age and opioid-replacement therapy.

“Our response should be grounded in public health,” Stephen Patrick, co-author of the report, said. ”We should be bolstering efforts targeted at primary prevention, like prescription drug-monitoring programs, and expanding treatment tailored to the specific needs of pregnant women and their families.”