Jacob Ruppert

The plume of burning hair occurring during laser hair removal should be considered a biohazard, reported Gary S. Chuang, MD, of Harvard Medical School, Boston and his coauthors.

Use of smoke evacuators, good ventilation, and respiratory protection are warranted, especially for health care workers exposed to the plume for extended periods, they said.

The plume of burning hair occurring during laser hair removal should be considered a biohazard, reported Gary S. Chuang, MD, of Harvard Medical School, Boston and his coauthors.

Use of smoke evacuators, good ventilation, and respiratory protection are warranted, especially for health care workers exposed to the plume for extended periods, they said.

The plume of burning hair occurring during laser hair removal should be considered a biohazard, reported Gary S. Chuang, MD, of Harvard Medical School, Boston and his coauthors.

Use of smoke evacuators, good ventilation, and respiratory protection are warranted, especially for health care workers exposed to the plume for extended periods, they said.

Older patients with bipolar I disorder appear to have lower serum levels of brain-deprived neurotrophic factor than similarly aged adults without bipolar I, a study showed.

At the beginning of the study, Aline T. Soares, MD, and her colleagues recruited 118 patients from clinics in the United States and Canada with bipolar disorder who were aged 50 and over and a similar control group of 76 healthy patients. Twenty-seven of the 118 patients had type II bipolar disorder, and 91 had type I bipolar disorder; all had been clinically euthymic for at least 4 weeks when they were evaluated, reported Dr. Soares of the department of internal medicine at the University of São Paulo (Brazil).

The results showed that patients positively identified with bipolar I disorder had lowered brain-deprived neurotrophic factor (BDNF) levels, compared with their control group counterparts. Lower levels of BDNF were not detected in those with bipolar II disorder, the investigators reported (Am J Geriatr Psychiatry. 2016 Aug;24[8]:596-601).

“Our study represents a continuation of the [bipolar disorder] and BDNF story: Prolonged bipolar illness appears to lead to decreased BDNF, even in the euthymic state,” Dr. Soares and her colleagues wrote. “This reduces the brain’s capacity for neurogenesis and neuroplasticity and theoretically increases the risk of hippocampal shrinkage, cognitive deficits, and dementia.”

Future studies are needed to look into how BDNF levels affect mood, cognitive abilities, and other areas of life related to bipolar disorder, they said.

Dr. Soares and her colleagues reported that they had no conflicts to disclose.

To read more about the study, click here.

Older patients with bipolar I disorder appear to have lower serum levels of brain-deprived neurotrophic factor than similarly aged adults without bipolar I, a study showed.

At the beginning of the study, Aline T. Soares, MD, and her colleagues recruited 118 patients from clinics in the United States and Canada with bipolar disorder who were aged 50 and over and a similar control group of 76 healthy patients. Twenty-seven of the 118 patients had type II bipolar disorder, and 91 had type I bipolar disorder; all had been clinically euthymic for at least 4 weeks when they were evaluated, reported Dr. Soares of the department of internal medicine at the University of São Paulo (Brazil).

The results showed that patients positively identified with bipolar I disorder had lowered brain-deprived neurotrophic factor (BDNF) levels, compared with their control group counterparts. Lower levels of BDNF were not detected in those with bipolar II disorder, the investigators reported (Am J Geriatr Psychiatry. 2016 Aug;24[8]:596-601).

“Our study represents a continuation of the [bipolar disorder] and BDNF story: Prolonged bipolar illness appears to lead to decreased BDNF, even in the euthymic state,” Dr. Soares and her colleagues wrote. “This reduces the brain’s capacity for neurogenesis and neuroplasticity and theoretically increases the risk of hippocampal shrinkage, cognitive deficits, and dementia.”

Future studies are needed to look into how BDNF levels affect mood, cognitive abilities, and other areas of life related to bipolar disorder, they said.

Dr. Soares and her colleagues reported that they had no conflicts to disclose.

To read more about the study, click here.

Older patients with bipolar I disorder appear to have lower serum levels of brain-deprived neurotrophic factor than similarly aged adults without bipolar I, a study showed.

At the beginning of the study, Aline T. Soares, MD, and her colleagues recruited 118 patients from clinics in the United States and Canada with bipolar disorder who were aged 50 and over and a similar control group of 76 healthy patients. Twenty-seven of the 118 patients had type II bipolar disorder, and 91 had type I bipolar disorder; all had been clinically euthymic for at least 4 weeks when they were evaluated, reported Dr. Soares of the department of internal medicine at the University of São Paulo (Brazil).

The results showed that patients positively identified with bipolar I disorder had lowered brain-deprived neurotrophic factor (BDNF) levels, compared with their control group counterparts. Lower levels of BDNF were not detected in those with bipolar II disorder, the investigators reported (Am J Geriatr Psychiatry. 2016 Aug;24[8]:596-601).

“Our study represents a continuation of the [bipolar disorder] and BDNF story: Prolonged bipolar illness appears to lead to decreased BDNF, even in the euthymic state,” Dr. Soares and her colleagues wrote. “This reduces the brain’s capacity for neurogenesis and neuroplasticity and theoretically increases the risk of hippocampal shrinkage, cognitive deficits, and dementia.”

Future studies are needed to look into how BDNF levels affect mood, cognitive abilities, and other areas of life related to bipolar disorder, they said.

Dr. Soares and her colleagues reported that they had no conflicts to disclose.

To read more about the study, click here.

Patients with HIV facial lipoatrophy (FLA) had improved quality of life scores after treatment with hyaluronic acid (HA) filler, report Derek Ho of the Sacramento VA Medical Center, and coauthors.

A prospective, open-label, phase I and II study assessed 20 patients with an HIV FLA Carruthers Lipoatrophy Severity Scale (CLSS) grade of 2 or higher, who had not received treatment for HIV FLA in the past year. Volumizing of the cheeks and temples was performed using a 20 mg/mL HA filler, with an optional touch-up at 2 weeks follow-up. Patients were given a vision exam before treatment, immediately after treatment, and 15 minutes after treatment.

Quality of life was assessed before treatment and at 12 months follow-up using the Dermatology Life Quality Index (DLQI). Satisfaction was evaluated using a subject satisfaction questionnaire at 12 months follow-up, Mr. Ho and his colleagues reported.

DLQI scores were 1.6±3.0 (range = 0-11) and 0.5±1.2 (range = 0-5) at baseline and follow-up, respectively, the authors said. Additionally, 100% of patients reported high satisfaction as indicated by answers on the subject satisfaction questionnaire, they added.

The investigators warned, however, that they would not recommend the DLQI in the future as a measure of quality of life, as this scale focuses on disability, and fails to account for mental health issues.

Still, the findings highlight “the importance of educating and offering aesthetic and corrective treatment to all patients with HIV FLA,” the authors concluded.

Read the full article in the Journal of Drugs in Dermatology.

Patients with HIV facial lipoatrophy (FLA) had improved quality of life scores after treatment with hyaluronic acid (HA) filler, report Derek Ho of the Sacramento VA Medical Center, and coauthors.

A prospective, open-label, phase I and II study assessed 20 patients with an HIV FLA Carruthers Lipoatrophy Severity Scale (CLSS) grade of 2 or higher, who had not received treatment for HIV FLA in the past year. Volumizing of the cheeks and temples was performed using a 20 mg/mL HA filler, with an optional touch-up at 2 weeks follow-up. Patients were given a vision exam before treatment, immediately after treatment, and 15 minutes after treatment.

Quality of life was assessed before treatment and at 12 months follow-up using the Dermatology Life Quality Index (DLQI). Satisfaction was evaluated using a subject satisfaction questionnaire at 12 months follow-up, Mr. Ho and his colleagues reported.

DLQI scores were 1.6±3.0 (range = 0-11) and 0.5±1.2 (range = 0-5) at baseline and follow-up, respectively, the authors said. Additionally, 100% of patients reported high satisfaction as indicated by answers on the subject satisfaction questionnaire, they added.

The investigators warned, however, that they would not recommend the DLQI in the future as a measure of quality of life, as this scale focuses on disability, and fails to account for mental health issues.

Still, the findings highlight “the importance of educating and offering aesthetic and corrective treatment to all patients with HIV FLA,” the authors concluded.

Read the full article in the Journal of Drugs in Dermatology.

Patients with HIV facial lipoatrophy (FLA) had improved quality of life scores after treatment with hyaluronic acid (HA) filler, report Derek Ho of the Sacramento VA Medical Center, and coauthors.

A prospective, open-label, phase I and II study assessed 20 patients with an HIV FLA Carruthers Lipoatrophy Severity Scale (CLSS) grade of 2 or higher, who had not received treatment for HIV FLA in the past year. Volumizing of the cheeks and temples was performed using a 20 mg/mL HA filler, with an optional touch-up at 2 weeks follow-up. Patients were given a vision exam before treatment, immediately after treatment, and 15 minutes after treatment.

Quality of life was assessed before treatment and at 12 months follow-up using the Dermatology Life Quality Index (DLQI). Satisfaction was evaluated using a subject satisfaction questionnaire at 12 months follow-up, Mr. Ho and his colleagues reported.

DLQI scores were 1.6±3.0 (range = 0-11) and 0.5±1.2 (range = 0-5) at baseline and follow-up, respectively, the authors said. Additionally, 100% of patients reported high satisfaction as indicated by answers on the subject satisfaction questionnaire, they added.

The investigators warned, however, that they would not recommend the DLQI in the future as a measure of quality of life, as this scale focuses on disability, and fails to account for mental health issues.

Still, the findings highlight “the importance of educating and offering aesthetic and corrective treatment to all patients with HIV FLA,” the authors concluded.

Read the full article in the Journal of Drugs in Dermatology.

Psoriasis patients may have more success with a second tumor necrosis factor (TNF) antagonist after failure with a first, report Paul S. Yamauchi, MD, PhD, and coauthors.

Investigators analyzed 15 studies evaluating the efficacy of switching TNF antagonists after primary or secondary failure. Response rates at 24 weeks for a second antagonist were 30%-74% for a 75% improvement in Psoriasis Area and Severity Index score, and 20%-70% for achieving a Physician Global Assessment score of 0/1. Mean improvements in Dermatology Life Quality Index ranged from –3.5 to –13, Dr. Yamauchi and colleagues reported.

©AzriSuratmin/Thinkstock

Patients who experienced secondary failure with initial treatment generally achieved better responses than those with primary failure, the authors said.

Though response rates to a second anti-TNF agent were lower than for a first, “a substantial proportion of patients in every study achieved treatment success,” they added.

Read the full article in the Journal of the American Academy of Dermatology.

dermnews@frontlinemedcom.com

Psoriasis patients may have more success with a second tumor necrosis factor (TNF) antagonist after failure with a first, report Paul S. Yamauchi, MD, PhD, and coauthors.

Investigators analyzed 15 studies evaluating the efficacy of switching TNF antagonists after primary or secondary failure. Response rates at 24 weeks for a second antagonist were 30%-74% for a 75% improvement in Psoriasis Area and Severity Index score, and 20%-70% for achieving a Physician Global Assessment score of 0/1. Mean improvements in Dermatology Life Quality Index ranged from –3.5 to –13, Dr. Yamauchi and colleagues reported.

©AzriSuratmin/Thinkstock

Patients who experienced secondary failure with initial treatment generally achieved better responses than those with primary failure, the authors said.

Though response rates to a second anti-TNF agent were lower than for a first, “a substantial proportion of patients in every study achieved treatment success,” they added.

Read the full article in the Journal of the American Academy of Dermatology.

dermnews@frontlinemedcom.com

Psoriasis patients may have more success with a second tumor necrosis factor (TNF) antagonist after failure with a first, report Paul S. Yamauchi, MD, PhD, and coauthors.

Investigators analyzed 15 studies evaluating the efficacy of switching TNF antagonists after primary or secondary failure. Response rates at 24 weeks for a second antagonist were 30%-74% for a 75% improvement in Psoriasis Area and Severity Index score, and 20%-70% for achieving a Physician Global Assessment score of 0/1. Mean improvements in Dermatology Life Quality Index ranged from –3.5 to –13, Dr. Yamauchi and colleagues reported.

©AzriSuratmin/Thinkstock

Patients who experienced secondary failure with initial treatment generally achieved better responses than those with primary failure, the authors said.

Though response rates to a second anti-TNF agent were lower than for a first, “a substantial proportion of patients in every study achieved treatment success,” they added.

Read the full article in the Journal of the American Academy of Dermatology.

dermnews@frontlinemedcom.com

Cosmetic dermatology patients are increasingly seeking hand rejuvenation procedures to eliminate appearance discrepancies between the face and hands, reported Ramin Fathi, MD, and Joel L. Cohen, MD, FAAD, who reviewed the benefits and complications of soft filler methods.

Pre-procedure evaluation includes assessing volume of lost fat from the skin via the Merz hand grading scale. Prior to augmentation, a detailed patient history, including medications, medical problems, and bleeding abnormalities, is typically taken, as well as assessment of patient lifestyle issues involving extensive hand activity, such as typing on a keyboard or playing piano. The authors reviewed three hand rejuvenation methods: autologous fat grafting, hyaluronic acid (HA), and poly-L-lactic acid (PLLA).

Although autologous fat grafting is still done in some practices, it is more invasive compared with soft tissue fillers, and can result in complications such as infection, cyst formation, temporary dysesthesia, and significant edema, the authors noted. PLLA is not approved for dorsal hand augmentation, and is used off label.

Hyaluronic acid (HA) fillers such as Restylane, Belotero, and Juvederm are approved only in the United States for facial soft tissue augmentation, and are also used off label for hand rejuvenation. The authors cited a small study of 16 patients evaluating small gel particle HA in the dorsal hand, in which vascular, tendon, bony prominence, and skin turgor were improved by 60.9%, 65.2%, 73.7%, and 26.3%, respectively, 2 weeks after treatment. “A distinct advantage of HA is that imperfections or undesired product can usually be reversed in the short term using hyaluronidase enzyme,” they added.

Despite the common adverse effects of erythema, pruritus, ecchymosis, and edema, “hand augmentation with soft tissue filler, alone or in conjunction with other rejuvenation modalities, can have a significant impact on improving appearance of the dorsal hands,” satisfying patient cosmetic objectives, the authors concluded.

Read the full article in the Journal of Drugs in Dermatology (J Drugs Dermatol. 2016;15[7]:809-15).

Cosmetic dermatology patients are increasingly seeking hand rejuvenation procedures to eliminate appearance discrepancies between the face and hands, reported Ramin Fathi, MD, and Joel L. Cohen, MD, FAAD, who reviewed the benefits and complications of soft filler methods.

Pre-procedure evaluation includes assessing volume of lost fat from the skin via the Merz hand grading scale. Prior to augmentation, a detailed patient history, including medications, medical problems, and bleeding abnormalities, is typically taken, as well as assessment of patient lifestyle issues involving extensive hand activity, such as typing on a keyboard or playing piano. The authors reviewed three hand rejuvenation methods: autologous fat grafting, hyaluronic acid (HA), and poly-L-lactic acid (PLLA).

Although autologous fat grafting is still done in some practices, it is more invasive compared with soft tissue fillers, and can result in complications such as infection, cyst formation, temporary dysesthesia, and significant edema, the authors noted. PLLA is not approved for dorsal hand augmentation, and is used off label.

Hyaluronic acid (HA) fillers such as Restylane, Belotero, and Juvederm are approved only in the United States for facial soft tissue augmentation, and are also used off label for hand rejuvenation. The authors cited a small study of 16 patients evaluating small gel particle HA in the dorsal hand, in which vascular, tendon, bony prominence, and skin turgor were improved by 60.9%, 65.2%, 73.7%, and 26.3%, respectively, 2 weeks after treatment. “A distinct advantage of HA is that imperfections or undesired product can usually be reversed in the short term using hyaluronidase enzyme,” they added.

Despite the common adverse effects of erythema, pruritus, ecchymosis, and edema, “hand augmentation with soft tissue filler, alone or in conjunction with other rejuvenation modalities, can have a significant impact on improving appearance of the dorsal hands,” satisfying patient cosmetic objectives, the authors concluded.

Read the full article in the Journal of Drugs in Dermatology (J Drugs Dermatol. 2016;15[7]:809-15).

Cosmetic dermatology patients are increasingly seeking hand rejuvenation procedures to eliminate appearance discrepancies between the face and hands, reported Ramin Fathi, MD, and Joel L. Cohen, MD, FAAD, who reviewed the benefits and complications of soft filler methods.

Pre-procedure evaluation includes assessing volume of lost fat from the skin via the Merz hand grading scale. Prior to augmentation, a detailed patient history, including medications, medical problems, and bleeding abnormalities, is typically taken, as well as assessment of patient lifestyle issues involving extensive hand activity, such as typing on a keyboard or playing piano. The authors reviewed three hand rejuvenation methods: autologous fat grafting, hyaluronic acid (HA), and poly-L-lactic acid (PLLA).

Although autologous fat grafting is still done in some practices, it is more invasive compared with soft tissue fillers, and can result in complications such as infection, cyst formation, temporary dysesthesia, and significant edema, the authors noted. PLLA is not approved for dorsal hand augmentation, and is used off label.

Hyaluronic acid (HA) fillers such as Restylane, Belotero, and Juvederm are approved only in the United States for facial soft tissue augmentation, and are also used off label for hand rejuvenation. The authors cited a small study of 16 patients evaluating small gel particle HA in the dorsal hand, in which vascular, tendon, bony prominence, and skin turgor were improved by 60.9%, 65.2%, 73.7%, and 26.3%, respectively, 2 weeks after treatment. “A distinct advantage of HA is that imperfections or undesired product can usually be reversed in the short term using hyaluronidase enzyme,” they added.

Despite the common adverse effects of erythema, pruritus, ecchymosis, and edema, “hand augmentation with soft tissue filler, alone or in conjunction with other rejuvenation modalities, can have a significant impact on improving appearance of the dorsal hands,” satisfying patient cosmetic objectives, the authors concluded.

Read the full article in the Journal of Drugs in Dermatology (J Drugs Dermatol. 2016;15[7]:809-15).

A comparison of psoriasis-like eruptions in Kawasaki disease (KD) with classic psoriasis shows a distinct phenotype with greater remission, report Ellen S. Haddock, AB, MBA and coauthors from the School of Medicine at the University of California, San Diego.

Investigators performed a retrospective study of 11 KD cases with a psoriasiform eruption matched by gender, age, and ethnicity with psoriasis-only and KD-only controls. Genotyping was performed in 10 cases for a deletion of two late cornified envelope genes associated with pediatric-onset psoriasis.

KD-associated eruptions were similar to classic psoriasis in presentation, but with less frequent diaper area involvement, more crust, more serious exudate, and significantly higher remission (91% vs. 23%; P less than .001), the authors noted.

The findings indicate that despite similarities to classic psoriasis, “this appears to be a distinct phenotype with significantly greater propensity for remission,” the authors concluded.

Read the full article in the Journal of the American Academy of Dermatology.

A comparison of psoriasis-like eruptions in Kawasaki disease (KD) with classic psoriasis shows a distinct phenotype with greater remission, report Ellen S. Haddock, AB, MBA and coauthors from the School of Medicine at the University of California, San Diego.

Investigators performed a retrospective study of 11 KD cases with a psoriasiform eruption matched by gender, age, and ethnicity with psoriasis-only and KD-only controls. Genotyping was performed in 10 cases for a deletion of two late cornified envelope genes associated with pediatric-onset psoriasis.

KD-associated eruptions were similar to classic psoriasis in presentation, but with less frequent diaper area involvement, more crust, more serious exudate, and significantly higher remission (91% vs. 23%; P less than .001), the authors noted.

The findings indicate that despite similarities to classic psoriasis, “this appears to be a distinct phenotype with significantly greater propensity for remission,” the authors concluded.

Read the full article in the Journal of the American Academy of Dermatology.

A comparison of psoriasis-like eruptions in Kawasaki disease (KD) with classic psoriasis shows a distinct phenotype with greater remission, report Ellen S. Haddock, AB, MBA and coauthors from the School of Medicine at the University of California, San Diego.

Investigators performed a retrospective study of 11 KD cases with a psoriasiform eruption matched by gender, age, and ethnicity with psoriasis-only and KD-only controls. Genotyping was performed in 10 cases for a deletion of two late cornified envelope genes associated with pediatric-onset psoriasis.

KD-associated eruptions were similar to classic psoriasis in presentation, but with less frequent diaper area involvement, more crust, more serious exudate, and significantly higher remission (91% vs. 23%; P less than .001), the authors noted.

The findings indicate that despite similarities to classic psoriasis, “this appears to be a distinct phenotype with significantly greater propensity for remission,” the authors concluded.

Read the full article in the Journal of the American Academy of Dermatology.

Anxiety is strongly associated with a higher risk of cognitive impairment, according to a meta-analysis by B. Gulpers and coauthors from Maastricht University Medical Center in the Netherlands.

Investigators performed a literature search up to January 2015 to identify studies on the relationship between anxiety and cognition. Pooled relative risks were calculated to examine anxiety as a possible factor for cognitive impairment, cognitive decline, and dementia in community studies, and for conversion to dementia in patients referred to memory clinics.

Anxiety predicted cognitive impairment (RR = 1.77; 95% confidence interval, 1.38-2.26; z = 4.50; P less than .001) and dementia (RR = 1.57; 95% CI, 1.02-2.42; z = 2.05; P = .040) in the community, especially with increased mean age, the authors reported. Anxiety did not, however, predict conversion to dementia (RR = 1.21; 95% CI, 0.90-1.63; z = 1.28; P = .200).

“Future studies should include mediating mechanism when studying anxiety as a predictor for cognitive decline and/or dementia,” the authors concluded.

Read the full article in the American Journal of Geriatric Psychiatry.

Anxiety is strongly associated with a higher risk of cognitive impairment, according to a meta-analysis by B. Gulpers and coauthors from Maastricht University Medical Center in the Netherlands.

Investigators performed a literature search up to January 2015 to identify studies on the relationship between anxiety and cognition. Pooled relative risks were calculated to examine anxiety as a possible factor for cognitive impairment, cognitive decline, and dementia in community studies, and for conversion to dementia in patients referred to memory clinics.

Anxiety predicted cognitive impairment (RR = 1.77; 95% confidence interval, 1.38-2.26; z = 4.50; P less than .001) and dementia (RR = 1.57; 95% CI, 1.02-2.42; z = 2.05; P = .040) in the community, especially with increased mean age, the authors reported. Anxiety did not, however, predict conversion to dementia (RR = 1.21; 95% CI, 0.90-1.63; z = 1.28; P = .200).

“Future studies should include mediating mechanism when studying anxiety as a predictor for cognitive decline and/or dementia,” the authors concluded.

Read the full article in the American Journal of Geriatric Psychiatry.

Anxiety is strongly associated with a higher risk of cognitive impairment, according to a meta-analysis by B. Gulpers and coauthors from Maastricht University Medical Center in the Netherlands.

Investigators performed a literature search up to January 2015 to identify studies on the relationship between anxiety and cognition. Pooled relative risks were calculated to examine anxiety as a possible factor for cognitive impairment, cognitive decline, and dementia in community studies, and for conversion to dementia in patients referred to memory clinics.

Anxiety predicted cognitive impairment (RR = 1.77; 95% confidence interval, 1.38-2.26; z = 4.50; P less than .001) and dementia (RR = 1.57; 95% CI, 1.02-2.42; z = 2.05; P = .040) in the community, especially with increased mean age, the authors reported. Anxiety did not, however, predict conversion to dementia (RR = 1.21; 95% CI, 0.90-1.63; z = 1.28; P = .200).

“Future studies should include mediating mechanism when studying anxiety as a predictor for cognitive decline and/or dementia,” the authors concluded.

Read the full article in the American Journal of Geriatric Psychiatry.

A new study has identified three distinct trajectories of fatigue levels in patients with early symptomatic osteoarthritis (OA) in the knee and hip, report Jadran Botterman, MSc, and coauthors from the department of psychology, health, and technology at the University of Twente (the Netherlands).

Six years of data were collected from the CHECK (Cohort Hip and Cohort Knee) participants and then separated into distinct trajectories using growth mixture modeling. Three distinct fatigue trajectories were found: low fatigue, low to high fatigue, and high fatigue.

The authors found a significant association between trajectory and patient characteristics. Women, patients with comorbid disease, and patients using medications were more likely to have a high fatigue trajectory, Dr. Botterman and his colleagues reported.

“Identification of these trajectories with differing patient characteristics may warrant tailored psychosocial interventions for patients with elevated levels of fatigue,” the authors concluded.

Read the full article in the Journal of Rheumatology.

A new study has identified three distinct trajectories of fatigue levels in patients with early symptomatic osteoarthritis (OA) in the knee and hip, report Jadran Botterman, MSc, and coauthors from the department of psychology, health, and technology at the University of Twente (the Netherlands).

Six years of data were collected from the CHECK (Cohort Hip and Cohort Knee) participants and then separated into distinct trajectories using growth mixture modeling. Three distinct fatigue trajectories were found: low fatigue, low to high fatigue, and high fatigue.

The authors found a significant association between trajectory and patient characteristics. Women, patients with comorbid disease, and patients using medications were more likely to have a high fatigue trajectory, Dr. Botterman and his colleagues reported.

“Identification of these trajectories with differing patient characteristics may warrant tailored psychosocial interventions for patients with elevated levels of fatigue,” the authors concluded.

Read the full article in the Journal of Rheumatology.

A new study has identified three distinct trajectories of fatigue levels in patients with early symptomatic osteoarthritis (OA) in the knee and hip, report Jadran Botterman, MSc, and coauthors from the department of psychology, health, and technology at the University of Twente (the Netherlands).

Six years of data were collected from the CHECK (Cohort Hip and Cohort Knee) participants and then separated into distinct trajectories using growth mixture modeling. Three distinct fatigue trajectories were found: low fatigue, low to high fatigue, and high fatigue.

The authors found a significant association between trajectory and patient characteristics. Women, patients with comorbid disease, and patients using medications were more likely to have a high fatigue trajectory, Dr. Botterman and his colleagues reported.

“Identification of these trajectories with differing patient characteristics may warrant tailored psychosocial interventions for patients with elevated levels of fatigue,” the authors concluded.

Read the full article in the Journal of Rheumatology.

Insomnia is a more pronounced problem than expected among Hispanics over age 50, according to results of a study by Christopher N. Kaufmann, PhD, and his coauthors.

Dr. Kaufmann and his colleagues studied 22,252 participants of white, Non-Hispanic black, Hispanic, or other race/ethnicity. Participant data came from a nationally representative survey from 2002 to 2010, in which patients rated the severity of four insomnia symptoms. All participants were adults older than 50 years.

Insomnia severity scores increased 0.19 points over time after the investigators controlled for sex, race/ethnicity, education, and baseline age (95% CI, 0.14-0.24; t = 7.52; design df = 56; P less than .001). After adjustment for accumulated health conditions and body mass index, this trend decreased, Dr. Kaufmann and his colleagues added. However, the increasing trajectory of insomnia severity was “significantly more pronounced” among Hispanics, compared with non-Hispanic whites, after adjustment for accumulated health conditions, body mass index, and number of depressive symptoms, the investigators said in the report.

Although health conditions can result in greater insomnia severity with age, “further research is needed to determine the reasons for a different insomnia trajectory among Hispanics,” the authors concluded.

Read the full article in the American Journal of Geriatric Psychiatry.

Insomnia is a more pronounced problem than expected among Hispanics over age 50, according to results of a study by Christopher N. Kaufmann, PhD, and his coauthors.

Dr. Kaufmann and his colleagues studied 22,252 participants of white, Non-Hispanic black, Hispanic, or other race/ethnicity. Participant data came from a nationally representative survey from 2002 to 2010, in which patients rated the severity of four insomnia symptoms. All participants were adults older than 50 years.

Insomnia severity scores increased 0.19 points over time after the investigators controlled for sex, race/ethnicity, education, and baseline age (95% CI, 0.14-0.24; t = 7.52; design df = 56; P less than .001). After adjustment for accumulated health conditions and body mass index, this trend decreased, Dr. Kaufmann and his colleagues added. However, the increasing trajectory of insomnia severity was “significantly more pronounced” among Hispanics, compared with non-Hispanic whites, after adjustment for accumulated health conditions, body mass index, and number of depressive symptoms, the investigators said in the report.

Although health conditions can result in greater insomnia severity with age, “further research is needed to determine the reasons for a different insomnia trajectory among Hispanics,” the authors concluded.

Read the full article in the American Journal of Geriatric Psychiatry.

Insomnia is a more pronounced problem than expected among Hispanics over age 50, according to results of a study by Christopher N. Kaufmann, PhD, and his coauthors.

Dr. Kaufmann and his colleagues studied 22,252 participants of white, Non-Hispanic black, Hispanic, or other race/ethnicity. Participant data came from a nationally representative survey from 2002 to 2010, in which patients rated the severity of four insomnia symptoms. All participants were adults older than 50 years.

Insomnia severity scores increased 0.19 points over time after the investigators controlled for sex, race/ethnicity, education, and baseline age (95% CI, 0.14-0.24; t = 7.52; design df = 56; P less than .001). After adjustment for accumulated health conditions and body mass index, this trend decreased, Dr. Kaufmann and his colleagues added. However, the increasing trajectory of insomnia severity was “significantly more pronounced” among Hispanics, compared with non-Hispanic whites, after adjustment for accumulated health conditions, body mass index, and number of depressive symptoms, the investigators said in the report.

Although health conditions can result in greater insomnia severity with age, “further research is needed to determine the reasons for a different insomnia trajectory among Hispanics,” the authors concluded.

Read the full article in the American Journal of Geriatric Psychiatry.