你的病患正在阅读的:疫苗保存剂与自闭症风险无关


  January 10, 2008 —看一下下列研究结果,最近经常出现在新闻中、以及你的病患可能询问你的问题。
  
  疫苗保存剂与自闭症风险无关
  精神学学志,2008年1月号,纽约时报同时报导
  
  纽约时报在一篇来自相关报社的新闻故事中报导,加州的自闭症发生率在汞为基础的保存剂,硫柳汞,从儿童疫苗剂型移除后仍然继续上升;来自加州公共卫生部门的研究者发现,虽然硫柳汞在2001年后自加州几乎所有的儿童疫苗中移除,但1995年到2007年之间的自闭症发生率仍然是上升的。研究作者表示,这样的研究结果进一步地稳固了硫柳汞为基础的疫苗不太可能是造成自闭症系列异常的原因。
  
  焦虑使心肌梗塞风险上升达40%
  美国心脏医学会期刊,2008年1月15日,彭博新闻同时报导
  
  南加州大学的研究者们表示,同时由彭博新闻引用,焦虑可能增加男性急性心肌梗塞(MI)风险达40%,即使在比例风险模式下控制其它危险因子,例如年龄、教育程度、婚姻状态、空腹血糖值、身体质量指数、高密度脂蛋白浓度、与收缩压后仍然是成立的;针对735位收纳在基准老化研究中的男性所进行的一项分析,追踪这些受试者平均达12年,结果显示,即使在校正健康行为(喝酒、吸菸与热量摄取)、高血压药物、高胆固醇浓度、追踪时罹患糖尿病、以及精神疾病相关变项,包括忧郁症、A型行为、敌意、发怒与负面情绪后,焦虑与AMI之间的风险仍然是显著的。
  
  哺乳可能降低过敏风险
  小儿医学,2008年1月,WebMD同时报导
  
  WebMD在美国小儿科医学会(AAP)更新政策声明中表示,在出生后头四个月,仅接受母亲哺乳的婴儿发生过敏性疾病的风险显著较低,这些疾病包括异位性皮肤炎、气喘与食物过敏,这项研究是与出生后头两个月接受牛乳配方哺育的婴儿比较;这项来自AAP营养与过敏及免疫部门委员会的声明也指出,在针对高过敏风险婴儿的、以及未接受哺乳四至六个月婴儿的研究中,有一些证据显示,透过使用水解配方相较于由完整牛乳蛋白制成的配方,发生过敏疾病的时间可能会被延迟,尤其是异位性皮肤炎;然而,有关于延迟开始使用固体食物时间超过四至六个月、提供任何预防过敏配方的好处目前证据仍然不足。
  
  FDA研究治疗骨质疏松药物引起的疼痛
  美国食品药物管理局,2008年1月7日,经济周刊同时报导
  
  经济周刊相关报社火线故事报导,美国食品药物管理局(FDA)已经发出一项警讯,部分病患在使用双磷酸盐药物时,可能会发生严重与可能是使肌肉无力的肌肉骨骼疼痛;FDA在网站上的一项声明指出,虽然严重肌肉骨骼疼痛包含在双磷酸盐药物的处方信息中,但双磷酸盐药物与严重肌肉骨骼疼痛之间的关连可能被健康照护者所轻忽,因此造成延迟诊断、延长疼痛以及或是损伤时间,并且使得病患需要使用止痛药物。当局表示,这种疼痛与某些病患在一开始使用这些药物引起的急性期反应不同;FDA警告,健康照护专家们应该对有这些症状的病患考虑使用双磷酸盐药物是否为严重肌肉骨骼疼痛相关,且考虑是否要暂时或永久停止使用这些药物。
  
  维生素D缺乏可能伤害心脏
  循环期刊(快速发表版),2008年1月7日,WebMD同时报导
  
  WebMD在一项有关于佛明罕后代研究分析数据的新闻故事中指出,维生素D缺乏显然是罹患高血压成人发生心血管疾病的危险因子之一,在1739位平均年龄59岁且过去无心血管疾病病史的成人中,有120件未预期心脏血管事件(心肌梗塞、中风、胸痛、心脏衰竭与周边循环异常造成的间歇性跛行);25-二氢氧化维生素D浓度过低(<15 mg/ml)的病患,在一项多变项校正分析中显示,发生心血管疾病风险高出62%;在这项观察性试验中,风险显然与维生素D浓度成反比,且无法由其它危险因子,例如C反应蛋白浓度、缺乏运动或是维生素补充解释。

What Your Patients Are Reading

By Neil Osterweil
Medscape Medical News

January 10, 2008 — Take a look at the following studies, recently in the news, that your patients may ask you about.

Vaccine Preservative Not Linked to Risk for Autism
Archives of General Psychiatry, January 2008, as reported in the New York Times

The incidence of autism in California continued to rise even after the mercury-based preservative thimerosal was removed from routine childhood vaccine formulations, reports the New York Times in a story from the Associated Press. Investigators from California's Public Health Department found that although thimerosal was removed from nearly all pediatric vaccines administered in California beginning in 2001, autism rates rose steadily from 1995 to 2007. The study authors note that the findings further bolster evidence that thimerosal-based vaccines are unlikely to be a cause of autism spectrum disorders.

Anxiety Boosts MI Risk by Up to 40%
Journal of the American College of Cardiology, January 15, 2008, as reported by Bloomberg News

Anxiety may increase the risk of acute myocardial infarction (AMI) in men by up to 40%, even after controlling for risk factors such as age, education, marital status, fasting glucose levels, body mass index, high-density lipoprotein cholesterol levels, and systolic blood pressure in proportional hazards models, report University of Southern California researchers and quoted by Bloomberg News. An analysis of data on 735 men enrolled in the Normative Aging Study and followed for a mean of 12 years showed that the relationships between anxiety and AMI risk remained significant even after further adjustments for health behaviors (drinking, smoking, and caloric intake), hypertension medications, high cholesterol, diabetes during follow-up, and psychologic variables including depression, type A behavior, hostility, anger, and negative emotions.

Breast-Feeding May Lower Allergy Risk
Pediatrics, January 2008, as reported by WebMD

Infants who are breast-fed exclusively for the first 4 months of life have a significantly lower risk for atopic diseases — atopic dermatitis, asthma, and food allergy — during the first 2 months of life compared with children reared on cows' milk–based formula, notes WebMD, reporting on an American Academy of Pediatrics (AAP) updated policy statement. The statement from the AAP's Committee on Nutrition and Section on Allergy and Immunology also notes that "in studies of infants at high risk of atopy and who are not exclusively breastfed for 4 to 6 months, there is modest evidence that the onset of atopic disease may be delayed or prevented by the use of hydrolyzed formulas compared with formula made with intact cow milk protein, particularly for atopic dermatitis." There is little evidence to suggest that delaying introduction of solid foods beyond 4 to 6 months offers any atopy-prevention benefits, however.

FDA Studies Pain in Osteoporosis Drugs
US Food and Drug Administration, January 7, 2008, as reported by Business Week

The US Food and Drug Administration (FDA) has issued an alert that some patients may experience severe and possibly incapacitating musculoskeletal pain while taking bisphosphonates, notes Business Week, carrying an Associated Press wire story. "Although severe musculoskeletal pain is included in the prescribing information for all bisphosphonates, the association between bisphosphonates and severe musculoskeletal pain may be overlooked by healthcare professionals, delaying diagnosis, prolonging pain and/or impairment, and necessitating the use of analgesics," the FDA says in a statement on its Web site. The pain is separate from the acute-phase response experienced by some patients following initial administration of the drugs, the agency noted. "Healthcare professionals should consider whether bisphosphonate use might be responsible for severe musculoskeletal pain in patients who present with these symptoms and consider temporary or permanent discontinuation of the drug," the FDA cautions.

Vitamin D Deficiency May Hurt the Heart
Circulation (Rapid Access edition), January 7, 2008, as reported by WebMD

Vitamin D deficiency appears to be a risk factor for cardiovascular disease in adults with hypertension, reports WebMD in a news story about an analysis of data from the Framingham Offspring Study. Among 1739 adults with a mean age of 59 years and no prior cardiovascular disease, there were 120 incident cardiovascular events (myocardial infarction, stroke, chest pain, heart failure, and peripheral claudication). Those with low 25-dihydroxyvitamin D levels (<15 mg/mL) had a 62% higher cardiovascular disease risk in a multivariate adjusted analysis. The risk in this observational study appeared to be inversely related to vitamin D levels and could not be explained by risk factors such as C-reactive protein levels, physical activity, or vitamin supplementation.

    
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