Archive for December 2014

Cytisine was superior to nicotine-replacement therapy for smoking cessation

http://www.nejm.org/doi/full/10.1056/NEJMoa1407764#t=abstract

Obesity, diabetes, and the moving targets of healthy-years estimation

Many studies have attempted to quantify the effect of obesity on death, fueling a sustained controversy about which levels of bodyweight can harm health.¹ However, many investigators have argued that life expectancy does not capture the essence of the damage that obesity causes across a lifetime and that better long-term metrics are needed to convey risk, judge interventions, and motivate behaviour.² In The Lancet Diabetes & Endocrinology, Steven Grover and colleagues³ model the effect of diabetes and cardiovascular disease in people who are overweight or obese and show what is intuitively known, but not often quantified, about obesity—that its effect on the number of number of healthy-years lost is far greater than its effect on total years of life.

Sleep-Disordered Breathing, Sleep Duration, and Childhood Overweight:
A Longitudinal Cohort Study

Karen Bonuck, PhD1
, Ronald D. Chervin, MD, MS2
, and Laura D. Howe, PhD3,4
Objectives To examine independent associations between sleep-disordered breathing (SDB), sleep duration
from birth through 6.75 years, and body mass index (BMI) through 15 years of age in a population-based cohort.
Study design The Avon Longitudinal Study of Parents and Children collected parent questionnaire data on child
sleep duration and SDB symptoms from birth through 6.75 years and child BMI from the Avon Longitudinal Study of
Parents and Children research clinics (n = 1899). For SDB, logistic regression models—minimal, confounder, and
confounder + sleep duration adjusted—examined associations with BMI at 7, 10, and 15 years of age. For short sleep
duration (#10th percentile), comparable SDB-adjusted models examined associations with BMI at 15 years of age.
Results Children with the worst SDB symptoms vs asymptomatic children, had increased odds of overweight at 7
(OR = 2.08, 95% CI = 1.04-4.17), 10 (OR = 1.79, 95% CI = 1.02-3.16), and 15 years of age (OR = 2.25, 95% CI = 1.27-
3.97) in models adjusted for sleep duration. Similarly, short sleep duration at z5-6 years was associated with
overweight at 15 years, independent of SDB. Children with short sleep duration at 4.75 years were more likely to
be overweight at 15 years in minimally (OR = 2.21, 95% CI = 1.52-3.20), confounder (OR = 1.99, 95% CI = 1.34-
2.96), and SDB-adjusted (OR = 2.04, 95% CI = 1.36-3.04) models.
Conclusions Both SDB and short sleep duration significantly and independently increase children’s odds of
becoming overweight. Findings underscore the potential importance of early identification and remediation of
SDB, along with insufficient sleep, as strategies for reducing childhood obesity. (J Pediatr 2014;-:—).

Take home message:

Make sure your child is sleeping enough hours and if they have sleep apnea make sure it is treated immediately.

DC is reminding clinicians of the benefits of influenza antiviral medications and urging continued influenza vaccination of unvaccinated patients this influenza season.

Summary

Influenza activity is currently low in the United States as a whole, but is increasing in some parts of the country. This season, influenza A (H3N2) viruses have been reported most frequently and have been detected in almost all states.

During past seasons when influenza A (H3N2) viruses have predominated, higher overall and age-specific hospitalization rates and more mortality have been observed, especially among older people, very young children, and persons with certain chronic medical conditions compared with seasons during which influenza A (H1N1) or influenza B viruses have predominated.

The cigarette smoking rate among adults in the U.S. dropped from 20.9 percent in 2005 to 17.8 percent in 2013, according to new data published by the Centers for Disease Control and Prevention in today’s Morbidity and Mortality Weekly Report (MMWR).

That is the lowest prevalence of adult smoking since the CDC’s National Health Interview Survey (NHIS) began keeping such records in 1965. The report also shows the number of cigarette smokers dropped from 45.1 million in 2005 to 42.1 million in 2013, despite the increasing population in the U.S.