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Mar 13 2013

Public Health News Roundup: March 13

NIH: Cardiovascular Benefits Outweigh Small Weight Gain for Former Smokers
When it comes to health, the small amount of weight someone can gain after quitting smoking is inconsequential compared to the improvement in cardiovascular health, according to a new study in the Journal of the American Medical Association. Researchers from the National Institutes of Health found that current smokers were at twice the risk of developing cardiovascular disease as were former smokers without diabetes. “Our findings suggest that a modest weight gain, around 5-10 pounds, has a negligible effect on the net benefit of quitting smoking,” said study co-author Caroline Fox, MD, MPH, senior investigator in the Laboratory for Metabolic and Population Health at the NIH’s National Heart, Lung, and Blood Institute (NHLBI). “Being able to quantify to some degree the relationship between the benefits and side effects of smoking cessation can help in counseling those who have quit or are thinking about quitting.” Read more on tobacco.

FDA: Antibiotic Azithromycin Can Cause Fatal Irregular Heart Rhythm
The antibiotic azithromycin, also known as Zithromax, can lead to a potentially fatal irregular heart rhythm by changing the heart’s electrical activity, the U.S. Food and Drug Administration (FDA) has warned. The FDA is cautioning physicians to be wary of certain risk factors when prescribing the antibiotic, including low levels of potassium or magnesium, a slower-than-normal heart rate and the presence or other drugs to treat abnormal heart rhythms. Read more on heart health.

Study: Breast-feeding has No Effect on Weight Later in Life
Despite previous studies suggesting a possible link, breast-feeding does not reduce the chances that a child will grow up to be overweight or obese, according to a new study in the Journal of the American Medical Association. Still, breast-feeding does bring several health benefits, including a reduced risk of gastrointestinal and respiratory infections; a higher IQ; and lower incidence of eczema. It also reduces the risk of breast and ovarian cancer in the mother. "Although breast-feeding is unlikely to stem the current obesity epidemic, its other advantages are amply sufficient to justify continued public health efforts to promote, protect and support it," said the study's lead author, Richard Martin, a professor of clinical epidemiology at the University of Bristol in England. Read more on infant and maternal health.

Nov 20 2012

Public Health News Roundup: November 20

Study: Medicare Patients More Likely to Have Repeated Tests
Older adults on Medicare are more likely to have heart, lung, stomach or bladder tests repeated within three years, according to a new study in the Archives of Internal Medicine. "What we were struck by is just how commonly these tests are being repeated," said H. Gilbert Welch, MD, from the Dartmouth Institute for Health Policy and Clinical Practice in Hanover, New Hampshire. "Either these patients continually develop new problems or there are doctors who routinely repeat tests." Excessive testing can lead to unnecessary costs and treatments, Welch said. Read more on access to health care.

Use of Discontinued Meds Shows Need for Electronic Updates to Pharmacies
Even though the treatments are complete, some pharmacists continue to fill prescriptions for patients, which can unintentionally cause health issues ranging from nausea or lightheadedness to low blood pressure or allergic reactions, according to a study in the Annals of Internal Medicine. Researchers found that about 12 percent of discontinued medications caused harm, which demonstrates the need to electronically alert pharmacies when a medication is prescription is discontinued, said Adrienne Allen, MD, associate medical director of quality, safety and risk at the Boston-area North Shore Physicians Group."Future research should focus on evaluating methods of improving communication between providers and pharmacies to better reconcile medication lists, as well as explore strategies to improve patient knowledge and awareness of their medication regimen." Read more on prescription drugs.

Link Between Antibiotic Use During Pregnancy, Asthma in Children
Antibiotic use during pregnancy increases the chance that a child will have asthma, according to a new study in The Journal of Pediatrics. Researchers concluded the children were 17 percent more likely to be hospitalized for the breathing disorder. "We speculate that mothers' use of antibiotics changes the balance of natural bacteria, which is transmitted to the newborn, and that such unbalanced bacteria in early life impact on the immune maturation in the newborn," said Hans Bisgaard, MD, a professor at the University of Copenhagen. The findings support previous research linking antibiotics to asthma. Read more on maternal and infant health.

Sep 25 2012

Public Health News Roundup: September 25

Health Insurers Now Providing User-friendly Benefit Guides
Starting this week, health insurers will provide patients with user-friendly guides that clearly explain their benefits. The goal of the new law is to enable “the private insurance market's 163 million beneficiaries to make side-by-side comparisons of plan offerings,” according to Reuters. The U.S. Department of Health and Human Services released a sample benefits form demonstrating the new standardized format. Read more on access to health care.

Inconsistencies in Antibiotic Prescriptions Could Contribute to Increased Resistance
Inconsistencies in how U.S. seniors are prescribed antibiotics could be contributing to increased bacterial resistance, according to a report in the Archives of Internal Medicine. The information was compiled from Medicare records. Seniors in some areas of the country average less than one prescription a year, while others averaged between one and two, suggesting overuse in some areas. "Once you get resistance to those broad spectrum antibiotics, next time you have anything where you really need that, it's not going to be as effective," said Yuting Zhang, the study's lead author. Read more on bacteria.

Task Force Recommends Screening, Intervention to Combat Alcohol Abuse
The U.S. Preventive Services Task Force has recommended that doctors make questions about drinking habits a part of routine patient visits. It is also recommending they provide alcohol abuse counseling. The task force found screening and intervention to be effective public health tactics in adults ages 18 and older. The new recommendations are in line with the task force’s 2004 guidelines, according to HealthDay. "The overarching message is the same as it was back then,” said Michael LeFevre, MD, co-vice chair for the task force. “At least in the adult population, the evidence shows that clinicians can help men and women who are drinking in ways that are not healthy to change those habits." Read more on alcohol.

Aug 27 2012

What Happens When the NIH Has Little in its Arsenal to Treat a Lethal Bacterial Outbreak?

Researchers at the National Institutes of Health published a journal article  last week  in Science Translational Medicine about how they used genetic testing to determine the source of a bacterial infection, Klebsiella pneumoniae, that killed eleven patients and is highly resistant to antibiotics. To treat the patient they believe initiated the outbreak, who had been transferred from another state but who had the infection when she entered the hospital, doctors used an old antibiotic, colistin, which is rarely used because it can damage kidneys. And to stem the spread, the hospital restored to extreme measures including tearing out plumbing that harbored the infection and regularly testing every patient in the hospital for the infection. The measures worked, but a recent article in the Washington Post highlights reasons why there are so few new antibiotics with reach to treat “superbugs” including a growing lack of interest among pharmaceutical firms because other drugs make more money.

>>Bonus Link: Read a NewPublicHealth post about an antibiotic resistance study by researchers at Extending the Cure, which is funded by the Robert Wood Johnson Foundation. The study found that in the winter time, flu symptoms boost both antibiotic use and resistance.

Aug 22 2012

Public Health News Roundup: August 22

AHA Identifies Most-Effective Public Health Strategies
American Heart Association researchers have examined more than 1,000 scientific studies to determine 43 of the most effective public health prevention strategies. They include school and workplace interventions; economic incentives to improve access to healthy food; direct mandates and restrictions related to nutrition; local environment efforts; and media and education campaigns. The findings were published in Circulation, an American Heart Association journal. “Policy-makers should now gather together and say, ‘These are the things that work—let’s implement many right away, and the rest as soon as possible,’” said Dariush Mozaffarian, MD, DrPH, chair of the statement writing group. Read more on heart health.

Poor Dental Health May Be Factor in Dementia
A new study in the Journal of the American Geriatrics Society shows a link between poor dental health and a greater risk of dementia. The study looked at the number of natural teeth, dentures worn, the number of visits to a dentist and other general oral health habits of 5,486 adults with the median age of 81 between the years of 1992 and 2010. The link was especially significant in men. A 2011 report from the Institute of Medicine of the National Academies, Improving Access to Oral Health Care for Vulnerable and Underserved Populations, stressed the importance of providing good oral health care to vulnerable and underserved populations. Read more on aging.

New Federal Report on the Health, Economic Status of Older Americans
While today’s older Americans are healthier and living longer than those of past generations, increased financial obligations and the rising obesity rate are still major considerations, according to Older Americans 2012: Key Indicators of Well-Being, a new report from the National Institutes of Health. The report looks at 37 key indicators to determine which areas are—and are not—improving for older Americans. By 1930 there will be approximately 72 million Americans age 65 and older, according to the Federal Interagency Forum on Aging-Related Statistics. Read more on older adults.

NYU Study Finds Antibiotic Use in Very Young May Increase Childhood Weight
Infants who received antibiotics before the age of 6 months are more likely to be overweight, according to a new study of more than 10,000 children. The study was published August 21 in the International Journal of Obesity and conducted by the NYU School of Medicine and the NYU Wagner School of Public Service. The researchers were careful to note that the study merely showed a correlation—not causation—and that more study is needed. “We typically consider obesity an epidemic grounded in unhealthy diet and exercise, yet increasingly studies suggest it’s more complicated,” said Leonardo Trasande, MD, MPP, an associate professor of pediatrics and environmental medicine at the NYU School of Medicine. “Microbes in our intestines may play critical roles in how we absorb calories, and exposure to antibiotics, especially early in life, may kill off healthy bacteria that influence how we absorb nutrients into our bodies, and would otherwise keep us lean.” Read more on infant health.

Aug 10 2012

Public Health News Roundup: August 10

CDC Recommends Against Using Popular Gonorrhea Treatment
Infectious disease experts at the Centers for Disease Control and Prevention recommended this week that the antibiotic Suprax (cefixime) no longer be used to treat gonorrhea. The CDC is discouraging use of Suprax because patients are developing resistance to the drug. As first line treatment, the CDC recommends use of the drug ceftriaxone in combination with azithromycin or doxycycline. Read more on sexual health.

Alcohol Ad Violations More Common in Magazines with High Youth Readership
As the youth readership level of a magazine goes up, so too does the likelihood that alcohol advertisements in the publication are in violation of industry standards, according to a new study. The study was conducted by the Center on Alcohol Marketing and Youth (CAMY) at the Johns Hopkins Bloomberg School of Public Health and published in the Journal of Adolescent Health. The study looked at 1,261 advertisements for alcopops, beer, spirits or wine that appeared more than 2,500 times in 11 different with youth readership levels of at least 15 percent. CAMY Director and study co-author David Jernigan, PhD said the findings indicate the industry standards should be strengthened. Read more on alcohol.

SAMHSA Awards $11M to Treat Substance Abuse in Pregnant and Postpartum Women
The Substance Abuse and Mental Health Services Administration (SAMHSA) has awarded up to $11 million in grants under the Service Grants Program for the Residential Treatment for Pregnant and Postpartum Women (PPW). There are seven total grants to be utilized over the next three years. They will go toward improving substance abuse treatment, prevention and recovery support services for pregnant women, new mothers and their minor children. “This program offers vital help and hope to women at a crucial time in their lives and in the lives of their children,” said SAMHSA Administrator Pamela S. Hyde in a release. “By including families in the supportive services that are being provided for these women, we acknowledge that people with substance use disorders are more than just their addictions.” Read more on substance abuse.

Aug 7 2012

Study: Flu Symptoms Boost Antibiotic Use, Antibiotic Resistance During Winter Months

Although a June study in Pediatrics noted a recent drop in antibiotics prescribed for infants, children and adolescents relative to past years, prescriptions continue to be high in winter months and may lead to increased antibiotic resistance, according to a new study in Clinical Infectious Diseases.  Research on the link between flu and a rise in antibiotic prescribing in the winter was conducted by Extending the Cure, which is funded by the Robert Wood Johnson Foundation Pioneer Portfolio, to research and examine solutions to antibiotic resistance.

The Clinical Infectious Diseases study found that increases in prescription sales for two popular groups of antibiotics during flu season led to a rapid increase, one month later, in resistant Escherichia coli (E. coli) in hospitals, as well as a rise in methicillin-resistant Staphylococcus aureas (MRSA), linked to the seasonal increase in antibiotic prescriptions.

In a recent op-ed published in Modern Healthcare, Ramanan Laxminarayan, study author and director of Extending the Cure, offered recommendations to help decease use of antibiotics and antibiotic resistance, such as giving all healthy people age 6 months and up the flu shot—because if fewer people experience flu symptoms, fewer people will receive unnecessary antibiotic prescriptions.

“It’s time to start viewing antibiotics as a natural resource that can be depleted with overuse, much like oil or other natural resources, and which must be conserved so these resources are there for us when we need them,” says Laxminarayan.

>>Read a related Q&A with Ramanan Laxminarayan, executive director of Extending the Cure, where he talks about the need for a shift in social norms around parents asking for antibiotics for their children when it may not be needed.

>>Bonus Link:  Read a policy brief from Extending the Cure about strategies to reduce doctor’s over-prescribing of antibiotics including education programs, incentives and mandating appropriate prescribing.  

>>New Study:  A new study in the Annals of Internal Medicine finds that adding data on circulating infections to electronic health records helps reduce antibiotic overuse by giving doctors real-time data to inform diagnosis on viral or bacterial infections. 

Jun 18 2012

Afternoon Public Health News Update: June 18

Study: Antibiotics Down, ADHD Drugs Up Among Kids

Fewer antibiotic prescriptions were dispensed by pharmacies for kids 17 and younger but prescriptions for ADHD drugs were up, according to a study by Food and Drug Administration researchers and published in Pediatrics. The researchers reviewed outpatient retail prescription databases. In addition to decreases in antibiotic prescriptions for children, the study also found decreases in allergy, pain and depression drugs as well as a 42 percent drop in cough and cold medicines for kids. The FDA issued an advisory in 2008 against using cough and cold drugs in very young kids.

In addition to increases in ADHD drugs, the study found higher rates of asthma drugs and contraceptives. Read more on prescription drugs.

Delaying Infant Vaccines Triples in Portland, Oregon

A new study in Pediatrics looks at the practice of delaying infant vaccinations, which experts say can increase the risk of communicable disease outbreaks. The study found that in 2009, about 9.5 percent of parents in the Portland, Ore., area did not consistently follow the recommended vaccine schedule for infants and children up to nine months old, up from 2.5 percent in 2006. Children whose parents delayed shots had more visits to providers for shots, fewer total shots, and did not generally catch up later with the recommended vaccination schedule.

The researchers say negative media attention about vaccine safety likely contributed to the increase in parents delaying or limiting the number of immunizations, and say there are no known benefits to delaying vaccines in infants. Read more on vaccines.

Jun 13 2012

Public Health News Roundup: June 13

DOT Requires Railroads to Add, Improve Emergency Information at Rail Crossings

The U.S. Department of Transportation (DOT) has announced new regulations requiring railroads to install signs at rail and train pathway crossings with toll-free phone numbers the public can use to alert railroad companies to unsafe conditions, such as malfunctioning warning signals, vehicles stuck on the tracks or other emergencies. The new rules take effect by 2015. Railroads receiving the calls will contact local law enforcement for immediate action and must take steps to correct any confirmed problems. According to DOT, there are about 200,000 public and private rail crossings in the nation. Read more on safety.

Studies Finds Inmates May Misuse Pharmaceutical Products

A survey by researchers at the Columbia University Mailman School of Public Health finds that inmates at two New York state prisons regularly misuse common pharmaceutical products such as antibiotic cream as shaving cream, skin lotion and lip balm. The researchers say the misuse of the products can result in antibiotic resistance, especially because methicillin-resistant Staphylococcus aureus (MRSA) has increased at correction facilities and could also pose a risk in the community when prisoners are released. Read more on antibiotic resistance.

Mar 22 2012

Public Health News Roundup: March 22

Having a Sense of Purpose May Prevent Some Heart Attacks

Having a feeling of purpose in life may help to protect against heart attacks among older American adults with coronary heart disease, according to a new study in the Journal of Behavioral Medicine. In the study, researchers surveyed more than 1,500 older adults with coronary heart disease and followed up after two years to investigate the association between purpose, which is typically conceptualized as a person’s sense of directedness and meaning in life, and the occurrence of a heart attack.

The study found a significantly reduced risk of heart attack among participants who reported a higher sense of meaning. The study was supported by the Robert Wood Johnson Foundation’s Pioneer Portfolio to explore Positive Health, an emerging concept that looks at whether in addition to health risks, people also have health assets which can be strengthened to produce a healthier life. Read more on heart health.

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