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Health Updates

June 27, 2016

By Mendy Hecht, Hamaspik Gazette

Most antidepressants don’t help youth: Study

For children and teens already taking antidepressant medications, parents should not stop those medications if a doctor says they must have them—the relapse of symptoms could be serious.

But for parents considering those medications for the first time, a recent report gives them something to think about.

According to a new study in The Lancet, the vast majority of antidepressants given to kids and teens are ineffective and potentially dangerous.  Drugs analyzed in the study, including Zoloft, Paxil, Celexa, and Cymbalta, showed no benefit over placebo for that age group.

Of 14 regularly prescribed drugs, only one, Prozac, proved effective enough to justify giving to children and teens, the researchers found—and if drugs are given at all, Prozac should be the drug of choice, the study concluded.

“No one should be on any other antidepressant, and I think it’s doubtful that people should be on Prozac, as well,” wrote Dr. Jon Jureidini, a child psychiatrist at the Robinson Research Institute at the University of Adelaide, in a commentary.  “The case for Prozac is quite weak.”

“What we’re up against is the marketing enterprise of the pharmaceutical industry combined with wishful thinking on the part of doctors and parents that there might be a good, simple solution for adolescent distress,” he said.  “It’s something we need to take very seriously, but we don’t need to make it into a medical condition when it most times isn’t.”

Talk therapy, including cognitive behavioral therapy, has been shown to be effective for depression in young people, and regular exercise and adequate sleep also help, Jureidini also wrote.  The vast majority of kids don’t need medication for depression, he added.

The new paper, a so-called meta-analysis, looked at 34 previously conducted studies.  Those studies included more than 5,200 children and teens who took one of 14 antidepressants or a placebo for an average of eight weeks.

The study did not consider long-term use of the drugs because there hasn’t been enough previous research to analyze.  Indeed, though several of the studies claimed to include patients as young as six, researchers said there exists virtually no scientific data on children younger than nine.

Study discovers blast TBI brain damage

Blast TBI involves waves of compressed air moving faster than the speed of sound, creating intense pressure in the brain of anyone within range.  Impact TBI simply involves the head hitting an object.

People with blast TBI often develop post-traumatic stress disorder (PTSD), headache, sleep disturbance, and memory problems—but, unlike impact TBI patients, few physical brain abnormalities show up in their brain scans.

But now, research by the Uniformed Services University of the Health Sciences found distinct damage patterns in the brains of deceased U.S. soldiers who had suffered blast traumatic brain injuries (TBIs) as opposed to impact TBIs.

The study found so-called astroglial scarring in parts of the brain crucial for cognitive function, memory, sleep, and other important functions. 

Comparison examination of the brains of deceased men who had suffered impact TBI, or no brain injuries, showed none of the same astroglial scarring.  The findings may explain blast TBI symptoms despite brain scans turning up largely normal.

The study was published recently in Lancet Neurology.

New cancer drug performs in larger second trial

Ibrance, a drug that treats certain cases of a common form of women’s cancer, was approved last year by the FDA after a Phase II clinical trial.  That study of 165 women had one group take existing cancer drug Femara and a placebo, and the other group take Femara and Ibrance.  The two-drug group had a median rate of progression-free survival double that of the placebo group.

The follow-up Phase III trial involved tracking 666 participants in 17 countries over two years.  Those participants were similarly split into drug and placebo groups, with the group taking Ibrance again showing twice the median survival rate of the placebo group.

Ibrance, a so-called CDK-4/6 inhibitor, is first in its class to be approved in the U.S.  It is meant for older women with advanced HER2-positive cancers and no previous endocrine therapy.

The trial results were reported at the most recent annual meeting of the American Society of Clinical Oncology.

New gene-editing method approved for human tests

On June 21, an NIH genetics ethics panel approved a planned experiment by the University of Pennsylvania to use the CRISPR technique to “edit” T cells to better target and fight cancer cells. 

The CRISPR gene-editing technique, done on lab mice, has never been done before on humans.

If approved by the FDA and participating cancer centers, the experiment would enroll 15 patients in a Phase I trial at three sites nationwide to first test if the editing technique would even work.  If successful, it would then be used to attempt a new treatment for three forms of cancer.

The genetic editing of T cells, the immune system’s defender against viruses and other foreign invaders, has already been used in recent years to create T cells configured to target and kill specific cancer cells by treating them like invaders, to some level of success.

Study: High-troponin hearts donation-safe

A higher level of troponin, a protein, in the bloodstream usually indicates heart muscle damage; the “troponin test” is typically done in ERs to confirm heart attacks.

But troponin testing is also done to rate the health and usability of a potential donor heart.  Many transplant centers would reject hearts whose donors show raised troponin levels.

However, the first large-scale study of troponin as a biomarker for donor hearts has now found no difference in patient survival or typical post-transplant complications when donors have more troponin. 

The review of data on over 10,000 heart recipients found no association between high troponin levels in donors and primary graft failure or cardiac allograft vasculopathy in patients.  Those two conditions are common post-transplant complications.

Last year, 2,804 heart transplants were performed in the U.S., while over 4,100 people a year need a heart transplant—and only one in three donor hearts is currently judged acceptable.

Widespread use of those donor hearts would provide 70 or 80 more available hearts a year, according to the study, published June 21 in the journal Circulation: Heart Failure.

Vaccines for Lyme disease?

In a small study published June 22 in Clinical Vaccine Immunology, scientists injected mice with two weakened strains of Borrelia burgdorferi, a bacterium that causes Lyme disease.

The scientists found that the mice vaccinated with both strains were later protected against infection by full-strength strains.  Scientists later injected them with live Lyme bacteria, or had them bitten by infectious ticks, with no appearance of Lyme symptoms.

If left untreated, Lyme disease can cause significant and long-term illness, which may continue after antibiotic therapy has been given and live bacteria are no longer detectable.

The increasing incidence and geographic spread of Lyme disease is renewing interest in vaccination of at-risk populations, the researchers said.