Sunday, March 5, 2017

Common acne medication doubles risk of eye infection, study suggests


Acne patients who take oral medications like Accutane double their risk of developing an eye infection compared to those who do not, new research suggests. Researchers say that the use of inexpensive artificial tears or eyedrops, which are available over-the-counter at the local pharmacy, can minimize the risk.

Millions of teenagers suffer from acne, and they deal with the embarrassing skin blemishes by taking popular prescription medications such as Accutane or Roaccutane. Now, however, research from Tel Aviv University shows that these pills can also cause eye infections such as conjunctivitis (pink eye) or sties.

According to Dr. Gabriel Chodick of TAU's School of Public Health at the Sackler Faculty of Medicine, clinicians have long theorized a connection between acne and eye infections, but there was little available statistical research on the subject. "Acne itself can increase the risk of ocular diseases," he explains. "There is a greater tendency towards inflammation, and sometimes this leads to irritation." His research revealed that patients who took these oral medications doubled the risk of developing an eye infection, compared to acne sufferers who did not.

Published in Archives of Dermatology, the work was done in collaboration with Drs. Meira Neudorfer, Orna Shamai-Lubovitz and Varda Shalev from the Sackler Faculty of Medicine and Inbal Goldshtein from Maccabi Health Care Services.

Drying those tears

The researchers looked at records of almost 15,000 adolescents from the Maccabi Health Care Services database, one of Israel's largest health funds. They were divided into three groups: those who were acne-free; those who had acne but did not take oral medication; and those who had acne and were prescribed a medication such as Accutane or Roaccutane.

Out of the 15,000 subjects, 1,791 people developed inflammatory ocular diseases, including 991 in the medicated group, 446 in the acne group, and 354 in the acne-free group. The most common infection was conjunctivitis, commonly called pink eye. Four percent of patients who were on acne medication contracted pink eye, compared to 2 percent for the normal population.

Doctor7online Co."A very common side effect of Accutane and Roaccutane is dryness of skin and lips, so it's only natural that these medications would also effect the lubrication of the eyelids -- specifically the oil glands along the rim of the eyelid," explains Dr. Chodick. Tears are crucial because they lubricate the surface of the eye and they wash away debris, including bacteria and viruses, that can lie on the eye or its lid. Infection of the gland itself can lead to sties, and more serious bacterial infections might lead to the swelling of the entire eyelid.

A simple solution

Though not a serious medical condition, acne is still worth treating, says Dr. Chodick. But dermatologists and patients should be aware of these side effects, because there is the potential for long-term damage. According to some studies, including one published in Clinical and Experimental Optometry, irritation and eye rubbing can lead to structural eye problems such as keratoconus, a degeneration of the cornea.

Dr. Chodick advises that patients on oral acne medication ask their doctors how to minimize eye damage. One simple step is to use artificial tears, or eye drops, to keep the eyes lubricated. Local pharmacies can offer several inexpensive over-the-counter options, he says.


Thursday, February 2, 2017

America’s booming pet health-care business


AT THE 42,000-square-foot clinic in Hollywood that is owned by VCA, an animal-hospital chain, you may find a Pomeranian on a course of stem-cell therapy or a Shih Tzu having a hip replacement. There is even an underwater treadmill for cats. As pets are treated more and more like members of the family, so they are getting more health care. That also means they are racking up bigger vet bills for their owners.

That is the backdrop to the purchase in January of VCA by Mars, a firm best known for selling chocolate and sweets, for $9.1bn. Analysts whistled at the 31% premium Mars offered on VCA’s share price at the time, but they also agreed that the deal reflects the industry’s vitality. Spending on animal clinic visits in America has increased from a total of $13.7bn in 2012 to almost $16bn last year.

The deal is not as out of character for Mars as it may appear. Sales of chocolate are declining. The company is second only to Nestle in the market for pet food in America, but competition from sellers on Amazon has sent the firm towards animal health. It was in 2007 that Mars bought Banfield Pet Hospital, then VCA’s largest rival. Since then it has steadily expanded in the field. With the VCA deal, it will own 1,900 veterinary clinics in America and Canada, more than four times as many as National Veterinary Associates, the nearest competitor.

The success of such groups is due to the fact that “anything you see in human medicine is likely to be applied to dogs and cats”, says John Mannhaupt of Brakke Consulting. The average vet used to be a generalist, offering everything from a bottle of pills to a quick death. The modern graduate is a specialist, whether in oncology or any other of the 40 fields listed by the American Veterinary Medical Association.

Diagnostic testing is a particularly profitable field. Veterinary clinics have invested in new equipment, from CT scanners to on-site MRI machines. A cat with toothache used to be anaesthetised before a vet could peer inside its mouth, but now a scan costing anywhere between $40 and $400 does the job instead. Mars, many believe, was keen on VCA’s diagnostic laboratories, which are superior to those of Banfield and which run blood tests, and other sorts, for more than half of America’s 24,000 or so veterinary clinics.

Most owners will buy the diagnostic tests. If it is bad news, many will go on and pay for the next stage of expensive treatments. Yet for some in the field of animal health, it is all too much. Lately accusations have mounted that VCA and Banfield are foisting unnecessary treatments on animals. Over-vaccination seems to be a particular bugbear. Banfield says it has reduced the frequency with which it administers core vaccines, and that it follows industry guidelines.

Technically, it remains illegal in many states for corporations to own veterinary practices, to prevent pets being over-treated for the sake of profits. But there is a way to structure ownership to deal with that. And although treatment options for pets now mirror those in human hospitals, the risks of getting things wrong do not. In law pets count as property, and usually have a small market value. Medical malpractice suits are hardly worth the bother, and are rare—another reason why Mars’s strategy promises healthy returns.