News in brief - Feb. 20, 2006

Kid's asthma medication masks may not be effective - Cancer screening rates flat - FDA approves constipation drug - Grants to study health disparities announced

Kid's asthma medication masks may not be effective

Mask-like devices used in conjunction with pressurized metered-dose inhalers to deliver asthma drugs to infants and very young children may not be delivering as much medication as hoped if they are rigid and allow for large amounts of dead space volume, according to a study published in the February Respiratory Care.

"With some masks, the amount of medicine available to the youngest children is severely decreased because of mask size, stiffness and poor fit on the face," said Bruce Rubin, MD, one of the paper's authors and a professor of pediatrics and biomedical engineering at Wake Forest University School of Medicine in Winston-Salem, N.C.

Researchers purchased seven versions of this type of mask and tested them on an infant-sized mannequin usually used to teach cardiopulmonary resuscitation. They found that the ability of these devices to seal to a child's face varied widely, and this poor fit may reduce the amount of medication the child receives.

This study did not look at actual drug delivered by the masks, although researchers intend to do that later this year with live test subjects.

Cancer screening rates flat

The number of people being screened overall for cancer changed little from 2002 to 2004, according to the "American Cancer Society Guidelines for the Early Detection of Cancer" published in the January/February CA: A Cancer Journal for Clinicians.

The document, which summarizes any changes in recommendations for cancer screening made over the past year and gathers data relevant to their implementation, is published annually by the society. Screening guidelines were unchanged in 2005, but the organization expressed concern because the rates had not increased and some remained stubbornly low.

"Too many adults are not receiving regular screening, and thus there is a persistent, avoidable fraction of advanced cancer diagnosed each year that could have been detected at an earlier, more treatable stage, or potentially even been prevented," said Robert A. Smith, PhD, lead author and the ACS director of cancer screening.

About 85% of women age 18 and older have had a Pap test within the past three years, but just more than 45% of adults age 50 and older have had either a colonoscopy or a flexible sigmoidoscopy. Both these rates are lower for those who don't have health insurance.

FDA approves constipation drug

Amitiza, or lubiprostone, was approved by the Food and Drug Administration Jan. 31 for treating chronic constipation among adults for whom no known cause can be found. The product will be available as capsules to be taken twice a day with food.

Chronic idiopathic constipation is one of the most common disorders among Americans, according to the FDA. The condition affects more people older than 65 and women more often than men.

Amitiza works by increasing intestinal fluid secretion to help alleviate constipation. The most common adverse events reported included headache, nausea, diarrhea, abdominal pain and distension.

Three long-term studies showed that Amitiza decreased constipation severity, abdominal bloating and discomfort over six to 12 months of use.

It is recommended that physicians periodically assess the need for continued treatment.

Grants to study health disparities announced

The Robert Wood Johnson Foundation is seeking real-world solutions that eliminate the gaps in care experienced by patients from racial and ethnic minorities. The foundation is inviting grant proposals for a new $5 million three-year program, Finding Answers: Disparities Research for Change.

Approximately 25 grants will be awarded to evaluate approaches already underway. Marshall H. Chin, MD, MPH, associate professor of medicine at the University of Chicago will direct the new program.

"We know disparities exist and these differences in care by race and ethnicity are unacceptable," said Dr. Chin. "There is a clear need for solutions that can improve the health of millions of Americans."

Interventions ranging from organization-wide improvements to initiatives aimed at individual health care professionals and patients are eligible for funding. Brief proposals are due by March 16. More information is available online (www.solvingdisparities.org) or by phone (866-344-9800).