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US Complacent on Infectious Disease Threats, Report Shows

- Saturday, January 2, 2016 No Comments
The United States has to do more to boost its ability to prevent and control infectious disease outbreaks, according to the third annual report card, released today, on the nation's infectious disease preparedness.
More than half of states (28) received a score of five or fewer of 10 key indicators related to preventing, detecting, diagnosing, and responding to outbreaks, according to the report from Trust for America's Health and the Robert Wood Johnson Foundation.
Seven states (Idaho, Kansas, Michigan, Ohio, Oklahoma, Oregon, and Utah) tied for the lowest score, at three of 10, whereas Delaware, Kentucky, Maine, New York, and Virginia tied for the top spot, achieving a score of eight of 10.
Sustained Interest, Investment Lacking
"We conduct the outbreaks report to examine the country's policies to respond to ongoing emerging infectious disease threats, including new threats such as [Middle East respiratory syndrome coronavirus] and antibiotic-resistant superbugs, as well as resurging illnesses like whooping cough, gonorrhea, and tuberculosis," Jeffrey Levi, PhD, executive director of Trust for America's Health, said during a press briefing today.
"Most infectious diseases are preventable, but we found overall that we haven't made the investments to put in place many of the basic protections that could avoid significant numbers of outbreaks and save billions of dollars in unnecessary healthcare costs," he said.
"The country's interest in infectious diseases tends to ebb and flow. When there is a new scary threat, like Ebola last year, there is a major ramp up, but once there is a sense that an outbreak is contained, we fall back to a place of complacency," Dr Levi added.

Live Attenuated Vaccine Safe for Children With Egg Allergy

- Tuesday, December 29, 2015 No Comments
Live-attenuated influenza vaccine (LAIV), administered intranasally, is unlikely to trigger systemic allergic reactions in children (aged 2 - 18 years) with egg allergy and is well tolerated in those with well-controlled asthma or recurrent wheeze. The results are from a new multicenter study by Paul J. Turner, PhD, from the Imperial College London and Public Health England, United Kingdom, and colleagues, published online December 8 in the BMJ.
The researchers recruited 779 children during the September 2014 to February 2015 influenza season to receive at least one dose of LAIV. All children had a physician diagnosis of egg allergy, and 270 (34.7%) had a previous anaphylaxis to egg. In addition, asthma or recurrent wheeze had been diagnosed in 445 (57.1%) of participants.
After vaccination, participants were monitored for 30 minutes, and a follow-up telephone call was made 72 hours later. For children with asthma or recurrent wheeze, the asthma control test was performed at the time of vaccination, and again 4 weeks later.
The researchers found that no systemic allergic reactions occurred within 2 hours of vaccination (upper 95% confidence interval [CI] for the overall population was 0.47% vs 1.36% for participants with anaphylaxis to egg). Nine participants (1.2%; 95% CI, 0.5% - 2.2%) experienced mild, self-limiting adverse events including rhinitis, urticaria, and oropharyngeal itch. These events were thought to be associated with a local, immunoglobulin E–mediated allergic reaction. Aside from a higher incidence of a possible reaction among participants with a history of reaction to aerosolized egg, no risk factors were identified.
Delayed events were noted in 221 participants, including 62 (8.1%) with lower respiratory tract symptoms within 72 hours (95% CI, 6.3% - 10.3%). None of these participants was hospitalized, and no risk factors were identified for the occurrence of delayed events.
The researchers also found that there was no significant change in the asthma control test score from baseline in the 4 weeks after vaccination in children aged 12 years or older (P = .12). A small improvement in this score was noted, however, for children aged from 2 to 11 years (P < .001).
"This study confirms our previous findings that LAIV is unlikely to trigger a systemic allergic reaction in young people with egg allergy," the investigators say.
The authors conclude that, "with the exception of children with severe anaphylaxis to egg which has previously required intensive care, children with a history of egg allergy can be safely vaccinated with [LAIV]." They do stress however, that staff should be trained in how to recognize and treat anaphylaxis, should it occur.
Funding for this study was provided through a grant from the Department of Health policy research program, the National Institute for Health Research Clinical Research Networks, Health Protection Scotland, and Health and Social Care Services of Northern Ireland. The authors have disclosed no relevant financial relationships.

Alcohol and Cancer: Drink at Your Own Risk

- Tuesday, December 15, 2015 No Comments

A Palatable Carcinogen

Fine wines, craft beers, cocktails, and champagne made by French monks are considered by many as complements to good company and fine cuisine. The last thing anyone wants to hear is that alcohol causes cancer.
However, the sobering truth is that alcohol consumption increases the risk for cancer, and this link has been known for some time. In 1988, the International Agency for Research on Cancer (IARC) declared that alcohol was a carcinogen.[1] The World Cancer Report released in 2014 highlighted the role of alcohol in cancer, finding that alcohol accounts for 3.5% of cancers (about 1 in 30 cancer deaths) globally.[2] Recent data indicate that the proportion of cancers attributable to alcohol worldwide has increased. In 2012, alcohol consumption caused 5.5% of all cases of cancer and 5.8% of all cancer deaths.[3]This increase is believed to be attributable primarily to an increase in the prevalence of drinkers and in the amount of alcohol consumed, particularly by women.
The fact that alcohol is a carcinogen has been clearly confirmed.
J├╝rgen Rehm, PhD, Director of the Social and Epidemiological Research Department at the Centre for Addiction and Mental Health in Toronto, Ontario, Canada, describes how our knowledge about the role of alcohol in cancer has advanced during the past year. "Very simply, the cancers that have been determined previously to be caused by alcohol have been confirmed. There is no discussion about whether alcohol causes these cancers. The fact that alcohol is a carcinogen has been clearly confirmed."
The cancers that Dr Rehm refers to include those of the oral cavity, pharynx, larynx, esophagus, breast, colon, rectum, gallbladder, and liver.[4] It is also considered probable that alcohol increases the risk for pancreas cancer, although the evidence is inconclusive.[4]
Recent evidence suggests that melanoma, as well as cancers of the stomach, lung, and prostate, may be associated with alcohol consumption, although only with high levels of consumption and to a moderate excess risk.[3] There are also differences of opinion on whether liver cancer should be considered an alcohol-related cancer and whether the risk for colorectal cancer is increased in both sexes or only in men.[5]

Alcohol-Cancer Link: New Evidence

Several large cohort studies of the association between alcohol and cancer, published in the past year, shed more light on this link.
The increased risk for cancer appears to be significant at lower levels of alcohol consumption in women than in men.
In August of 2015, data were published from two large, prospective, ongoing cohort studies—the Nurses' Health Study and the Health Professionals Follow-up Study.[6] During long-term follow-up (up to 30 years) of 88,084 women and 47,881 men, 19,269 and 7571 incident cancers were diagnosed, respectively (excluding nonadvanced prostate cancers). Alcohol consumption was significantly associated with increased risk for cancer, in both women (P trend<.001) and men (Ptrend=.006), with linear dose-response relations. The increased risk for cancer appears to be significant at lower levels of alcohol consumption in women than in men, and total alcohol consumption, rather than regularity of drinking or heavy episodic drinking, drove the association between alcohol consumption and risk for cancer.

Tremor Relief at Last | Brain Surgery Live

- Wednesday, December 2, 2015 No Comments

Tremor Relief at Last | Brain Surgery Live Via National Geographic 

Sildenafil Improves Risk Markers in Prediabetes, Small Study Shows

- Monday, November 30, 2015 No Comments
The erectile dysfunction drug sildenafil improves insulin sensitivity and markers of endothelial function in people with prediabetes, a new study finds.
The results were published online November 18 in the Journal of Clinical Endocrinology and Metabolism by Claudia E Ramirez, MD, and colleagues, of Vanderbilt University, Nashville, Tennessee.

FDA Panel Backs Approval of 'Female Viagra'

- Thursday, November 26, 2015 2 Comments
WASHINGTON, DC — Is third time a charm for "female Viagra"? After being rejected twice before, a US Food and Drug Administration (FDA) advisory committee voted today to back approval of flibanserin, which stands to become the first drug approved specifically for boosting female sexual desire.
Despite an 18-6 vote in favor of approval by the members of the Bone, Reproductive and Urologic Drugs Advisory Committee and the Drug Safety and Risk Management Advisory Committee, it was not a slam dunk for flibanserin, dubbed the female or "pink Viagra."
The drug's maker, Sprout Pharmaceuticals, was seeking FDA approval of once-daily, 100-milligram (mg) flibanserin for the treatment of hypoactive sexual desire disorder (HSDD) — as defined in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders — in premenopausal women. Sprout said that up to 7% of premenopausal women have HSDD.
"The benefits are modest, maybe less than modest," said panelist Walid Gellad, MD, MPH, associate professor of medicine at the University of Pittsburgh in Pennsylvania. "That puts it in good company with other approved drugs," said Dr Gellad, drawing laughter. But, he added, "I have serious, serious safety concerns."
He was not alone. Summing up the committee's view, panel chair Vivian Lewis, MD, said that the modest improvement meant that many women would still have the HSDD diagnosis. "However, even a modest improvement may be helpful clinically for someone who has HSDD," said Dr Lewis, professor of obstetrics and gynecology at the University of Rochester in New York.
The slight benefits barely outweighed the risks for most panelists — especially as many acknowledged that once the drug was approved, it would likely be used off-label in a much wider group of women. The committee told the FDA they'd like to see a Risk Evaluation and Mitigation Strategy for flibanserin that required prescribers to certify that they had been educated about the drug's risks and that they had counseled patients as well.
Some committee members urged the FDA to consider a boxed warning against using alcohol while taking flibanserin, while others wanted to see heightened warnings about drug-drug interactions when taking CYP3A4 inhibitors.
No Third Strike?

This was the third time that flibanserin had come before the FDA for approval. It was rejected by the agency after an advisory panel declined to recommend it in 2010. At that time, flibanserin developer Boehringer Ingelheim sold rights to Sprout. After a second rejection, Sprout appealed the decision. Although the agency said more studies were still required, it agreed to a new advisory committee meeting.
New efficacy data from a phase 3 study designed with the FDA's input showed that women had a 0.5 to 1 event per month additional satisfying sexual event (over baseline), and a 0.3 to 0.4 improvement (on a scale of 1.2 to 6) in the Female Sexual Function Index. They also had a mean 0.3 to 0.4 improvement on the Female Sexual Distress Scale (four-point scale) compared with placebo.

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Childhood Obesity Link to Prenatal Exposure to Perfluoroalkyls

- Monday, November 23, 2015 No Comments
Children had greater overall adiposity and a more rapid increase in body mass index z-scores (BMIz) in early childhood if their mothers had been exposed to higher concentrations of perfluorooctanoic acid (PFOA), according to a prospective cohort study published online November 11 in Obesity.