jueves, 25 de mayo de 2017

1 in 5 U.S. Kids Killed in Crashes Not Restrained Properly: MedlinePlus Health News

1 in 5 U.S. Kids Killed in Crashes Not Restrained Properly: MedlinePlus Health News

MedlinePlus Trusted Health Information for You

1 in 5 U.S. Kids Killed in Crashes Not Restrained Properly

Finding highlights importance of car seats, seat belts for young passengers
By Robert Preidt
Wednesday, May 24, 2017
WEDNESDAY, May 24, 2017 (HealthDay News) -- If parents need more proof that car seats and seat belts save young lives, researchers now report that one in every five children killed in car crashes in the United States was unrestrained or improperly restrained.
The analysis involved nationwide data on nearly 2,900 traffic crash deaths involving children under the age of 15 between 2010 and 2014. It found that 13 percent of crash victims were inappropriately placed in the front seat.
The research team, from UT Southwestern Medical Center in Dallas and Harvard Medical School, "hypothesized that state-level policies related to child traffic safety would be associated with state mortality rates."
And while the study found that the national crash death rate was 0.94 per 100,000 children a year, there were significant regional differences, the researchers noted in a UT Southwestern news release.
The South had 1,550 deaths and a death rate of 1.34 per 100,000 children per year, while the Midwest had 585 deaths and a death rate of 0.89 per 100,000 children per year. Other regions fared better: The West had 561 deaths and a death rate of 0.76 per 100,000 children per year, while the Northeast had 189 child deaths and a death rate of 0.38 per 100,000 children per year.
States with the most deaths were: Texas (346); California (200); Florida (144); North Carolina (132); Georgia (130); and Alabama (125). States with the fewest deaths were: Rhode Island (3); Alaska (4); Delaware, New Hampshire, and Vermont (5); Maine (7); and Hawaii (9).
According to senior study author Dr. Faisal Qureshi, associate professor at UT Southwestern, and colleagues, "No prior study has examined trends in motor vehicle crash-related pediatric mortality across states and factors associated with geographic variation at the state or regional level."
The researchers explained that "this geographic variation is important because laws regarding child traffic safety remain within the state domain."
The national data also showed that nearly 9 percent of drivers were under the influence of alcohol. And vans and minivans had the fewest fatalities, followed by pickups, SUVs and cars.
Qureshi and his colleagues concluded that just a 10 percent improvement in child-restraint use in vehicles would prevent about 232 deaths a year, or more than 1,100 over five years.
The findings were published online May 23 in The Journal of Pediatrics.
SOURCE: UT Southwestern Medical Center, news release, May 23, 2017
HealthDay
News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services.
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Compound in Pot Eases Severe Form of Epilepsy: MedlinePlus Health News

Compound in Pot Eases Severe Form of Epilepsy: MedlinePlus Health News

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Compound in Pot Eases Severe Form of Epilepsy

Cannabidiol not associated with the 'high' of marijuana, researchers report
Wednesday, May 24, 2017
WEDNESDAY, May 24, 2017 (HealthDay News) -- A landmark clinical trial has shown that a compound in marijuana can ease life-threatening seizures in children with a rare and devastating form of epilepsy.
Cannabidiol -- a non-intoxicating chemical -- reduced seizure frequency by 39 percent in patients with Dravet Syndrome, researchers report.
This is the first randomized, controlled trial to show that cannabidiol (CBD) can help control seizures in some people with epilepsy, said study author Dr. Orrin Devinsky. He is director of the Comprehensive Epilepsy Center at NYU Langone Medical Center in New York City.
"It's a big landmark in the scientific study of cannabis, and it's a major landmark in epilepsy care," Devinsky said. "After four millennia of using cannabis to treat epilepsy, we now have for the first time scientifically rigorously obtained data that this specific compound works in this specific form of epilepsy."
Brandy Fureman, vice president of research and new therapies for the Epilepsy Foundation, agreed that the new trial provides "gold standard" evidence of cannabidiol's effectiveness.
"We now have strong evidence that CBD [cannabidiol] can be helpful for some people with Dravet Syndrome," Fureman said. "This trial provides important information for doctors and families who are trying to decide if CBD should be tried in their child's particular case, how it can be administered safely, and what side effects to watch out for."
The clinical trial relied on a liquid formulation of cannabidiol called Epidiolex, which was developed by British company GW Pharmaceuticals.
Epidiolex has not been approved by the U.S. Food and Drug Administration. GW Pharmaceuticals -- which paid for the clinical trial -- expects to file for FDA approval of the drug this year.
In the trial, Devinsky and his colleagues recruited 120 children and teenagers with Dravet Syndrome, which generally starts causing severe seizures within the first year of life. The seizures often are prolonged and repetitive; 1 in 5 children with Dravet Syndrome do not live to see age 20, Devinsky said.
The patients, ranging in age from 2 to 18, were randomly assigned to receive every day either 20 milligrams of liquid Epidiolex or a placebo, on top of their usual medication. The study took place across 23 sites in the United States and Europe, and lasted 14 weeks.
Children receiving Epidiolex experienced fewer seizures, going from an average of 12 convulsive seizures a month before the study to about six seizures a month. Three patients' seizures stopped entirely.
At the same time, children in the placebo group only had a slight reduction in seizures, from about 15 to 14 seizures a month.
More than 9 out of 10 children did experience side effects from treatment with Epidiolex, the researchers found. The most common side effects were vomiting, fatigue and fever.
Although these symptoms generally were mild to moderate, eight children in the Epidiolex group withdrew from the trial due to side effects, compared to one patient in the placebo group.
The study appears in the May 25 issue of the New England Journal of Medicine.
Despite the side effects, Epidiolex seems as safe as other epilepsy medications, said Dr. Samuel Berkovic, director of the University of Melbourne's Epilepsy Research Center in Australia.
"Side effects are always an issue, but the drug was tolerated about as well as conventional anti-epileptic drugs," said Berkovic, who wrote an editorial accompanying the clinical trial report.
"Like other epilepsy medications, CBD appears to work for some people and not for others," Fureman said. "Like other epilepsy treatments, there are side effects of CBD that should be considered."
Cannabidiol-based treatments are available in the 29 states that have approved medical marijuana, Devinsky said.
The problem is that these products aren't manufactured under strict FDA oversight, and might contain varying levels of cannabidiol. The products also might contain THC, the biochemical in marijuana that produces a high, Devinsky said.
"Hopefully, in the next year to two years Epidiolex would get FDA approval, and then this drug could be available in pharmacies and people could have it covered by their health insurance," Devinsky said.
"In the interim, people are getting something like this from medical dispensaries in states with legalized medical marijuana," he continued. "The question is, how different are batches to batches."
SOURCES: Orrin Devinsky, M.D., director, Comprehensive Epilepsy Center, NYU Langone Medical Center, New York City; Brandy Fureman, Ph.D., vice president, research and new therapies, Epilepsy Foundation; Samuel Berkovic, M.D., director, University of Melbourne's Epilepsy Research Center, Australia; May 25, 2017, New England Journal of Medicine
HealthDay
News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services.
More Health News on
Epilepsy
Marijuana

Levels of Evidence: Adult and Pediatric Treatment Studies (PDQ®)—Health Professional Version - National Cancer Institute

Levels of Evidence: Adult and Pediatric Treatment Studies (PDQ®)—Health Professional Version - National Cancer Institute



National Cancer Institute

Levels of Evidence for Adult and Pediatric Cancer Treatment Studies (PDQ®)–Health Professional Version





SECTIONS



Changes to This Summary (05/19/2017)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Revised text in the third type of study design to include case series or other observational study designs.
Revised text to include nonconsecutive cases or other observational study designs (e.g., cohort or case-control studies).
Revised text to state that the clinical experiences always raise issues of patient selection and comparability with other populations. In order of generalizability to other populations are population-based studies that have a definable population, nonpopulation-based but consecutive series, and nonconsecutive cases. Added that some study designs (e.g., cohort and case-control studies) have internal-control study subjects, and the strength of conclusions that can be drawn from these studies depends on the homogeneity of patients managed with the interventions. If the subjects are sufficiently comparable, stronger conclusions are possible than with case-only series with no internal comparison group or with case-only series that are compared to historical controls.
This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® - NCI's Comprehensive Cancer Database pages.
  • Updated: May 19, 2017

Genetics of Breast and Gynecologic Cancers (PDQ®)—Health Professional Version - National Cancer Institute

Genetics of Breast and Gynecologic Cancers (PDQ®)—Health Professional Version - National Cancer Institute

National Cancer Institute

Genetics of Breast and Gynecologic Cancers (PDQ®)–Health Professional Version



SECTIONS



Changes to This Summary (05/18/2017)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Added as Cybulski et al. as reference 50.
Added text to state that breastfeeding for more than 12 months may be associated with a reduction in ovarian cancer among carriers of BRCA1/BRCA2 pathogenic variants (cited Kotsopoulos et al. as reference 70).
Added text about expansion of the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm model to include additional pathogenic variants, including CHEK2ATM, and PALB2 (cited Lee et al. as reference 141).
Added text to state that a study of Ashkenazi Jewish (AJ) individuals who had comprehensive testing as their initial test or who had reflex testing ordered only if testing for the three common AJ founder pathogenic variants was negative suggests that the true incidence of nonfounder pathogenic variants is closer to 7% (cited Rosenthal et al. as reference 52).
Added text about results of 286 TP53 pathogenic variant–positive individuals in the National Cancer Institute’s Li-Fraumeni Syndrome Study that indicated a cumulative cancer incidence of almost 100% by age 70 years for both males and females (cited Mai et al. as reference 358).
Added Snyder et al., Nguyen-Dumont et al., and Damiola et al. as references 425, 426, and 427 respectively.
Added text to state that the timing of genetic testing and knowledge of BRCA pathogenic variant status may influence surgical decision making and may prevent subsequent surgeries. Therefore, it is important to consider genetic testing in advance of surgery when possible in individuals at increased risk of carrying a BRCA pathogenic variant (cited Chiba et al. as reference 56).
Added text about a study that confirmed the malignant potential of serous tubal intraepithelial carcinoma (STIC) lesions. While 3 of 243 women with benign pathology at risk-reducing salpingo-oophorectomy subsequently developed primary peritoneal carcinoma, 2 of 9 women with STIC developed high-grade pelvic serous carcinoma after a median follow-up time of 63 months (cited Zakhour et al. as reference 199).
Added text about a case-control study of women with pathogenic variants in BRCA1 that demonstrated maximum benefit after 5 years of oral contraceptive (OC) use, while women with pathogenic variants in BRCA2 seemed to reach maximum benefit after 3 years of OC use (cited Kotsopoulos et al. as reference 227).
Revised text to state that formal, objective evaluation of emotional outcomes in recipients of genetic counseling are well documented.
Added text about a study conducted in Austria that noted that certain subgroups of counselees experienced greater distress, including those who were older, had a more recent cancer diagnosis, or those who had received counseling but declined BRCA testing (cited Oberguggenberger et al. as reference 106).
This summary is written and maintained by the PDQ Cancer Genetics Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® - NCI's Comprehensive Cancer Database pages.
  • Updated: May 18, 2017