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.

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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).

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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

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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.

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40% of Cancers Associated With Overweight and Obesity

MedicalResearch.com Interview with:
Dr. C. Brooke Steele D.O.

Division of Cancer Prevention and Control
Centers fo Disease Control and Prevention 

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

Response: This report contains new information about cancer risk and people being overweight and obese. Research shows that being overweight or having obesity is associated with at least 13 types of cancer (adenocarcinoma of the esophagus; cancers of the breast [in postmenopausal women], colon and rectum, endometrium, gallbladder, gastric cardia, kidney, liver, ovaries, pancreas, and thyroid; meningioma; and multiple myeloma). We also know that the number of people who weigh more than recommended has increased over the past few decades. Therefore, we looked at the numbers of new cases of cancers associated with overweight and having obesity in the United States, as well as how the rates have changed over a 10-year period. Because screening for colorectal cancer can reduce colorectal cancer incidence through detection and removal of precancerous polyps before they become cancerous, we analyzed trends with and without colorectal cancer.

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Healthy Behaviors and Academic Success Go ‘Hand in Hand’

MedicalResearch.com Interview with:

Catherine N. Rasberry, PhD Health Scientist, Division of Adolescent and School Health CDC Atlanta

Dr.Raspberry

Catherine N. Rasberry, PhD
Health Scientist, Division of Adolescent and School Health
CDC Atlanta

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

Response: For many years, researchers have documented links between health-related behaviors and educational outcomes such as letter grades, test scores, and other measures of academic achievement. However, many of those studies are becoming out-of-date or have used samples that were not nationally representative. The aim of this study was to see if previous findings held in a current, national sample of high school students.

Consistent with previous studies, our findings revealed that regardless of sex, race/ethnicity and grade-level, high school students who received mostly A’s, mostly B’s, or mostly C’s had higher levels of most protective health-related behaviors and lower levels of most health-related risk behaviors. For example, we found that:

  • Students who reported receiving mostly Ds and Fs, were nine times more likely than students who received mostly As to report having ever injected any illegal drugs.
  • Also, students who reported receiving mostly Ds and Fs were more than four times more likely than students who received mostly As to report that they had four or more sexual partners.
  • Conversely, students who reported receiving mostly As were twice as likely as students who received mostly Ds and Fs to report eating breakfast every day in the past week.

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CDC Finds Public Health Preparedness Improved Since 9/11, Needs Ongoing Support

MedicalResearch.com Interview with:

Dr. Bhavini Patel Murthy, MD MPH Division of State and Local Readiness Office of Public Health Preparedness and Response and Epidemic Intelligence Service CDC, Atlanta 

Dr. Murthy

Dr. Bhavini Patel Murthy, MD MPH
Division of State and Local Readiness
Office of Public Health Preparedness and Response and
Epidemic Intelligence Service
CDC, Atlanta 

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

Response: Public health preparedness is critical to ensure national health security. Recurring disasters (both natural and man-made), especially recent weather emergencies in Texas in Florida, have highlighted the need for robust coordination between federal, state, local, territorial and tribal governments to adequately prepare and respond to public health emergencies.

The Public Health Emergency Preparedness (PHEP) program provides funding to state, local and territorial governments to prevent, protect, respond, and rapidly recover from large and small public health emergencies.

This is the first analysis of preparedness capabilities based on reports from all 62 jurisdictions that receive PHEP funding across the United States and its territories. We found that most jurisdictions had limited preparedness capacity prior to 9/11, but now have made considerable progress. For example, all 62 jurisdictions now report having an incident management infrastructure.

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CDC Reports Progress In Reducing Strokes Has Stalled

MedicalResearch.com Interview with:

Quanhe Yang, PhD Division for Heart Disease and Stroke Prevention National Center for Chronic Disease Prevention and Health Promotion CDC

Dr. Yang

Quanhe Yang, PhD
Division for Heart Disease and Stroke Prevention
National Center for Chronic Disease Prevention and Health Promotion
CDC

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

Response: The prominent decline in U.S. stroke death rates observed for more than 4 decades has slowed in recent years. CDC examined trends and patterns in recent stroke death rates among U.S. adults aged ≥ 35 years by age, sex, race/ethnicity, state, and census region.

Declines in stroke death rates have slowed down in 3 out of every 4 states from 2000 to 2015, and the stroke death rates increased significantly in southern states and among Hispanics from 2013 to 2015.

An estimated 30,000 excess stroke deaths might have occurred because of the unfavorable changes in the rate of decline in stroke mortality during 2013–2015.

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Risky Behaviors Linked To Contact Lens–Related Eye Infections Among Adults and Adolescents

MedicalResearch.com Interview with:

Dr. Jennifer R. Cope MD Medical Officer Division of Foodborne, Waterborne, and Environmental Diseases National Center for Emerging and Zoonotic Infectious Diseases CDC

Dr. Cope

Dr. Jennifer R. Cope MD
Medical Officer
Division of Foodborne, Waterborne, and Environmental Diseases
National Center for Emerging and Zoonotic Infectious Diseases
CDC

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

Response: Wearing contact lenses can increase your chances of getting a severe eye infection. Eye infections can lead to serious problems, including blindness. All contact lens wearers can help prevent serious eye infections by correctly wearing and caring for their contact lenses.

Eighty-one percent of young adults, 85% of adolescents, and 88% of older adults regularly did at least one risky behavior related to their contact lenses. The most frequently reported risk behaviors in adolescents were not visiting an eye doctor as least annually, sleeping or napping in lenses, and swimming in lenses.

Among young adults and older adults, the most frequently reported risk behaviors were replacing lenses at intervals longer than those prescribed, replacing lens storage cases at intervals longer than those recommended, swimming in lenses, and sleeping or napping in lenses.

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Many Young Adults Have One or More Modifiable Cancer Risk Factors

MedicalResearch.com Interview with:

Mary C. White, ScD MPH Epidemiology and Applied Research Branch Division of Cancer Prevention and Control CDC Atlanta GA 30341

Dr. White

Mary C. White, ScD MPH
Epidemiology and Applied Research Branch
Division of Cancer Prevention and Control
CDC
Atlanta GA 30341

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

Response: Most cancers are caused not by just one thing, but instead by a combination of different factors over many years. Early adulthood is a time of many life changes and stresses, and exposure to harmful products and unhealthy habits during early adulthood can set the stage for developing cancer at older ages. We analyzed responses from a national sample of young adults to questions about diet, physical activity, tobacco products, alcohol, indoor tanning, sleep, the HPV vaccine, and obesity. These factors have been linked to higher risks of different types of cancer.

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Single Measurement May Underestimate HIV Viral Suppression

MedicalResearch.com Interview with:
Dr. Nicole Crepaz PhD
Behavioral Scientist
Division of HIV/AIDS Prevention
CDC

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

Response: The most common measure of viral suppression in clinical and surveillance studies is the most recent viral load in past 12 months. This single-value measure does not capture the viral load dynamics over time. We examined durable viral suppression, never virally suppressed, and cumulative HIV burden (measured in the viremia copy-year) to help us better understand viral suppression and transmission risk potential.

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Majority of Murdered Women Are Killed By Current or Former Partners

MedicalResearch.com Interview with:

EmikoPetrosky MD M.P.H Science Officer, National Violent Death Reporting System at Centers for Disease Control and Prevention Centers for Disease Control and Prevention Emory University Rollins School of Public Health

Dr. Petrosky

EmikoPetrosky MD M.P.H
Science Officer, National Violent Death Reporting System at Centers for Disease Control and Prevention
Centers for Disease Control and Prevention
Emory University Rollins School of Public Health

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

Response: Homicide is one of the leading causes of death for women aged 44 years and younger. In 2015, 3,519 girls and women died by homicide in the United States.  It is the 5th leading cause of death for women under 45 years age (defining women as 18-44 years of age).

The National Violent Death Reporting System (NVDRS) links together data from death certificates, coroner/medical examiner reports, and law enforcement reports, resulting in more information about the circumstances of death than what is available elsewhere.

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Opioid Prescriptions Decrease But Still Elevated Compared To 20 Years Ago

MedicalResearch.com Interview with:

Deborah Dowell, MD, MPH Chief Medical Officer, Division of Unintentional Injury Prevention National Center for Injury Prevention and Control Centers for Disease Control and Prevention

Dr. Dowell

Deborah Dowell, MD, MPH
Chief Medical Officer, Division of Unintentional Injury Prevention
National Center for Injury Prevention and Control
Centers for Disease Control and Prevention 

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

Response: CDC analyzed retail prescription data from QuintilesIMS which provides estimates of the number of opioid prescriptions dispensed in the United States from approximately 59,000 pharmacies, representing 88% of prescriptions in the United States. CDC assessed opioid prescribing in the United States from 2006 to 2015, including rates, amounts, dosages, and durations prescribed. CDC examined county-level prescribing patterns in 2010 and 2015.
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Cancer Death Rates Higher in Rural America

MedicalResearch.com Interview with:

Lisa C. Richardson, MD, MPH, Oncologist Director,Division of Cancer Prevention and Control CDC

Dr. Richardson

Lisa C. Richardson, MD, MPH, Oncologist
Director,Division of Cancer Prevention and Control
CDC

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

Response: This MMWR report is the first complete description of cancer incidence and mortality comparing rural and urban America.  From previous reports we know that rural residents are more likely to be older, have more comorbid conditions and participate in high risk behaviors that can lead to cancer. CDC researchers were interested in how these factors were related to new cancers and cancer deaths in rural counties compared to metropolitan counties.

Researchers found that rates of new cases for lung cancer, colorectal cancer, and cervical cancer were higher in rural America. In contrast, rural areas were found to have lower rates of new cancers of the female breast, and prostate. Rural counties had higher death rates from lung, colorectal, prostate, and cervical cancers.

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Unorthodox Treatment of Presumed Chronic Lyme Disease Can Be Deadly

MedicalResearch.com Interview with:

Dr. Christina Nelson, MD MPH Medical epidemiologist, Division of Vector-Borne Diseases CDC

Dr. Nelson

Dr. Christina Nelson, MD MPH
Medical epidemiologist, Division of Vector-Borne Diseases
CDC 

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

Response: Patients who are given a diagnosis of “chronic Lyme disease” have been offered a variety of treatments that have not been shown to be effective.  Many patients are treated with prolonged courses of antibiotics (for months or years), which have not been shown to provide substantial long-term benefit to patients.  Anecdotal reports about adverse outcomes associated with these treatments for chronic Lyme disease are common, but there have not been systematic efforts to collect data about the frequency of these events.

MedicalResearch.com: Why is the diagnosis of ‘Chronic Lyme Disease’ so common?

Response: The term “chronic Lyme disease” (CLD) has been used to describe people with different illnesses. While the term is sometimes used to describe illness in patients with Lyme disease, in many occasions it has been used to describe symptoms in people who have no evidence of a current or past infection with Lyme disease.  Because of the confusion in how the term CLD is employed, experts in this field do not support its use.

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Most Health Care Personnel Not Getting Tdap Vaccination

MedicalResearch.com Interview with:
Anup Srivastav, DVM, MPVM, PhD

National Center for Immunization and Respiratory Diseases (NCIRD)
Centers for Disease Control and Prevention
Atlanta GA

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

Response: Healthcare personnel (HCP) are at risk for being exposed to pertussis (whooping cough) and spreading the disease to patients in their work settings. CDC recommends tetanus, diphtheria, acellular pertussis (Tdap) vaccination for healthcare personnel to reduce their risk of getting the disease and spreading it to patients. This is the first report of Tdap vaccination coverage among healthcare personnel by occupational setting.

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Many Teens Use Less Effective Contraceptives After Pregnancy

MedicalResearch.com Interview with:
Deborah L. Dee, PhD
Division of Reproductive Health
National Center for Chronic Disease Prevention and Health Promotion
CDC

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

Response: Although the national teen birth rate has dropped to a historic low (22.3 births per 1,000 females aged 15-19 years in 2015), many teens continue to have repeat births. Because repeat teen births are more likely than first teen births to be preterm and low birth weight, and giving birth more than once as a teenager can significantly limit a mother’s ability to attend school and obtain work experience, it’s important to assess patterns in repeat teen births and better understand contraceptive use within this population. Continue reading

Rapid Tests For Foodborne Infections Can Provide Faster Treatment But Curtail Important Outbreak Data

MedicalResearch.com Interview with:

Ms. Ellyn Marder MPH</strong> Surveillance Epidemiologist, CDC Centers for Disease Control and Prevention Atlanta, Georgia

Ellyn Marder

Ms. Ellyn Marder MPH
Surveillance Epidemiologist, CDC
Centers for Disease Control and Prevention
Atlanta, Georgia

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

Response: CDC’s Foodborne Diseases Active Surveillance Network (FoodNet) report provides the most up-to-date information about foodborne illnesses in the United States. Each year, FoodNet publishes a report that includes preliminary data compared with data from the previous three years. FoodNet has been monitoring illness trends since 1996 and collects data on about 15 percent of the U.S. population.

Campylobacter and Salmonella caused the most reported bacterial foodborne illnesses in 2016, according to preliminary data. FoodNet sites alone reported 24,029 foodborne infections, 5,512 hospitalizations, and 98 deaths in 2016. The numbers of reported illnesses by germ are: Campylobacter (8,547), Salmonella (8,172), Shigella (2,913), Shiga toxin-producing E. coli (1,845), Cryptosporidium (1,816), Yersinia (302), Vibrio (252), Listeria (127) and Cyclospora (55).

This is the first time the report also includes in the total number of infections those foodborne bacterial infections diagnosed only by rapid diagnostic tests in FoodNet sites. Previously, the report counted foodborne bacterial infections confirmed only by traditional culture-based methods in the total numbers.

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Long-Term Opioid Use Increases With Each Additional Day On Opioid Therapy

MedicalResearch.com Interview with:
Anuj Shah (B.Pharm)

Doctoral Student
Division of Pharmaceutical Evaluation and Policy
University of Arkansas for Medical Sciences

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

Response: The CDC guideline on opioid prescribing, published in March 2016, included recommendations for initiation of opioid therapy. The guideline noted that there is a lack of data describing how acute opioid use transitions to long-term opioid use. This report seeks to address this gap by determining characteristics of initial opioid prescribing prognostic of long-term use, among opioid naïve cancer-free adults.
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Persistence of Zika Virus in Body Fluids — Preliminary Report

MedicalResearch.com Interview with:
Gabriela Paz-Bailey MD PhD

Senior Epidemiologist
Centers for Disease Control and Prevention 

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

Response: Zika virus is recognized as a cause of microcephaly and other severe birth defects when a woman is infected during pregnancy. Additionally, it has been associated with potentially fatal complications, such as Guillain-Barré syndrome. It is not well understood how often Zika virus particles can be detected in semen and other body fluids and for how long they remain detectable. Existing evidence is based on case reports and cross-sectional observations, primarily from returning travelers. A more comprehensive description of the dynamics of the early stages of Zika virus infection, observed within infected people over time, is needed to inform diagnostic testing as well as prevention recommendations and interventions.
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Do Financial Conflicts Influence CDC Guidelines For Prescription Opioids?

MedicalResearch.com Interview with:
Dora Lin, MHS
Sr. Research Assistant
Johns Hopkins Bloomberg School of Public Health
Center for Drug Safety and Effectiveness
Baltimore, MD 21205 

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

Response: In response to the opioid epidemic and growing number of overdose deaths each year, the CDC released draft guidelines to improve the safe use of opioids in primary care. The draft guidelines were open to public comment, and many organizations, ranging from professional societies to consumer advocates to local governmental organizations, submitted comments regarding the guidelines. We examined the levels of support or non-support for the draft guidelines among the 158 organizations who submitted comments.   We also examined each organization’s relationship to opioid manufacturers. Most organizations supported the guidelines, regardless of whether or not they had a financial relationship to a drug company. However, organizations receiving funding from opioid manufacturers were significantly more likely to be opposed to the guidelines than those who did not receive such funding.

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Fewer African Americans, More Whites Injecting Drugs

MedicalResearch.com Interview with:

Cyprian Wejnert, Ph.D. National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention CDC

Dr. Cyprian Wejnert

Cyprian Wejnert, Ph.D.
National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention
CDC

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

Response: Our country is dealing with a devastating epidemic of opioid misuse and overdose that affects individuals, families and communities. We have long known that sharing needles and syringes is an incredibly efficient route for HIV, hepatitis and other infections to spread.

Yet, about 10% of annual HIV diagnoses in the United States occur among people who inject drugs, and there are clusters of hepatitis C infections across the country. These infections can be prevented when people who inject drugs use sterile needles, syringes and other injection equipment. One of the main findings of this study is that use of syringe services programs (SSPs) has increased substantially during the past decade, but most people who inject drugs still don’t always use sterile needles.

The analysis finds that more than half (54%) of people who inject drugs in 22 cities with a high number of HIV cases reported in 2015 they used an SSP in the past year, compared to only about one-third (36%) in 2005. Although syringe services program use has increased, findings indicate that too few people who inject drugs use only sterile needles. One in three (33%) reported in 2015 that they had shared a needle within the past year – about the same percentage that reported sharing a decade ago (36% in 2005).

The report also highlights some successes in HIV prevention among African Americans and Latinos who inject drugs, as well as concerning trends in whites who inject drugs. From our study of 22 urban areas, it appears that fewer African Americans are injecting drugs. However, it also appears there has been an increase in white Americans injecting drugs.

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Despite Recent Modest Declines, Childhood Obesity Prevalence Remains High

MedicalResearch.com Interview with:
Liping Pan, MD MPH

Centers for Disease Control and Prevention
Atlanta, GA

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

Response: This CDC report is the first to use the WIC Participant Characteristic (WIC PC) data from the USDA to monitor trends in obesity among young children aged 2 to 4 years in the WIC program.

The main findings of the study are:

• 34 of 56 (61%) WIC state agencies reported modest decreases in obesity among young children from 2010 to 2014.
• From 2000 to 2010, the prevalence of obesity among 2-4 year olds increased from 14.0% to 15.9%, then dropped to 14.5% from 2010 to 2014.
• Obesity prevalence varied by state, ranging from 8.2 percent in Utah to 20.0 percent in Virginia.
• From 2010 to 2014, obesity prevalence decreased among all major racial/ethnic groups, including non-Hispanic whites, non-Hispanic blacks, Hispanics, American Indians/Alaska Natives, and Asians/Pacific Islanders.
• From 2000 to 2014, obesity prevalence decreased significantly among Asian/Pacific Islanders, from 13.9 percent to 11.1 percent.

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Smoking Deaths Disproportionately Affect Poor and Black Americans

MedicalResearch.com Interview with:
Jane Henley MSPH

Epidemiologist
Division of Cancer Prevention and Control

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

Response: The Surgeon General concluded that cigarette smoking causes at least 12 types of cancer: oral cavity and pharynx, esophagus, stomach, colon and rectum, liver, pancreas, larynx, lung, bronchus and trachea, bladder, kidney and renal pelvis, cervix, and acute myeloid leukemia. Other tobacco products — cigars, chewing tobacco and snuff — and secondhand smoke are also linked to some of these cancers.

MedicalResearch.com: What are the main findings?

Response: We examined rates and trends of new cases and deaths from these cancers using U.S. registry and mortality data from 2004 to 2013. We broke the data down by characteristics that might display disparities — sex, age, race, ethnicity, state, county-level poverty and education, rural/urban continuum, and cancer site.

We found that about 660,000 people were diagnosed with and 343,000 people died each year from these cancers. Rates were higher among men, black men and women, and people in counties with low education or high poverty. Rates ranged by state from a low of 130 cases in Utah (126 in Puerto Rico) to a high of 248 cases in Kentucky. Incidence decreased 1.3 percent per year and mortality decreased faster, at about 1.6 percent per year; decreases were observed across most groups, but not at the same rate. Disparities persist among certain groups with higher rates or slower declines in rates.

We also looked at changes in cancer death rates from 1970 to 2014 and estimated that 1.3 million tobacco-related cancer deaths were averted since 1990, in part because of comprehensive cancer and tobacco control efforts to reduce tobacco use and other cancer risk factors, early detection of cancer, and improvements in cancer treatment.

MedicalResearch.com: What should readers take away from your report?

Response: Further reducing tobacco use can save thousands more people from getting and dying from cancer. Based on current estimates, about 36.5 million people smoke, and about half will die from a smoking related disease, unless programs are implemented to help them quit smoking. Comprehensive cancer and tobacco control programs actions can be done at the state and local level, such as:

• Promoting healthy, tobacco-free environments
• Increasing access to early detection and care for tobacco-related cancers
• Helping cancer survivors who use tobacco quit
• Better assisting communities disproportionately impacted by cancer

And of course, increasing the price of tobacco products and ongoing media campaigns, like Tips from Former Smokers, have a huge impact.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Ongoing surveillance efforts are needed to monitor changes in the number of new cases and deaths from tobacco-related cancers and whether there are differences among communities or groups of people. This work will provide insight into the impact of comprehensive cancer and tobacco control efforts and how to target these efforts in the areas where they’re needed most.

MedicalResearch.com: Is there anything else you would like to add?

Response: You can find more information at https://www.cdc.gov/cancer/tobacco/

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Henley SJ, Thomas CC, Sharapova SR, et al. Vital Signs: Disparities in Tobacco-Related Cancer Incidence and Mortality — United States, 2004–2013. MMWR Morb Mortal Wkly Rep 2016;65:1212–1218. DOI: http://dx.doi.org/10.15585/mmwr.mm6544a3.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

More Medical Research Interviews on MedicalResearch.com

CDC Reports On First Seven US Cases of Resistant Fungal Infection

MedicalResearch.com Interview with:
Dr. Snigdha Vallabhaneni

Medical epidemiologist
Mycotic Diseases Branch
CDC

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

Response: This report is the first to describe U.S. cases of C. auris infection. C. auris is often resistant to antifungal drugs and tends to occur in hospitalized patients. In June 2016, CDC issued a clinical alert describing the global emergence of C. auris and requesting that laboratories report C. auris cases and send patient samples to state and local health departments and CDC. Since then, CDC has been investigating reports of C. auris with several state and local health departments. Seven of the cases occurred between May 2013 and August 2016 and are described in this report.

Among the seven cases detailed in the report, patients with C. auris were reported in four states: New York, Illinois, Maryland and New Jersey. All of the patients had serious underlying medical conditions and had been hospitalized an average of 18 days when C. auris was identified. Four of the patients died; it is unclear whether the deaths were associated with C. auris infection or underlying health conditions.

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Death Rate Higher In C.diff Patients Who Do Not Receive Guideline-Adherent Therapy

MedicalResearch.com Interview with:

Dr. Shannon Novosad, MD Epidemic Intelligence Service, CDC Division of Healthcare Quality Promotion National Center for Emerging and Zoonotic Infectious Diseases

Dr. Shannon Novosad

Dr. Shannon Novosad, MD
Epidemic Intelligence Service, CDC
Division of Healthcare Quality Promotion
National Center for Emerging and Zoonotic Infectious Diseases

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

Response: Clostridium difficile can cause an infection in the colon called colitis. Symptoms include diarrhea, fever, nausea, and abdominal pain. It is an important cause of healthcare associated infections with approximately half a million C. difficile infections and 29,000 associated deaths in 2011. The Infectious Diseases Society of America and Society for Healthcare Epidemiology of America published guidelines in 2010 advising clinicians on appropriate antibiotic regimens to treat C. difficile infection.  Prior studies have found that provider adherence to these guidelines, particularly in those with severe disease, is poor.  However, these studies primarily involved patients treated at a single healthcare facility. We were interested in examining CDI treatment practices in a larger group of patients with C. difficile infection located across geographically diverse areas. Further we wanted to learn more about what patient characteristics might be associated with receiving guideline-adherent therapy for C. difficile infection.

We used data from the Center for Disease Control and Prevention’s Emerging Infections Program (EIP) which performs active population and laboratory-based surveillance for C. difficile infections in 10 U.S. sites and examined how 11,717 patients including 2006 with severe disease were treated. We found that provider adherence to national treatment guidelines was low with only around 40% of those with severe disease being prescribed the appropriate antibiotic treatment. Our analysis suggests that those who were tested for C. difficile in the hospital or who were admitted to the hospital around the time of diagnosis were more likely to receive recommended antibiotic therapy.

In addition, patients greater than 65 years old or with more underlying comorbidities were more likely to receive the right antibiotic treatment. We also found that after adjusting for age and underlying comorbidities, the odds of death within 30 days of diagnosis was almost 400% higher in patients who did not receive guideline-adherent therapy compared to those who did.

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Adverse Life Experiences are a Major Risk Factor for Youth Firearm Violence

MedicalResearch.com Interview with:

Steven A. Sumner, MD, MSc Centers for Disease Control and Prevention National Center for Injury Prevention and Control, Division of Violence Prevention Atlanta GA

Dr. Steven A. Sumner

Steven A. Sumner, MD, MSc
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control, Division of Violence Prevention
Atlanta GA

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

Response: In 2014, CDC was invited to Wilmington, Delaware, to conduct a study because the city had been experiencing a high level of homicides and shootings. Our investigation looked at multiple risk factors for youth violence involvement across a wide variety of areas of young people’s lives. For example, youth who had previously experienced a gunshot wound injury were 11 times more likely to later commit a gun crime than youth who had not been similarly injured. Study investigators looked at histories of violence victimization, educational problems, unemployment histories, child welfare experiences, and prior criminal involvement. The more adverse life experiences a young person had, the more likely they were to commit firearm violence.

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Health and Economic Burden of Falls Expected To Surge

MedicalResearch.com Interview with:

Gwen Bergen, PhD Division of Unintentional Injury National Center for Injury Prevention and Control CDC

Dr. Gwen Bergen

Gwen Bergen, PhD
Division of Unintentional Injury
National Center for Injury Prevention and Control
CDC

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

Response: Older adult falls are the leading cause of injury death and disability for adults aged 65 years and older (older adults). In this study, we analyzed data from the Centers for Disease Control and Prevention’s (CDC) Behavioral Risk Factor Surveillance System (BRFSS) survey. Our study found that, in 2014, older Americans reported 29 million falls. Almost a quarter of these or 7 million falls required medical treatment or restricted activity for at least one day. Women reported a higher percentage of falls (30%) compared with men (27%). Whites and American Indian/Alaskan Natives (AI/AN) were more likely to fall compared with Blacks and Asian/Pacific Islanders; and AI/AN were more likely to report a fall injury compared with all other racial/ethnic groups. The percentage of older adults who reported a fall varied by state, ranging from 21% in Hawaii to 34% in Arkansas.

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Costs of Prescription Opioid Overdose, Abuse and Dependence Top $75 Billion

MedicalResearch.com Interview with:

Curtis Florence, PhD National Center for Injury Prevention and Control and Assistant professor, Department of Health Policy Management Rollins School of Public Health at Emory

Curtis Florence, PhD

Curtis Florence, PhD
National Center for Injury Prevention and Control and
Assistant professor, Department of Health Policy Management
Rollins School of Public Health
Emory

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

  • This study presents most recent CDC estimates of the economic burden of prescription opioid abuse, dependence and overdose in the United States.
  • In 2013, over 16,000 persons died of prescription opioid overdoses, and almost 2 million people met the diagnostic criteria for abuse and/or dependence.

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Roundworm Infection Transmitted By Raccoons Has Serious Neurologic Complications

MedicalResearch.com Interview with:

Anita D. Sircar, MD Epidemic Intelligence Service Division of Parasitic Diseases and Malaria Center for Global Health CDC

Dr. Anita Sircar

Anita D. Sircar, MD
Epidemic Intelligence Service
Division of Parasitic Diseases and Malaria
Center for Global Health
CDC

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

Response: Baylisascaris procyonis is a roundworm commonly found in raccoons. It can be found anywhere in the United States where raccoons live. People, especially children, can be infected by this roundworm when they accidentally ingest contaminated raccoon feces. Infection with Baylisascaris procyonis can have severe outcomes in people such as blindness and even death if not treated promptly.

Despite expansion of the geographic distribution of Baylisascaris procyonis in the last 14 years and probable increasing human exposure, baylisascariasis is likely an underreported disease: only 22 documented cases were reported in the United States during 1973–2010.

During May 2013–December 2015, seven additional cases of baylisascariasis were identified among patients in the United States through testing at CDC, including six cases of central nervous system disease and one of ocular disease. Laboratory and clinical information for each patient was gathered and reviewed in a case series to contribute to knowledge about Baylisascaris procyonis infection. All seven patients survived, although approximately half had residual neurologic sequelae.

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Sexual Assaults More Common Against Gay, Lesbian, and Bisexual High School Students

MedicalResearch.com Interview with:

Laura Kann, Ph.D. Chief of the School-Based Surveillance Branch Division of Adolescent and School Health CDC

Dr. Laura Kann

Laura Kann, Ph.D.
Chief of the School-Based Surveillance Branch
Division of Adolescent and School Health
CDC

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

Response: CDC has been using the Youth Risk Behavior Survey (YRBS) to collect data on the sexual identity of high school students at the state and local levels and on the prevalence of health risk behaviors among gay, lesbian, and bisexual students for many years. Starting with the 2015 YRBS cycle, we had enough support to add questions to the national YRBS to provide the first ever nationally representative look at health risk behaviors among these students.

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Violent Deaths Disproportionately Affect Young, Minority Males

MedicalResearch.com Interview with:

Bridget H. Lyons

Bridget Lyons

Bridget H. Lyons, MPH
Division of Violence Prevention, National Center for Injury Prevention and Control
Centers for Disease Control and Prevention
Atlanta

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

Response: The National Violent Death Reporting System has been collecting data since 2003. NVDRS collects data regarding violent deaths obtained from death certificates, coroner/medical examiner reports, law enforcement reports, and secondary sources (e.g., child fatality review team data, supplementary homicide reports, hospital data, and crime laboratory data). This study examines 17 states that collected statewide data in 2013.

Our main findings are:
1. Violent deaths resulting from suicide or interpersonal violence disproportionately affected persons less than 65 years of age, males, and certain minority populations.
2. Primary circumstances for homicide and suicide included intimate partner problems, interpersonal conflicts, mental health problems and recent crises.

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Dramatic Increase in the Number of US Adults Living With Congenital Heart Defects

MedicalResearch.com Interview with:

Suzanne Meredith Gilboa, PhD Epidemiologist at the Centers for Disease Control and Prevention’s National Center on Birth Defects and Developmental Disabilities

Dr. Suzanne Gilboa

Suzanne Meredith Gilboa, PhD
Epidemiologist at the Centers for Disease Control and Prevention’s
National Center on Birth Defects and Developmental Disabilities

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

Response: Because of advancements in care, there has been a decline in mortality from congenital heart defects (CHD) over the last several decades. However, there are no current empirical data documenting the number of people living with CHD in the United States (US).

The purpose of this study was to estimate the  congenital heart defects prevalence across all age groups in the US for the year 2010. Using prevalence data from Québec, Canada in the year 2010 as a foundation for a mathematical model, we estimated that approximately 2.4 million people (1.4 million adults, 1 million children) were living with CHD in the US in the year 2010. Nearly 300,000 subjects had severe CHD. Overall, there was a slight predominance of females compared to males.

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Diets High In Subsidized Foods May Raise Risk of Diabetes and Heart Disease

MedicalResearch.com Interview with:

Edward Gregg, PhD Chief of the Epidemiology and Statistics Branch Division of Diabetes Translation National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention

Dr. Edward Gregg

Edward Gregg, PhD
Chief of the Epidemiology and Statistics Branch
Division of Diabetes Translation
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention

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

Response: The research was led by the lead author, Karen R. Siegel, PhD, as part of her PhD graduate studies at Emory for her dissertation. Although subsidized foods are intended to ensure adequate availability of storable, staple foods, studies at the population level have linked these subsidies to risk of cardiovascular disease and type 2 diabetes. This study is the first of its kind to examine these relationships at the individual level – specifically, the relationship between diets made up of more subsidized foods, and an individual’s personal risks for developing cardiovascular disease and type 2 diabetes.

The study design that was used here does not allow us to say that these subsidized foods specifically cause type 2 diabetes and cardiovascular disease. Rather, people whose diets contain more corn, soybean, wheat, rice, sorghum, dairy, and livestock products are at greater risk for type 2 diabetes and cardiovascular disease.

According to this research, people whose diets contained more subsidized foods were on average younger, less physically active and more likely to be smokers. They also had much less income, education and food security – or the ability to get enough safe and healthy food to meet their dietary needs.

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Risky Behaviors Among High School Students Have Evolved Over Time

MedicalResearch.com Interview with:

Laura Kann, PhD  Chief, School-Based Surveillance Branch Division of Adolescent and School Health National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) Centers for Disease Control and Prevention (CDC)

Dr. Laura Kann

Laura Kann, PhD
Chief, School-Based Surveillance Branch Division of Adolescent and School Health
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP)
Centers for Disease Control and Prevention (CDC)

MedicalResearch.com: What is YRBSS?

Dr. Kann: The Youth Risk Behavior Surveillance System (YRBSS) is the only surveillance system designed to measure the major health risk behaviors among our nation’s high school students and to track those behaviors over time at the national, state, and local levels. Reports from this surveillance system have been released every two years since 1991. More information is available at: www.cdc.gov/yrbs.

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Teen Obesity Rate Rises to 20%

MedicalResearch.com Interview with:

Cynthia L Ogden PhD, MRP Public Health, Nutrition and Dietetics CDC Atlanta

Dr. Cynthia Ogden

Cynthia L Ogden PhD, MRP
Public Health, Nutrition and Dietetics
CDC Atlanta

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

Dr. Ogden: Monitoring trends in obesity prevalence is important because of the health risks associated with obesity and because obesity often tracks from childhood to adulthood. The most recent data before this point showed no increases overall in youth, men or women over the previous decade.

We used the most recent nationally representative data with measured weights and heights from the National Health and Nutrition Examination Survey to look at trends in obesity prevalence.

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Age of Solid Food Introduction To Babies Not Linked With Childhood Obesity

MedicalResearch.com Interview with:
Chloe Barrera MPH ORISE Fellow Centers for Disease Control and PreventionChloe Barrera MPH
ORISE Fellow
Centers for Disease Control and Prevention

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

Response: Previous studies have been inconsistent in whether introduction of solid foods to babies before 4 months may be associated with later obesity.  In our analysis of more than a thousand babies followed through the first year of life and contacted again at 6 years, we did not find this association.

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Signs and Symptoms of Acute Retroviral Infection May Improve Early HIV Detection

MedicalResearch.com Interview with:

Martin Hoenigl, MD Postdoctoral Fellow AntiViral Research Center, Department of Medicine University of California, San Diego

Dr. Martin Hoenigl

Martin Hoenigl, MD
Postdoctoral Fellow
AntiViral Research Center, Department of Medicine
University of California, San Diego

Medical Research: What is the background for this study?

Response: The detection of acute HIV infection (AHI) is critical to HIV prevention and treatment strategies. Many field-based testing programs rely on point-of-care HIV antibody testing, which will reliably identify persons with established infection, but fail to detect persons with AHI. In many of these programs additional tests for AHI are only performed / recommended in persons presenting with signs and symptoms consistent with an acute retroviral syndrome (ARS). These signs and symptoms are unspecific and include fatigue, headache, pharyngitis, skin rash, GI symptoms, night sweats and others. However, the proportion of persons with acute HIV infection presenting symptomatic for their diagnostic test remains unknown.

The objective of our study was therefore to determine the proportion of persons with acute HIV infection presenting with signs and symptoms consistent with ARS for HIV screening.

Medical Research: What are the main findings?

Response: We analyzed signs and symptoms in 90 patients diagnosed with acute HIV infection in a community-based program in San Diego that offered universal HIV-1 nucleic acid amplification testing, independent of signs and symptoms. Forty-seven (52%) patients reported ongoing signs or symptoms consistent with ARS on the day of NAT screening. Another 25 (28%) reported signs or symptoms that had occurred during the 14 days before testing, but had resolved by the testing date. Another 12 (13%) reported signs and symptoms that started after the diagnostic test. Only 6/90 (7%) reported no signs and symptoms consistent with ARS. As a secondary finding, viral loads were significantly higher (p=0.001) in the 72 individuals reporting signs and symptoms consistent with ARS before or at the time of NAT screening compared to the 18 participants who did not report signs and symptoms at their diagnostic test. Most frequently reported ARS signs and symptoms included fever, myalgia, fatigue and headache.

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New Test Can Improve Detection of Early, Acute HIV Infections

MedicalResearch.com Interview with:

Philip J. Peters, M.D. HIV Testing and Biomedical Interventions Activity Lead Epidemiology Branch CDC’s Division of HIV/AIDS Prevention

Dr. Phillip Peters

Philip J. Peters, M.D.
HIV Testing and Biomedical Interventions Activity Lead
Epidemiology Branch
CDC’s Division of HIV/AIDS Prevention

Medical Research: What is the background for this study? What are the main findings?

Dr. Peters:  Acute HIV infection contributes disproportionately to HIV transmission and identifying individuals with acute HIV infection is critical to prevent further HIV transmission, as diagnosis can lead to several effective HIV prevention interventions. Acute HIV infection can be diagnosed with assays that detect either HIV RNA (the reference standard) or the p24 antigen (an HIV core protein), which are both detectable early after HIV infection and before an antibody response develops. HIV immunoassays that detect both the p24 antigen and anti-HIV antibody (fourth generation antigen/antibody [Ag/Ab] combination immunoassays) are currently being implemented as the initial screening test in the 2014 CDC and American Public Health Laboratories (APHL) recommended HIV diagnostic algorithm. In a prospective study we evaluated the performance of an HIV Ag/Ab combination assay to detect acute HIV infection compared with pooled HIV RNA testing in a high-prevalence population.

All participants were first screened with a rapid HIV test to detect established HIV infection (antibody detectable).  All participants with a negative rapid HIV test result were then screened for acute HIV infection with an HIV Ag/Ab combination assay (index test) and pooled HIV-1 RNA testing.  HIV RNA testing was the reference standard, with positive reference standard result defined as detectable HIV-1 RNA on an individual RNA test.

Among 86,836 participants with complete test results (median age, 29 years; 75.0% male; 51.8% men who have sex with men), acute HIV infection was diagnosed in 168 (0.19%). Acute HIV infection was detected in 134 (0.15%) participants with HIV Ag/Ab combination testing (acute HIV infection sensitivity, 79.8%) and in 164 (0.19%) with pooled HIV RNA testing (sensitivity, 97.6%; sensitivity comparison, p<0.001). Overall HIV Ag/Ab combination testing detected 82% of acute HIV infections detectable by pooled HIV RNA testing. Compared with rapid HIV testing alone (which detected established HIV infection), HIV Ag/Ab combination testing increased the relative HIV diagnostic yield (both established and acute HIV infections) by 10.4% and pooled HIV RNA testing increased the relative HIV diagnostic yield by 12.4%.

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Lyme Disease Ticks Double Range Over Past Twenty Years

More on Lyme Disease on MedicalResearch.com

MedicalResearch.com Interview with:
Rebecca Eisen PhD research biologist and
Ben Beard, Ph.D. 
Chief, Bacterial Diseases Branch
Division of Vector-Borne Diseases
Centers for Disease Control and Prevention

Medical Research: What is the background for this study?

Dr. Eisen: Since the late 1990s, the number of reported cases of Lyme disease in the United States has tripled and the number of counties in the northeastern United States that are considered high-risk for Lyme disease has increased by more than >320%.

In 1998, a comprehensive review was published that described the geographic distributions of the blacklegged tick (Ixodes scapularis) and the Western blacklegged tick (Ixodes pacificus). These ticks are responsible for infecting humans with the pathogens that cause Lyme disease, anaplasmosis, and babesiosis.

Medical Research: Would you tell us about the methodology?

Response: CDC researchers recently published an update to the 1998 tick distribution map. The authors reviewed the scientific literature and individual state health department websites for data. Additionally, they contacted public health officials, entomologists, and Lyme disease investigators throughout the United States to assess county-level tick collection data.

Researchers characterized counties with Ixodes scapularis and Ixodes pacificus ticks as “established” if at least 6 individual ticks or at least 2 of the 3 tick life stages had been identified during a collection period. Counties were characterized as “reported” if at least one tick of any life stage had been identified at any time in that county, or if county records did not specify the number of ticks or life stages collected.

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More Multistate Foodborne Outbreaks Identified With Better Surveillance and Centralized Food Processing

MedicalResearch.com Interview with:
Sam Crowe, PhD, MPH

Epidemic Intelligence Service Officer
Enteric Diseases Epidemiology Branch
Division of Foodborne, Waterborne, and Environmental Diseases
Centers for Disease Control and Prevention

Medical Research: What were the leading causes of multistate foodborne outbreaks and the most common contaminated foods during the study period?

Dr. Crowe:   Salmonella, Shiga toxin-producing Escherichia coli, and Listeria monocytogenes were the leading pathogens causing multistate foodborne outbreaks. In order of frequency, fruits, vegetable row crops, beef, sprouts, and seeded vegetables were the leading contaminated foods.

Medical Research: How severe are multistate foodborne outbreaks?

Dr. Crowe:  From 2010 through 2014, multistate foodborne outbreaks accounted for only 3% of all U.S. foodborne outbreaks detected, but caused over one third of the hospitalizations and more than half of the deaths.

Medical Research: Are these outbreaks occurring more frequently?

Dr. Crowe: Multistate foodborne outbreaks are being identified more often in the United States because of better surveillance. Greater centralization of food processing and distribution practices also could be increasing the frequency and size of multistate foodborne outbreaks.

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HPV Vaccination Rate Low for Girls Under Both Commercial and Medicaid Plans

Shannon Stokley, MPH Epidemiologist in the CDC Immunization Services Division

Shannon Stokley MPH

MedicalResearch.com Interview with:
Shannon Stokley, MPH

Epidemiologist in the
CDC Immunization Services Division

Medical Research: What is the background for this study? What are the main findings?

Response: To determine whether the recommended HPV vaccination series is currently being administered to adolescents with health insurance, CDC and the National Committee for Quality Assurance (NCQA) assessed 2013 data from the Healthcare Effectiveness Data and Information Set (HEDIS). The HEDIS HPV Vaccine for Female Adolescents performance measure evaluates the proportion of female adolescent members in commercial and Medicaid health plans who complete the recommended HPV vaccination series by age 13 years. In 2013, in the United States, the median HPV vaccination coverage level for female adolescents among commercial and Medicaid plans was 12% and 19%, respectively (ranges = 0%–34% for commercial plans, 5%–52% for Medicaid plans). The results of this study indicate that there are significant opportunities for improvement as HPV vaccination coverage among female adolescents was low for both commercial and Medicaid plans.

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Black Men, White Women Have Highest Cancer Incidence in US

MedicalResearch.com Interview with:
Dr. Simple Singh MD

Epidemiologist
Division of Cancer Prevention and Control
CDC 

Medical Research: What is the background for this study?

Dr. Singh: This report provides official federal statistics on the occurrence of cancer for 2011 and trends for 1999–2011 as reported by CDC and the National Cancer Institute (NCI). Cancer incidence data are from population-based cancer registries that participate in CDC’s National Program of Cancer Registries (NPCR) and NCI’s Surveillance, Epidemiology, and End Results (SEER) program reported as of November 2013. Cancer mortality data are from death certificate information reported to state vital statistics offices in 2013 and compiled into a national file for the entire United States by CDC’s National Center for Health Statistics’ (NCHS) National Vital Statistics System (NVSS). This report is a part of the first-ever Summary of Notifiable Noninfectious Conditions and Disease Outbreaks — United States, which encompasses various surveillance years but is being published in 2015.

Medical Research: What are the main findings?

Dr. Singh: In 2011, approximately 1.5 million invasive cancers were diagnosed in the United States, an annual incidence rate of 451 cases per 100,000 persons. In the same year, approximately 576,000 persons died of cancer nationally, an annual death rate of 169 deaths per 100,000 persons.

Cancer incidence and death rates increase with age.

Overall, 54% of cancer cases and 69% of cancer deaths in 2011 occurred among persons aged ≥65 years.

Among men in 2011, blacks had the highest cancer incidence and death rates in the United States, and American Indians/Alaska Natives and Asians/Pacific Islanders had the lowest cancer incidence and death rates.

Among women in 2011, whites had the highest cancer incidence rates and blacks had the highest cancer death rates. American Indians/ Alaska Natives had the lowest cancer incidence rates, and Asians/Pacific Islanders had the lowest cancer death rates.

By state, overall (all cancer sites combined) cancer incidence rates in 2011 ranged from 374 to 509 cases per 100,000 persons, and overall cancer death rates ranged from 126 to 201 deaths per 100,000 persons.

Four cancer sites accounted for half of all cases diagnosed in 2011, including 209,292 prostate cancers, 220,097 female breast cancers, 207,339 lung and bronchus cancers (110,322 among men and 97,017 among women), and 135,260 colon and rectum cancers (70,099 among men and 65,161 among women). These four sites also accounted for half of cancer deaths in 2011, including 156,953 lung cancer deaths, 51,783 colon and rectum cancer deaths, 40,931 female breast cancer deaths, and 27,970 prostate cancer deaths.

During 1999–2011, cancer incidence rates declined from 485 cancer cases per 100,000 population in 1999 to 444 cases in 2011. Although lung cancer incidence declined steadily among men from 1999 to 2011, it increased among women from 1999 to 2005 and has since declined from 2005 to 2011. Prostate cancer incidence declined from 170 cases per 100,000 men in 1999 to 128 cases in 2011. Colorectal cancer incidence declined from 57 cases per 100,000 persons in 1999 to 40 cases in 2011. Female breast cancer incidence declined from 135 cases per 100,000 women in 1999 to 121 cases in 2005, increased to 125 cases in 2009, and declined again to 122 cases in 2011. During 1999–2011, cancer death rates declined from 201 deaths per 100,000 persons in 1999 to 169 deaths in 2011; during the same period, death rates declined for each of the top four cancers.

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Risk Factors For MRSA Infections After Discharge Identified

MedicalResearch.com Interview with:
Dr. Lauren Epstein M.D., M.S.

Division of Healthcare Quality Promotion Epidemic Intelligence Service
Centers for Disease Control and Prevention
Atlanta, GA, USA 

Medical Research: What is the background for this study? What are the main findings?

Dr. Epstein: Nearly 80% of methicillin resistant Staphylococcus aureus (MRSA) infections occurs outside of the hospitals and mostly among individuals with a recent hospitalization.  However, risk factors for MRSA infections among patients recently discharged from an acute care hospital have not been well explored.   The goal of this study was to identify modifiable risk factors associated with MRSA infections among recently discharged patients to target future prevention efforts.  We found that patients with a history of MRSA colonization, chronic wounds, invasive devices at discharge such as central lines and surgical drains, and those discharged from a hospital to a nursing home are at increased risk of invasive MRSA infections within 12 weeks after hospital discharge.

Medical Research: What should clinicians and patients take away from your report?

Dr. Epstein: MRSA infections are a significant public health concern and patients remain at risk for MRSA infections following acute care hospitalizations, especially in the 3 months following discharge from an acute care facility.

Patients with a prior history of MRSA colonization are at increased risk for MRSA infections following an acute care hospitalization.  In addition, patients who have an invasive device (such as a central line or surgical drain) or a chronic wound at the time of discharge from a hospitalization are at increased risk of MRSA infection following discharge.  Finally, patients who are discharged to a long term care facility, regardless of other risk factors, are at increased risk of MRSA infection.

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Many Petroleum Product Releases Due To Private Accidents and Damage To Utilities or Lines

MedicalResearch.com Interview with:
Ayana R. Anderson, MPH
Division of Toxicology and Human Health Sciences
Agency for Toxic Substances and Disease Registry

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

Response: Large mass casualty gas explosions and oil spills are widely reported in the media and receive considerable regulatory attention. However, smaller less catastrophic events are less likely to receive publicity. The Agency for Toxic Substances and Disease Registry (ATSDR) analyzed 2010–2012 data from the National Toxic Substance Incidents Program (NTSIP) to describe the causes and public health impacts of petroleum product release incidents and to better focus and prioritize prevention efforts.

There were a total of 1,369 petroleum product releases reported from 7 states resulting in 512 injured persons and 36 deaths.

         Approximately one fourth of the incidents were associated with utilities.

         Approximately one fifth were associated with private vehicles or residences.

         Approximately 10 percent of petroleum product releases resulted from inadvertent damage to utility lines.

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CDC Study Finds No Pattern Suggesting Vaccines Contributed To Or Caused Deaths

MedicalResearch.com Interview with:
Dr. Pedro Moro, MD, MPH

Immunization Safety Office
Division of Healthcare Quality Promotion
Centers for Disease Control and Prevention
Atlanta, GA 3033

Medical Research: What is the background for this study? What are the main findings?

Response: The Vaccine Adverse Event Reporting System (VAERS) is a US national vaccine safety surveillance system, co-administered by the Centers for Disease Control and Prevention (CDC) and the US Food and Drug Administration (FDA). VAERS accepts reports of adverse events (possible side effects) following vaccination. Anyone can submit a report to VAERS.

The study team searched VAERS for US reports of death after any vaccination from 7/1/1997 to 12/31/2013.

During that time period, VAERS received 2,149 death reports, with most (68.4%) occurring in children. Among children, the most common causes of death were:

o   sudden infant death syndrome (44%)

o   asphyxia, or lack of oxygen to the brain (6%)

o   septicemia, or blood poisoning from a bacterial infection (5%)

o   pneumonia (5%)

Among adults, the most common causes of death were:

o   diseases of the circulatory system (47%)

o   diseases of the respiratory system (15%)

o   infections and parasitic diseases (12%)

o   tumors (4%)

The main causes of death seen in VAERS reports were consistent with the most common causes of death in the US population. When studied separately, none of these causes of death have found to be related to vaccines. This finding is reassuring, and consistent with previous research on vaccine safety. Continue reading

Electronic Health Records Allow Agencies To Improve Surveillance and Patient Care

Dawn Heisey-Grove, MPHCDCMedicalResearch.com Interview with:
Dawn Heisey-Grove, MPH
Office of Planning, Evaluation, and Analysis Office of the National Coordinator for Health Information Technology U.S. Department of Health and Human Services Washington, DC

Medical Research: What is the background for this study?

Response:  Population health surveillance can be costly, time consuming, and limited, depending on the data source. Electronic Clinical Quality Measures (eCQMs) reported to the Medicare Electronic Health Record (EHR) Incentive Program reflect aggregate data on all patients seen by a participating health care provider during a given measure’s reporting period and therefore represent a substantial proportion of the U.S. population. These data are reported as a function of a federal program and are the result of automated extraction from an EHR, which might streamline the reporting process for the health care provider, resulting in data that are a useful resource in public health surveillance.

Medical Research:? What are the main findings?

Response: This first published use of Medicare EHR Incentive Program data for national population surveillance reported on an eCQM that is aligned with Million Hearts®, a national initiative launched by the U.S. Department of Health and Human Services to prevent 1 million heart attacks and strokes by 2017. The eCQM tracks the proportion of patients with hypertension who had controlled blood pressure during the reporting period. During the first three years of the EHR Incentive Program (2011-2013), approximately 3 in 10 participating health care professionals reported on this eCQM, making it the 5th most commonly selected measure overall. This represented 63,000 ambulatory care professionals and approximately 17 million patients. On average, 62 percent of patients with hypertension had controlled blood pressure. Read more here.

Medical Research: What should clinicians and patients take away from your report?

Response: Electronic health record systems provide an opportunity to improve patient care and more easily monitor population health. Using data stored in EHRs, clinicians may be better equipped to generate reports that track the health of high risk patients. In addition, public health could expand its surveillance capabilities, potentially at lower costs and in a more timely fashion, by taking advantage of existing systems such as eCQM reporting. Further alignment of eCQMs across federal and private sector programs will enable clinicians to collect data once and report to selected programs.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Future research endeavors should begin to maximize the potential data captured through eCQM reporting. State and local public health agencies can partner with state, regional, or local health information exchanges; the state primary care associations; the state Medicaid programs; and health systems to explore the use of existing EHR data for surveillance while still ensuring appropriate safeguards to maintain patient privacy. As EHR implementation becomes more widespread, the data collected by these systems will be invaluable for monitoring numerous clinical conditions.

Citation:

Using Electronic Clinical Quality Measure Reporting for Public Health Surveillance

Weekly

May 1, 2015 / 64(16);439-442

MedicalResearch.com Interview with: Dawn Heisey-Grove, MPH CDC (2015). Electronic Health Records Allow Agencies To Improve Surveillance and Patient Care MedicalResearch.com

Malaria Vaccine Has Potential To Contribute To Disease Control

Mary J Hamel, M.D. Chief, Strategic and Applied Sciences Unit, And Deputy Branch Chief for Science, CDC Malaria Branch US Centers for Disease Control and Prevention 1600 Clifton Rd, NE, MS A06 Atlanta GA 30333MedicalResearch.com Interview with:
Mary J Hamel, M.D.
Chief, Strategic and Applied Sciences Unit,
And Deputy Branch Chief for Science, CDC Malaria Branch
US Centers for Disease Control and Prevention
1600 Clifton Rd, NE, MS A06
Atlanta GA 30333
Dr. Hamel was principal investigator at the Siaya site in western Kenya.

Medical Research: What is the background for this study? What are the main findings?

Dr. Hamel: Major progress has been made in malaria control during the past decade with the scale up of proven interventions including insecticide treated nets (ITNs), indoor residual spraying, effective diagnosis and treatment for malaria, and intermittent preventive treatment of malaria in pregnancy. Nonetheless, malaria remains a major cause of morbidity and mortality, and a leading cause of pediatric death worldwide. An estimated 198 million cases of malaria and 580,000 deaths occurred in 2013 – most of these in African children.

Now we face additional challenges in malaria control – the emergence of insecticide and drug resistance threatens some of our most effective interventions. New tools are needed to reach the goal of malaria elimination and eventual eradication. Vaccines are some of our most cost-effective interventions, and an effective malaria vaccine would be an important addition to our current malaria control tools.

This week, the RTS,S Clinical Trials Partnership published the final vaccine efficacy and safety results from the RTS,S/AS01 malaria vaccine phase 3 trial in the Lancet (Efficacy and safety of RTS,S/AS01 malaria vaccine with or without a booster dose in infants and children in Africa: final results of a phase 3, individually randomised, controlled trial, http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60721-8/abstract). This large randomized controlled double-blind phase 3 clinical trial was conducted in 11 sites in 7 African countries across a range of malaria transmission levels. In all, 15,460 children and young infants were enrolled in two age-categories, those first vaccinated at 5-17 months of age (referred to as children), and those first vaccinated at 6-12 weeks of age (referred to as young infants) who received the RTS,S/AS01 vaccine along with their routine childhood immunizations. Participants were randomized into 3 groups – the first group received three doses of the RTS,S/AS01 vaccine followed 18 months later by a booster dose; the second group received three doses of the RTS,S/AS01 vaccine without a booster; and the third group received a comparator vaccine. All participants received an ITN. Children were followed for an average of 48 months and infants for an average of 38 months.

We found that vaccine efficacy was modest. Vaccine efficacy against clinical malaria in children was 36% with a booster and 28% without, and vaccine efficacy against severe malaria was 32% with a booster and non-significant without.   Efficacy results in young infants were lower than those in children– vaccine efficacy against clinical malaria was 36% with a booster and 28% without, and vaccine efficacy against severe malaria was non-significant.

However, impact, defined as the number of cases averted per 1000 participants vaccinated, was substantial in both age-categories, and highest where malaria burden was greatest. In children who received the booster, during 4 years follow-up, 1700 cases of clinical malaria were averted per 1000 children vaccinated. In young infants, during 3 years follow-up, nearly 1000 cases were averted per 1000 young infants vaccinated.

The safety findings were comparable overall in the different study arms, but two safety findings are notable. Meningitis occurred more frequently among children (but not young infants) who received RTS,S/AS01 than among those who received the comparator vaccines. There was no relationship between when the vaccine was administered and when meningitis occurred, most cases occurred in only two study sites, and the finding may be due to chance. If RTS,S/AS01 is licensed, post-licensing studies will be done to establish the significance of this finding. Both children and young infants experienced more episodes of fever and associated febrile convulsions during the 7 days following vaccination; convulsions occurred in 2.2 – 2.5/1000 vaccine doses. Continue reading

Opioid Tampering By Health Care Providers Can Lead To Hepatitis C Transmission

MedicalResearch.com Interview with:
ChongGee Teo, MD, PhD
Chief, Laboratory Branch
Division of Viral Hepatitis
CDC

Medical Research: What is the background for this study?

Dr. Teo: Hepatitis C outbreaks in the course of providing healthcare continue to occur. Some happen when hepatitis C virus (HCV) is transmitted to patients following breakdowns in safe injection and infection control practices, and mishaps during surgery. Another route of provider – to patient HCV transmission is diversion, self-injection and substitution of opioids intended for anesthetic use (collectively referred to as “tampering”). A patient acquires infection when an HCV-infected provider, who is an injecting drug user, self-injects from a syringe prefilled with opioid anesthetic, fills the syringe with a volume substitute (e.g., saline or water), and then administers the adulterated preparation to the patient.

The study consisted of two parts:
1) to quantify the extent that anesthetic opioid tampering contributes to hepatitis C outbreaks by analyzing healthcare-associated outbreaks occurring between 1990 and 2012 in developed countries.

2) to estimate the probabilities of provider-to-patient transmission reflecting the “real-world” setting in which a patient presents for health care, unaware of risks posed by procedures conducted by a provider who may or may not be an injecting drug user or HCV infected.

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CDC Discusses Best Practices and Resources For Childhood ADHD

Susanna N. Visser, DrPH Epidemiologist at the National Center on Birth Defects and Developmental Disabilities CDCMedicalResearch.com Interview with:
Susanna N. Visser, DrPH

Epidemiologist at the National Center on Birth Defects and Developmental Disabilities
CDC

 

Medical Research: What is the background for this study? What are the main findings?

Dr. Visser: Attention-Deficit/Hyperactivity Disorder, or ADHD is one of the most common chronic conditions of childhood. It often persists into adulthood.   When children diagnosed with ADHD receive proper treatment, they have the best chance of thriving at home, doing well at school, and making and keeping friends.

In 2011, the American Academy of Pediatrics (AAP) updated their guidelines for ADHD treatment. The new guidelines give this advice to healthcare providers, psychologists, educators, and parents of children with ADHD:

  • For preschoolers ages 4-5 with ADHD, use behavioral therapy before medication.
  • For older children and teens with ADHD, use behavioral therapy along with medication.

In order to learn more about ADHD treatment patterns, CDC researchers looked at data from a national sample of children with special health care needs, ages 4-17 years, collected in 2009-10 just before the release of the 2011 guidelines.

We found that most children with ADHD received either medication treatment or behavioral therapy. However, we also found that many children were not receiving treatment in the way it was outlined in the 2011 best practice guidelines.

  • Less than 1 in 3 children with ADHD received both medication treatment and behavioral therapy, the preferred treatment approach for children ages 6 and older.
  • Only half of preschoolers (4-5 years of age) with ADHD received behavioral therapy, which is now the recommended first-line treatment for this group.
  • About half of preschoolers with ADHD were taking medication for ADHD, and about 1 in 4 were treated only with medication.

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