Switzerland’s medical products authority has granted the first approval for a malaria medicine designed for small infants, touted as an advance against a disease that takes hundreds of thousands of lives — nearly all in Africa — each year.
Swissmedic gave a green light Tuesday for the medicine from Basel-based pharmaceutical company Novartis for treatment of babies with body weights between 2 and 5 kilograms (nearly 4½ to 11 pounds), which could pave the way for hard-hit African nations to follow suit in coming months.
The agency said that the decision is significant in part because it’s only the third time it has approved a treatment under a fast-track authorization process, in coordination with the World Health Organization, to help developing countries access needed treatment.
The newly approved medication, Coartem Baby, is a combination of two antimalarials. It is a lower dose version of a tablet previously approved for other age groups, including older children.
Dr. Quique Bassat, a malaria expert not affiliated with the Swiss review, said the burden of malaria in very young children is “relatively low” compared to older kids.
But access to such medicines is important to all, he said.
“There is no doubt that any child of whichever age — and particularly very, very young ones or very light-weighted ones — require a treatment,” said Bassat, the director- general of the Barcelona Institute for Global Health, known as ISGlobal.
Up to now, antimalarial drugs designed for older children have been administered to small infants in careful ways to avoid overdose or toxicity, in what Bassat called a “suboptimal solution” that the newly designed medicine could help rectify.
“This is a drug which we know is safe, we know works well, and therefore it will just be available as a new version for a specific age group,” he said.
Ruairidh Villar, a Novartis spokesperson, said that eight African countries took part in the assessment and are expected to approve the medicine within 90 days. The company said that it’s planning on a rollout on a “largely not-for-profit basis” in countries where malaria is endemic.
Dr. Bhargavi Rao, co-director of the Malaria Centre at the London School of Hygiene and Tropical Medicine, noted that malaria cases continue to rise — especially in crisis-hit countries — despite new vaccines and programs targeting the mosquitoes that spread the parasite.
She said access strategies for the new medicine must include a look at where needs are greatest, and urged clarity on pricing.
“We need transparency around what Novartis’ ‘largely not for profit’ statement means including publicly available pricing, which countries will benefit and how long for,” she wrote in an email.
Still, she said it was “significant to finally have a suitable and safe treatment for very young children — more than 20 years since WHO first pre-qualified Coartem for older age groups.
She noted the announcement comes as resistance to antimalarials has been growing and many traditional donor countries have been sharply cutting outlays for global health — including for malaria programming and research.
The mosquito-borne illness is the deadliest disease in Africa, whose 1.5 billion people accounted for 95% of an estimated 597,000 malaria deaths worldwide in 2023, according to WHO. More than three-quarters of those deaths were among children.
The IAS 2025 conference will raise a call to action after global funding cuts are impacting HIV cases in low- and middle-income countries. Image credit: Michel Lunanga / Stringer / Getty Images.
Global funding cuts, including those made by the Trump administration, are set to increase cases of human immunodeficiency virus (HIV) in Africa, research suggests.
At the 2025 International AIDS Society (IAS) meeting, taking place from 13 to 17 July in Kigali, Rwanda, researchers will present several studies that address the current political and financial issues affecting the HIV response, including the implications for Africa and the rest of the world.
Abstracts to be presented will show the impact of the financing cuts, as well as how personnel on the ground, including experts and advocates, are working to address these new and urgent challenges.
IAS president Dr Beatriz Grinsztejn said: “On the one hand, we’re witnessing extraordinary scientific breakthroughs that could transform prevention and treatment and even bring us closer to a cure.
“On the other hand, these very advances are under threat from massive funding cuts that risk stalling clinical trials, slowing our progress, and jeopardising the progress we’ve fought so hard to achieve.”
PEPFAR funding cuts set to increase HIV incidence
One abstract will examine projected changes in HIV incidence, mortality and access to pre-exposure prophylaxis (PrEP) in sub-Saharan Africa following the discontinuation of the US President’s Emergency Plan for AIDS Relief (PEPFAR).
PrEP funded by PEPFAR was received by nearly 700,000 people living across 28 sub-Saharan African countries by late 2024; however, funding was paused in January 2025. The study indicates that this pause could lead to around 6,671 extra HIV infections over a year and 3,617 further infections over the next five years.
Another abstract, set to be presented by Khensani Chauke of the Gauteng Provincial Department of Health, Pretoria, South Africa, will explore the impact in Johannesburg after the Accelerating Program Achievements to Control HIV Epidemic (APACE) award, funded through PEPFAR, was withdrawn in February 2025.
The study team has compared HIV tests, HIV diagnoses and antiretroviral therapy (ART) initiations from 2023 to 2025 and has already seen that testing decreased by 8.5% from Q1 2024 to Q1 2025. There was also a 31% decline in HIV diagnoses and a 30% decline in ART initiations. HIV positivity declined from 3% to 2.2%.
Mozambique sees 25% reduction in ART initiation
Mozambique has the third highest number of people living with HIV worldwide, with around 2.4 million people living with HIV.
As a result, the US funding freeze had an immediate impact on the African country, with the number of patients accessing ART declining by 25%, from more than 22,000 in February 2024 to just over 17,000 in February 2025.
To be presented by International AIDS Society’s senior technical adviser Anna Grimsrud, the real-world study also noted a 38% reduction in viral load tests performed in adults.
Among children, there was a 44% reduction in viral load tests, a 71% decrease in test results received and a 43% drop in virally suppressed results, indicating a higher impact on the paediatric population.
The study projects that if the funding interruption persists, Mozambique could see a 15% rise in HIV infections and a 10% increase in HIV-related deaths by the year 2030.
Conference set to demand action
The IAS 2025 conference will call for action to try and curb increasing cases in low- and middle-income countries that could occur because of the funding cuts.
Zackie Achmat, founder of the Treatment Action Campaign and a member of the Global HIV Treatment Coalition, has shared the urgent need for debt refinancing to protect the HIV response in low- and middle-income countries.
“You can’t end the AIDS pandemic while African nations must choose between paying creditors and saving lives,” Achmat said.
“As someone who has lived with HIV for more than half my life, I have seen the cost of political inaction. We fought for treatment when the world said it was impossible. Now, the convergence of crushing debt and funding cuts threatens everything we’ve built. We need urgent debt restructuring so African countries can invest in saving lives instead of servicing debt.”
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Long overlooked and underestimated, glial cells – non-neuronal cells that support, protect and communicate with neurons – are finally stepping into the neuroscience spotlight. A new Florida Atlantic University study highlights the surprising influence of a particular glial cell, revealing that it plays a much more active and dynamic role in brain function than previously thought.
Using sophisticated computational modeling and machine learning, researchers discovered how astrocytes, a “star” shaped glial cell, subtly – but significantly – modulate communication between neurons, especially during highly coordinated, synchronous brain activity.
“Clearly, glial cells are significantly implicated in several brain functions, making identifying their presence among neurons an appealing and important problem,” said Rodrigo Pena, Ph.D., senior author, an assistant professor of biological sciences within FAU’s Charles E. Schmidt College of Science on the John D. MacArthur Campus in Jupiter, and a member of the FAU Stiles-Nicholson Brain Institute. “To that end, modeling can be helpful. However, the simulation of the complex interactions between glial cells and neurons is a challenging task that requires advanced computational approaches.”
The research, in collaboration with the Federal University of São Carlos and the University of São Paulo in Brazil, addresses a fundamental gap in neuroscience.
“While neurons have long dominated the conversation, glial cells – and predominantly astrocytes – have been treated as passive support structures. But recent discoveries have challenged this neuron-centric view, suggesting astrocytes are active participants in processes like synaptic modulation, energy regulation and even network coordination,” said Laura Fontenas, Ph.D., co-author, an assistant professor of biological sciences within FAU’s Charles E. Schmidt College of Science on the John D. MacArthur Campus, and a member of the FAU Stiles-Nicholson Brain Institute.
The study, published in the journal Cognitive Neurodynamics, takes those ideas further, showing that astrocytes influence how groups of neurons fire together, especially when the brain is in a “synchronous” state – where large populations of neurons fire in a coordinated rhythm, a condition crucial for functions like attention, memory formation and sleep cycles.
To explore this, the team generated artificial brain network data and applied a suite of machine learning models including Decision Trees, Gradient Boosting, Random Forests, and Feedforward Neural Networks to classify and detect the influence of astrocytes under different network states.
Findings reveal that Feedforward Neural Networks emerged as the most effective, especially in asynchronous (less coordinated) conditions, where capturing subtle patterns required richer and more complex data.
“Our goal was to identify the presence of glial cells in synaptic transmission using different machine-learning methods, which do not require strong assumptions about the data,” said Pena. “We found that the Mean Firing Rate – a common experimental measure – was particularly effective in helping these models detect glial influences, especially when paired with robust algorithms like Feedforward Neural Networks.”
According to Fontenas, the researchers can now investigate these computational findings in appropriate animal models such as in the Zebrafish.
One of the study’s key findings is that astrocytes exert their strongest influence during synchronous brain states. In these conditions, advanced statistical tools such as spike-train coherence, which measures the timing relationships between neural signals, detected a shift toward more coordinated and frequency-diverse firing when astrocytes were present. This suggests that astrocytes not only support but may also fine-tune the rhythmic dynamics of brain networks, potentially contributing to stability and information flow.
“Even with the difficulties of identifying the presence of glial cells, our study highlights the utility of machine learning in detecting their influence within neural networks, particularly by leveraging the Mean Firing Rate as an effective data collection method,” Pena said.
Traditional brain activity metrics like firing rate and coefficient of variation often miss these subtleties. The study shows that although astrocytes affect network behavior, their contributions don’t always produce large changes in conventional measures. As a result, detecting their influence requires more nuanced tools – ones that can see beyond the obvious and identify the deeper patterns in brain activity.
As science continues to unravel the complexities of the human mind, this study is a reminder that some of the brain’s most important contributors have long gone unnoticed. Thanks to machine learning and computational neuroscience, the invisible influence of astrocytes is now coming into view – and with it, a richer, more complete picture of how the brain really works.
“By enhancing our ability to detect glial influence through advanced statistical methods, we open new avenues for exploring how neuron-glia interactions shape brain function,” said Pena. “It’s a critical step toward understanding neurological disorders and could inform future therapies that target not just neurons, but the entire cellular ecosystem of the brain.”
This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source. Our press release publishing policy can be accessed here.
Patients with type 2 diabetes (T2D) and peripheral artery disease or diabetic foot ulcers who initiated semaglutide instead of other glucose-lowering medications had a significantly reduced risk for the composite outcome of peripheral percutaneous transluminal angioplasty or critical limb ischemia and were less likely to require a lower extremity amputation.
METHODOLOGY:
The management of peripheral artery disease in diabetes involves controlling risk factors and using standard atherosclerosis therapies, and recent trials have shown that certain GLP-1 receptor agonists reduce cardiovascular risk and improve limb perfusion and walking ability.
Researchers conducted a single-center retrospective observational study to compare the occurrence of major limb events in patients with T2D who initiated either injective or oral semaglutide vs other glucose-lowering medications (metformin, SGLT2 inhibitors, sulfonylurea/glinides, insulin, and pioglitazone) in a real-world setting between January 2020 and April 2025.
They included two propensity score-matched cohorts of 167 participants each, comprising patients with T2D for at least 1 year; documented peripheral artery disease or diabetic foot ulcers with an exposed tendon, joint, or bone; and data on outcomes of major limb events available.
The primary outcome was major limb events, defined as a composite of peripheral percutaneous transluminal angioplasty or critical limb ischemia.
TAKEAWAY:
During a mean follow-up duration of 30.1 months, the risk for major limb events was 23% lower with semaglutide than with other glucose-lowering medications (hazard ratio [HR], 0.77; P = .029).
Compared with other medications, semaglutide was associated with a 24% lower risk for peripheral percutaneous transluminal angioplasty (HR, 0.76; P = .045) and a 50% lower risk for lower extremity amputation (HR, 0.50; P = .008).
Only 8% of patients experienced adverse events (mainly gastrointestinal) with semaglutide, and none required treatment discontinuation.
IN PRACTICE:
“Among persons with T2DM [type 2 diabetes mellitus] and PAD [peripheral artery disease] or foot ulcers, the use of semaglutide was associated with a significantly lower risk of major limb events than other GLT [glucose-lowering therapies]. This is coherent with the cardiovascular benefits associated with the use of certain GLP-1RAs [GLP-1 receptor agonists],” the authors of the study concluded.
SOURCE:
This study was led by Paola Caruso, PhD, Division of Endocrinology and Metabolic Diseases, University Hospital Luigi Vanvitelli, Naples, Italy. It was published online on July 07, 2025, in Diabetes, Obesity and Metabolism.
LIMITATIONS:
The observational and retrospective nature of the study design are major drawbacks of this study. As a single-center study, the findings have lower external validity and generalizability compared with multicenter studies. The authors noted that residual confounding may exist due to measurement error and unmeasured factors, such as socioeconomic variables that are associated with worse prognosis of diabetes and its vascular complications.
DISCLOSURES:
This study did not receive any funding. Some authors disclosed that they received consultancy fees from and/or gave lectures for certain pharmaceutical companies.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
China-based Wiskind Cleanroom has secured a contract for the design and construction of a new animal vaccine production base in Brazil.
The project marks a strategic partnership with a prominent Brazilian biopharmaceutical company.
The win also represents a significant milestone for Wiskind in the South American biomedical sector.
The new facility will comprise six separate buildings, including a virus diagnosis building, a virus workshop, a bacteria workshop, an animal house, a bacteria diagnosis building, and a research and development centre.
Key operational zones will comply with ABSL-3 standards, meeting biosafety requirements set by the World Health Organization
The total construction area exceeds 12,000 sqm.
Once completed, the project will become Brazil’s first high-level veterinary Good Manufacturing Practice (GMP) benchmark facility, integrating virus diagnosis, vaccine production, and R&D testing.
The facility is expected to set a new standard for veterinary vaccine production in the region.
A notable feature of the project is the implementation of an Animal Biosafety Level 3 (ABSL-3) protection system, incorporating a negative pressure gradient control system across all areas.
Once completed, the project will become Brazil’s first high-level veterinary Good Manufacturing Practice benchmark facility
Key operational zones will comply with ABSL-3 standards, meeting biosafety requirements set by the World Health Organization (WHO), the European Union (EU), and Brazil’s Ministry of Agriculture, Livestock and Food Supply (MAPA).
The construction phase will involve the parallel development of all six individual buildings, facilitated by the use of Building Information Modelling (BIM) technology to enable multi-disciplinary, collaborative construction management.
This approach is anticipated to reduce the traditional construction timeline by over 30%, setting a new benchmark for similar projects in the sector.
Wiskind Cleanroom, headquartered in Shandong, China, specialises in the design, manufacture, and installation of modular cleanroom systems for biopharmaceutical, healthcare, and high-tech industries.
The company provides integrated cleanroom engineering solutions globally, with a focus on innovative technologies and international quality standards.
WHO’s
global health sector strategies for HIV, viral hepatitis, and sexually transmitted infections (STIs) aim
to reduce gonorrhoea and syphilis infections by 90% by 2030, emphasizing
improved prevention, diagnostic,
and treatment services. Addressing asymptomatic STIs is crucial, as many
infections remain undetected, particularly in women and in non-urethral
sites like the pharynx and rectum. The rising antimicrobial resistance in pathogens such as N. gonorrhoeae
and M. genitalium complicates treatment, with ceftriaxone currently
being the last effective option for gonorrhoea in many countries.
WHO’s
new guidelines focus on managing asymptomatic STIs with evidence-based
recommendations for screening N. gonorrhoeae and
C. trachomatis, complementing existing guidelines for syphilis, STI
partner services, and symptomatic infections.
These guidelines also aim
to support national health programs in reaching the 2030 targets and are
intended for policy-makers, healthcare workers,
and organizations involved in STI care and prevention. The
recommendations were developed using the GRADE approach, with systematic
reviews and expert evaluations ensuring their robustness.
Annex
Evidence-to-decision framework and systematic review for the management of asymptomatic sexually transmitted infections (PDF, 1.7 Mb)
The human microbiome, particularly microbial communities living in our gut, has captured the interest of both scientists and the lay public due to its potential to change how nutrition and medical treatments work.
Patrick Veiga, PhD, Research Director of the MetaGenoPolis unit at the French National Research Institute for Agriculture, Food, and Environment (INRAE), and gut microbiome expert, has just launched the novel “Mission: Microbiome – Metchnikoff’s Legacy” in which science and suspense blend to digest the most relevant microbiome research findings in an easy-to-understand language. Joël Doré, PhD, Research Director at the INRAE and gut microbial ecologist, wrote the book’s prologue. The book is available in English, French, and will soon be released in Italian.
Through the lens of a story involving microbiologist Rafael Martins, who must save his wife Clara and the reputation of Professor Andrew Smith after falsified research result come to light, Veiga delves into the hidden work of cutting-edge microbiome research, from a blend of gut microorganisms administered in capsules to manage recurring Clostridioides difficile infections to the discovery of a gene that acts like a satiety inhibitor that is highly abundant in the American microbiome and nearly absent in the Japanese. The setting is the fascinating city of Boston.
Regarding what inspired the author to write a science thriller about the microbiome, Veiga acknowledged to GMFH editors that: “today, a lot of people know what the gut microbiome is. But most still don’t realize how much it could change medicine and nutrition. More than 100 years ago, researchers like Metchnikoff were pioneers in studying the “gut flora.” As a legacy of their work, yogurt and fermented foods became part of our diets. And today, pharmacies are full of probiotics and prebiotics.
Now imagine the legacy of today’s research: next-generation probiotics, precision medicine, and personalized nutrition. That’s hope for better health. And this book is a message of that hope”.
Given the emerging role of gut microbes in health and disease, emerging research must be clearly communicated to help the non-expert audiences interpret findings accurately and make informed health choices. Beyond immersing the reader in the scientific thriller, Veiga also separates the wheat from the chaff, separating hype from real facts in the microbiome field. The format of a good story makes microbiome science more memorable, not only for the lay public but even for scientists. The end of the book includes relevant scientific references that support the statement in each chapter, so the curious reader can check the information presented throughout the book.
The book highlights that diet and lifestyle are the most studied tools available to care for our gut microbiome. Regarding diet, a high diversity of fibers and polyphenols is essential to nourish gut microbes. This implies eating a variety of whole grains, fruits, nuts, and pulses, and not only increasing the amount of these food staples. Fermented foods like yogurt also increase the diversity of gut microbes, and scientists are figuring out how they impact the gut and immune system.
Veiga states, “Science isn’t just for scientists. The microbiome is part of our story, our health, our diet. I hope this book sparks curiosity, conversation, and maybe even new habits!”.
Children can benefit from a variety of dermatologic laser procedures, from hair removal to treatment of scars and vascular anomalies. However, the data on the safety and effectiveness of lasers for treating skin conditions in pediatric patients is lacking, as are clinical guidelines.
Lasers have been widely used in pediatric dermatology, with the earliest reports of laser treatment of port-wine stains going back 30 years or more. The steady evolution of devices has improved clinical results, but the use of lasers in children for dermatologic conditions carries unique challenges, pediatric dermatologists who specialize in laser treatments have reported.
A multitude of indications for ablative fractional lasers (AFL) for pediatric patients exist. However, “performing laser surgery on kids tends to be a very different experience than working with adult patients,” Andrew C. Krakowski, MD, network chair of Dermatology at St. Luke’s University Health Network in Easton, Pennsylvania, told Medscape Medical News. “First off, adult patients want to be there, usually to have something being made to look better. Kids, on the other hand, want to be anywhere other than the doctor’s office.”
Kristen M. Kelly, MD
Lasers can be useful for patients of all ages, “from newborns to people over 100 years old, depending on what you’re trying to treat,” Kristen M. Kelly, MD, professor and chair of Dermatology at the UCI Irvine School of Medicine, Irvine, California, told Medscape Medical News. “Just like any therapeutic modality, you want to make sure that you know how to use it, that you’re using it for the correct indications, you’re using it in the correct way for that particular indication.”
Indications for Lasers in Pediatric Dermatology
Pediatric patients can undergo laser procedures for many of the same indications as adults, including hair removal. Anna Yasmine Kirkorian, MD, chief of Dermatology at Children’s National Hospital, Washington, DC, and colleagues reviewed the ethical and clinical considerations of lasers and other hair removal modalities in pediatric patients in a 2024 review. “All methods of hair removal appear to be safe and generally well tolerated in children, and there are no age restrictions to any modality,” Kirkorian and her coauthors wrote. Regarding lasers specifically, they added, “in the pediatric population, lasers have the most extensive data supporting their use for hair removal, and their safety profile in treating other dermatologic conditions adds to the existing body of evidence.”
AFL can be used for a host of scarring indications in pediatric patients, including hypertrophic scarring, keloid scarring, acne scarring, and surgical scarring. At the Society for Pediatric Dermatology annual meeting held the day before the American Academy of Dermatology meeting in March, Krakowski said the treatment of self-cutting scars is another indication.
Andrew C. Krakowski, MD
“A big focus of mine is treating kids’ scars; not just the appearance of scars but, perhaps even more importantly, any deficit in function the scar may be causing,” Krakowski told Medscape Medical News.
Other pediatric indications Krakowski enumerated include collagen nodules and contracture, repigmentation of pulse dye laser hypopigmentation, porokeratotic eccrine ostial and dermal duct nevus, Dowling-Degos disease, angiofibromas in tuberous sclerosis, recessive dystrophic epidermolysis bullosa, Goltz syndrome, and infantile hemangiomas and birthmarks.
Psychosocial Issues in Children
“Scars can also be associated with posttraumatic stress disorder and depression,” Krakowski said. Burn scars are a typical example of the latter. And disfiguring scars can also be associated with increased anxiety and feelings of social isolation in adolescents and teenagers.
“These scar-related comorbidities are often under-investigated and underreported, so you really have to make the deliberate point to ask your patients and then be prepared to address what they share,” he said.
Children with chronic skin conditions deal with a host of psychosocial issues, such as bullying and stigmatization, different from those that adults deal with, a multisite cross-sectional study of 1671 children published last year in JAMA Dermatology reported.
The study concluded that this is an area that requires further study and one that dermatologists need to take more seriously. While skin disorders “are often regarded as less serious” than other groups of diseases, “a child or adolescent with a chronic skin disorder risks becoming the target for bullying, alienation, and feelings of reduced self-worth, leading to stigma,” the authors wrote.
“There are both physical and emotional scars,” Kelly said. “Sometimes, that’s something that people need an opportunity to be able to deal with.” In some cases, other resources, such as counseling or group therapy, may be in order, she said.
Informed Consent for Pediatric Patients
Obtaining informed consent for a dermatologic laser procedure for a child is far different from the process for adults, Kirkorian told Medscape Medical News. “Children cannot consent to procedures, but as often as is possible, they should be able to assent,” she said. The dermatologist must be able to explain the procedure to the child in an age-appropriate manner.
Anna Yasmine Kirkorian, MD
“For procedures, such as laser hair removal, which are elective and not medically necessary, the child should both want to participate in the procedure and be able to comply with safety requirements,” such as having the ability to wear eye protection and stay still during the procedure, she said.
Parents play an integral role in the informed consent process because they are the ones ultimately giving the informed consent for their child, Kirkorian said. But the child must also cooperate. “It’s important that we do not force children to undergo procedures that are not medically necessary or the only option if they are unwilling participants,” she said.
Two examples Kirkorian offered where the child’s cooperation is vital are cryotherapy for the treatment of verruca or intralesional steroid injections for the treatment of alopecia areata. She only performs these procedures on children if they “are willing and able to participate because these procedures can be painful and do not lead to resolution of the condition in all cases,” she said. “If a child cannot or will not participate with such procedures, then alternative medical treatments would be indicated.”
Medically necessary procedures, such as biopsy of a changing nevus, require a different approach, she said. “If a child cannot comply, then we consider a sedated procedure as an alternative,” Kirkorian said.
Informing parents and children of procedures requires different approaches for each, Kelly said. “Obviously, the language you might use for the parents and the children could be somewhat different, because, certainly, you want everyone to understand.”
In addition, “you want to work with the parents to find the best way to approach the information with the child,” she added. “You want them to be informed. You also don’t want to create unnecessary fear, and so you need to find the right approach to let them know what will be happening but not scare them.”
Pain Management in Children
Children also have different pain management needs. “Obviously, it’s not a totally painless procedure,” Lisa Arkin, MD, director of Pediatric Dermatology and co-director of the Birthmarks and Vascular Anomalies Program at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin, said of laser ablation. “Most kids of an appropriately selected age and maturity can tolerate these procedures in the office.”
Here, the dermatologist may need to take a nuanced approach based on the type of injury or condition being treated, she said. “There’s always sort of a select patient population, particularly the kids who’ve had extensive burns, where there’s just too much trauma, and you just need to leverage general anesthesia to keep them comfortable.”
In children, the same principles apply as in adults: mitigating anxiety, pain, and fear, Arkin said. Techniques include topical anesthetic cream, cooling of the epidermis, and use of the Buzzy handheld device that combines a reusable ice pack and vibration near the treatment area.
Lisa Arkin, MD
“Control is a big thing for kids,” Arkin said. “They want to know how much it’s going to hurt and how many pulses it will take so that they can mentally wrap their head around expectations.”
Another strategy in small children that Kirkorian has found useful is having the parent hold the child during the laser treatment. “There are many positions or embraces that can be taught, especially by collaborating with child-life teams,” she said. “The parent’s job is to provide comfort, not to ‘hold the child down.’”
Besides topical anesthetics, vibratory devices, and cold sprays, other approaches include distraction with videos, music, or virtual reality, Kirkorian said.
“Lastly, dermatologists who perform procedures on children should feel very comfortable doing so and be able to perform the procedures quickly and effectively on a moving patient,” she added. Otherwise, the child should be referred to a board-certified pediatric dermatologist.
Managing Expectations
Preparing parents and children for the eventual outcome also requires some skill and nuance. “Dermatologists should explain the procedure plan in detail with parents in advance of the procedure while being mindful that this discussion might be best performed without the child present in case it will increase the child’s anxiety if it is a small child,” Kirkorian said.
“For older children or adolescents, it’s important to include them in the discussion because they cannot be ‘held down’ or restrained safely, so they need to be able to understand and assent,” she added.
Kelly gave an example of how that conversation can go with a child. “If I’m treating a scar — and I would say the same thing to adults — I never promise that I’m going to completely remove the scar,” she said. “I’m not going to be able to make it go away like it had never happened, but we can dramatically improve it.”
A Word About Teenagers
In Krakowski’s experience, “teenagers are awesome” and have often been the most motivated of patients “because they want nothing more than to fit in with their peers,” whereas adults “tend to want to stand out from the people around them.”
However, teenagers can also present unique challenges compared with younger children, he said.
“The trouble with teenagers, though, is that they are old enough and strong enough to be able to get off the exam table and walk out of the procedure room,” Krakowski said. “You can be halfway through a procedure, and if they decide they are finished, there is not much you can do about it.”
His advice: Plan ahead so that the treatment can be completed. For example, to treat atrophic scars from chronically inflamed acne, which is the most common condition he treats with lasers in teenagers, he’s switched from AFL to a fractional nonablative device because patients tolerate it better. Referring to AFL, he said, “I know this device hurts and is associated with significant downtime.”
With the nonablative device, “I can finish the treatments, and I know the patients will notice some significant improvement by the end of our third or fourth treatment session,” Krakowski said.
That, he said, improves the chances that these potentially difficult pediatric patients will complete their treatment.
Krakowski and Kirkorian reported having no relevant financial relationships. Arkin reported having financial relationships with Amgen, Eli Lilly and Company, Merck, and Sanofi/Regeneron. Kelly reported having financial relationships with Solta Medical, Candela, Michelson Diagnostics, Sciton, Inc., Lutronic, Cutera, Primus Pharmaceuticals, and Shanghai Fudan-Zhangjiang BioPharmaceutical.
Richard Mark Kirkner is a medical journalist based in Philadelphia.
SYDNEY, July 9 (Xinhua) — More than 230,000 cancer deaths have been prevented in Australia since the mid-1980s thanks to decades of investment in cancer prevention, screening and treatment, a new study revealed.
The study, published in the Australian and New Zealand Journal of Public Health on Tuesday, found that anti-smoking campaigns have driven a sharp decline in lung cancer deaths, while improved screening and treatments have reduced mortality from breast, cervical, and stomach cancers, said the study’s lead researcher Brigid Lynch, deputy dead of Cancer Epidemiology at Cancer Council Victoria.
“What we’re seeing is a snowball effect, we’re now seeing the result of investments made in cancer control over the many decades,” Lynch said.
Since the 1980s, the risk of dying from cancer has dropped by 20 percent for men and 11 percent for women, said the study.
However, the study warns that deaths from liver and brain cancers are still rising, largely due to lifestyle factors and chronic infections.
Experts call for continued investment in prevention and early detection, especially as cancer incidence is expected to rise by 50 percent by 2044 due to Australia’s ageing population. ■
