CDC’s Change in HIV Policy Impacted Providers’ Role in Prevention

MedicalResearch.com Interview with:

Rogério M. Pinto, LCSW, Ph.D. Associate Professor Associate Dean for Research School of Social Work University of Michigan Ann Arbor, USA

Dr. Pinto

Rogério M. Pinto, LCSW, Ph.D.
Associate Professor
Associate Dean for Research
School of Social Work
University of Michigan
Ann Arbor, Michigan

MedicalResearch.com: What is the background for this study?

Response: This research, published in Health Education & Behavior (https://doi.org/10.1177/1090198118760681),highlights the crucial role of providers of social and public health services in helping patients to access lifesaving HIV services. Before 2012, providers were encouraged and trained to link patients to behavioral interventions to help patients modify their behaviors to protect themselves against HIV transmission and infection. A shift in policy from targeting anyone at risk to those at highest risk (called “High Impact Prevention”) made these interventions less available (they were actually discontinued) and new policy dictated that providers should have as many people as possible access HIV testing and link them to HIV primary care in order to receive antiretroviral medication.

Continue reading

Severe Obesity More Common in Rural or Urban Areas in US?

MedicalResearch.com Interview with:

Cynthia L. Ogden, PhD, MRP Chief, NHANES Analysis Branch Epidemiologist, NCHS/CDC Hyattsville, MD 20782

Dr. Ogden

Cynthia L. Ogden, PhD, MRP
Chief, NHANES Analysis Branch
Epidemiologist, NCHS/CDC
Hyattsville, MD 20782

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: 40% of adults and over 18% of youth in the US have obesity. Disparities in obesity have been reported by demographics and urbanization.

We looked at the prevalence of obesity and severe obesity by demographics and by level of urbanization – rural, small/medium metro and large urban. We also looked at trends over time in urban and rural areas.

Obesity and severe obesity rates were higher in rural areas than large urban areas among adults. Among youth, severe obesity rates were higher in rural areas compared to large urban areas.

Differences in age, smoking, education or race/ethnicity between urban and rural areas did not explain the differences we found between urban and rural areas.

Between 2001-2004 and 2013-2016 severe obesity among men in rural areas more than tripled and among women more than doubled. Increases in severe obesity also occurred in urban areas in men and women but they were not nearly as large.

Continue reading

Guillain-Barré Syndrome With and Without Zika

MedicalResearch.com Interview with:

Dr. Emilio Dirlikov, PhD Office of Epidemiology and Research, Puerto Rico Department of Health Epidemic Intelligence Service Division of Scientific Education and Professional Development CDC

Dr. Dirlikov

Dr. Emilio Dirlikov, PhD
Office of Epidemiology and Research, Puerto Rico Department of Health
Epidemic Intelligence Service
Division of Scientific Education and Professional Development
CDC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: After reporting local Zika transmission in December 2015, the Puerto Rico Department of Health (PRDH), US Centers for Disease Control and Prevention (CDC), and University of Puerto Rico began identifying cases of Guillain-Barré syndrome (GBS), testing specimens, and conducting follow-up telephone interviews after patients left the hospital.

Through these efforts, we were able to characterize acute clinical features and long-term disability of GBS associated with Zika infection by analyzing data from GBS patients with and without evidence of Zika infection.

This investigation increases scientific and medical understanding of Guillain-Barré syndrome following Zika infection, provides insight into the disease processes involved in GBS following Zika infection, and adds to growing evidence of a causal association between Zika and GBS.  Continue reading

Fewer US Children Taking Prescription Medications

MedicalResearch.com Interview with:

Craig M. Hales, MD, MPH, MS CDR, U.S. Public Health Service Division of Health and Nutrition Examination Surveys National Center for Health Statistics Centers for Disease Control and Prevention

Dr. Hales

Craig M. Hales, MD, MPH, MS
CDR, U.S. Public Health Service
Division of Health and Nutrition Examination Surveys
National Center for Health Statistics
Centers for Disease Control and Prevention

MedicalResearch.com: What is the background for this study?

Response: Monitoring trends in prescription medication use among children and adolescents is an important part of understanding the health of youth in the U.S. and the healthcare they receive.

For this study we used data from the National Health and Nutrition Examination Survey or NHANES, which is a nationally representative survey of the US population and as part of this face-to-face survey in the home, we ask participants about their prescription medication use in the last 30 days and collect information about the prescription directly from the medication package.

Continue reading

Over 2.5 Million US Kids Diagnosed With Anxiety and Depression

MedicalResearch.com Interview with:
Rebecca H. Bitsko, PhD

National Center on Birth Defects and Developmental Disabilities
Centers for Disease Control and Prevention 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: CDC’s National Center on Birth Defects and Developmental Disabilities(https://www.cdc.gov/ncbddd/index.html) (NCBDDD) is committed to helping children who have mental, emotional, and behavioral disorders. Anxiety and depression are both internalizing mental disorders that often start during childhood, and that frequently occur together.

In this study, we show that more than 1 in 20, or 2.6 million, US children aged 6-17 had a current diagnosis of anxiety or depression, by parent report, in 2011-12. We also found an increase of diagnosed anxiety in these children from 1 in 28 in 2007 to 1 in 24 in 2011-12.

Further, in 2011-12, approximately 1 in 5 children with current anxiety or depression did not receive mental health treatment in the past year.

Children with current anxiety or depression were more likely than those without to have:

  • Another mental, behavioral, or developmental disorder such as ADHD, learning disability, or speech or language problems
  • School problems
  • Parents who report high levels of stress and frustration with parenting
  • Unmet medical and mental health service needs

Continue reading

Falls in Older Adults Cost US Over $50 Billion Dollars Annually

MedicalResearch.com Interview with:

Curtis Florence, PhD Division of Analysis, Research and Practice Integration  CDC’s Injury Center

Dr. Florence

Curtis Florence, PhD
Division of Analysis, Research and Practice Integration
CDC’s Injury Center

MedicalResearch.com: What is the background for this study?

Response: The estimates in this study provide a more robust indicator of the economic impact falls have on the U.S. economy.  Previous studies focused on Medicare spending. This study includes Medicare, Medicaid and out-of-pocket spending.

MedicalResearch.com: What are the main findings? 

Response: Our study found that older adult (65 years and over) falls impose a large economic burden on the U.S. healthcare system. In 2015, with a total medical cost $50 billion for non-fatal and fatal falls.  About three-quarters of the total cost was paid by government-funded programs.  Medicare paid nearly $29 billion for non-fatal falls, Medicaid $8.7 billion, and $12 billion was paid for by Private/Out-of-pocket expenses.  For fatal falls, $754 million was spent in 2015.

Continue reading

HIV Incidence Decreasing But Not Among Latino and AA Gay and Bisexual Men

MedicalResearch.com Interview with:
Sonia Singh, PhD, Epidemiologist
Division of HIV/AIDS Prevention
CDC 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: HIV infection is a persistent health concern in the United States, particularly for people at high risk of infection such as gay and bisexual men. We used data from the National HIV Surveillance System to estimate HIV incidence and prevalence and the percentage of undiagnosed HIV infections overall and among gay and bisexual men.

Estimated HIV incidence declined nearly 15% overall in the U.S. from an estimated 45,200 infections in 2008 to 38,500 in 2015. Estimated HIV incidence declined for both males (9%) and females (33%) over this period. Estimated HIV incidence declined 32% among heterosexuals, 42% among people who inject drugs and 20% among gay and bisexual men who also inject drugs. Estimated HIV incidence remained relatively stable among gay and bisexual men; however, it increased over 25% among Latino gay and bisexual men, almost 45% among gay and bisexual men ages 25 to 34 and 30% among gay and bisexual men ages 55 and older.

The percentage of undiagnosed HIV infections decreased nearly 20%, from 18.1% in 2008 to 14.5% in 2015. The percentage of undiagnosed HIV infections among gay and bisexual men declined 21.6%, from 21.3% in 2008 to 16.7% in 2015. In 2015, the percentage of undiagnosed HIV infections was highest among gay and bisexual males ages 13-24 (52.2%) compared to other age groups and higher among Latino (20.1%) and African American (19.6%) gay and bisexual men, as well as Asian gay and bisexual men (20.5%), compared to white gay and bisexual men (11.9%).

Continue reading

Sinus Infections: Majority of Antibiotic Prescriptions Longer Than Recommended

MedicalResearch.com Interview with:

Dr. Katherine Fleming-Dutra, MD, senior author Deputy Director Office of Antibiotic Stewardship CDC

Dr. Fleming-Dutra

Dr. Katherine Fleming-Dutra, MD, senior author
Deputy Director
Office of Antibiotic Stewardship
CDC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: As noted in a previous study, antibiotics are prescribed more for sinus infections than any other illness in the United States. We found that almost 70% of antibiotic prescriptions were for 10 days or longer, whereas 5-7 days is recommended for most patients when antibiotics are needed. In addition, more than 20% of antibiotic prescriptions for sinus infections were for 5 days of azithromycin, even though guidelines recommend against prescribing azithromycin for sinus infections. Continue reading

Obesity Increased in Adults But Not Youth in Last Ten Years

MedicalResearch.com Interview with:
Craig M. Hales, MD Cheryl D. Fryar, MSPH; Margaret D. Carroll, MSPH; David S. Freedman, PhD; Cynthia L. Ogden, PhD

National Center for Health Statistics
National Center for Chronic Disease Prevention and Health Promotion
US Centers for Disease Control and Prevention
Atlanta, Georgia

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In this analysis we examined recent trends in the prevalence of obesity and severe obesity among both youth and adults, by sex and age group.

Among adults, obesity and severe obesity prevalence has increased over the last 10 years.  Obesity prevalence increased from 33.7% in 2007-2008 to 39.6% or almost 40% in 2015-2016, and severe obesity increased from 5.7% in 2007-2008 to 7.7% in 2015-2016.  We see this same pattern of increasing prevalence of obesity and severe obesity in both men and women, and in different age groups.

On the other hand, among youth, we saw no increasing or decreasing trends in obesity or severe obesity prevalence over the 10 year period.  And this was true for both boys and girls and for different age groups.

Measured height and weight is the gold standard for generating accurate estimates of obesity prevalence.  The National Health and Nutrition Examination Survey is unique in that it combines both interviews in the home and physical examinations in mobile examination centers, and it is the only national survey where people’s height and weight are physically measured.  This is why NHANES is such an important source of data for understanding trends in obesity in youth and adults. 

Citations: 

Hales CM, Fryar CD, Carroll MD, Freedman DS, Ogden CL. Trends in Obesity and Severe Obesity Prevalence in US Youth and Adults by Sex and Age, 2007-2008 to 2015-2016. JAMA. Published online March 23, 2018. doi:10.1001/jama.2018.3060

 

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

Study Finds Adults Who Used Sunscreen Slightly More Likely To Get Sunburned

MedicalResearch.com Interview with:
“Sunburn” by Beatrice Murch is licensed under CC BY 2.0Dawn Holman, MPH
Behavioral Scientist Division of Cancer Prevention and Control
CDC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Sunburn at any age increases a person’s chances of developing skin cancer in the future. Using a combination of strategies including staying in the shade, wearing clothing that covers the arms and legs, wearing a hat with a wide brim, and wearing sunscreen (SPF 15+) on exposed skin can protect skin from sun damage and reduce risk of sunburn.

This study used national data to examine how often US adults used these sun protection strategies when outdoors in the sun for an hour or longer and how many US adults got sunburned in 2015.

Among adult women, staying in the shade and using sunscreen were the most common sun protection methods. About 40% of women regularly used these strategies. Women were less likely to wear a wide-brimmed hat (14%) or wear clothing covering their arms (11%) and legs (23%).

Among adult men, wearing pants or other clothing covering their legs and staying in the shade were the most common sun protection methods. Just over 30% of men regularly used these strategies. Men were less likely to use sunscreen (22%), wear a wide-brimmed hat (14%) or wear a shirt with long sleeves (13%).

About one-third of US adults got sunburned in 2015. Sunburn was even more common among certain groups. For example, about half of individuals with sun-sensitive skin and about half of adults aged 18-29 got sunburned.

Certain behaviors and health conditions were related to sunburn. For example, adults who used sunless tanning products to darken their skin, binge drank, engaged in aerobic activity, or were overweight or obese were more likely to get sunburned compared to other adults. Adults who regularly stayed in the shade when outdoors or avoided long periods of time in the sun were slightly less likely to get sunburned compared to other adults.

Adults who regularly used sunscreen were slightly more likely to get sunburned. Continue reading

Steady Increase in Melanoma In Older Adults

MedicalResearch.com Interview with:
Dawn Holman, MPH

Behavioral Scientist Division of Cancer Prevention and Control
CDC

MedicalResearch.com: What is the background for this study?

Response: Melanoma is the third most common type of skin cancer and the most deadly. Each year in the United States, over 70,000 people are diagnosed with melanoma, and more than 9,000 die from the disease. Melanoma is often caused by overexposure to ultraviolet (UV) rays from the sun or artificial sources like tanning beds.

Previous reports have shown a steady increase in melanoma incidence rates over time, specifically among non-Hispanic whites. The purpose of this study was to determine if this trend differs across age groups.  

Melanoma CDC/ Carl Washington, M.D., Emory Univ. School of Medicine; Mona Saraiya, MD, MPH

This image depicts the gross appearance of a cutaneous pigmented lesion, which had been diagnosed as superficial spreading malignant melanoma (SSMM). Note the roughened edges of this mole, its heterogeneous, mottled, multicolored appearance, as well as its multi-textural composition, which are all characteristics that should evoke suspicions about its classification.
SSMM makes up 60 – 70% of clinical subtypes of melanoma, can appear at any site on the body, displays a radial growth pattern, and histopathologically, is found to reveal a more pagetoid, i.e., melanocytes spreading upward into epidermal layer, and less elastotic cytoarchitecture. Solar elastosis is characterized by a degeneration of the skin’s elastic and collagen fibers, giving it a sagging, wrinkled appearance.
SSMM:
– diagnosed most frequently between the ages of 30-50 years
– Most common on trunk in men and legs in women
– Brown-black macule that becomes a patch, and eventually takes on the appearance of a nodule
– 1/3rd arise from pre-existing nevus
– Regression common

Continue reading

Majority of Middle and High School Students Do Not Get Enough Sleep on School Nights

MedicalResearch.com Interview with:
“He isn't sleeping, he is mad. When we don't get our way pouting always works (okay.. It's worth a try at least!) #kids #dad #father #family #funny #like #parenting #photooftheday #instaphoto #instacute” by dadblunders is licensed under CC BY 2.0Anne G. Wheaton, Ph.D.
Epidemiologist
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Division of Population Health
Epidemiology and Surveillance Branch
Atlanta, GA  30341-3717

MedicalResearch.com: What is the background for this study?

Response: Insufficient sleep among children and adolescents is associated with an increased risk for obesity, diabetes, injuries, poor mental health, and attention and behavior problems.

In previous reports, CDC had found that, nationwide, approximately two thirds of U.S. high school students report sleeping <8 hours per night on school nights. CDC conducted this study to provide state-level estimates of short sleep duration on school nights among middle school and high school students using age-specific recommendations from the American Academy of Sleep Medicine (AASM). AASM has recommended that children aged 6–12 years should regularly sleep 9–12 hours per 24 hours and teenagers aged 13–18 years should sleep 8–10 hours per 24 hours for optimal health.

Continue reading

Better Data Allows IFSAC and CDC To Identify Sources of Food Poisoning

MedicalResearch.com Interview with:

National Institute of Allergy and Infectious Diseases (NIAID)

NIAID image of salmonella invading an immune cell

LaTonia Richardson, PhD, Statistician
Division of Foodborne, Waterborne, and Environmental Diseases, Enteric Diseases Epidemiology Branch
CDC

MedicalResearch.com: Who is IFSAC?

Response: The Interagency Food Safety Analytics Collaboration (IFSAC) was created in 2011 by three federal agencies—the Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), and the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS)—to improve coordination of federal food safety analytic efforts and address cross-cutting priorities for food safety data collection, analysis, and use.  The current focus of IFSAC’s activities is foodborne illness source attribution, defined as the process of estimating the most common food sources responsible for specific foodborne illnesses. For more information on IFSAC, visit https://www.cdc.gov/foodsafety/ifsac/index.html.

Continue reading

Frequent Exertion and Frequent Standing at Work Varies By Industry and Occupation Group

MedicalResearch.com Interview with:
Taylor M. Shockey, MPH

Title 42 Fellow
Division of Surveillance, Hazard Evaluations and Field Studies
NIOSH

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Research has linked repeated exposure to occupational ergonomic hazards, such as frequent exertion and frequent standing, to injuries and musculoskeletal disorders (MSDs) among workers.

To determine the industry and occupation groups that have the highest prevalence rates of frequent exertion at work and frequent standing at work, NIOSH researchers analyzed 2015 National Health Interview Survey data. The results showed large differences among the groups with the agriculture, forestry, fishing, and hunting industry group having the highest prevalence of frequent exertion and standing at work (70.9%) and the construction and extraction occupation group having the highest prevalence of frequent exertion and standing at work (76.9%). These differences indicate a need for targeted interventions to reduce workplace exposure.

Continue reading

Prevalence of Severe Obesity Drops for First Time Among All Age, Sex and Race/Ethnic Groups

MedicalResearch.com Interview with:
Liping Pan, MD, MPH
Epidemiologist,
Epidemiology & Surveillance Team
Obesity Prevention and Control Branch
Division of Nutrition, Physical Activity and Obesity
National Center for Chronic Disease Prevention & Health Promotion
CDC 

MedicalResearch.com: What is the background for this study?

Response: Children with severe obesity face significant health and social challenges. Children with obesity and severe obesity are at higher risk for having other chronic health conditions and diseases, such as asthma, sleep apnea, bone and joint problems, and type 2 diabetes. They also have more risk factors for heart disease like high blood pressure, impaired glucose tolerance, and high cholesterol than their normal weight peers.

These lifelong health risks associated with severe obesity during early childhood indicate the importance of preventing and identifying severe obesity. Childhood obesity disproportionately affects children living in low-income families. However, no recent trends on severe obesity in this population have been reported.
Continue reading

Breast Cancer Survival Remains Lower For Black Women

MedicalResearch.com Interview with:
“Family Weekend 2014-Breast Cancer Walk” by Nazareth College is licensed under CC BY 2.0
Dr. Jacqueline Miller, MD
Division of Cancer Prevention and Control
CDC 

MedicalResearch.com: What efforts have proven successful in reducing racial disparities like these?

Response: While some racial disparities will exist due to differences in tumor types, improving early diagnosis and providing specific treatment based on tumor characteristics in a timely fashion would result in reducing breast cancer disparities.

Continue reading

Disparities in Ovarian Cancer Survival in the United States

MedicalResearch.com Interview with:

The Centers for Disease Control and Prevention CDC image

Site of Ovarian Cancer CDC image

Dr. Sherri Stewart, PhD
Division of Cancer Prevention and Control
CDC

MedicalResearch.com: What do women most need to know about ovarian cancer detection and treatment?

Response: There is no effective test to detect ovarian cancer at an early stage where treatment is most likely to be effective.  Many women mistakenly believe that the Pap test can detect ovarian cancer, but it does not. The Pap test is recommended only for the detection of cervical cancer.

 Recognizing early symptoms of ovarian cancer and seeking timely care may help lead to detection of the cancer at an earlier stage, where treatment is likely to be more effective.  Symptoms – such  as abdominal and back pain, feeling full quickly after eating, and frequent urination – are often present among women with ovarian cancer.  Women should talk with their doctors if they experience any of these symptoms for 2 weeks or longer and the symptoms persist or worsen.

If a woman is diagnosed with ovarian cancer, she should seek treatment from a gynecologic oncologist, a physician specially trained to treat ovarian cancer.  Ovarian cancer patients who have been treated by gynecologic oncologists have been shown to survive longer than those treated by other physicians.           Continue reading

Black Men and Women Continue To Have Lower Colon Cancer Survival Rates

MedicalResearch.com Interview with:

“Large Colon Cancer Arising in Adenoma” by Ed Uthman is licensed under CC BY 2.0

“Large Colon Cancer Arising in Adenoma” by Ed Uthman

Dr. Arica White PhD MPH
Division of Cancer Prevention and Control
CDC

MedicalResearch.com: What is the likelihood of reaching the 80% CRC screening rate goal by next year?

Response: As of 2016, 67% of adults age 50-75 years reported being up-to-date with colorectal cancer screening. The 80% by 2018 initiative represented an aspirational goal that public health, non-profit, and community-based organizations will continue to strive for regardless of the outcome in 2018.

Continue reading

Vast Majority of Adults Do Not Consume Enough Fruit and Vegetables

MedicalResearch.com Interview with:

Seung Hee Lee-Kwan, PhD Epidemiologist, Division of Nutrition, Physical Activity, and Obesity Centers for Disease Control and Prevention (CDC).

Dr. Seung Hee Lee-Kwan

Seung Hee Lee-Kwan, PhD
Epidemiologist, Division of Nutrition, Physical Activity, and Obesity
Centers for Disease Control and Prevention (CDC).

Seung Hee Lee-Kwan has a PhD in International Health at Johns Hopkins Bloomberg School of Public Health. Her previous work focused community-based interventions that aimed to promote healthy eating. Dr. Lee-Kwan’s current work at CDC is on fruits and vegetable surveillance, and research of health behaviors and environmental factors associated with obesity.

 

MedicalResearch.com: What is the background for this study?

Response: The purpose of the study was to update a 2013 report that estimated how many people in each state are meeting fruit and vegetable intake recommendations with the latest data from 2015. These estimates looked at the percent of adults meeting the intake recommendations by age, sex, race/ethnicity, and income-to-poverty ratio for the 50 states and District of Columbia (DC).

Continue reading

Less Than Half of Health Care Workers Receive Tdap Vaccine

MedicalResearch.com Interview with:
“Syringe and Vaccine” by NIAID is licensed under CC BY 2.0
Alissa C. O’Halloran, MSPH
Immunization Services Division
National Center for Immunization and Respiratory Diseases
Centers for Disease Control and Prevention
Atlanta GA 30329 

MedicalResearch.com: What is the background for this study?

Response: Outbreaks of pertussis (whooping cough) can occur in healthcare settings. Vaccinating healthcare personnel (HCP) may be helpful in protecting HCP from pertussis and potentially limiting spread to others in healthcare settings.

The Advisory Committee on Immunization Practices (ACIP) recommends a single dose of tetanus, diphtheria, and acellular pertussis (Tdap) vaccine for all adults, including pregnant women during each pregnancy, to protect themselves and reduce the risk for transmitting pertussis to infants too young to be vaccinated. To assure high Tdap coverage and disease prevention among HCP, patients, and others, ACIP recommends that healthcare employers provide Tdap vaccination to HCP and use approaches that maximize vaccination rates.

In this study, we assessed Tdap vaccination coverage among healthcare personnel  by occupation, industry, demographics, access-to-care characteristics, and by the 21 states in the study.

Continue reading

Your Mother Was Right! Raw Cookie Dough Can Make You Sick

MedicalResearch.com Interview with:

Escherichia coli CDC Image

E. coli – Escherichia coli
CDC Image

Samuel J. Crowe, Ph.D., M.P.H.
Food and Drug Administration
College Park, MD
CDC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Flour has been a suspected outbreak vehicle for Shiga toxin-producing E. coli (STEC) infections since 2009, when a multistate outbreak of foodborne disease was linked to prepackaged cookie dough. The 2016 STEC outbreak investigation described in this study was the first investigation to confirm flour as the source of an E. coli outbreak. Linking the outbreak to flour was challenging for several reasons, but epidemiologic, traceback, and microbiologic data ultimately confirmed that flour produced at a single facility was the source of the illnesses.

Continue reading

CDC Study Finds Lyme Disease Remains a Public Health Challenge

MedicalResearch.com Interview with:

This 2007 photograph depicts the pathognomonic erythematous rash in the pattern of a “bull’s-eye”, which manifested at the site of a tick bite on this Maryland woman’s posterior right upper arm, who’d subsequently contracted Lyme disease. Lyme disease patients who are diagnosed early, and receive proper antibiotic treatment, usually recover rapidly and completely. A key component of early diagnosis is recognition of the characteristic Lyme disease rash called erythema migrans. This rash often manifests itself in a “bull's-eye” appearance, and is observed in about 80% of Lyme disease patients. Lyme disease is caused by the bacterium Borrelia burgdorferi, and is transmitted to humans by the bite of infected blacklegged ticks. Typical symptoms include fever, headache, fatigue, and as illustrated here, the characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system. Note that there are a number of PHIL images related to this disease and its vectors.

This 2007 photograph depicts the pathognomonic erythematous rash in the pattern of a “bull’s-eye”, which manifested at the site of a tick bite on this Maryland woman’s posterior right upper arm, who’d subsequently contracted Lyme disease.
Lyme disease patients who are diagnosed early, and receive proper antibiotic treatment, usually recover rapidly and completely. A key component of early diagnosis is recognition of the characteristic Lyme disease rash called erythema migrans. This rash often manifests itself in a “bull’s-eye” appearance, and is observed in about 80% of Lyme disease patients.
Lyme disease is caused by the bacterium Borrelia burgdorferi, and is transmitted to humans by the bite of infected blacklegged ticks. Typical symptoms include fever, headache, fatigue, and as illustrated here, the characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system. From CDC image library

Kiersten Kugeler, PhD
Division of Vector-Borne Diseases
CDC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Lyme disease has been a nationally notifiable disease in the United States since 1991. Each year, possible cases of Lyme disease are investigated and tallied by state and local public health officials according to criteria set by the surveillance case definition. States voluntarily share human case data with CDC, which summarizes the data to provide a national perspective on disease trends.

This report summarizes national Lyme disease data reported during 2008-2015. Lyme disease continues to be the most commonly reported vector-borne disease in the United States with more than 275,000 cases of Lyme disease reported to CDC during the study period. Although most cases continue to be reported from states with high incidence in the Northeast, mid-Atlantic, and upper Midwest regions, case counts in most of these states have remained stable or decreased during this time. In contrast, case counts have increased in states that neighbor those with high incidence. The trend of stable to decreasing case counts in many states with high incidence may be due to multiple factors, including the possibility that occurrence of the disease has stabilized in these areas or that some state health agencies have changed their reporting practices to lower the resource burden associated with Lyme disease surveillance. Lyme disease surveillance is not meant to document every case, but rather to indicate disease trends over time, define high-risk groups, and describe the geographic distribution of the condition.

Continue reading

Rapid Increase in ER Visits For Young Girls With Self-Inflicted Injuries

MedicalResearch.com Interview with:

Dr. Melissa C. Mercado PhD, MSc, MA Behavioral scientist Division of Violence Prevention National Center for Injury Prevention and Control CDC

Dr. Mercado

Dr. Melissa C. Mercado PhD, MSc, MA
Behavioral scientist
Division of Violence Prevention
National Center for Injury Prevention and Control
CDC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Suicide ranks as the 10th leading cause of death for all age groups combined and has been among the top 12 leading causes of death since 1975 in the U.S. In 2015, across all age groups, suicide was responsible for 44,193 deaths in the U.S., which is approximately one suicide every 12 minutes.

Suicide was the second leading cause of death among U.S. youth aged 10-24 years in 2015. Self-inflicted injury is one of the strongest risk factors for suicide.

This study examined trends in non-fatal self-inflicted injuries treated in hospital emergency departments (EDs) among youth aged 10 to 24 years in the United States from 2001-2015.  The overall weighted age-adjusted rate for this group increased by 5.7% annually during the 2008 to 2015 period.  Age-adjusted trends for males overall and across age groups remained stable throughout 2001-2015.  However, rates among females increased significantly, by 8.4% annually. The largest increase among females was observed among those aged 10-14 years, with an increase of 18.8% annually from 2009 to 2015.

Continue reading

US Heat-Related Deaths Disproportionately Affect Non-Citizens

MedicalResearch.com Interview with:
“Wood for Heat” by Alternative Heat is licensed under CC BY 2.0
Ethel V. Taylor, DVM, MPH
Division of Environmental Hazards and Health Effects
National Center for Environmental Health,
Centers for Disease Control and Prevention
Atlanta, GA

MedicalResearch.com: What is the background for this study?

Response: CDC sought to identify and measure whether or not differences exist for deaths associated with extreme heat among non-citizens, who had been identified by previous studies as higher risk due to occupation.

CDC compared heat-related deaths among non-US and US citizens from 2005-2014. Heat-related deaths accounted for 2.4% of all deaths among non-U.S. citizens (n=999) compared to 0.02% of U.S. citizens (n=4196).

Continue reading

Nearly Half of Adolescents Had At Least One Sunburn In Past Year

MedicalResearch.com Interview with:
“Dymchurch Beach - May 2012 - Sunburn with Matching Bikini” by Gareth Williams is licensed under CC BY 2.0
Dawn M. Holman, MPH
Behavioral Scientist
Division of Cancer Prevention and Control
Centers for Disease Control and Prevention

MedicalResearch.com: What is the background for this study?

Response: Scientific evidence clearly shows that even one sunburn during adolescence can increase a person’s chances of developing skin cancer as an adult. Surprisingly, little research has been done to understand the factors associated with sunburn during this phase of life. The CDC wanted to examine beliefs, behaviors, and demographic characteristics that might be associated with adolescent sunburns in hopes that the findings could inform future intervention efforts. We used data from the 2015 YouthStyles survey (adolescents aged 12 to 17 years) to explore this research question

Continue reading

Kidney Failure From Diabetes Decreasing Across US

MedicalResearch.com Interview with:
Nilka Ríos Burrows, MPH, MT (ASCP)
Lead, Chronic Kidney Disease Initiative
CDC Division of Diabetes Translation. 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Kidney failure treated with dialysis or a kidney transplant is called end-stage renal disease (ESRD).  ESRD is a costly and disabling condition often resulting in premature death.

During 2000–2014, kidney failure from diabetes among U.S. adults with diabetes decreased by 33%, and it declined significantly in most states, the District of Columbia, and Puerto Rico. No state experienced an increase in kidney failure from diabetes. Continued awareness and interventions to reduce risk factors for kidney failure, improve diabetes care, and prevent type 2 diabetes might sustain these positive trends.

Continue reading

Half Of People Who Died of Opioid Overdoses Tested Positive For Fentanyl

MedicalResearch.com Interview with:
“no drugs” by Anderson Mancini is licensed under CC BY 2.0
Julie K. O’Donnell, PhD
Division of Unintentional Injury Prevention
National Center for Injury Prevention and Control
CDC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The opioid overdose epidemic has killed over 300,000 Americans from 1999 to 2015—including 33,091 in 2015. Over this time, the epidemic has evolved from being primarily driven by prescription opioids to increasingly being driven by illicit opioids. The first wave of the epidemic began in 1999 with a steep increase in deaths involving prescription opioids, such as hydrocodone, oxycodone, and morphine. The second wave began in 2010 with rapid increases in overdose deaths involving heroin. The third wave of the epidemic began in 2013, with significant increases in overdose deaths involving synthetic opioids—particularly those involving illicitly-manufactured fentanyl (IMF), which are commonly laced into heroin products. Most recently, the IMF market continues to evolve, with an ever-widening array of illicitly manufactured fentanyl analogs being distributed.

This report indicates that over half of people in 10 states who died of opioid overdoses tested positive for fentanyl during the second half of 2016. The report found that out of a total of 5,152 opioid overdose deaths, almost 3,000 tested positive for fentanyl, and over 700 tested positive for drugs that have similar chemical structures to fentanyl (fentanyl analogs) – including the extremely potent fentanyl analog, carfentanil, which is used to sedate large animals.

Continue reading

Overdose Deaths Increase Across Urban Status, Sex and Race Lines

MedicalResearch.com Interview with:
“Pills” by Kurtis Garbutt is licensed under CC BY 2.0
Christopher M. Jones, PharmD
Office of the Assistant Secretary for Planning and Evaluation
Office of the Secretary
U.S. Department of Health and Human Services 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Drug overdoses are the leading cause of injury death in the United States, resulting in approximately 52,000 deaths in 2015. Although prescription drugs, in particular opioid pain relievers, were primarily responsible for the rapid expansion of this large and growing public health crisis, illicit drugs (heroin, illicit fentanyl, cocaine, and methamphetamines) now are contributing substantially to the problem. Understanding differences in illicit drug use, illicit drug use disorders, and overall drug overdose deaths in metropolitan and nonmetropolitan areas is important for informing public health programs, interventions, and policies.

We found that the prevalence of self-reported past-month use of illicit drugs increased significantly across urban status (large metropolitan, small metropolitan, and nonmetropolitan) between 2003-2005 and 2012-2014. Prevalence was higher for males than females, however, in the large metropolitan group, the percentage increase in prevalence from 2003–2005 to 2012–2014 was greater for females (23.4%) than for males (21.6%). There were notable differences by age. During 2012–2014, respondents aged 18–25 years had the highest prevalence of past-month use of illicit drugs for all urban levels. For respondents in this age group, the prevalence increased slightly from 2003–2005 to 2012–2014 in large metropolitan areas while the prevalence remained stable among small metropolitan area respondents and nonmetropolitan area respondents. Past-month use of illicit drugs declined over the study period for the youngest respondents (aged 12–17 years), with the largest decline among small metropolitan area youth.

Continue reading

More Evidence for Zika as a Causal Agent Of Guillain-Barré Syndrome

MedicalResearch.com Interview with:

Emilio Dirlikov, PhD Epidemic Intelligence Service Officer CDC 

Dr. Dirlikov

Emilio Dirlikov, PhD
Epidemic Intelligence Service Officer
CDC 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In December 2015, Puerto Rico Department of Health (PRDH) reported its first confirmed locally acquired case of Zika virus disease. In February 2016, PRDH reported the first person diagnosed with Guillain-Barré syndrome (GBS) who also had evidence of Zika virus infection. At the time, scientific evidence of the potential association between Zika virus infection and GBS was lacking, and rigorous studies were needed.

Through a collaboration between PRDH, CDC, and the University of Puerto Rico (UPR), we conducted a case-control study to determine risk factors for GBS during the 2016 Zika virus epidemic. By prospectively enrolling case-patients, we shortened the time to enrollment, increasing the likelihood of detecting Zika virus nucleic acids to confirm Zika virus infection.

As a result, we found that an acute Zika virus infection confirmed by laboratory testing is a risk factor for developing Guillain-Barré syndrome. This is the first case-control study to find laboratory evidence showing this given the difficulty of confirming Zika virus infection among people diagnosed with GBS.

Continue reading

Antibiotics Prescribed By Dentists May Contribute To C.diff Infections

MedicalResearch.com Interview with:

Stacy Holzbauer, DVM, MPH, DACVPM CDC Career Epidemiology Field Officer (CEFO) Commander, USPHS Minnesota Department of Health St. Paul, MN

Dr. Holzbauer

Stacy Holzbauer, DVM, MPH, DACVPM
CDC Career Epidemiology Field Officer (CEFO)
Commander, USPHS
Minnesota Department of Health
St. Paul, MN

MedicalResearch.com: What is the background for this study?

  • Antibiotics are not harmless drugs—Clostridium difficile infection, which can sometimes cause a deadly diarrhea, is a complication of antibiotic use and can occur after even one dose of an antibiotic.
  • The Minnesota Department of Health (MDH) is part of the larger Centers for Disease Control and Prevention (CDC) Emerging Infections Program (EIP). The healthcare-associated infection component of CDC’s EIP engages a network of state health departments and their academic medical center partners to help answer critical questions about emerging HAI threats including Clostridium difficile also known as “C. diff.”
  • In Minnesota, the majority of C. diff infections occur outside the hospital and are driven by antibiotic use in community or outpatient settings. In addition to routine surveillance data, we interview patients with C. diff who were not hospitalized prior to their infection to identify potential risks for developing C. diff infection, including identifying antibiotics received outside of routine healthcare settings.
  • Dentists prescribe approximately 10% of the antibiotics in outpatient settings, which was over 24 million prescriptions in 2013. When asked about their prescribing practices in a 2015 survey with the Minnesota Dental Association, 36% of dentists surveyed prescribed antibiotics for dental conditions that are generally not recommended to receive antibiotics according to American Dental Association (ADA) guidelines.

Continue reading