News in brief - April 4, 2005

FDA panel recommends pertussis vaccines for teens, adults - Obesity and life expectancy - Blood tests and women's heart risks - Pediatricians issue guidance for chronic abdominal pain in kids

FDA panel recommends pertussis vaccines for teens, adults

The Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee unanimously recommended the approval of two vaccines that would provide immunity against whooping cough for teens and adults, according to statements from manufacturers.

Both formulations add pertussis to the already recommended booster for tetanus and diphtheria. The FDA is not bound to follow the advice but usually does.

The committee recommended the approval of Boostrix, a vaccine manufactured by GlaxoSmithKline that would provide protection against diphtheria, tetanus and whooping cough for those ages 10 to 18.

Endorsement also was given to Adacel, a similar formulation manufactured by sanofi pasteur, which is intended for those ages 11 to 64.

Public health officials long have been looking for ways to reduce the growing number of adolescents contracting pertussis and spreading it to infants, who are particularly vulnerable. "Adding pertussis to the current tetanus and diphtheria booster shot for teens is a logical strategy," said Colin Marchant, MD, adjunct associate professor at Boston University School of Medicine.

Obesity and life expectancy

Over the next few decades, life expectancy of the average American could decline by as much as five years unless aggressive efforts are made to slow rising rates of obesity, according to an analysis conducted by a team of scientists.

The United States could be facing its first sustained drop in life expectancy in the modern era, the researchers said, but the decline is not inevitable if Americans, particularly younger ones, trim their waistlines or if other health improvements outweigh the impact of obesity.

The new analysis was published in the March 17 New England Journal of Medicine.

Unlike previous life expectancy forecasts, which rely on past mortality trends, the new research bases its prediction on an analysis of body mass indexes and other factors that potentially could affect the health and well-being of the current generation of children and young adults, some of whom began having weight problems early in life.

The researchers said younger Americans likely would face a greater risk of mortality throughout life than previous generations unless steps are taken to curb excessive weight gain.

Blood tests and women's heart risks

A white blood cell count might predict cardiovascular events and risk of death in postmenopausal women who are not identified by traditional risk factors, according to an article in the March 14 Archives of Internal Medicine.

As evidence builds that inflammation plays a role in the development of atherosclerosis, the study authors note that white blood cell count is a stable, well-standardized, widely available and inexpensive measure of systemic inflammation.

Physicians also can determine inflammation levels by using a more costly C-reactive protein test.

The researchers used data from 72,242 postmenopausal women ages 50 to 79 who participated in the Women's Health Initiative Observational Study to assess white blood cell count as an independent predictor of cardiovascular events and death from any cause.

The women were divided into four levels or quartiles, with the first quartile representing women with the lowest level of white blood cells and the fourth quartile representing women with the highest level. Women in the fourth quartile had a doubled risk of death from coronary heart disease compared with women in the first quartile after statistical adjustment for other risk factors.

The researchers recommend additional studies to assess the effectiveness of risk reduction in patients with high levels of white blood cells.

Pediatricians issue guidance for chronic abdominal pain in kids

When dealing with children with chronic abdominal pain, physicians should be alert to persistent fever, significant vomiting and other symptoms that could indicate disease and the need for diagnostic tests. For cases where there is no evidence of organic disease, treatment goals should focus on the return to full function rather than complete elimination of pain, says a technical report in the March Pediatrics.

Experts from the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition reviewed the literature to develop recommendations for a condition that is common but that has few easy solutions. The committee also concluded that most children presenting with the problem in the primary care pediatrician's office do not need diagnostic testing but that there is little conclusive evidence for one therapeutic strategy or another.

Peppermint oil might help children with irritable bowel syndrome. Fiber supplements may decrease the frequency of pain attacks, and a lactose-free diet could reduce symptoms in some children.