More people beating skin cancer - UK report

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Main Category: Melanoma / Skin Cancer
Also Included In: Cancer / Oncology
Article Date: 25 Jul 2013 - 3:00 PDT Current ratings for:
More people beating skin cancer - UK report

Cancer Research UK says more and more people are surviving malignant melanoma, the most dangerous form of skin cancer. Their latest statistics, published online this week, reveal that more than 8 in 10 people diagnosed with malignant melanoma will now survive the disease. Forty years ago, the survival rate was only around 5 in 10.

The charity says the improvement is most likely due to better treatments and earlier diagnosis, and also because people are more aware of the symptoms.

The report shows that 80% of men and 90% of women live more than ten years after being diagnosed with malignant melanoma compared with only 38% of men and 58% of women in the early 70s.

In the UK every day, around 35 people discover they have malignant melanoma, totalling nearly 13,000 new cases a year.

Professor Richard Marais, director of the Cancer Research UK Paterson Institute for Cancer Research at the University of Manchester, says in a statement that much of the huge progress in the fight against skin cancer is down to the generosity of supporters who have funded research that increases understanding of the disease and finds new ways to beat it. He says:

"More and more people are beating skin cancer but we can't stop there and we need to develop better treatments for the 2 out of 10 where things don't look so good."

There are now some very effective new drugs, such as vemurafenib, which was developed with the help of research funded by the charity.

"Although these drugs do not cure skin cancers, they can give patients with advanced melanoma valuable extra months and show the progress we are making," Marais adds.

Skin cancer is one of the fastest rising cancers in the UK, which the charity says is likely due to more Britons sunbathing than before, and the rise of cheap package holidays in earlier decades.

Treatment for skin cancer is more likely to succeed the earlier the disease is detected.

The key to early diagnosis, says Dr. Harpal Kumar, Cancer Research UK's chief executive, is to get to know your skin, notice anything unusual, such as a change to a mole or a blemish that hasn't healed after a few weeks, and see your doctor.

One area that has seen enormous progress in research on melanoma is genetics.

Melanoma is really an umbrella term for the most virulent types of skin cancer. It is a highly complex disease from a genetic point of view: melanoma tumors have more mutations per cell than any other type of cancer.

An example of how scientists are investigating the genetics of melanoma is following up on the knowledge that ultraviolet light from the sun damages DNA, which increases the chance of normal skin cells becoming cancerous.

Scientists can use the information gained from studying how UV light damages DNA to develop new treatments.

One study by Cancer Research UK, which is looking at genetic changes that cause skin cancer, is collecting samples of tissue and blood from people diagnosed with melanoma and non-melanoma skin cancer of the head and neck.

The researchers are examining the samples to find genetic changes that may be responsible for the cancer and to discover how the immune system reacts to the cancer.

In another piece of research, scientists have discovered that people who have inherited a faulty gene called p16 or CDKN2A have a higher risk for developing melanoma than people who do not have the faulty gene.

They are now running a long-term study to find out how genes and environment affect risk of developing melanoma.

Fortunately thanks to new tools like DNA sequencing, scientists are able to sort through huge volumes of data to decode each melanoma tumor's genetic "fingerprint."

For example, Prof. Marais was the lead author on another Cancer Research UK study that recently revealed how DNA sequencing helped the team find possible new treatment targets for a rare form of cancer known as mucosal melanoma.

The list of known gene flaws that cause melanoma is growing. This opens doors to new drugs that can target the effect of these faulty genes by blocking the signalling pathways that cause cells to malfunction and make tumors grow and spread.

There are currently about 100 new drugs being developed to treat melanoma, and new combinations of drugs show promise as treatments that block these tumor-causing signalling pathways.

In a recent journal report, Brian Nickoloff, director of a dermatology and cutaneous sciences division at Michigan State University's College of Human Medicine in the US, and colleagues outline recent advances that have put melanoma at the forefront of cancer research.

Nickoloff says he has been working in this field for 30 years, and "now is by any measure the most exciting time for melanoma research."

"In the past melanoma outsmarted us, but now we're starting to outsmart melanoma," he adds.

For more information on the latest melanoma research see the Cancer Research UK web page.

Written by Catharine Paddock PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today Visit our melanoma / skin cancer section for the latest news on this subject. "Cancer Statistics Report: Skin Cancer"; Cancer Research UK, July 2013; Link to Report (pdf). Additional source: Cancer Research UK Press Release. Please use one of the following formats to cite this article in your essay, paper or report:

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Fullest clinical report of Saudi MERS cases to date points to important differences with SARS

Main Category: Infectious Diseases / Bacteria / Viruses
Also Included In: Flu / Cold / SARS
Article Date: 26 Jul 2013 - 2:00 PDT Current ratings for:
Fullest clinical report of Saudi MERS cases to date points to important differences with SARS

Saudi and UK scientists provide the most detailed picture yet of the clinical and laboratory characteristics of Middle East Respiratory Syndrome (MERS) coronavirus, revealing a wide range of clinical symptoms and an extremely high death rate among patients with co-existing medical conditions.

The new research, published in The Lancet Infectious Diseases, also reveals some important differences with severe acute respiratory syndrome (SARS).

MERS emerged a year ago in Saudi Arabia and almost all those infected have been reported there, or have been linked to people who contracted the virus there.

The new analysis, the largest case series to date, includes 47 cases (46 adults, 1 child) of confirmed MERS infections from Saudi Arabia between Sept 1, 2012, and June 15, 2013.

By combining clinical records, laboratory results, and imaging findings with demographic data, the authors noted a trend of older patients, more men, and patients with underlying medical conditions who succumb to the disease.

As with SARS, MERS infections presented with a wide spectrum of symptoms. Most patients admitted to hospital exhibited fever (98%), chills/rigors (87%), cough (83%), shortness of breath (72%), and muscle pain (32%). A quarter of patients also experienced gastrointestinal symptoms, including diarrhoea and vomiting.

However, in contrast to SARS, the majority of cases (96%) occurred in people with underlying chronic medical conditions including diabetes (68%), high blood pressure (34%), chronic heart disease (28%), and chronic renal disease (49%).

"Despite sharing some clinical similarities with SARS (eg, fever, cough, incubation period), there are also some important differences such as the rapid progression to respiratory failure, up to 5 days earlier than SARS"*, explains Professor Ziad Memish, the Deputy Minister for Public Health from the Kingdom of Saudi Arabia, who led the research.

"In contrast to SARS, which was much more infectious especially in healthcare settings and affected the healthier and the younger age group, MERS appears to be more deadly with 60% of patients with co-existing chronic illnesses dying, compared with the 1-2% toll of SARS. Although this high mortality rate with MERS is probably spurious due to the fact that we are only picking up severe cases and missing a significant number of milder or asymptomatic cases, so far there is little to indicate that MERS will follow a similar path to SARS."*

According to co-author Professor Ali Zumla from University College London, "The recent identification of milder or asymptomatic cases of MERS in health care workers, children, and family members of contacts of MERS cases indicates that we are only reporting the tip of the iceberg of severe cases and there is a spectrum of milder clinical disease which requires urgent definition. Ultimately the key will be to identify the source of MERS infection, predisposing factors for susceptibility to infection, and the predictive factors for poor outcome. Meanwhile infection control measures within hospitals seem to work."*

Writing in a linked Comment, Professor Christian Drosten from the University of Bonn Medical Centre in Germany points to the urgent need for accurate diagnostic tests to help focus control efforts and minimise the risk of spread to others, "To ascertain relevant data for MERS epidemiology, we need to develop serological assays using samples from well defined groups of patients, such as described here. Population-based antibody testing could establish the extent of MERS-CoV infection, instead of only seeing the tip of the iceberg represented by cases admitted, such as those summarised in this important paper."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our infectious diseases / bacteria / viruses section for the latest news on this subject.

*Quotes direct from authors and cannot be found in text of Article.

The Lancet

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New IOM Report: Medicare spending rates based on regional cost variations unlikely to improve health care

Main Category: Medicare / Medicaid / SCHIP
Article Date: 26 Jul 2013 - 1:00 PDT Current ratings for:
New IOM Report: Medicare spending rates based on regional cost variations unlikely to improve health care

A "geographic value index" that would tie Medicare payment rates to the health benefits and costs of health services in particular regions of the country should not be adopted by Congress, says a new congressionally mandated report from the Institute of Medicine. The committee that wrote the report concluded that decisions about health care generally are made at the level of the physician or organization, such as a hospital, not at the regional level. Because individual physician performance varies, sometimes even within a single practice group, an index based on regions is unlikely to encourage more efficient behavior among individual providers, and therefore, is unlikely to improve the overall value of health care. The new report reiterates the findings of the committee's interim report released in March 2013.

Variation in Medicare spending across geographic areas is driven largely by differences in the use of post-acute care, which includes home health services, skilled nursing facilities, rehabilitation facilities, long-term care hospitals, and hospices, the committee said. If regional variation in post-acute care spending did not exist, Medicare spending variation would fall by 73 percent, and it would fall by 89 percent if there was no variation in both acute and post-acute care. However, an overall explanation for geographic variation in spending remains elusive. The statistical analyses that the committee examined accounted for factors such as beneficiary health status and demographics, insurance plans, and factors related to health care markets, but much of the variation could not be explained by such factors.

The committee also examined the differences in spending at a variety of levels progressively smaller than geographic regions, such as hospital referral regions, hospital service areas, hospitals, and individual providers. Spending varies greatly across all these levels, and providers even at a small level do not practice the same way or perform similarly. Consequently, a geographic value index would reward low-value providers for practicing in areas that are on average high-value and punish high-value providers in low-value regions. As a result, area-level performance calculations would likely mischaracterize the actual value of services delivered by many providers and hospitals, resulting in unfair payments and inappropriate incentives.

The committee found that in contrast to Medicare, variations in spending in the commercial insurance market are due mainly to differences in price markups by providers rather than differences in the use of health care services. Medicare spending is weakly correlated with commercial insurance across regions, and total spending by all payers in a region is not strongly correlated with either Medicare spending or spending by commercial insurers.

To improve care, payment reforms need to create incentives for behavioral change by decision makers, whether they are at the level of individual providers, hospitals, health care systems, or stakeholder collaboratives. The committee recommended that the Centers for Medicare & Medicaid Services (CMS) continue to test Medicare payment reforms that incentivize the clinical and financial integration of health care delivery systems to encourage coordination of care among individual providers, real-time sharing of data and tracking of service use and health outcomes, receipt and distribution of provider payments, and assumption of risk managing their populations' care continuum. CMS should also evaluate the effects of test payment reforms on health care quality by measuring Medicare spending and beneficiaries' clinical health outcomes and use the results to improve the payment models. If these evaluations demonstrate increased quality, Congress should give CMS the flexibility to accelerate the adoption of the new Medicare payment models.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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New IOM Report: Medicare spending rates based on regional cost variations unlikely to improve health care

Main Category: Medicare / Medicaid / SCHIP
Article Date: 26 Jul 2013 - 1:00 PDT Current ratings for:
New IOM Report: Medicare spending rates based on regional cost variations unlikely to improve health care

A "geographic value index" that would tie Medicare payment rates to the health benefits and costs of health services in particular regions of the country should not be adopted by Congress, says a new congressionally mandated report from the Institute of Medicine. The committee that wrote the report concluded that decisions about health care generally are made at the level of the physician or organization, such as a hospital, not at the regional level. Because individual physician performance varies, sometimes even within a single practice group, an index based on regions is unlikely to encourage more efficient behavior among individual providers, and therefore, is unlikely to improve the overall value of health care. The new report reiterates the findings of the committee's interim report released in March 2013.

Variation in Medicare spending across geographic areas is driven largely by differences in the use of post-acute care, which includes home health services, skilled nursing facilities, rehabilitation facilities, long-term care hospitals, and hospices, the committee said. If regional variation in post-acute care spending did not exist, Medicare spending variation would fall by 73 percent, and it would fall by 89 percent if there was no variation in both acute and post-acute care. However, an overall explanation for geographic variation in spending remains elusive. The statistical analyses that the committee examined accounted for factors such as beneficiary health status and demographics, insurance plans, and factors related to health care markets, but much of the variation could not be explained by such factors.

The committee also examined the differences in spending at a variety of levels progressively smaller than geographic regions, such as hospital referral regions, hospital service areas, hospitals, and individual providers. Spending varies greatly across all these levels, and providers even at a small level do not practice the same way or perform similarly. Consequently, a geographic value index would reward low-value providers for practicing in areas that are on average high-value and punish high-value providers in low-value regions. As a result, area-level performance calculations would likely mischaracterize the actual value of services delivered by many providers and hospitals, resulting in unfair payments and inappropriate incentives.

The committee found that in contrast to Medicare, variations in spending in the commercial insurance market are due mainly to differences in price markups by providers rather than differences in the use of health care services. Medicare spending is weakly correlated with commercial insurance across regions, and total spending by all payers in a region is not strongly correlated with either Medicare spending or spending by commercial insurers.

To improve care, payment reforms need to create incentives for behavioral change by decision makers, whether they are at the level of individual providers, hospitals, health care systems, or stakeholder collaboratives. The committee recommended that the Centers for Medicare & Medicaid Services (CMS) continue to test Medicare payment reforms that incentivize the clinical and financial integration of health care delivery systems to encourage coordination of care among individual providers, real-time sharing of data and tracking of service use and health outcomes, receipt and distribution of provider payments, and assumption of risk managing their populations' care continuum. CMS should also evaluate the effects of test payment reforms on health care quality by measuring Medicare spending and beneficiaries' clinical health outcomes and use the results to improve the payment models. If these evaluations demonstrate increased quality, Congress should give CMS the flexibility to accelerate the adoption of the new Medicare payment models.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our medicare / medicaid / schip section for the latest news on this subject. Please use one of the following formats to cite this article in your essay, paper or report:

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OPP launches MBTI report for healthcare professionals, UK

Main Category: Primary Care / General Practice
Article Date: 24 Jul 2013 - 2:00 PDT Current ratings for:
OPP launches MBTI report for healthcare professionals, UK

Leading workplace psychologists, OPP, have launched a dedicated personality report for those working on the frontline of healthcare. The Myers-Briggs Report for Healthcare Professionals applies Myers-Briggs Type Indicator (MBTI) insights to help doctors, nurses, healthcare assistants and other clinical staff foster a more mutually rewarding patient-centred service.

Written specifically for healthcare professionals, the report highlights the impact of personality preference on style of care; provides actionable insight and suggestions for flexing care style; and explains why misunderstandings and conflicts may arise when giving care. As a result, the report can help anyone involved in patient care to:

keep patients better informedshow patients that they are listening to themcreate a supportive environmenthelp patients manage the side effects of treatmentsupport post-care transition.

The report also describes the impact of work stress as it affects care style, and provides tangible advice for building resilience.

Robert McHenry, OPP's Chairman, commented: "The fact that the NHS is once again coming under close public scrutiny over care standards, suggests that there is a real need for interventions based on this MBTI report. The MBTI framework deserves its global reputation for helping individuals and organisations become more productive. The Myers-Briggs Report for Healthcare Professionals is unique in the marketplace; it can absolutely enable healthcare professionals to improve their own job performance and their interactions with patients.

"We have heard in the news that there is often a lack of focus within the NHS on engaging patients in their own clinical care, despite strong evidence that this can make a real difference to treatment outcomes. By raising awareness of personality differences, use of this report will help front-line staff improve the quality of care experienced by patients, reduce the impact of work stress, and increase patient satisfaction."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our primary care / general practice section for the latest news on this subject.

The Myers-Briggs Report for Healthcare Professionals can be generated from MBTI Step I or Step II questionnaires and can be administered by qualified MBTI practitioners.

For more information visit http://www.opp.com/hcr

OPP

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When to order vascular laboratory tests: New report helps clinicians decide

Main Category: Vascular
Article Date: 24 Jul 2013 - 0:00 PDT Current ratings for:
When to order vascular laboratory tests: New report helps clinicians decide

A new report issued by the American College of Cardiology (ACC) and developed in collaboration with 10 other leading professional societies provides detailed criteria to help clinicians optimize the appropriate use of certain noninvasive vascular tests when caring for patients with known or suspected disorders of the venous (veins) system. Also included are first-time recommendations for when and how to use these tests to plan for or evaluate dialysis access placement.

"Vascular lab testing is central to the care of patients with most peripheral vascular disorders, but appropriate use criteria for these [technologies] have lagged behind those for cardiac testing," said Heather Gornik, MD, FACC, cardiologist and vascular medicine specialist at the Cleveland Clinic and chair of the writing committee. "With this report, we now have multidisciplinary criteria upon which we can start maximizing the quality and appropriateness of what we do in the vascular lab every day."

Vascular testing is often used to help evaluate possible venous thromboembolism, which is the third most common cardiovascular disease, after coronary disease and stroke, and includes deep vein thrombosis (DVT) as well as pulmonary embolism (PE). These conditions can be fatal and result in hospitalizations and long-term complications. Therefore, identifying the best methods for detecting clots in the veins early on can be lifesaving, Dr. Gornik said. "But we must know that we are ordering the right test for the right reasons," she added.

The new report offers comprehensive, at-a-glance guidance on when - and when not - to refer patients for vascular laboratory testing (for example, duplex ultrasound and physiological testing using blood flow sensors) to help detect such problems as venous insufficiency, varicose veins, blood clots in the veins the leg, arm or abdomen, and pulmonary embolism. These criteria are a follow-up to the group's previously issued guidance evaluating the use of the vascular laboratory for diagnosing and monitoring the arterial side of the circulatory system.

To develop the criteria, a diverse writing group including representatives from vascular medicine, cardiology, interventional radiology, orthopedic and vascular surgery identified 116 clinical scenarios when the use of vascular testing might be considered. A separate group of experts then used a rating scale to determine whether vascular testing for each circumstance would be appropriate, possibly appropriate or rarely appropriate.

Overall, vascular studies were deemed appropriate when clinical signs and symptoms are the main reason for testing. For example, if a patient has swelling, discoloration or pain in one leg, experts agree that it is reasonable to order a duplex ultrasound evaluation of the legs to determine whether there might be a DVT or clot. In contrast, it is rarely appropriate to use these tests to screen for DVT in patients without symptoms - even in those who are more prone to clotting or who have had an extended intensive care unit or hospital stay, recent (major) orthopedic surgery or a positive D-dimer blood test.

"Vascular ultrasound is now the best, most accurate test we have for diagnosing DVT and it has clear advantages, including its low risk to the patient with no exposure to radiation or contrast dye and the fact that it is less expensive relative to other tests," Dr. Gornik said. "But a lot of screening ultrasounds are done indiscriminately for asymptomatic patients, and we found there is little evidence to support that practice."

The report also shows the vascular lab plays a central role in evaluating patients with chronic venous insufficiency, a condition in which blood pools in the veins of the legs and causes swelling, non-healing ulcers and worsening varicose veins. This condition can seriously affect a person's quality of life and mobility. The writing committee also rated pre-operative vascular testing for preparing a dialysis access site as appropriate as long as it was done within three months of the procedure; however, vascular testing was rarely appropriate for general surveillance of a functional dialysis fistula or graft unless there is some indication of a problem (e.g., palpable mass or arm swelling, low volume flow during dialysis sessions).

Unlike with arterial disease - for example, for follow-up of small aortic aneurysms or narrowing or blockages of the carotid artery - there are far fewer clinical scenarios in which vascular testing is deemed useful for repeat monitoring of venous disease, and further research is needed.

"There is also growing need for comparative and cost-effectiveness research of vascular laboratory testing in the care and diagnosis of patients with deep vein thrombosis and pulmonary embolism," Dr. Gornik said. "There are also a number of controversial areas that have not yet been fully explored, which we have outlined."

One example is whether patients with blood clots in their calf should be treated with blood thinning medication versus duplex ultrasound surveillance. Another area requiring more research is how ultrasound of the veins in the legs and arms can be used as part of clinical algorithms to diagnose and manage PE (blood clots in the lungs). Similarly, the role of duplex ultrasound for follow-up after venous procedures (e.g., venous stenting procedures) or to assess dialysis access maturity is not as well established.

These appropriate use criteria were developed in collaboration with the American College of Radiology, American Institute of Ultrasound in Medicine, American Society of Echocardiography, American Society of Nephrology, Intersocietal Accreditation Commission, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Interventional Radiology, Society for Vascular Medicine, and Society for Vascular Surgery. The authors stress these criteria should not supersede sound clinical judgment for individual patients.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our vascular section for the latest news on this subject.

The full text of the report, "2013 Appropriate Use Criteria for Peripheral Vascular Ultrasound and Physiological Testing Part II: Testing for Venous Disease and Evaluation of Hemodialysis Access," is published online and in the Aug. 13, 2013, issue of the Journal of the American College of Cardiology.

American College of Cardiology

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New report warns of conflict threatening global nutrition progress

Main Category: Nutrition / Diet
Also Included In: Pediatrics / Children's Health;  Public Health
Article Date: 19 Jul 2013 - 1:00 PDT Current ratings for:
New report warns of conflict threatening global nutrition progress

Major progress in tackling child undernutrition in some of the world's toughest countries is under threat as military and security funding takes precedence, a new report from aid agency World Vision warns.

The number of children under five who die every year has decreased by half since 1990. Yet, World Vision's Fragile but not Helpless report (PDF) finds that this progress is under threat. Countries marred by conflict or fragility have some of the highest rates of acute and chronic undernutrition in the world.

In Africa alone it is on average 50 percent higher in fragile countries than in more stable ones.

"Striving for peace is vital - but that shouldn't mean pooling all our resources into security and sidelining basic needs like nutrition. Undernutrition kills many more children than conflict, and we need to do a better job of getting the balance right between the security needs of fragile states and the nutrition needs of fragile infants in a tight fiscal environment. When the proposed increase in defense spending by both Congress and the Administration is about double the size of the total amount the U.S.

Government spends on international humanitarian assistance, the balance can be improved within existing resources, it just requires political will and focus," said Robert Zachritz, senior director of Government Relations and Advocacy at World Vision.

Though in many cases child undernutrition is well above acceptable thresholds, nearly two-thirds of fragile and conflict-affected states have not joined up to the global movement to tackle nutrition, known as Scaling Up Nutrition (SUN).

Undernutrition contributes to the deaths of more than two million children every year. Globally, 165 million children, or one in four of all children under five, are stunted due to undernutrition, chronically undernourished and at risk of long-lasting damage to their cognitive and physical development.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our nutrition / diet section for the latest news on this subject.

A link to the full report is available here.

World Vision

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WHO Report Demonstrates Need For Higher Tobacco Taxes

Main Category: Smoking / Quit Smoking
Article Date: 12 Jul 2013 - 2:00 PDT Current ratings for:
WHO Report Demonstrates Need For Higher Tobacco Taxes

A report released by the World Health Organization concludes that tax and price measures are the "least-achieved" of a global menu of regulations to combat the growing tobacco epidemic, in spite of overwhelming evidence that higher tobacco taxes are the most effective means to lower tobacco consumption and deter children from taking up the habit.

The WHO Report on the Global Tobacco Epidemic tracks global progress of the world's first public health treaty, the Framework Convention on Tobacco Control (FCTC). Without strong action, tobacco is expected to take 1 billion lives this century, 10 times the toll of the 20th century. In response, the FCTC came into force in 2005, and has been joined by 176 countries, representing nearly 90% of the world's population. The U.S. has signed but not ratified the FCTC.

"The first phase of a global response to the tobacco epidemic has been a success," said Laurent Huber, Executive Director of Action on Smoking and Health, an anti-tobacco organization founded in 1967. "The FCTC is one of the most rapidly-embraced treaties in history. Now we must work to implement it."

The WHO report focuses on six key aspects of the FCTC, and notes important progress among some countries. However, very few nations have fully embraced all of the measures necessary to stem the tide of the tobacco epidemic, which currently kills 6 million people per year and is increasing rapidly in the developing world.

"Taxation is the single most effective way to curb tobacco use," said Huber. "The tobacco industry has been successful in claiming that increasing taxes will bring economic chaos to national treasuries, in spite of the fact that there is a long track record demonstrating that increased taxes always lead to increased government revenue."

Tobacco taxes make it more difficult for children to get cigarettes, cause smokers to decrease consumption, and inspire many to quit for good. New taxes can further benefit public health if some of the additional funds are used for tobacco control education, enforcement and other measures. Studies have shown that a 10% increase in cigarette taxes leads to a 4% reduction in consumption, and a 7% reduction among children, especially in low- and middle-income countries.

In the U.S., tobacco taxes have helped lead to dramatic declines in cigarette smoking; in some states, the percentage of smokers was cut by more than half. Financially, tobacco use still costs the U.S. nearly $200 billion a year in health and other direct costs.

Article adapted by Medical News Today from original press release. Source: Action on Smoking and Health (ASH)
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American Heart Association Rapid Access Journal Report On Statin Use And Side Effects

Main Category: Statins
Also Included In: Cholesterol
Article Date: 11 Jul 2013 - 0:00 PDT Current ratings for:
American Heart Association Rapid Access Journal Report On Statin Use And Side Effects

Statins - the popular class of cholesterol-lowering drugs used widely to prevent recurrent heart disease or stroke as well as risk for having a first cardiac or stroke event - appear to cause few side effects, according to new research reported in Circulation: Cardiovascular Quality and Outcomes.

Researchers conducted the largest meta-analysis on statin side effects to date, reviewing data from 135 previous drug studies to evaluate the safety of the seven statins on the market. They concluded "as a class, adverse events associated with statin therapy are not common."

Researchers noted that simvastatin and pravastatin, the generic names of the brands Zocor and Pravachol, were found to have the best safety profile in the class. This is particularly true when patients were prescribed low to moderate doses of those statins, said Huseyin Naci, M.H.S., the study's lead author and a doctoral candidate at the London School of Economics and Political Science and research fellow at Harvard Medical School's Department of Population Medicine.

Researchers also noted a 9 percent increased risk of diabetes among statin users. But according to a previous landmark study, 250 patients need to be treated with a statin for one case of diabetes to be diagnosed.

"I am concerned that patients may misunderstand this small increase in risk and stop adhering to their medications," Naci said. The proven ability of statins to significantly cut the rate of death and hospitalization in patients who have heart disease outweighs the "small increase in diabetes risk," he said.

Researchers reviewed trials published between 1985 and early 2013, which included almost 250,000 patients. On average, the trials lasted a bit longer than a year. Some compared one statin to another, while others compared a statin to an inactive placebo, which is often called a sugar pill or dummy pill.

The study also found that statins were not linked to an increase in cancer risk. However, the drugs were associated with a typically reversible increase in liver enzymes, which Naci said still resulted in a very low rate of actual liver toxicity in statin patients.

"Although the benefits of statins clearly outweigh risks at the population level, individualizing such benefits and risks is more difficult," he said. "This brings into sharp focus the importance of identifying the individuals who stand to benefit the most from statin therapy.

Although the risk of developing diabetes is low, what this risk would amount to over time is simply not known based on the existing evidence," Naci said.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our statins section for the latest news on this subject.

Co-authors are Jasper Brugts, M.D., Ph.D., M.Sc.; and Professor Tony Ades, Ph.D. Author disclosures are on the manuscript. The study, which was conducted at the London School of Economics and Political Science, received no funding.

American Heart Association

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