New CT Device Offers Improved Imaging, Substantially Reduced Radiation
A new type of CT scanner from National Institutes of Health (NIH) researchers and engineers at Toshiba Medical Systems offers improved image quality while reducing the amount of potentially harmful radiation to patients by as much as 95 percent. This device will enable doctors to better diagnose conditions such as heart disease, according to coauthor Andrew Arai, MD, chief of the Cardiovascular and Pulmonary Branch at the NIH’s National Heart, Lung, and Blood Institute (NHLBI). Author Marcus Chen, MD, a clinician in the NHLBI’s Advanced Cardiovascular Imaging Laboratory, said the “improvements could help clinicians identify problems in even the smallest blood vessels or enable them to conduct complicated tests like measuring blood flow in the heart while limiting radiation exposure.” The U.S. Food and Drug Administration has approved the CT scanner, which still requires additional study. Read more on heart health.

Study: Black Patients Less Likely to Receive Kidney Transplants before Needing Dialysis
Patients who are black or do not have private insurance are less likely than others to receive a kidney transplant before having to go on dialysis, according to a new study in Clinical Journal of the American Society of Nephrology. The study was conducted by researchers at the Johns Hopkins University School of Medicine, including lead author Morgan Grams, MD, who told Reuters it shows "just another disparity" for African American patients. Douglas Scott Keith, MD, head of the kidney transplant program at the University of Virginia Medical Center in Charlottesville and not part of the study, said studies "over the last 10 to 15 years have consistently shown that minorities have poorer access to transplantation. This article basically shows that it's persisting, it hasn't gotten much better.” African American patients are about 56 percent less likely than white patients to receive a kidney transplant before needing dialysis. Read more on health disparities.

Medical School Conflict of Interest Policies May Affect New Doctors’ Prescription Habits
Doctors who graduate from medical schools with policies restricting gifts from pharmaceutical companies may be less likely to prescribe new medications over current options, according to a new study in the BMJ. "Our findings suggest that conflict of interest policies, which have been increasingly adopted by medical schools since 2002, may have the potential to substantially impact clinical practice and reduce prescribing of newly marketed pharmaceuticals," wrote Marissa King, an assistant professor of organizational behavior at the Yale University School of Management, and colleagues. The researchers say further study is needed to determine whether the measures affect the prescription of all new medications, or if the effect is more selective. Read more on prescription drugs.

MLB to Test for Human Growth Hormone During the Season
Major League Baseball and the Major League Baseball Players Association have agreed to perform in-season blood testing for human growth hormone, as well as a test to detect synthetic testosterone. The use of performance-enhancing drugs has become a significant issue in baseball over the past several years, calling into question the accomplishments of many players going back to the 1980s. Earlier this week the sport’s Hall of Fame announced no one had been elected on this year’s ballot, which included perhaps the greatest batter and the greatest pitcher of the past 40 years—both of whom are tainted by the scandal of the steroid era. Read more on substance abuse.

Flu Season Seeing Shortages of Vaccine, Tamiflu
The increasingly bad flu season is also now seeing a shortage of flu vaccine and the Tamiflu treatment for children. Many forms of the vaccine are sold out and major vaccine provider Sanofi SA said it cannot make any more vaccine for this season because its facilities are already preparing for next season, according to Reuters. "People who haven't been vaccinated and want to get the vaccine may have to look in several places for it," said Tom Skinner, a spokesman for the U.S. Centers for Disease Control and Prevention. Earlier this week the city of Boston declared a public health emergency due to the flu. The city has reported about 700 cases since October 1. Read more on influenza.

Prescription Painkiller Misuse Trails only Marijuana Abuse In U.S.
Prescription painkillers trail only marijuana when it comes to substance abuse in the United States, according to a new report from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). Approximately 22 million people have misused the drugs since 2002. "Any time you have 2 percent of the population using medications like this there is a lot to do, but we are doing a lot with a combination of putting tighter controls on who can get these drugs and public education," said Peter Delany, director of SAMHSA's Center for Behavioral Health Statistics and Quality, according to HealthDay. Painkiller abuse is also taking a growing toll on emergency departments who deal with people seeking treatment. Read more on prescription drugs.

The U.S. Food and Drug Administration (FDA) yesterday announced it is requiring the manufacturers of widely used sleeping pills that contain the active ingredient zolpidem, to lower current recommended doses. Recommended doses will be required to be lowered on drug labels that doctors use to prescribe medicines and on medication guides given to patients, for the following drugs: Ambien, Ambien CR, Edluar and Zolpimist. FDA is also urging physicians to prescribe the drugs at the lowest dose capable of treating the patient’s insomnia.

The FDA announcement is based on driving simulation and laboratory studies showing that, in some individuals, zolpidem blood levels the morning after use appear capable of impairing driving to a degree that increases the risk of a motor vehicle accident. Reducing deaths from motor vehicle accidents is a priority for the Centers for Disease Control and Prevention. While these deaths declined between 2000 and 2009, car crashes are still among the top ten causes of death for all Americans.

New data is driving the announcement, according to the FDA. “Over the years FDA has received spontaneous adverse event reports of driving impairment and motor vehicle accidents associated with zolpidem, but these reports lacked the information necessary to fully understand whether and how zolpidem affected people’s mental alertness and ability to drive,” said Dr. Unger. “Recently, data from clinical trials and other types of studies have become available, which allowed FDA to better characterize the risk of next-morning impairment.”

Disabled Adults Have Very High Rates of Emergency Room Use
A review of medical expenditure data by researchers at the National Institutes of Health finds that disabled adults account for a disproportionately high amount of annual emergency room (ER)  visits.

The study found that despite representing 17 percent of the working age U.S. population, adults with disabilities accounted for 39.2 percent of total emergency room visits. The researchers say the higher ER use is a problem not just because of the higher costs, but also because many disabled adults have non-urgent needs that are not met by the ER visits.

Recommendations to improve care for disabled adults include prevention and chronic condition management programs tailored for the functional limitations and service needs of people with disabilities, wider use of coordinated care systems for the disabled that provide case management, integration of psychosocial care and 24/7 access to medical assistance.

Read more on disability.

Change in Color of their Pills Keeps Some Patients from Taking Generic Drugs
A new study in JAMA Internal Medicine finds that some people stop taking their medicines when a generic becomes available if the color of the dispensed generic drug is different than the brand name drug they received previously.

The authors say the study shows the need for a reconsideration of the FDA’s current regulations that allow wide variation in the appearance of generic drugs.

Read more news about the Food and Drug Administration.

Mental Health Disorders Increase the Risk of Becoming a Victim of Domestic Violence
People diagnosed with mental illness are more likely than those who are not to be victims of domestic violence, according to a new study in PLoS One.

The researchers say the causality may run in both directions. Domestic violence can result in mental health problems and people with mental health problems are more likely to experience domestic violence. The researchers say studies they reviewed show that the link between domestic violence and mental health problems is a concern for both men and women.

Read more on mental health.

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.

Meningitis Toll at 29 Dead, 368 Infected
A national meningitis outbreak linked to potentially tainted steroids has now caused 29 deaths, according to the U.S. Centers for Disease Control and Prevention. There have been 368 cases in 19 states. New England Compounding Center of Framingham, Massachusetts, which manufactured the drugs, is under multiple investigations. Westborough, Massachusetts-based Ameridose, a sister company to New England Compounding Center, has also announced a voluntary recall of all its products after the U.S. Food and Drug Administration voiced concerns with the sterility of its facility. Ameridose said there have been no reports of any issues with its products. Read more on infectious disease.

Study: Black Women at Greater Risk of Death from Breast Cancer
Black women with breast cancer are at greater risk of death within the first three years of diagnosis than white women, according to preliminary research presented at an American Association for Cancer Research in San Diego, Calif. The study looked at approximately 19,000 women with breast cancer between 2000 and 2007, finding black women were 48 percent more likely to die than white women; Asian women were 40 percent less likely to die than white women. The study linked the higher mortality rate for black women to particular types of tumors. "The results of this study emphasize that clinical management and follow-up for patients with breast cancer, particularly black women, is important in the first few years after diagnosis," said Erica Warner, a postdoctoral fellow at Harvard School of Public Health in Boston. Read more on cancer.

Boys More Likely Than Girls to Abuse OTC Drugs
New research suggests boys are more likely than girls to abuse over-the-counter drugs. Researchers at the University of Cincinnati looked at 2009-2010 survey results for students in grades 7-12 in 133 schools, finding 10 percent of students overall abused drugs such as cough syrup or decongestants, which can lead to accidental poisoning; seizures; and physical and mental addictions, according to HealthDay. "Findings from this study highlight and underscore OTC drugs as an increasing and significant health issue affecting young people," said Rebecca Vidourek, an assistant professor of health promotion, in a release. The preliminary results were presented at the American Public Health Association annual meeting in San Francisco. Read more on prescription drugs.

A recent article in the New York Times looks at a shift in thinking to combat drug abuse from efforts to prevent drugs such as heroin and cocaine from entering the U.S. illegally, to combating the rising, more significant problem in the fifty states—abuse of prescription drugs.

>>Bonus Link: Read a NewPublicHealth interview with R. Gil Kerlikowske, director of the Office of National Drug Control Policy.

New Pilot Program Aimed at Reducing Prescription Drug Abuse

The Office of the National Coordinator for Health Information Technology has announced a pilot program in Ohio and Indiana that will make existing prescription drug use information available to doctors and pharmacists in outpatient and emergency settings. The goal is to allow providers to intervene in cases of suspected prescription drug abuse.

“The PDMP pilot projects being launched today will help hospital staff identify a patient’s controlled substance history at the point of care to enable better targeting appropriate treatments and reduce the potential of an overdose or even death,” said Farzad Mostashari, MD, ScM, national coordinator for health IT.

According to the Centers for Disease Control and Prevention, deaths from prescription drugs now outnumber deaths from heroin and cocaine combined, and over the past decade, prescription drug-induced deaths have approached motor vehicle deaths as the leading cause of all injury deaths. Read a Q&A with Farzad Mostashari on the potential for health IT to support public health.

Traffic Noise May Increase Heart Attack Risk for People Living Nearby

High levels of traffic noise put people who live nearby at an increased risk for a heart attack, according to a new study in the journal PLoS One. Researchers followed more than 50,000 people in Denmark, ages 50 to 64, for ten years and found that for every 10 decibel rise in traffic noise near a person's home, there was a 12 percent increased risk of a first heart attack. Read more on community health.

Mouse Study Links High-Fat, High Calorie Diet to Development of Pancreatic Cancer

In a study presented at the American Association for Cancer Research's Pancreatic Cancer: Progress and Challenges conference, UCLA researchers fed mice that had a genetic mutation that predisposed them to pancreatic cancer a diet high in fat and calories, and found that this diet triggered and accelerated increased pancreatic inflammation and pancreatic cancer development for many. The researchers say that the mutation was not sufficient for the mice to develop the cancer, but that the high-fat, high-calorie diet could provide an “environmental secondary hit and trigger cancer development." Read more on cancer.

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.

The Centers for Disease Control and Prevention (CDC) National Center for Injury Prevention is celebrating its twentieth anniversary this year. Throughout the year, the Injury Center will be holding events and activities to mark the anniversary and raise awareness of injury and violence prevention community opportunities. NewPublicHealth recently spoke with Linda Degutis, DrPH, the center’s director, about milestones in injury prevention of the last twenty years, and what’s ahead.

NewPublicHealth will be posting interviews with several injury prevention experts this week.

NewPublicHealth: Tell us about the National Center for Injury Prevention, and some of the successes in injury prevention to date.

Linda Degutis: We’re one of the younger centers at CDC, and I think a lot of the successes that we’ve seen are not just successes of the Center itself but of the field of injury and violence prevention as a whole, and I think that’s really important for us to stress. For example, the reduction in motor vehicle crash deaths have been so very significant where we’re now talking about something more like closer to 30,000 motor vehicle crash deaths per year—when at the time the Center started it was probably closer to 50,000. That’s a great success.

>>For more on preventing motor vehicle crashes, read an interview with Andrea Gielen, MD, director of the Johns Hopkins Center for Injury Research and Prevention.

NPH: What types of preventable injury issues have emerged or increased in prevalence since the Center launched?