Daily ReCAP March 14, 2017

Chronic: Oral, Topical Antibiotics Provide No Meaningful Benefit in Children with Mild Eczema

Although an estimated 40% of eczema flares are treated with topical antibiotics, a new study found that children with milder eczema are unlikely to benefit from oral or topical antibiotics. For the CREAM study, investigators sought to determine if oral or topical antibiotics help improve eczema severity in children with infected eczema. All study participants also received standard eczema treatment with steroid creams and emollients for their physician. The investigators used data from 113 children with non-severely infected eczema and found no significant difference between the groups in the resolution of eczema symptoms at 2 weeks, 4 weeks, or 3 months. A rapid resolution was found in response to mild-to-moderate strength topical corticosteroids and emollient treatment, and the investigators ruled out a clinical meaningful benefit from the addition of oral or topical antibiotics. “Our research shows that even if there are signs of infection, children with milder eczema are unlikely to benefit from antibiotics, and their use can promote resistance and allergy or skin sensitization” said lead investigator Dr Nick Francis. “Providing or stepping up the potency of topical corticosteroids and emollients should be the main focus in the care of milder clinically infected eczema flares.”

Acute: Wireless Arm Patch Diminishes Migraine Pain

A wireless arm patch containing rubber electrodes and a chip that produce electric impulses that block pain signals from reaching the brain shows promise in treating migraines, according toHealthDay News. When a migraine starts, patients can control the intensity of the electric impulses using a smartphone app. “You can use skin stimulation at an intensity which is not painful and be able to stop or substantially diminish the development of a migraine attack, as long as you do it early enough in the migraine attack,” said lead investigator Dr David Yarnitsky. “There are no side effects. You feel a tingle in your upper arm.” Dr Yarnitsky said a clinical trial with nearly 200 patients is about to begin, and he hopes the device will be up for FDA approval by next year. “People with migraine are looking for non-drug treatments, and this new device is easy to use and has no side effects.”

Preventive: Novel Approach May Prevent, Treat Cholesterol Gallstone Disease

A novel approach that activated the constitutive androstane receptor (CAR) helps prevent and treat cholesterol gallstone disease. In a study published inThe American Journal of Pathology, investigators compared mice injected weekly for 2 weeks with a medication that stimulates CAR activity with mice administered control injections. All the study mice were fed a standard diet of a lithogenic diet that induced gallstones. The results of the study showed 94.7% of the non-CAR-stimulant injected mice developed gallstones compared with 33% of CAR-stimulant-injected mice when fed the lithogenic diet. Upon further examination, the investigators found that gallbladders from the non-CAR-stimulant treated mice were filled with gallstones composed of bile with aggregated cholesterol crystals. Whereas, the CAR-stimulant-treated mice had transparent bile free of cholesterol precipitates. After 2 weeks of the lithogenic diet, the walls of the gallbladders of the control mice showed evidence of inflammation, which was not noticeable in the treated group. Additionally, CAR stimulation enhanced conversion of cholesterol into bile acids and elevation of bile acid reabsorption. “Collectively, it appears that CAR plays an important role in maintaining the homeostasis of cholesterol, bile acids, and triglyceride levels,” said lead investigator Jinhan He, PhD. “Whether CAR could be a novel target in preventing or treating cholesterol gallstone disease in humans remains to be further determined.”