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MEASLES VACCINE SAFE FOR CHILDREN WITH EGG ALLERGIES
Pediatricians no longer need to be "chicken" about giving measles vaccine to kids with egg allergies. A new study says more than 99 percent of allergic children have no reaction to the small amount of egg-related antigen found in the combined measles-mumps-rubella (MMR) vaccine.
Researchers from the Johns Hopkins Children's Center and the University of Arkansas confirmed that the vaccine is safe even for children who react to eggs. Published recently in the New England Journal of Medicine, their study underscores a need for change in the national guidelines, they say.
"Currently, children who react to a skin test of the vaccine get six progressive injections, rather than a single shot. It's an upsetting and painful procedure," says Hugh Sampson, M.D., professor of pediatrics, allergy and immunology at the Children's Center. "We're hoping the American Academy of Pediatrics will reconsider the current recommendation."
In their report, the Hopkins/Arkansas team states that none of the 54 allergic children given the single-dose MMR vaccine, including three children with positive responses to skin testing, had an immediate or delayed adverse reaction. More than 1,200 allergic children worldwide have been safely vaccinated this way, adds Sampson.
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CONQUERING SKIN CANCER
Overexposure to sunlight, especially repeated sunburns in childhood, is the suspected leading cause of a fatal form of skin cancer, melanoma. Symptoms include the appearance of dark spots on the skin and changes in existing moles. Wide-brim hats, light-colored, loose-fitting clothing and sunblock lotion are the best protection from the sun.
The number of cases of melanoma in the United States has doubled in the past decade and is projected to continue rising. About 17,000 people die of melanoma each year and about 35,000 new cases are diagnosed.
Johns Hopkins scientists and physicians recently created a multispecialty melanoma clinic to coordinate patient care and to develop melanoma vaccines, says Stanley Miller, M.D., a dermatologic surgeon at The Johns Hopkins Medical Institutions.
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COMBATING PULMONARY DISEASE
Johns Hopkins and other medical centers are developing and refining treatments for chronic obstructive pulmonary disease (COPD). Marked by emphysema, asthma and bronchitis, COPD is the leading cause of death and disability in older adults, affecting 13 million Americans and adding an estimated $12 billion a year to health care costs.
One relatively new procedure, lung volume reduction surgery, removes diseased lung tissue. "We can help some patients have a normal life again," says Stephen C. Yang, M.D., an assistant professor of surgery at Johns Hopkins Medical Institutions. In June, Yang performed the procedure for the first time at Hopkins.
Hopkins investigators also are leading a multicenter trial of inhaled anti-inflammatory drugs in 1,400 middle-age smokers with COPD; using a breathing capacity test to predict who will develop COPD; and running a smoking cessation program in which 22 percent of participants were smoke-free after five years, compared with only 4 percent of a control group.
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INSURERS, PAIN DOCTORS DEBATE PROOF OF NEW TREATMENTS
Aided by new insights into the basic chemical and biological processes that cause pain, doctors are developing a range of new treatments to help patients afflicted with chronic pain. Many patients, however, may find these new paths to relief blocked by a refusal from their health care insurer.
"For many insurers, a patient's testimony that their pain has decreased does not prove the effectiveness of a new pain treatment," says James Campbell, M.D., director of Johns Hopkins' Blaustein Pain Treatment Center and president of the American Pain Society, an association of pain specialists.
"Many insurers who handle workers' compensation look at the return-to-work rate of patients for final proof of whether a pain treatment is successful," he says. "We just look at whether a treatment alleviates suffering to determine success." Such policies represent a very real difference between the health care goals of patients and insurers, he adds.
"Most patients consider substantial pain relief to be reasonable care," he notes. "It would be very upsetting to many of them to learn that insurers sometimes don't consider relief of pain by itself to be a worthwhile goal."
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