Author Interviews, CDC, Lyme / 21.01.2016

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. (more…)
Author Interviews, CDC, Infections / 05.11.2015

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. This is why your business should Look for Ruggedised Industrial Pointing Devices Today, to ensure your business is staying up with the industry standards. (more…)
Author Interviews, CDC, Cost of Health Care, HPV, Vaccine Studies / 30.10.2015

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. (more…)
Author Interviews, Cancer Research, CDC, Gender Differences, Race/Ethnic Diversity / 24.10.2015

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. (more…)
Author Interviews, CDC, MRSA / 15.09.2015

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. (more…)
Author Interviews, CDC, Toxin Research / 23.06.2015

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. (more…)
Author Interviews, CDC, Vaccine Studies / 10.06.2015

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. (more…)
Author Interviews, CDC, Infections, Lancet, Vaccine Studies / 25.04.2015

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. (more…)
Author Interviews, CDC, Hepatitis - Liver Disease, Outcomes & Safety / 22.04.2015

MedicalResearch.com Interview with: Chong-Gee 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. (more…)
ADHD, AHRQ, Author Interviews, CDC / 17.04.2015

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 as well as some other form of ADHD therapy to help. 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.
(more…)
Annals Internal Medicine, Author Interviews, CDC, Infections / 17.03.2015

MedicalResearch.com Interview with: Dr.Yecai Liu Division of Global Migration and Quarantine Centers for Disease Control and Prevention, Atlanta, Georgia Medical Research: What is the background for this study? What are the main findings? Response: Since the early 1900s, immigrants and refugees applying for a visa to come to the United States undergo a medical examination that includes tuberculosis (TB) screening. In 2007, CDC began implementing the new screening guidelines, which require people suspected of having TB to receive a much more sensitive sputum culture test to confirm TB to ensure that those individuals who do have TB receive treatment before they arrive in the United States. These requirements have now been completely rolled out to all countries with U.S.-bound immigrants and refugees. From 2007 through 2012, half of the 3.2 million arrivals of immigrants and refugees to the United States were screened for TB by the new screening guidelines. Out of more than 4,000 TB cases diagnosed by the new screening guidelines during this period, nearly 2,200 were smear-negative and culture positive. These cases would likely have been missed under the previous screening requirements. The results of this study showed that the updated overseas screening guidelines led to a roughly one-third decrease in the annual number of TB cases among foreign-born persons within their first year in the United States. (more…)
Author Interviews, CDC, Emory, OBGYNE, Social Issues / 13.03.2015

MedicalResearch.com Interview with: Elizabeth Burns, MPH Rollins School of Public Health Emory University MedicalResearch: What is the background for this study? What are the main findings? Response: Epidemiologic studies suggest that prenatal stress is associated with preterm birth, low birth weight and peripartum anxiety and depressive symptoms. The most recent population-based study on the prevalence of stress among pregnant women, which used data from 1990-1995, reported that 64% of women experience stressful life events (SLEs) in the year before their infant’s birth. More recent estimates of prevalence and trends of prenatal stressful life events are useful for clinicians in order to understand the risk profile of their patients. The Pregnancy Risk Assessment Monitoring System (PRAMS) collects self-reported information on maternal experiences and behaviors before, during, and after pregnancy among women who delivered a live infant. PRAMS includes 13 questions about maternal SLEs experienced in the year preceding the birth of the child. Based on previous research, SLEs were grouped into four dichotomous constructs: 1) emotional stressors (family member was ill and hospitalized or someone very close died); 2) financial stressors (moved to a new address, lost job, partner lost job, or unable to pay bills); 3) partner-associated stressors (separated/divorced, argued more than usual with partner/husband, or husband/partner said he did not want pregnancy); and 4) traumatic stressors (homeless, involved in a physical fight, partner or self-went to jail, or someone very close had a problem with drinking or drugs). The prevalence of self-reported stressful life events decreased modestly but significantly during 2000–2010. Despite this, 70.2% of women reported ≥1 SLEs in 2010. Prevalence of stressful life events vary by state and maternal demographic characteristics and are especially prevalent among younger women, women with ≤12 years of education (75.6%), unmarried women (79.6%), and women that were covered by Medicaid for prenatal care or delivery of their child (78.7%). (more…)
AHA Journals, Author Interviews, CDC, Salt-Sodium / 07.03.2015

Dr. Sandra L. Jackson, Ph.D., M.P.H Epidemic intelligence service fellow Centers for Disease Control and Prevention, Chamblee, GAMedicalResearch.com Interview with: Dr. Sandra L. Jackson, Ph.D., M.P.H Epidemic intelligence service fellow Centers for Disease Control and Prevention, Chamblee, GA Medical Research: What is the background for this study? What are the main findings? Dr. Jackson: With more than 90 percent of U.S. adults exceeding recommended sodium intake levels, healthcare providers can play a key role in counseling patients on the importance of limiting salt in the diet. To assess the impact of medical advice on an individual’s efforts to reduce sodium intake, CDC researchers examined self-reported telephone survey information from nearly 174,000 U.S. adults. Overall, more than half of the respondents reported watching or reducing their sodium intake in 2013 – but less than one quarter (23 percent) said they received advice from a doctor or healthcare professional about sodium reduction. Of those that received the medical advice, 82 percent reported taking action to limit their sodium intake. In comparison, only 44 percent of respondents who reported not receiving medical advice said they took steps to reduce sodium. The substantial proportion of patients who are not receiving medical advice (77%), according to these findings, reveals a missed opportunity to reduce sodium intake, particularly among groups that have a higher risk of developing cardiovascular disease. This includes African Americans, and those with high blood pressure, diabetes or chronic kidney disease. (more…)
Author Interviews, CDC, HIV, Race/Ethnic Diversity, Sexual Health / 05.03.2015

MedicalResearch.com Interview with: Cyprian Wejnert Center For Disease Control MedicalResearch: What is the background for this study? What are the main findings? Cyprian Wejnert: Men who have sex with men (MSM) remain the risk group most severely affected by HIV in the United States, accounting for approximately two-thirds of new infections each year.  Understanding racial and age disparities among MSM is critical to tailor effective prevention efforts. Our study examined data from CDC’s National HIV Behavioral Surveillance system (NHBS) from 20 U.S. cities. We assessed changes in HIV prevalence, awareness of infection, and risk behavior among MSM, by age and race, from 2008 to 2011, finding that: o   Among black Men who have sex with men, 30 percent were HIV-infected overall, and 1 in 5 black MSM aged 18-24 were infected with HIV. Compared to 14 percent and 4 percent among white MSM. o   In all age groups younger than 40 years, black Men who have sex with men were significantly more likely to be HIV-positive compared to all other racial/ethnic groups. o   Disparities in HIV prevalence between black and white MSM were greatest among the youngest MSM, and increased between 2008 and 2011. o   Black MSM were less likely to be aware of their infection than their white counterparts (54 vs. 86 percent). o   Black Men who have sex with men did not report higher levels of condomless sex overall or condomless sex with partners of discordant or unknown HIV status. (more…)
Author Interviews, CDC, OBGYNE, Sexual Health / 03.03.2015

MedicalResearch.com Interview with: Amy Branum M.S.P.H., Ph.D and Jo Jones Ph.D Center for Health Statistics Division of Vital Statistics, Reproductive Statistics Branch Medical Research: What is the background for this study? Response: This data brief was based on multiple years of the National Survey of Family Growth (NSFG).  The NSFG, first conducted in 1973, is administered by NCHS in response to a legal mandate that says that NCHS “shall collect statistics on …family formation, growth, and dissolution.” (PHS Act, Sec 306). Up through the 2002 NSFG, the survey was conducted periodically; with the 2006-2010 data collection, the NSFG is a continuous survey with interviews conducted over multiple years.  We felt it was important to examine long-term trends in  Long-acting Reversible Contraception use due to fluctuations over time in IUD and implant acceptability and availability as contraception methods, especially in light of recent efforts to promote LARC use to prevent unintended pregnancies and for birth spacing. Medical Research: What are the main findings? Response: We found that Long-acting Reversible Contraception use declined between 1982 and 1988, remained stable through 2002 and then increased almost five-fold between 2002 and 2011-2013 (from 1.5% to 7.2).  Long-acting Reversible Contraception use has, and continues to be, generally highest among women aged 25-34 but has increased the most among women 15-24 since 2002.  Hispanic women used Long-acting Reversible Contraception at higher rates in 1982 compared to non-Hispanic white and non-Hispanic black women but patterns of use diverged after 1995 so that by 2011-2013, patterns of use were more similar by race and Hispanic origin.  Women who have at least one previous live birth have used, and continue to use, LARCs at a higher rate compared to women with no previous births. (more…)
Author Interviews, CDC, NEJM, Pediatrics, Respiratory / 27.02.2015

Seema Jain, MD Medical Epidemiologist Epidemiology and Prevention Branch, Influenza Division Centers for Disease Control and Prevention Atlanta, GA 30329MedicalResearch.com Interview with: Seema Jain, MD Medical Epidemiologist Epidemiology and Prevention Branch, Influenza Division Centers for Disease Control and Prevention Atlanta, GA 30329 MedicalResearch: What is the background for this study? What are the main findings? Dr. Jain: Pneumonia is the leading cause of hospitalization among children in the United States with medical costs estimated at almost $1 billion in 2009.  The Centers for Disease Control and Prevention’s Etiology of Pneumonia in the Community (EPIC) study was a multi-center, active population-based surveillance study that aimed to estimate the incidence and etiology of community-acquired pneumonia requiring hospitalization in U.S. children.  Children in the study were enrolled from January 2010 to June 2012 in three U.S. children’s hospitals in Memphis, Nashville, and Salt Lake City. Study staff tested children using a range of laboratory tests for viral and bacterial respiratory pathogen detection. During the study period, the EPIC study team enrolled 2,638 children, of which 2,358 (89 percent) had radiographically-confirmed pneumonia. The median age of children in the study was 2 years old. Intensive care was required for 497 (21 percent) of the children, and three children died.  Among 2,222 children with radiographic pneumonia and specimens available for both bacterial and viral testing, a pathogen was detected in 1802 (81%).  One or more viruses were detected in 1,472 (66%) of these children.  Bacteria were detected in 175 (8%), and bacterial and viral co-detection occurred in 155 (7%).  The study estimated that annual pneumonia incidence was 15.7/10,000 children during the study period.  The highest incidence was among children younger than 2 years old (62.2/10,000).  Respiratory syncytial virus (RSV) was the most common pathogen detected (28%), and it was associated with the highest incidence among children younger than 2 years old with pneumonia.  Human rhinovirus was detected in 22 percent of cases, but it was also identified in 17 percent of asymptomatic controls who were enrolled, by convenience sample, at the same site during the same time period; thus, making it challenging to interpret the meaning of human rhinovirus detection in children hospitalized with pneumonia.  Other detected pathogens were human metapneumovirus (13%), adenovirus (11%), Mycoplasma pneumoniae (8%), parainfluenza viruses (7%), influenza (7%), coronaviruses (5%), Streptococcus pneumoniae (4%), Staphylococcus aureus (1%), and Streptococcus pyogenes (<1%).  The low prevalence of bacterial detections likely reflects both the effectiveness of bacterial conjugate vaccines and suboptimal sensitivity of bacterial diagnostic tests. (more…)
Author Interviews, CDC, Vaccine Studies / 10.02.2015

MedicalResearch.com Interview with: Tom Shimabukuro, MD, MPH, MBA Captain, U.S. Public Health Service Deputy Director Immunization Safety Office Centers for Disease Control and Prevention (CDC) Medical Research: What is the background for this study? What are the main findings? Response: CDC conducted a study looking at reports of adverse events (possible side effects) following measles, mumps, and rubella (MMR) vaccination in adults. Researchers reviewed the Vaccine Adverse Event Reporting System (VAERS) database for U.S. reports of adults aged 19 years and older who received MMR vaccine from January 1, 2003 to July 31, 2013. During this period, VAERS received 3,175 U.S. reports after MMR vaccine in adults. The most common signs and symptoms for all reports were fever (19%), rash (17%), pain (13%), and joint pain (13%). The study included adults only, a population for which there is limited safety data for this vaccine. This study further supports the MMR vaccine’s safety.  Researchers did not find any new or unexpected safety concerns. (more…)
Author Interviews, CDC, OBGYNE, Occupational Health / 06.02.2015

MedicalResearch.com Interview with: Barbara Grajewski, Ph.D., M.S., Epidemiologist Elizabeth Whelan, Ph.D., Branch Chief Christina Lawson, Ph.D., Epidemiologist Division of Surveillance, Hazard Evaluations and Field Studies National Institute for Occupational Safety and Health Centers for Disease Control and Prevention Medical Research: What is the background for this study? Response: The study, published January 5 online ahead of print in the journal Epidemiology, looked at potential workplace reproductive hazards for flight attendants. While in flight, flight attendants are exposed to cosmic radiation from space and, periodically, can be exposed to radiation from solar particle events. Flight attendants can also experience circadian disruption (disruption to the body’s internal time clock) from traveling across time zones and from working during hours when they would normally be asleep. For this study, we analyzed 840 pregnancies among 673 female flight attendants and examined company records of 2 million single flights flown by these women. From these data, we estimated a marker of circadian disruption—working during normal sleeping hours—and exposure to cosmic and solar particle event radiation for each flight. This gives us a much more specific estimate of the exposures these workers face on the job every day. We also assessed the physical demands of the job, such as standing and walking for more than 8 hours a day and bending at the waist more than 25 times a day. Cosmic radiation and circadian disruption among flight attendants are linked very closely on many flights and are very difficult to look at separately when trying to understand what causes miscarriage. This is the first study that has attempted to separate these two exposures to determine which is potentially linked to miscarriage. This study is also an improvement over other studies in its assessment of cosmic radiation for each individual flight flown and from documentation of solar particle events. Earlier studies have looked at how many years a flight attendant has worked or other ways to estimate exposures that are not as specific. (more…)
Author Interviews, CDC, Cost of Health Care, HIV / 05.02.2015

MedicalResearch.com Interview with: Ya-lin (Aileen) Huang, PhD. Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention Atlanta, GA, 30329 Medical Research: What is the background for this study? What are the main findings? Dr. Huang: With an estimated 50,000 new HIV infections each year in this country, and no vaccine or cure available yet, prevention is critical. Maximizing the impact of all available prevention strategies could significantly reduce new infections in this country. The purpose of this study is to provide evidence for the cost effectiveness of the interventions recommended under the funding announcement and to highlight where more cost-effectiveness studies may be needed. We limited our scope to the four interventions required under the health department funding announcement, including HIV testing, prevention with HIV-positives and their partners, condom distribution and efforts to align policies with optimal HIV prevention, care and treatment. Our review provides an updated summary of the published evidence of cost-effectiveness of four key HIV prevention interventions recommended by CDC: HIV testing, prevention with HIV-positives and their partners, condom distribution and policy initiatives. Models suggest that more than 350,000 HIV infections have been avoided because of the nation’s HIV prevention efforts. In addition to lives saved, HIV prevention has also generated substantial economic benefits. For every HIV infection that is prevented, an estimated $402,000 (http://www.ncbi.nlm.nih.gov/pubmed/23615000) is saved in the cost of providing lifetime HIV treatment. It is estimated that HIV prevention efforts have averted more than $125 billion in medical costs since the beginning of the epidemic. (more…)
Author Interviews, CDC, Gastrointestinal Disease, Infections, Pediatrics, Vaccine Studies / 04.02.2015

MedicalResearch.com Interview with: Margaret M. Cortese MD Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia Medical Research: What is the background for this study? What are the main findings? Dr. Cortese: The introduction of rotavirus vaccine in the United States resulted in a dramatic reduction in hospitalizations and emergency department care for rotavirus disease among young children, as well as provided indirect protection to unvaccinated peers. However, what our study looked at was whether or not older children and adults may experience indirect protection from having children in the house who are vaccinated for rotavirus. We used 2008-2012 Marketscan claims data to compare gastroenteritis rates among households whose child had received rotavirus vaccine with households whose child did not receive vaccine. We found statistically significantly lower rates of hospitalization from rotavirus gastroenteritis or unspecified-gastroenteritis in vaccinated households among all persons 20-29 years and females 20-29 years during the 2008-2009 rotavirus season as well as males 30-39 years in the 2009-2010 season. Lower emergency department gastroenteritis rates occurred in vaccinated households among females 20-29 years during the 2009-2010 season and individuals 5-19 years during the 2010-2011 season. (more…)
Author Interviews, CDC, HPV, OBGYNE, Vaccine Studies / 22.12.2014

dr-pedro-moroMedicalResearch.com Interview with: Pedro Moro MD MPH Immunization Safety Office, Division of Healthcare Quality Promotion National Center for Emerging and Zoonotic Infectious Diseases Centers for Disease Control and Prevention Medical Research: What is the background for this study? What are the main findings? Dr. Moro: Gardasil® is a human papillomavirus (HPV) vaccine recommended for all girls and boys at age 11 or 12, and teens and young adults who did not get the vaccine when they were younger. Because there is limited safety data available on use of the vaccine during pregnancy, it is not currently recommended for pregnant women. However, some pregnant women will inadvertently receive Gardasil® because they do not yet know that they are pregnant at the time of vaccination. The study reviewed non-manufacturer reports to the Vaccine Adverse Event Reporting System (VAERS) about pregnant women who received Gardasil®. VAERS is a national vaccine safety surveillance program co-administered by the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA). VAERS accepts reports of health problems that occur after any US-licensed vaccine (these are called adverse events). VAERS may also accept reports not describing any health problem but vaccination errors (for example, administration of a vaccine not recommended to a particular group of people like pregnant women). VAERS is an early-warning system and cannot generally assess if a vaccine caused an adverse event. After reviewing all non-manufacturer reports of Gardasil vaccination during pregnancy, this study found no unexpected patterns of safety issues for pregnant woman who received Gardasil®, or for their babies. This finding is reassuring and reconfirms the safety of this vaccine for pregnant women, as was previously reported by the pregnancy registry maintained by Gardasil®’s manufacturer. (more…)
Author Interviews, CDC, Cost of Health Care, Smoking / 17.12.2014

MedicalResearch.com Interview with: Xin Xu, Ph.D. Senior Economist Office on Smoking and Health and Darryl Konter Health Communications Specialist McNeal Professional Services Centers for Disease Control and Prevention Office on Smoking and Health Atlanta, GA 30341 Medical Research: What is the background for this study? What are the main findings? Response: Tips From Former Smokers (Tips), the first federally funded national mass media antismoking campaign, launched by the CDC, provides a unique opportunity to assess the cost effectiveness of a nationwide public health intervention that meets the ad exposure recommendation in CDC’s 2014 Best Practices for Comprehensive Tobacco Control Programs.  The 2012 campaign spent $393 per year of life saved—far less than the $50,000 per year of life saved figure used as a common threshold for cost-effectiveness. The campaign  added about 179,000 healthy life years, at $268 per healthy year gained. The campaign spent about $480 per smoker who quit. The campaign averted more than 17,000 premature deaths, at a cost of about $2,200 per premature death averted. (more…)
Author Interviews, CDC, Dermatology, Emergency Care, JAMA / 16.12.2014

Gery P. Guy Jr., PhD, MPH Health economist Division of Cancer Prevention and Control’s Epidemiology and Applied Research Branch CDCMedicalResearch.com Interview with: Gery P. Guy Jr., PhD, MPH Health economist Division of Cancer Prevention and Control’s Epidemiology and Applied Research Branch CDC Medical Research: What is the background for this study? What are the main findings? Dr. Guy: Indoor tanning exposes users to intense UV radiation and is associated with an increased risk of skin cancer. However, little is known about the more immediate adverse outcomes of indoor tanning. This study provides the first national estimates of visits to emergency departments related to indoor tanning. We examined cases from the Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS), a national probability sample of hospitals in the U.S. and its territories. Patient information is collected from each NEISS hospital for every emergency visit involving an injury associated with consumer products. From this sample, the total number of product-related injuries treated in hospital emergency rooms nationwide can be estimated. (more…)
Author Interviews, CDC, Smoking / 30.11.2014

MedicalResearch.com Interview with: Darryl Konter Health Communications Specialist, Office on Smoking and Health at Centers for Disease Control and Prevention Medical Research: What is the background for this study? What are the main findings? Response: Tobacco use is the leading cause of preventable disease and death in the United States, resulting in more than 480,000 premature deaths and $289 billion in direct health care expenditures and productivity losses each year. Despite progress over the past several decades, millions of adults still smoke cigarettes, the most commonly used tobacco product in the United States. Cigarette smoking among U.S. adults declined from 20.9% in 2005 to 17.8% in 2013. Among cigarette smokers who smoke daily, the average number of cigarettes smoked per day declined from 16.7 in 2005 to 14.2 in 2013, and the proportions of daily smokers who smoked 20–29 or ≥30 cigarettes per day also declined. However, an estimated 42.1 million adults still smoked cigarettes in 2013. Moreover, cigarette smoking remains particularly high among certain groups, including adults who are male, younger, multiracial or American Indian/Alaska Native, have less education, live below the federal poverty level, live in the South or Midwest, have a disability/limitation, or who are lesbian, gay, or bisexual. (more…)
Author Interviews, CDC, HIV / 26.11.2014

MedicalResearch.com Interview with: Heather Bradley, PhD Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC Medical Research: What is the background for this study? What are the main findings? Dr. Bradley: The key to controlling the HIV epidemic is controlling the virus.  When used consistently, antiretroviral medication can keep HIV controlled at very low levels in the body (known as viral suppression), allowing people with HIV to live longer, healthier lives and reducing the likelihood they will transmit HIV to others. Yet, only one-third of the 1.2 million people with HIV in the U.S. have the virus under control.  Among those who did not have the virus under control, approximately two-thirds had been diagnosed but were not in medical care. Young people were least likely to have the virus under control.  Only 13 percent of 18 – 24 year olds were virally suppressed, primarily because half don’t know they are infected.  To close this gap among young people, increased HIV testing is critical. The study did not find statistically significant differences in viral suppression by race or ethnicity, sex, or risk group. (more…)
Author Interviews, Cancer Research, CDC, Pediatrics / 16.09.2014

Dr. Jun Li, MD, PhD, MPH Epidemiology and Applied Research Branch Division of Cancer Prevention and Control National Center for Chronic Disease Prevention and Health PromotionMedicalResearch.com Interview with: Dr. Jun Li, MD, PhD, MPH Epidemiology and Applied Research Branch Division of Cancer Prevention and Control National Center for Chronic Disease Prevention and Health Promotion Medical Research: What are the main findings of the study? Dr. Li: Using the 2001 to 2009 National Program of Cancer Registries (NPCR) and Surveillance, Epidemiology, and End Results (SEER) data, which represent 94.2% of the US population, we identified 120,137 pediatric cancer cases with an incidence rate of 171 cases per million children and adolescents. Overall cancer incidence rates were stable from 2001-2009. However, we found rates were increasing significantly at 1.3% per year in African American children and adolescents.  This increase might be partially attributed to the rise among renal tumors and thyroid cancer. We also found rising incidence in thyroid cancer and renal carcinoma among children and adolescents. As has been previously established, pediatric cancer is more common in males, in white, in adolescents, and in the Northeast. Leukemia is the most common pediatric cancer, followed by central nervous system (CNS) neoplasms, and then lymphomas. (more…)
Author Interviews, CDC, HIV / 21.07.2014

Anna Satcher Johnson MPH Division of HIV/AIDS Prevention Centers for Disease Control and Prevention (CDC) Atlanta, GeorgiaMedicalResearch.com: Interview with: Anna Satcher Johnson MPH Division of HIV/AIDS Prevention Centers for Disease Control and Prevention (CDC) Atlanta, Georgia Medical Research: What are the main findings of the study? Answer: The new analysis confirms historical trends suggesting that we’ve made significant progress in reducing HIV in the U.S. over time – overall and among several key populations, including injection drug users and heterosexuals.  Overall, new HIV diagnoses from 2002 to 2011 declined 33 percent.  However, these findings underscore continued concerns of a surging HIV epidemic among young gay and bisexual men.  We found a significant increase in HIV diagnoses among young men who have sex with men between the ages of 13 and 24. (more…)
Author Interviews, CDC, Hand Washing, Hospital Acquired, Infections, NEJM / 26.03.2014

MedicalResearch.com Interview with: Shelley S. Magill, M.D., Ph.D. From the Centers for Disease Control and Prevention Emory University School of Medicine Atlanta, Georgia MedicalResearch.com: What are the main findings of the study? Dr. Magill: The results of this survey show that healthcare-associated infections continue to be a threat to patient safety in U.S. acute care hospitals. Among the more than 11,000 patients included in the survey, approximately 4% (or 1 in 25) had at least one healthcare-associated infection at the time of the survey. We used these results to develop national estimates of healthcare-associated infections. We estimated that in 2011, there were approximately 721,800 healthcare-associated infections in U.S. acute care hospitals. The most common types of infections were surgical site infections (SSIs), pneumonias, and gastrointestinal infections. (more…)