News in brief - Nov. 22/29, 2004

Tobacco control scores wins on election day - SSRI talking points issued by AACAP - Frequent Pap smears may be an option for young women with abnormal tests - Cardiac valve disease deaths run in the family

Tobacco control scores wins on election day

Several state and local ballot initiatives were approved by voters on election day to ban smoking in bars, restaurants and workplaces in general and raise taxes on cigarettes. Among them:

Colorado, Montana and Oklahoma will raise cigarette taxes. In Montana, taxes will increase by $1, to $1.70 per pack. Colorado's tax will increase from 64 cents per pack to 84 cents. Oklahoma's tax will increase by 55 cents per pack.
Several communities approved initiatives to ban smoking in various settings. Voters in Columbus, Ohio, approved a ban of all indoor smoking that was initially passed last June by the city council. The ban, which will take effect on Jan. 31, had been challenged by a group of bar and restaurant owners and placed on the ballot for voter scrutiny.
Voters in Lincoln, Neb.; Fargo and West Fargo, N.D.; Copperas Cove, Texas; Winooski, Vt.; Wauseon, Ohio; and Wausau, Wis.; passed an array of smoking bans, while Duluth, Minn. and Toledo, Ohio, rejected smoking bans.

SSRI talking points issued by AACAP

The American Academy of Child and Adolescent Psychiatry advised its 7,400 members to continue to treat depressed children and adolescents with selective serotonin reuptake inhibitors and other antidepressants either alone or with psychotherapy and accompanied by proper treatment management and monitoring.

Last month the Food and Drug Administration directed manufacturers of antidepressants to add black box warnings to the drugs' labels to reflect a heightened risk of suicidal thoughts and actions by children and teens who take them.

In a letter e-mailed to its members, the AACAP expressed concern that the black box warning may keep depressed patients from seeking treatment and cause physicians to avoid treating depressed children and adolescents because of fears of potential lawsuits.

Pediatric depression is a real illness with neurobiological underpinnings. Although antidepressant treatment carries risks, untreated depression has potentially greater risks, and treatment is effective, especially when started early, according to the AACAP.

The letter is accompanied by a set of talking points that explain the research findings and other documents designed to improve treatment planning and the monitoring of patients.

Frequent Pap smears may be an option for young women with abnormal tests

Having Pap smears more often rather than having a colposcopy may be a viable option for adolescent girls with low-grade cervical lesions. Human papillomavirus testing may also play a role in deciding the course of action, according to a study published Nov. 6 in the Lancet.

For five years, researchers at the University of California, San Francisco, monitored 187 women ages 13 to 22 at the time of their first abnormal Pap smear. After one year, 61% of the lesions had disappeared. After three years, that number reached 91%. A negative HPV test was associated with regression.

Researchers concluded that HPV testing could be useful for monitoring cervical lesions and that colposcopy may be not be needed.

An accompanying commentary by researchers from London's Wolfson Institute of Preventive Medicine said that the data suggested that colposcopy for young women with these kinds of lesions is unwarranted.

Cardiac valve disease deaths run in the family

Having a relative who died of mitral valve disease increases the risk of dying from the disease, according to a paper published online Nov. 1 in Circulation: Journal of the American Heart Assn.

University of Utah researchers analyzed data from the state's population database showing that having a first-degree relative who died of the disease increases the risk by 155%. Having a second-degree relative increases the risk by 67%.

Authors of the paper say this suggests a genetic factor plays a role in the development of this medical condition. They are advocating further studies to identify the gene.