News in brief - April 5, 2004

Teen years peak time for inhalant abuse - Smallpox rash most often a benign skin reaction - Large study of treatments for childhood type 2 diabetes launched - TB decline starts to slow

Teen years peak time for inhalant abuse

Millions of Americans are believed to abuse inhalants and the Partnership for a Drug-Free America fears those numbers may be on the upswing, particularly among young teens.

"Anytime an inhalant is used, someone's life can be snuffed out," warned Charles Curie, who heads the federal Substance Abuse and Mental Health Services Administration. Sudden death can occur on first use or with any random subsequent use, he said.

To more firmly pin down the number of people who abuse inhalants, the National Inhalant Prevention Coalition released new guidelines March 18 to be used by medical examiners to diagnose deaths from inhalants.

SAMHSA data released at the same news conference in Washington, D.C., show the peak ages for inhalant use are 14 and 15.

A sharp erosion of anti-inhalation attitudes was also tracked in a study conducted by the partnership. The group noted a drop from 68% to 48% over two years when sixth-graders were asked whether they agreed with the statement "sniffing or huffing things to get high can kill you." There was also a decline in agreement from 73% to 63% when eighth-graders responded to the same statement.

The attitudinal change should serve as a warning that the abuse of inhalants is likely to continue to increase among youngsters, said Stephen J. Pasierb, president and CEO of the Partnership for a Drug-Free America.

Smallpox rash most often a benign skin reaction

People who have never received a smallpox vaccination may develop any of a variety of benign skin rashes a few days after being vaccinated, said a study in the April 1 Clinical Infectious Diseases.

This rash should not be confused with more dangerous vaccinial lesions, said the researchers.

The five different types of rashes described in the article were all "self-limiting," and cleared up on their own after one to three weeks. The rashes were not accompanied by fever or any other serious symptoms.

A physician who is unaware of the possibility for a benign skin reaction might wrongly assume that a patient's rash signaled the development of a more dangerous variety. "These skin reactions are rather dramatic, and if we're going to be vaccinating against smallpox, the physician should know that these are benign complications and not subject the patient to unnecessary worry," said lead author Richard Greenberg, MD, University of Kentucky professor of medicine.

Large study of treatments for childhood type 2 diabetes launched

The National Institute of Diabetes and Digestive and Kidney Diseases in March launched a large-scale study to hunt for the best treatments for type 2 diabetes in children and teens.

The study, titled Treatment Options for type 2 Diabetes in Adolescents and Youth -- TODAY -- will recruit those ages 10 to 17 who have had a diagnosis for at least two years. All participants at the 12 research centers around the country will receive metformin. Some will be randomized to receive either rosiglitazone or intensive lifestyle changes as well.

Adults with type 2 diabetes have many long-established treatment options. Younger people, a population that has only recently started developing the disease in great numbers, do not have as many established options. The hope is that this trial will answer questions about medication safety and efficacy in this age group as well as determining which lifestyle interventions are most useful.

TB decline starts to slow

Tuberculosis is continuing to decline but at a slower rate, according to a paper published in Morbidity and Mortality Weekly Report to mark World TB day last month.

According to the data gathered from the national TB surveillance system, 14,871 Americans developed the disease in 2003, a 1.4% decline from 2002. This was the smallest decrease since 1992.

"These data raise concerns that increased efforts might be required to maintain the progress made in controlling TB," wrote the authors from the Centers for Disease Control and Prevention Division of TB Elimination.

The paper also reported that just more than 42% of all cases were in California, New York and Texas. Foreign-born people accounted for 53% of cases with most coming from Mexico, the Philippines, Vietnam, India and China. The case rate was also high among African-Americans who account for 45% of all TB patients. The rate of drug resistance has remained stable with 80% of patients able to complete therapy in one year.