Nearly one in 5 school-age children are afflicted with eczema, a monumentally annoying skin disorder characterized by red, itchy, patchy lesions that when scratched, mature into crusty, weeping sores which often become superinfected with staphylococcus aureus.

Once bacterial superinfection occurs, physicians typically prescribe oral or topical antibiotics with the downside being rapid development of resistance including that dreaded scourge, MRSA.

But now scientists at Northwestern are reporting that adding a small amount of household bleach to the bathwater of children with moderate to severe eczema markedly improves the condition.

Jennifer Huang, Amy Paller and colleagues prescribed oral antibiotics to 31 patients who were between the ages of 6 months and 17 years and were afflicted by eczema that had been complicated by staphylococcal superinfection.

Half the patients were also instructed to bathe in a standard tub into which a half a cup of bleach had been added. These patients also received intranasal antibiotic ointment to eliminate bacterial colonization of that orifice.

Controls added an inert substance that looked and smelled like bleach to their baths, and applied an ointment containing fake antibiotics into their noses.

All subjects were instructed to bathe twice a week for 5-10 minutes.

The scientists saw so much improvement in the treatment group, they halted the study early and switched kids in the control group over to the bleach.

“The eczema kept getting better and better with the bleach baths, and these baths prevented it from flaring again,” Paller told BurrillReport. 

“We presume the bleach has antibacterial properties and decreased the number of bacteria on the skin, which is one of the drivers of flares,” added the Chariman of Pediatric Dermatology.
 
The write-up is in Pediatrics.

Business scholars have concluded that venture capitalists pay little or no heed to those magnificent, 50-page business plans produced by young companies, preferring instead to rely on instinct and experience to sort the myriad opportunities before them.

That’s especially true about the stuff on educational credentials, prior start-up experience or success raising capital, or the wondrous prior achievements of management team members.

“In general, business plans don’t matter,” concluded Brent Goldfarb for the New York Times.

The senior author of the counterintuitive paper is an associate professor at the Robert H. Smith School of Business, a part of U. Maryland.

The conclusion was no surprise for Jeff Fagnan, a GP at Massachusetts-based Atlas Venture, which provides early-stage funding to small companies.

“I’ve never given funding to an entrepreneur who had a business plan with him when he walked into my office,” Fagnan confirmed for the Times. “Most of the information you find there…is not relevant.”

Fangan looks instead for “market validation.” For him, that means whether the company has actually sold its product or minimally, secured likely customers. And Fangan wants to hear this in a PowerPoint or white-board presentation, or from “somebody just talking.”

So how, then, does the entrepreneur gain an audience with Fangan?

“The No. 1 way is referrals (by a respected figure in business or banking),” responded Fagnan. If he asked such people for a business plan, he added, “they would probably say they don’t have one.”

But the study authors and most people interviewed for the Times piece hedged their bets, adding that it’s still useful to create a business plan.

It helps entrepreneurs sort through growth strategies, competitive threats and so on, they said.

For the record, Fagnan is a judge on MIT’s annual business plan competition. And Goldfarb’s school requires its students to take a business planning course.

“Our (study) got some press just before this requirement was due,” Goldfarb told the Times.“Some (students) questioned the assignment.”

For years, physicians have debated when to start therapy for HIV-infected patients. Starting it early might delay, perhaps indefinitely, progression from a quiescent carrier state to the full blown syndrome, but it exposes patients to unpleasant, sometimes life-threatening side effects.

A study by Mari Kitahata and colleagues may have settled the argument in favor of early drug treatment.

The scientists tracked survival in 17,517 asymptomatic HIV-infected patients who started antiretroviral therapy at different points in the course of their disease, as determined by serum CD4 cell counts.

About a quarter of the subjects began therapy when their CD4 counts were in the 351- 500 range, and the remainder started therapy only after counts dropped to 350 or less.

The mortality risk was 69% higher in the latter group. These findings were confirmed in a second, separate cohort.

The write-up appears in the New England Journal of Medicine.

“This has been one of the most important questions in the last decade: what the optimal timing is for starting therapy,” Kitahata told the New York Times.

“Our study provides evidence that patients would live longer if antiretroviral treatment was begun when their CD4 count was above 350,” added Kitahata, who is director of clinical epidemiology at the Center for AIDS and STDs at the University of Washington.

National guidelines recommend beginning therapy in asymptomatic patients when CD4 counts drop below 350.