The Vast Majority Of Kids Who Die Of The Flu Aren’t Vaccinated

April 5, 2017

“We could prevent more flu-related deaths by vaccinating more of our children and teenagers,” says a CDC investigator.

By Erin Schumaker/The Huffinton Report/News/March 4, 2017.

The majority of kids who died of the flu between 2010 and 2014 didn’t receive their yearly vaccine for influenza prior to their deaths, according to a study published in the journal Pediatrics on April 3.

“The lower percentage of vaccination among those who died suggests that the vaccine prevents deaths due to flu,” Brendan Flannery, lead author of the study and epidemiologist at the U.S. Centers for Disease Control and Prevention, told The Huffington Post.

“We could prevent more flu-related deaths by vaccinating more of our children and teenagers,” he added.

The study, which examined 358 confirmed flu deaths in kids ages 6 months to 17 years, found that of the 291 children whose vaccination status could be determined, only 26 percent had received that year’s flu vaccine. (This percentage didn’t include children who had been vaccinated less than 14 days before their deaths, because it takes about that long for the vaccine to take effect.)

The CDC recommends that everyone 6 months and older get a flu shot every year, with a few rare exceptions ― for individuals who have life-threatening allergies to the vaccine’s ingredients, for example.

Approximately half of the children who died between 2010 and 2014 had at least one high-risk medical condition, such as a neurological disorder, diabetes, asthma, heart disease or an immune deficiency, which can increase susceptibility to influenza complications. And although the flu vaccine is especially important for high-risk people, only 31 percent of the high-risk children who died in that period had been vaccinated, according to the study.

“Parents of children with high-risk conditions often know that their children are at increased risk of severe illness if they get the flu,” Flannery noted. “It was surprising therefore that only one in three children with underlying risk factors for severe flu had been vaccinated.”

Among the healthy children who died of the flu, just 20 percent had received a seasonal flu vaccine.

Researchers determined the flu vaccine was 51 percent effective in high-risk children and 65 percent effective in low-risk kids.

“It reduced the chances of dying of flu by 65 percent, but it was not 100 percent,” Dr. John Treanor, a flu vaccine researcher at the University of Rochester Medical Center who was not involved in the study, told NBC News.

“The vaccine is not perfect and some children in this study died from flu despite receiving [the] vaccine,” Flannery said. “However, flu vaccines are the best way to prevent against getting the flu, and this study reminds us that flu can be deadly, even in previously healthy children and adolescents.”

Among adults, influenza-related deaths ranged from a low of 12,000 seasonal flu deaths to a high of 56,000 seasonal flu deaths between 2010 and 2014, according to the CDC. (The agency uses estimates rather than exact counts for adult influenza deaths because flu deaths tend to be underreported on death certificates and not all states are required to report them.

Also, some people who die from flu complications aren’t tested for the flu.)

This reporting is brought to you by HuffPost’s health and science platform, The Scope.

The upside of surprise Joint Commission surveys: Lower patient death rates

March 22, 2017

FierceHealthcare/by Ilene MacDonald/Mar 21, 2017 11:27am

Patients are less likely to die within 30 days of admission if they happen to be treated at hospitals at the same time The Joint Commission arrives for a surprise inspection.

The reason for the better mortality rates during the unannounced on-site surveys compared to weeks before and after the surveys may be due to the fact that clinicians are aware they are under scrutiny and are therefore more vigilant, according to the new study published Monday in JAMA Internal Medicine.

For full article, see Fierce Healthcare.

RISE Summit 2017 kicks off with talk of Trump, politics, ACA

March 8, 2017

By Leslie Small/March 6, 2017/Fierce Healthcare

NASHVILLE, Tenn.—Though the annual RISE Summit takes place in “Music City,” the 2017 conference began with a discussion about what’s going on in the nation’s capital.

The reason, according to CenseoHealth Chief Strategy Officer Nathan Goldstein, is simple.

“Every one of us works at a job deeply influenced by what happens in Washington,” he said during the RISE chairpersons’ opening remarks.

With that in mind, keynote speaker Howard Fineman—an NBC/MSNBC political analyst and global editorial director of The Huffington Post Media Group—offered an insider’s view of the current climate within the Beltway now that President Donald Trump is in power.

Many new administrations come to the White House with a combination of a “burst of energy” and confusion about the complicated task of governing, he said, but with the exception of perhaps the Carter administration, “nobody has come in knowing less about how it all works than the Trump people.”

The Trump administration nevertheless is very sure about the way it wants to run the government, he added, and Democrats are just as determined to impede the Republicans’ agenda.

“I’ve never seen the city this divided into warring, distrustful and mutually exclusive camps,” Fineman said.

That contentious political climate also colors Republicans’ plans to repeal and replace the Affordable Care Act, according to Fineman.

For full article go to Fierce Healthcare.

BMJ: Trump Administration Worrying for Science, Health Policy

February 26, 2017

Alicia Ault/February 21, 2017

Donald Trump’s presidency has “raised worrying questions about its likely impact on science and health policy,” write several BMJ editors in an editorial published online today.

The administration seems to place little value on facts or analysis, and may not be considering the consequences of its pronouncements and policies on biomedical research and the health of Americans and citizens around the world, the authors said. The editorial was written by José Merino, BMJ US clinical research editor, Elizabeth Loder, BMJ head of research, Kamran Abbasi, BMJ executive editor, and Ashish Jha, who is KT Li professor of health policy at the Harvard TH Chan School of Public Policy.

“We are particularly concerned that Trump’s administration is acting in ways that will suppress research and limit communication on scientific topics that it deems politically inconvenient,” wrote the authors.

For full article, see Medscape Nurses

Football and Its Injuries and Maladies

February 5, 2017

Laurie Scudder DNP, NP; Laura Stokowski, RN, MS  |  September 11, 2015. Medscape Nurses.  

Updated January 30, 2017. Football is said to be the most popular sport in America. Polls show that professional football has held the top spot in the hearts of US sport fans for the past 30 years. In terms of youth sport participation, football comes in third place behind basketball and baseball. Participation in high school football declined by 2.3% in 2012-2013 compared with 2008-2009. With participation in all organized youth sports (age 6-17 years) on the decline, this might reflect a general trend toward inactivity, but football faces the extra hurdle of concern about concussions and other injuries that can cause permanent harm.

These concerns are well-founded. Recent data show that 61% of retired players in the National Football League (NFL) report having had a concussion. Among 5- to 24-year-olds, football is a leading cause of visits to emergency departments for nonfatal injuries, easily outnumbering motor vehicle-related injuries among teenage boys.

Watching from the safety of a sofa or stadium seat is one thing, where the greatest dangers to one’s health are posed by alcohol, high-calorie snack foods, and prolonged sitting. But playing the game brings risk of another order of magnitude. The constellation of football-associated injuries is wide, ranging from the well-known contact head injuries to heat stroke, stress injuries, catastrophic joint injuries, rhabdomyolysis, and even sudden death. In 2014, six fatalities were directly related to football played at any level. In time for Super Bowl LI, Medscape brings you this review of common and not-so-common injuries and events associated with this sometimes dangerous sport.

For full article, see Medscape Nurses.

Trump Nominees Make Clear Plans to Sweep Away Obama Policies

January 20, 2017

WASHINGTON — President-elect Donald J. Trump’s cabinet nominees, while moderating some of their stances, have made it clear during two weeks of hearings that they intend to work hard to sweep away President Obama’s domestic policy by embracing a deeply conservative approach to governing.

In dozens of hours of testimony, Mr. Trump’s nominees told senators that they favored less regulation, a smaller federal government, more state control over policy decisions and taxpayer money, and greater personal responsibility by Americans across the country.

The sometimes contentious hearings continued up until the day before the inauguration, as Mr. Trump triumphantly arrived in Washington on Thursday to kick off three highly choreographed days that will usher Republicans back into full political power in Washington for the first time in more than a decade.

See full article at the New York Times, January 19, 2017

Young Adolescents as Likely to Die From Suicide as From Traffic Accidents

November 11, 2016

WASHINGTON — It is now just as likely for middle school students to die from suicide as from traffic accidents.

That grim fact was published on Thursday by the Centers for Disease Control and Prevention. They found that in 2014, the most recent year for which data is available, the suicide rate for children ages 10 to 14 had caught up to their death rate for traffic accidents.

The number is an extreme data point in an accumulating body of evidence that young adolescents are suffering from a range of health problems associated with the country’s rapidly changing culture. The pervasiveness of social networking means that entire schools can witness someone’s shame, instead of a gaggle of girls on a school bus. And with continual access to such networks, those pressures do not end when a child comes home in the afternoon.

“It’s clear to me that the question of suicidal thoughts and behavior in this age group has certainly come up far more frequently in the last decade than it had in the previous decade,” said Dr. Marsha Levy-Warren, a clinical psychologist in New York who works with adolescents. “Cultural norms have changed tremendously from 20 years ago.”

Death is a rare event for adolescents. But the unprecedented rise in suicide among children at such young ages, however small the number, was troubling and federal researchers decided to track it. In all, 425 children ages 10 to 14 killed themselves in 2014. In contrast, 384 children of that age died in car accidents.

“This graph is really surprising,” said Sally Curtin, an expert at the National Center for Health Statistics who analyzed the data. “We think of traffic accidents as so commonplace.”

The crossing-over point was reached in part because suicide had spiked, but also because fatal traffic accidents had declined.

In 1999, the death rate for children ages 10 to 14 from traffic accidents — about 4.5 deaths per 100,000 — was quadruple the rate for suicide. But by 2014, the death rate from car crashes had been cut in half, part of a broader trend across the entire population. The suicide rate, however, had nearly doubled, with most of the increase happening since 2007. In 2014, the suicide death rate was 2.1 per 100,000.

Far more boys than girls killed themselves in 2014 — 275 boys to 150 girls — in line with adults in the general population. American men kill themselves at far higher rates than women. But the increase for girls was much sharper — a tripling, compared with a rise of about a third for boys.

The reasons for suicide are complex. No single factor causes it. But social media tends to exacerbate the challenges and insecurities girls are already wrestling with at that age, possibly heightening risks, adolescent health experts said. (The data published Thursday did not include methods, but an earlier report gave those details.)

“Social media is girl town,” said Rachel Simmons, the author of “Odd Girl Out: The Hidden Culture of Aggression in Girls.” “They are all over it in ways that boys are not.”

Statistically, girls dominate visual platforms like Facebook and Instagram where they receive instant validation from their peers, she said. It also is a way to quantify popularity, and take things that used to be private and intangible and make them public and tangible, Ms. Simmons added.

“It used to be that you didn’t know how many friends someone had, or what they were doing after school,” she said. “Social media assigns numbers to those things. For the most vulnerable girls, that can be very destabilizing.”

The public aspect can be particularly painful, Dr. Levy-Warren said. Social media exponentially amplifies humiliation, and an unformed, vulnerable child who is humiliated is at much higher risk of suicide than she would otherwise have been.

“If something gets said that’s hurtful or humiliating, it’s not just the kid who said it who knows, it’s the entire school or class,” she said. “In the past, if you made a misstep, it was a limited number of people who would know about it.”

Another profound change has been that girls are going through puberty at earlier ages. Today girls get their first period at age 12 and a half on average, compared with about 16 at the turn of the 20th century, according to “The New Puberty,” a 2014 book that describes the phenomenon. That means girls are becoming young women at an age when they are less equipped to deal with the issues that raises — sex and gender identity, peer relationships, more independence from family. Girls experience depression at twice the rate of boys in adolescence, Ms. Simmons said, a pattern that continues into adulthood.

What is more, they live in a culture of fast answers and immediate change. That compounds the pressure.

“For a young girl who starts to develop breasts, hips, body hair — it’s a long haul before you land,” Dr. Levy-Warren said. “You don’t really know how you’re going to look for a number of years, and a lot of kids don’t know how to wait anymore. It’s just so painful.”

She added, “There’s this collision of emotional need, social circumstances and a sense of needing an immediate answer.”

Depression is being diagnosed more often these days, and adolescents are taking more medication than ever before, but Dr. Levy-Warren cautioned that it was not clear whether that is because more people are actually depressed, or because it is simply being identified more than before.

Suicide is just the tip of a broader iceberg of emotional trouble, experts warn. One recent study of millions of injuries in American emergency departments found that rates of self-harm, including cutting, had more than tripled among 10- to 14-year-olds. “This is particularly concerning as this type of injury often heralds suicidal behavior,” the researchers wrote.

CDC: Many Factors Affect IBD’s (Inflammatory Bowel Disease) Population Prevalance

October 28, 2016
The Gupta Gude. Sanjay Gupta, MD, E

CDC: Many Factors Affect IBD’s Population Prevalence

Federal survey data yield several surprises

  • by Alexandria Bachert
    Staff Writer, MedPage TodayOctober 27, 2016

A new report identifying population subgroups with greater prevalence of inflammatory bowel disease (IBD) might lead to a better understanding of the disease and the populations most affected, CDC researchers said.

Data from the 2015 National Health Interview Survey indicated that nearly 3.1 million (1.3%) U.S. adults reported receiving a diagnosis of IBD in 2015, with the prevalence distribution varying with certain sociodemographic factors including age, education, ethnicity, income, and employment status.

This estimate was nearly three times the number of adults previously reported to have IBD based on administrative data sources and limited geographic coverage, said James M. Dahlhamer, PhD, and colleagues in the analysis published Thursday in the CDC’s Morbidity and Mortality Weekly Report.

Dahlhamer and colleagues analyzed 33,672 adults, ages 18 and older, from the Sample Adult Core component of NHIS, as well as sociodemographic characteristics from the Household Module and Family Core sections of the survey. Using these data, they estimated the number of IBD cases and prevalence of IBD for the overall U.S. adult population, as well as by various sociodemographic characteristics.

Similar to previous reports, a higher prevalence of IBD was seen among adults ages 45 and older (3.2%), as well as among non-Hispanic whites (1.4%).

But Dahlhamer and colleagues also found variations in certain subgroups that had not been previously reported.

Adults with less than a high school level of education had a higher prevalence of IBD (1.7%) compared with those who had a bachelor’s degree or higher (1.1%). Additionally, 1.6% of unemployed adults, compared with 1.2% of adults who were currently employed, reported ever receiving a diagnosis of IBD.

Adults living in poverty (family incomes <100% of the federal poverty level) had a higher prevalence of IBD (1.8%) than adults from families with incomes ≥400% of the federal poverty level (1.1%).

Regionally, adults living outside the central city of a metropolitan statistical area (MSA) had a higher prevalence of IBD (1.4%) than did adults living in the central or principal city of an MSA (1.0%). Individuals born in the U.S. were more likely to have been diagnosed with IBD (1.4%) than those who were born elsewhere (0.8%).

Also, the data contradicted findings from some earlier reports, including regional and sex differences in prevalence.

However, Dahlhamer and colleagues noted several limitations to the analysis — data were self-reported and excluded adults in long-term care facilities, active duty military personnel, and incarcerated people. Additionally, only diagnosed cases of Crohn’s disease and ulcerative colitis were included.

CMS Awards $347 Million for Patient Safety Initiative

October 2, 2016

Money will go toward reducing inpatient harm, readmissions.

By Joyce Frieden/News Editor/MedPage Today/September 30, 2016

WASHINGTON — The Centers for Medicare & Medicaid Services (CMS) is awarding $347 million to healthcare organizations in an effort to reduce patient harm and decrease readmissions, the agency announced Thursday.

The money will go to 16 different groups, including hospital associations, quality improvement organizations, and health systems as part of an effort to reduce hospital-acquired conditions and readmissions among Medicare beneficiaries.

We made significant and successful progress in keeping patients safe over the last few years,” CMS chief medical officer Patrick Conway, MD, said on a conference call with reporters. “Since 2010, we have seen an unprecedented reduction in preventable patient harm in hospitals across the U.S., resulting in 2.1 million fewer people harmed, 87,000 lives saved and $20 billion in costs saved.”

Now CMS wants to continue these efforts and set additional goals, Conway explained, noting that these improvements would not have been possible without the Affordable Care Act and the work of CMS’s innovation center.

A Minnesota Doctor Is Trying Get a $50 EpiPen Alternative to Market

September 18, 2016

By   SEPTEMBER 15, 2016, 1:31 PM EDT, Fortune

To provide an option other than Mylan’s pricey device.

A Minnesota doctor wants to make fighting deadly allergies cheaper—a lot cheaper.

Douglas McMahon of the Allergy and Asthma Center of Minnesota in Eagan has created what he says is a more convenient epinephrine-delivering device for treating anaphylaxis—a severe allergic reaction which can cause difficulty breathing and other dangerous symptoms—that would be available at about a tenth of the price of Mylan’s MYL 0.67% brand name EpiPen, according to a local CBS affiliate.

“By chance I came to realize how inexpensive the parts were, including the medicine, and I realized we can sell it to patients for a very reasonable cost,” McMahon told the network in an interview.

Mylan has been under intense scrutiny since reports emerged that the pharma giant had raised the price of the EpiPen from less than $100 for a one-year, two-pack supply to about $600 over the course of a decade. The firm scrambled to bolster price-lowering coupons for patients after its share value nosedived and has pledged to release a generic competitor to its own product that will be about half the cost of the branded one.

But McMahon says his alternative device, dubbed theAllergyStop, would cost as little as $50. And he believes the technology itself is superior to Mylan’s since it is far more compact and easier to carry—particularly important since most Americans who die from anaphylaxis do not have their epinephrine with them. The device can also be customized to provide different dosages for different body types.Still, there are some big hurdles that need to be cleared before the AllergyStop can reach the market. For one, McMahon needs to conduct the thorough, expensive safety and clinical trials necessary for Food and Drug Administration (FDA) clearance. Such testing can easily cost upwards of $1 million, which is why McMahon is currently trying to raise money through an Indiegogo campaign.

There’s also the question of how realistically the physician can stick to his low target price. If he opens up the product to outside investors, they may press him to raise its tab, he admits.

In the meantime, Mylan is still facing tough questions (and an investigation by New York’s Attorney General) about its decision to hike the EpiPen’s price. CEO Heather Bresch is slated to testify in front of the U.S. House Committee on Government and Oversight in a September 21 congressional hearing.