RoACTEMRA Approved In Europe To Treat Patients Suffering From Rheumatoid Arthritis
First in class therapy offers new treatment option to patients with moderate to severe form of the disease
Roche today announced that the European Commission has approved RoACTEMRA (tocilizumab, known as Actemra outside of the EU), to treat patients with rheumatoid arthritis (RA). RoACTEMRA, in combination with methotrexate (MTX), is indicated for the treatment of adult patients with moderate to severe RA who have either responded inadequately to, or who were intolerant to, previous therapy with one or more disease modifying anti-rheumatic drugs (DMARDs) or tumour necrosis factor (TNF) antagonists. In these patients, RoACTEMRA can be given as monotherapy in cases of intolerance to methotrexate (MTX) or where continued treatment with MTX is inappropriate. RoACTEMRA is the first interleukin-6 (IL-6) receptor-inhibiting monoclonal antibody developed for the treatment of RA and is a novel approach to help tackle this debilitating disease.
RA is a chronic, progressive inflammatory disease of the joints and surrounding tissues that is associated with intense pain, irreversible joint destruction and systemic complications such as fatigue and anemia. There are several key cytokines, or proteins, involved in the inflammatory process including tumor necrosis factor (TNF) alpha, interleukin-1 (IL-1) and interleukin-6 (IL-6). IL-6 has been identified as having a pivotal role in the inflammation process. The exact cause of RA is unknown and there is no cure currently available.
“Many patients suffering from rheumatoid arthritis fail to respond to any treatment and few actually achieve lasting remission, which is currently the ultimate goal of treatment for RA. The approval of RoACTEMRA offers new hope for patients suffering from the debilitating effects of rheumatoid arthritis” said William M. Burns, CEO of Roche’s Pharmaceuticals Division. “Roche will work with the authorities in EU member countries to ensure that this groundbreaking therapy will be available to patients as quickly as possible.”
The European Commission’s approval for RoACTEMRA was based on results from the largest clinical program undertaken by a biologic in RA including, five multi-national Phase III studies which demonstrated that treatment with RoACTEMRA alone or combination with MTX or other DMARDs significantly reduced RA signs and symptoms, compared with current DMARDs alone. These benefits were regardless of previous therapy or disease severity.
The approval in the EU follows earlier approvals for the product in several countries, including Japan, India and Switzerland.
About ACTEMRA/RoACTEMRA
RoACTEMRA is the result of research collaboration by Chugai and is being co-developed globally with Chugai. RoACTEMRA is the first humanized IL-6 receptor-inhibiting monoclonal antibody. In Japan, ACTEMRA was launched by Chugai in June 2005 as a therapy for Castleman’s disease; in April 2008, additional indications for RA, polyarticular-course juvenile idiopathic arthritis and systemic-onset juvenile idiopathic arthritis were also approved in Japan.
RoACTEMRA is generally well tolerated. The overall safety profile of RoACTEMRA is consistent across all global clinical studies. The serious adverse reactions reported in RoACTEMRA clinical studies include serious infections, gastrointestinal perforations and hypersensitivity reactions including anaphylaxis. The most common adverse reactions reported in clinical studies were upper respiratory tract infection, nasopharyngitis, headache, hypertension and increased ALT. Increases in liver enzymes (ALT and AST) were seen in patients; these increases were generally mild and reversible, with no evidence of hepatic injuries. Laboratory changes, including increases in lipids (total cholesterol, LDL, HDL, triglycerides) and decreases in neutrophils and platelets, were seen in patients without association with clinical outcomes. Treatments that suppress the immune system, such as RoACTEMRA, may cause an increase in the risk of malignancies.
About Roche in rheumatoid arthritis
One of the most important drivers for growth at Roche over the next few years is expected to be the company’s emerging franchise in autoimmune diseases with RA as the first indication. Following the launch of MabThera (rituximab) there are a number of projects in development, potentially allowing Roche to build on further opportunities. MabThera is the first and only selective B-cell therapy for RA, providing a fundamentally different treatment approach by targeting B cells, one of the key players in the pathogenesis of RA. ACTEMRA/RoACTEMRA is Roche’s second novel medicine and is a humanised monoclonal antibody to the IL-6 receptor, inhibiting the activity of IL-6 , a protein that plays a major role in the RA inflammation process. Additional projects creating a rich pipeline include compounds in Phase I, II and III clinical trials. Notably, ocrelizumab, a humanised anti-CD20 antibody, has entered phase III development for RA.
About Roche
Headquartered in Basel, Switzerland, Roche is one of the world’s leading research-focused healthcare groups in the fields of pharmaceuticals and diagnostics. As the world’s biggest biotech company and an innovator of products and services for the early detection, prevention, diagnosis and treatment of diseases, the Group contributes on a broad range of fronts to improving people’s health and quality of life. Roche is the world leader in in-vitro diagnostics and drugs for cancer and transplantation, and is a market leader in virology. It is also active in other major therapeutic areas such as autoimmune diseases, inflammatory and metabolic disorders and diseases of the central nervous system. In 2007 sales by the Pharmaceuticals Division totalled 36.8 billion Swiss francs, and the Diagnostics Division posted sales of 9.3 billion francs. Roche has R&D agreements and strategic alliances with numerous partners, including majority ownership interests in Genentech and Chugai, and invested over 8 billion Swiss francs in R&D in 2007. Worldwide, the Group employs about 80,000 people. Additional information is available on the Internet at http://www.roche.com
All trademarks used or mentioned in this release are legally protected.
Roche
http://www.roche.com
Non Prescription Weight Loss Pill Gets European Go Ahead
Drug company GlaxoSmithKline (GSK) has received the go ahead to market its non-prescription weight loss pill alli
(orlistat) in Europe; the drug has already been on sale over the counter in the US for over year.
News came in yesterday, Wednesday 21 January, that the European Medicines Agency (EMEA) has granted license to GSK to market its non-prescription weight loss
pill alli (orlistat 60mg) in all 27 member countries of the European Union, plus Norway. The drug is aimed at adults with a body mass index of 28
kg/m2 or more, that is those who are overweight or obese (BMI of 25 or more is classed as overweight).
GSK said it is planning to launch the drug over the next few months.
There is no news of the price, but in the US it costs about the equivalent of 1 Euro (about 1 British pound) a day. The drug is not intended to replace
but to enhance the effect of dieting and exercise, said GSK.
In the US, alli has “successfully helped millions of users lose weight gradually and steadily, and adopt a healthy lifestyle,” said Manfred Scheske,
GSK’s president of consumer healthcare in Europe. The product was launched in the US in June 2007, as the only non-prescribed Food and Drug
Administration (FDA) approved weight loss aid.
In trials, people lost 50 per cent more weight when they used alli with a reduced calorie, lower fat diet than dieting alone; thus helping them lose an
extra pound for every two pounds they would lose if they dieted but did not take the pill.
Alli (orlistat), a lipase inhibitor, works by stopping the fat we eat from being turned into body fat. It acts locally within the digestive system and thus
very little of the active ingredient goes into the bloodstream, said GSK in a statement.
The drug has been on prescription for over 10 years and over 100 clinical studies have yielded information about its safety and efficacy, said the
company.
In February 2007, GSK signed an agreement with Roche that allowed it to seek approval for the 60 mg version as Europe’s first licensed non-prescription weight loss product. Roche market the 120 mg prescription version as Xenical (orlistat) capsules.
An obesity expert from Germany’s Cardio-Metabolic Institute, professor Stephan Jacob said that studies have shown every year people spend millions
of Euros on fad diets, so-called “miracle pills” and potentially unsafe weight loss supplements, many of which are scientifically unproven.
“By making a licensed non-prescription product available, consumers will have the option of a proven therapy which can support them with their
struggle against weight loss,” said Jacob, explaining that for many people losing weight spur them to do other things that improve their health and self
esteem.
GSK said that alli is for people with a BMI of 28 or higher for use in conjunction with a reduced calorie, lower fat diet. The advised dose is one 60
mg capsule three times a day, taken with meals that have the recommended amount of fat.
Click here for EMEA.
Sources: GSK.
Written by: Catharine Paddock, PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
Kaiser Daily Health Policy Report Highlights CMS Actions
Summaries of news about several recent actions taken by CMS appear below.
- Billing codes: CMS has finalized a new system of codes for physicians and hospitals to use when they bill health insurers for services and has delayed the date for implementation from Oct. 1, 2011, to Oct. 1, 2013, the Wall Street Journal’s “Health Blog” reports. CMS had received more than 3,000 comments on a proposed version of the system, called ICD-10, many of which requested more time to comply. The new system has almost 10 times more codes for services than the current system (Rubenstein, “Health Blog,” Wall Street Journal, 1/15). CMS officials said that they hope the new system will help promote the adoption of health care information technology (Zhang, Wall Street Journal, 1/16).
- Chronic disease management: Three care management organizations with “demonstrated success” have been given three-year extensions for a Medicare demonstration project on managing care for high-cost beneficiaries with at least one chronic disease, CMS recently announced, CQ HealthBeat reports. The three organizations receiving the extensions — Key to Better Health, Massachusetts General Care Management Program and the Health Hero’s Network Health Buddy Program — “are unique because of their defined intervention focus on the fee-for-service Medicare population,” CMS said in a release. Six organizations initially were chosen to participate in the demonstration project. According to the release, care management services are designed to improve the quality of care and limit costs for fee-for-service Medicare beneficiaries, as well as foster collaboration between primary care physicians and specialists to improve communication of clinical information (Teitelbaum, CQ HealthBeat, 1/16).
- Durable medical equipment: CMS officials on Thursday announced an interim final rule that incorporates changes to a competitive bidding program for durable medical equipment required by a law enacted last year, CQ HealthBeat reports. The law, which blocked a scheduled reduction in Medicare physician reimbursements and added certain benefits to the program, delayed the first round on the bidding program, which began on July 1, 2008, in 10 metropolitan areas. According to acting CMS Administrator Kerry Weems, the announcement of the rule and appointees to a new federal advisory committee that will oversee the bidding program “are the first steps to take to restart the competitive bidding process” (Reichard, CQ HealthBeat, 1/15).
Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.
© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
760,000 Maryland Residents Did Not Have Health Insurance In 2006-2007, Report States
Between 2006 and 2007, 15.4% of Maryland’s non-elderly residents — or about 760,000 people ages 65 and younger — did not have health insurance coverage, according to a report released on Thursday by the Maryland Health Care Commission, the Annapolis Capital reports. According to the commission’s report, the rate was similar to the 14.9% rate for the 2004-2005 period and remains below the national uninsurance average of 17.5%.
The MHCC study, which also found that the uninsured rate had increased by more than 3% from 2000 to 2001 and 1% from 2002 to 2003, included data based on several demographics, such as age, race and marital status. According to the study, 30% of state residents ages 19 to 29 were uninsured, making it the age group with the highest uninsured rate. In comparison, 8% of residents ages 55 to 64 were uninsured, the lowest rate of uninsurance.
Married adults were most likely to be insured, with 85% having had some type of private coverage plan and 4% having been covered by Medicaid. Among single adults, single women were more likely to be insured than single men, the study found. At least 67% of single women had private coverage, compared with 60% of single men, according to the study (Woodards, Annapolis Capital, 1/15).
The study is available online (.pdf).
Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.
© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Iowa Lawmakers Seek To Pass Bill That Will Allow Small Businesses, Others To Buy Into State Program
Some Iowa lawmakers last week announced their support for a measure that would allow small businesses, local governments and not-for-profit groups to buy into the state employee health care coverage program, the AP/Omaha World-Herald reports.
The plan still is being developed, but if approved it would help small businesses compete, Sen. Jack Hatch (D-Iowa) said at a Statehouse press conference. He added that previously, many business owners resisted efforts to expand health care coverage but as the price of health insurance continues to increase, they are reconsidering their positions.
Hatch said that Gov. Chet Culver (D) has promised to support the measure (AP/Omaha World-Herald, 1/15).
Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.
© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
San Francisco Health Plan Is U.S. Leader In Childhood Immunizations
San Francisco Health Plan (SFHP), the City’s community health plan, announced it is honored to be the U.S. leader in childhood immunizations for Medicaid health plans nationwide. 90.7% of SFHP’s pediatric members are fully immunized, besting second-ranked Kaiser Permanente of Hawaii by approximately 0.2 percentage points.
“We couldn’t be more thrilled with the results,” said Dori Lange, SFHP Director of Quality Improvement of San Francisco Health Plan. “It’s a clear indicator that our methods for achieving success in quality care are working, and that our commitment to the good health and well-being of the residents of San Francisco is being realized.”
Strategies for achieving high childhood immunization rates include incentive programs that encourage parents of health plan members to take their children in for required vaccinations before age two. A complete shot record that indicates all required immunizations have been received results in a $50 gift card for the parent. Required immunizations consist of four diphtheria, tetanus and acellular pertussis (DTaP), three polio (IPV), one measles, mumps and rubella (MMR), three H influenza type B (HiB), three hepatitis B, one chicken pox (VZV) and four pneumococcal conjugate vaccines.
National rankings are determined by Health Employer Data Information Set (HEDIS) results, a set of nationally recognized performance measures of health plans developed by the National Committee for Quality Assurance (NCQA). Ranking high on HEDIS quality measures is a key indicator that SFHP providers are taking good care of members, and that SFHP has established an exceptional provider support system.
“We cannot underscore the importance and impact of provider participation enough,” said John F. Grgurina, Jr., CEO of San Francisco Health Plan. “Though we create and implement quality improvement ideas, it’s our provider network at the forefront daily, providing exceptional care and unparalleled service that makes the difference. Indeed, we owe this honor to their extraordinary abilities and unwavering dedication.”
SFHP also ranks within the top 10 for additional Medicaid measures nationwide, such as comprehensive diabetes care, well child visits, and treatment of children with upper respiratory infections.
SFHP most recently garnered national attention by being named by San Francisco Mayor Gavin Newsom as administrator of the Healthy San Francisco program, a model for county-based universal health care access.
About San Francisco Health Plan
San Francisco Health Plan is a licensed community health plan that provides affordable health coverage to low and moderate-income San Franciscans. San Francisco Health Plan was designed for and by the residents it serves – many of whom would not be able to otherwise obtain health care for themselves or their families. San Francisco Health Plan’s mission is to provide superior, affordable health care that emphasizes prevention and promotes healthy living. San Francisco Health Plan strives to improve the quality of life for the people of San Francisco, and is committed to supporting the providers who serve them. San Francisco is the first city in the country to offer healthcare access to uninsured residents through the Healthy San Francisco program, which is administered in partnership with San Francisco Health Plan and the San Francisco Department of Public Health. For more information on San Francisco Health Plan, visit http://www.sfhp.org.
About HEDIS
HEDIS (Health Employer Information Data Set) is a set of standardized performance measures designed to ensure that purchasers and consumers have the information they need to reliably compare the performance of managed health care plans. The performance measures in HEDIS are related to many significant public health issues such as cancer, heart disease, smoking, asthma and diabetes. Health Plan performance is reported publicly through consumer materials to help people choose the best health plan for their needs. HEDIS has become more than a set of measures; it is part of an integrated system to establish accountability in health care nationwide. HEDIS is sponsored, supported and maintained by National Committee for Qualify Assurance (NCQA). For more information on HEDIS, visit http://www.ncqa.org.
San Francisco Health Plan
http://www.sfhp.org
Physicians Agree Moderate Weight Loss Will Help Patients Manage Their Type 2 Diabetes
Physicians say they are counseling their overweight type 2 diabetes patients to lose weight, but patients say that the message is not getting through, according to a new survey announced by the Behavioral Diabetes Institute.
Eight in 10 physicians surveyed said that they discuss weight issues with their patients every/almost every visit, yet half as many patients – only four in 10 – report having these discussions with such frequency. In particular, roughly half of overweight patients and a third of obese patients say their physician seldom or never discusses their weight with them.
Almost all of surveyed physicians (85 percent) acknowledge that losing even a little weight can help manage type 2 diabetes. When discussing weight issues with their patients, 90 percent of physicians surveyed report that they tell their overweight patients to lose weight. However, when the surveyed patients were asked whether or not their doctor ever suggested that they lose weight, only 66 percent of them said yes.
“Type 2 diabetes is often associated with obesity. Losing weight can help to improve blood glucose, blood pressure, cholesterol and so much more. But it is notoriously difficult to lose weight and to keep it off and this can be even more difficult for someone with diabetes,” said Founder and Chief Executive Officer of the Behavioral Diabetes Institute William Polonsky, PhD, CDE. “Genetics and our immediate, food-rich environment play large roles in making weight loss tough, but disconnects between physicians and patients can make weight loss efforts even more difficult and frustrating.”
The phone survey conducted by Yankelovich, part of The Futures Company, assessed the behaviors, opinions and attitudes of 703 people with type 2 diabetes and 200 physicians that treat patients with type 2 diabetes. The survey was conducted in the fall of 2008 on the heels of the release of the American Diabetes Association and the European Association for the Study of Diabetes consensus statement placing increased focus on weight management as a treatment consideration in type 2 diabetes care.
According to the U.S. Centers for Disease Control and Prevention (CDC), 23.6 million people in the United States have diabetes, an increase of more than 3 million in two years. This means that 7.6 percent of the U.S. population has diabetes, mostly type 2 diabetes, which is linked with obesity, improper diet and a lack of exercise. Estimates show that another 57 million people have pre-diabetes, a condition that puts people at increased risk for diabetes. In addition, about two-thirds of US adults–133.6 million–are overweight. Of these, 63.3 million are obese.
The survey also found that when physicians and their type 2 diabetes patients are talking about weight loss, it is not always in specifics. While more than half of patients do report having been referred to a dietitian or diabetes educator, told to eliminate certain foods from their diet and receiving literature about weight loss, only 27 percent of patients say their physician prescribed specific recommendations for exercise and less than 20 percent say their physician suggested a commercial diet plan such as Weight Watchers. And, even though more than half of the physicians said their patients understand that diabetes medications can cause weight gain, only 34 percent of surveyed patients report being warned by their physician that this could occur.
In addition to the communication gap, the survey found a number of other barriers impacting physicians’ and patients’ abilities to properly manage weight as part of diabetes treatments.
– Physicians see patients’ reluctance to change lifestyle as the biggest barrier to achieving the level of care they would like for their patients.
– While some physicians say that their patients don’t try hard enough to lose weight, they also recognize that willpower alone is not enough. However, nearly half of surveyed patients (46 percent) believe that losing weight is mostly a matter of willpower and if they try hard enough, they can lose weight.
– Physicians see the lack of support for education services and prevention by the healthcare system as another major barrier to successful treatment of type 2 diabetes.
“There are effective strategies for overcoming the weight management obstacles patients with type 2 diabetes face. Physicians and patients can start by talking together about the best ways to manage weight by developing a comprehensive plan of action that includes diet, exercise and the right medications,” Dr. Polonsky said.
For more information about behavioral strategies for successful weight loss and diabetes management, visit the Behavioral Diabetes Institute (www.behavioraldiabetes.org).
Easy Tips for Patients with Type 2 Diabetes to Successfully Manage Their Weight:
– Ask your doctor about diabetes therapies that help control blood glucose and weight
– Work with a diabetes-knowledgeable dietitian or diabetes educator to develop a realistic weight loss plan and set specific goals for action
– Educate your loved ones about diabetes and your needs; ask for their support
– Adjust your immediate home environment so that it supports, rather than sabotages, your weight loss efforts
– Create new eating and exercise habits
Easy Tips for Physicians to Successfully Manage Their Type 2 Diabetes Patients’ Weight:~
– Don’t be reluctant about discussing the importance of weight loss issues with your patients, but do so in a way that is not blaming, shaming or judgmental.
– Refer your patients to weight loss programs and health care professionals in your area who specialize in nutrition and weight management
– Provide your patients with basic tools to enable them to make appropriate lifestyle changes
– Reinforce the importance of setting manageable, achievable goals
– Encourage your patients to be patient with their own efforts and progress; acknowledge with them that weight management is not easy and occasional setbacks are common
– In a collaborative and caring manner, remember to ask your patients how they are doing each and every visit
About the survey
The Behavioral Diabetes Institute and Amylin Pharmaceuticals, Inc. collaborated on the design of the survey. The survey was sponsored by Amylin and conducted by Yankelovich, part of The Futures Company, assessing the behaviors, opinions and attitudes of 703 people with type 2 diabetes and 200 physicians that treat patients with type 2 diabetes. The survey was conducted in October and November of 2008. The margin of error for the physician study is +/- 6.9 percent and for the patient study it is +/- 3.7 percent.
About Behavioral Diabetes Institute (BDI)
The Behavioral Diabetes Institute (BDI) is a nonprofit 501(c)3 organization dedicated to helping people with diabetes live long, healthy and happy lives. Addressing these real-life emotional aspects of diabetes is critical for long-term success, yet often they are given little attention in common medical practice. The BDI was created to better recognize, understand, and tackle these problems. The BDI provides clinical services for people with diabetes, professional services for health care professionals and research programs. More information is available at: http://www.behavioraldiabetes.org.
About The Futures Company
The Futures Company is the coming together of Henley Centre, HeadlightVision and Yankelovich, three premier research consultancies with deep legacies of thought leadership and a combined heritage of nearly 100 years of cutting-edge innovation, including Global MONITOR, a trends service combining survey data with an observational database of trends examples called Global Streetscapes and the Yankelovich MONITOR, the largest and longest running tracking of US consumer values and lifestyles. The Futures Company also offers future-facing qualitative and quantitative custom research and trends and futures consulting, with proprietary expertise in health, sustainability, and generational and multicultural marketing. Clients include leaders in CPG, pharmaceuticals, financial services, technology, telecommunications, travel and leisure, media and the public sector. The Futures Company is part of the Kantar Group of WPP with offices in London, Chapel Hill, NC, New York, Mumbai and Delhi and an established intelligence network spanning 28 countries. More information is available at: http://www.thefuturescompany.com.
Behavioral Diabetes Institute
http://www.behavioraldiabetes.org
Patients Seek Quick Recovery From Cosmetic Procedures In Order To Return To Work Faster
As unemployment rises in the United States, people are doing all they can to ensure their job security. Thus the cosmetic surgery industry has since seen a significant increase in the less invasive and less costly procedures. These types of procedures are extremely effective but require less downtime and allow the patient to return to work quicker.
“The days of taking two or more weeks off of work in order to have a cosmetic procedure are long gone,” states AACS President Patrick McMenamin, MD. “If most people take that amount of time off in this economic climate, they may return to their job to find that someone has replaced them.”
In addition, cosmetic procedures are becoming an integral part of employees looking their best for jobs. “Any way someone can have a leg up in this job market is a plus. Looking young and feeling young can be a strong component when trying to get or keep a job and that is the reason more people are seeking cosmetic procedures,” says Dr. McMenamin.
Lynn is a patient of Dr. McMenamin’s who went in for a Laser Facelift on December 16th, 2008. She was determined to get back to her job as an RN as quickly as possible and did; she was back at work in three days. “It was a top priority of mine to get an effective procedure that required little to no downtime,” explains Lynn. “Dr. McMenamin recommended the laser facelift, I trust his judgment and in no time I was ready to get back to work feeling and looking younger than ever. In the workplace, I now look less stressed and my job was never in jeopardy due to a lengthy recovery time.”
To speak with Dr. McMenamin and his patient, Lynn, please contact the Academy. Information on choosing a cosmetic surgeon and questions to ask before having cosmetic surgery can be found on the AACS website, at http://www.cosmeticsurgery.org.
The American Academy of Cosmetic Surgery is a professional medical society whose members are dedicated to patient safety and physician education in cosmetic surgery. Most members of the AACS are dermatologic surgeons, facial plastic surgeons, head and neck surgeons, general surgeons, oral and maxillofacial surgeons, plastic surgeons, or ocular plastic surgeons – all of whom specialize in cosmetic surgery. AACS is an organization that represents all cosmetic surgeons in the American Medical Association through its seat in the AMA House of Delegates.
American Academy of Cosmetic Surgery
http://www.cosmeticsurgery.org
A Face Full Of Clues; Injuries May Tip Off Doctors To Abuse
Women who suffer abuse at the hands of a loved one may not be so quick to talk about it. However, their facial injuries speak volumes. Newly released research in the January/February issue of Archives of Facial Plastic Surgery, one of the JAMA/Archives journals, shows women who are victims of intimate partner violence tend to have different patterns of facial injury than women who experience facial trauma from other causes.
Temple University facial plastic surgeon Oneida Arosarena, MD, FACS, and her colleagues reviewed six years worth of medical and dental records from 326 women treated for facial trauma at the University of Kentucky Medical Center. Arosarena also saw this type of abuse first hand.
“I remember a patient who suffered a nasal fracture at the hands of her husband,” said Arosarena, an associate professor in the department of otolaryngology at the School of Medicine. “I repaired her injuries and social workers found her safe housing, but she still went back to him. That was a very touching case because it wasn’t just about fixing someone’s facial fracture; it involved social work and a community of health care workers trying to help this woman.”
Stories like these pushed Arosarena to ask her patients difficult questions about their relationships. Those answers, coupled with her team’s research, revealed women who are injured by an intimate partner tend to suffer from distinct types of upper facial injuries, while those injured from other causes, such as a car accident or fall, are more likely to suffer lower facial fractures. In other words, brain injuries or breaks around the eye socket and cheekbones would signal intimate partner violence, whereas a broken jaw might not. The findings surprised Arosarena and her co-researchers.
“We fully expected the injuries to be distributed like they are in other traumas, but they weren’t.”
Of the 326 women treated for facial trauma, 45 patients were assault victims, including 18 documented victims of intimate partner violence, while 24 of the remaining 26 assault victims could not or did not identify their assailant. Other common causes of injury included car crashes (139 patients), falls (70 patients) and unknown or undocumented causes (35 patients).
Unlike domestic violence, which may be perpetrated by a spouse, sibling or other family member, intimate partner violence is more specifically described as abuse by a spouse or significant other. Experts estimate more than one in four women in this country suffer from intimate partner violence. That figure along with this research has Arosarena hopeful that the particular pattern of injury may tip off doctors when women are being beaten.
“This research will hopefully make first responders and trauma surgeons more aware that there is a correlation between intimate partner violence and certain facial injuries. And we hope it prompts them to ask just how those injuries happened.”
Other authors in the study include Travis Fritsch, MS, Intimate Partner Violence Surveillance Project, Kentucky Injury Prevention and Research Center; Richard Haug, DDS, University of Kentucky; Yichung Hsueh, MD, University of Louisville; and Behrad Aynehcki, MD, State University of New York, Downstate Medical Center.
Temple University
301 University Services Bldg.1601 N Broad St.
Philadelphia
PA 19122
United States
http:// www.temple.edu
Cleaner Air Increased Life Expectancy In US Cities
A new study of American cities showed that in recent decades, average life expectancy went up by nearly three years, of which 5 months can be
attributed to cleaner air.
The study was the work of researchers at Brigham Young University (BYU) and Harvard School of Public Health (HSPH) and is published in the 22
January issue of the New England Journal of Medicine.
Previous research has already shown that exposure to air pollution, as measured by the amount of fine particles in the air, is linked to higher rates of
illnesses and deaths, suggesting that when air quality improves, these rates should go down, so the authors of this study decided to investigate the
effect of changes in air pollution during the 1980s and 1990s on life expectancy.
For the study, the researchers brought together life expectancy, socioeconomic and demographic data for 51 US cities with matching data on air
pollution for the two decades spanning the late 1970s to the early 2000s. They used statistical regression tools to search for significant links between
pollution changes and life expectancy, while ruling out the effect of socioeconomics and demographics (eg population changes, income, migration and
education), and cigarette smoking.
The researchers used the PM2.5 measure of air pollution that assesses levels of particles smaller than 2.5 microns in diameter (that is smaller than four
hundredths of the width of human hair). This threshold was set by landmark studies on air pollution in the 1990s, which some of the authors in this
study worked on. The threshold was also used by the US Environmental Protection Agency to set standards for air pollution in 1997.
The results showed that:
- A decrease of 10 micrograms per cubic meter in the concentration of fine particles was linked to with an estimated increase in mean life
expectancy of more than 7 months (0.61 years plus or minus standard error of 0.20 y, p=0.004).
- This link was largely unaffected by ruling out potential confounders such as changes in socioeconomic, demographic, or smoking prevalence, and
neither was it much affected by ruling out the fact the data came mostly from the larger counties in the 51 cities.
- In cities with the largest reduction in air pollution, the estimated increase in life expectancy was about 10 months.
- Drops in air pollution accounted for as much as 15 per cent of the overall rise in life expectancy in the 51 cities, which on average came to
2.72 years over the two decades studied.
The authors concluded that:
“A reduction in exposure to ambient fine-particulate air pollution contributed to significant and measurable improvements in life expectancy in the
United States.”
Lead author C. Arden Pope III, an epidemiologist at BYU told the press that “such a significant increase in life expectancy attributable to reducing air pollution is remarkable,” adding that America was getting a good return on the investment made in air quality improvement for not only was the cleaner air improving the environment but it was also improving public health.
Other studies suggest these improvements are most likely due to reductions in diseases that normally come with high air pollution, such as those that
affect the heart, lungs and circulation.
Co-author Douglas Dockery, chair of the Department of Environmental Health at HSPH said:
“There is an important positive message here that the efforts to reduce particulate air pollution concentrations in the United States over the past 20
years have led to substantial and measurable improvements in life expectancy.”
His colleague and co-author Majid Ezzati, associate professor of international health at HSPH, added:
“Life expectancy is the single most comprehensive summary of how people’s longevity is affected by factors like air pollution that cause early death.”
“We were able to use routine mortality statistics to track longevity in all cities over a long period of time and analyze how it has been influenced by
changes in air pollution,” said Ezzati.
The study was sponsored by the US Centers for Disease Control and Prevention, the Association of Schools of Public Health, the Environmental
Protection Agency, the National Institute of Environmental Health Sciences, and the Mary Lou Fulton Professorship at BYU.
“Fine-Particulate Air Pollution and Life Expectancy in the United States.”
Pope, C. Arden, III, Ezzati, Majid, Dockery, Douglas W.
N Engl J Med Volume 360, No 4, pp 376-386, 22 Jan 2009.
Click here for Article.
Sources: Brigham Young University , journal abstract.
Written by: Catharine Paddock, PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
