Jan Dyer

Transgender men and women are at high risk for HIV infection. In a recent analysis of more than 9 million CDC-funded HIV test results, transgender women had the highest percentage of confirmed positive results (2.7%) of any gender category. But this group also tends to have too-low testing numbers. In a CDC study, only 36% of transgender women and 32% of transgender men reported being tested; only 10% of both groups had been tested in the past year. By comparison, gay and bisexual men reported getting tested at roughly twice the rates (61.8% ever and 21.6% past year).

Black transgender women and men had twice the prevalence of ever testing compared with their white counterparts (63%-67% vs 31%-33%). Transgender women who had been diagnosed with a depressive disorder had the highest prevalence of getting tested for HIV (69%).

Transgender persons face “unique barriers to testing,” the CDC researchers say, such as the HIV stigma within the transgender community, gender identity stigma in health care settings, and socioeconomic marginalization. The CDC is working on “innovative approaches” to delivering HIV testing and other prevention and support services to transgender persons who are at risk for or have newly diagnosed HIV.

Transgender men and women are at high risk for HIV infection. In a recent analysis of more than 9 million CDC-funded HIV test results, transgender women had the highest percentage of confirmed positive results (2.7%) of any gender category. But this group also tends to have too-low testing numbers. In a CDC study, only 36% of transgender women and 32% of transgender men reported being tested; only 10% of both groups had been tested in the past year. By comparison, gay and bisexual men reported getting tested at roughly twice the rates (61.8% ever and 21.6% past year).

Black transgender women and men had twice the prevalence of ever testing compared with their white counterparts (63%-67% vs 31%-33%). Transgender women who had been diagnosed with a depressive disorder had the highest prevalence of getting tested for HIV (69%).

Transgender persons face “unique barriers to testing,” the CDC researchers say, such as the HIV stigma within the transgender community, gender identity stigma in health care settings, and socioeconomic marginalization. The CDC is working on “innovative approaches” to delivering HIV testing and other prevention and support services to transgender persons who are at risk for or have newly diagnosed HIV.

Transgender men and women are at high risk for HIV infection. In a recent analysis of more than 9 million CDC-funded HIV test results, transgender women had the highest percentage of confirmed positive results (2.7%) of any gender category. But this group also tends to have too-low testing numbers. In a CDC study, only 36% of transgender women and 32% of transgender men reported being tested; only 10% of both groups had been tested in the past year. By comparison, gay and bisexual men reported getting tested at roughly twice the rates (61.8% ever and 21.6% past year).

Black transgender women and men had twice the prevalence of ever testing compared with their white counterparts (63%-67% vs 31%-33%). Transgender women who had been diagnosed with a depressive disorder had the highest prevalence of getting tested for HIV (69%).

Transgender persons face “unique barriers to testing,” the CDC researchers say, such as the HIV stigma within the transgender community, gender identity stigma in health care settings, and socioeconomic marginalization. The CDC is working on “innovative approaches” to delivering HIV testing and other prevention and support services to transgender persons who are at risk for or have newly diagnosed HIV.

More than 1.5 million Americans develop sepsis each year, and at least 250,000 die of it. “Detecting sepsis early and starting immediate treatment is often the difference between life and death. It starts with preventing the infections that lead to sepsis,” said CDC Director Brenda Fitzgerald, MD, introducing the CDC’s Get Ahead of Sepsis campaign, which launched in August. “We created Get Ahead of Sepsis to give people the resources they need to help stop this medical emergency in its tracks.”  

The campaign is an educational initiative for both the public and health care professionals in hospitals, home care, long-term care, and urgent care. For many patients, the CDC says, sepsis develops from an infection that begins outside the hospital. Health care professionals are not only in prime positions to monitor for signs and symptoms of sepsis in the health care setting—they can also help educate patients about things they can do to prevent sepsis. For instance, people with chronic conditions can take good care to avoid infections that could lead to sepsis.  

The campaign website, www.cdc.gov/sepsis, provides fact sheets, infographics, brochures, and other materials to help spread the word.

More than 1.5 million Americans develop sepsis each year, and at least 250,000 die of it. “Detecting sepsis early and starting immediate treatment is often the difference between life and death. It starts with preventing the infections that lead to sepsis,” said CDC Director Brenda Fitzgerald, MD, introducing the CDC’s Get Ahead of Sepsis campaign, which launched in August. “We created Get Ahead of Sepsis to give people the resources they need to help stop this medical emergency in its tracks.”  

The campaign is an educational initiative for both the public and health care professionals in hospitals, home care, long-term care, and urgent care. For many patients, the CDC says, sepsis develops from an infection that begins outside the hospital. Health care professionals are not only in prime positions to monitor for signs and symptoms of sepsis in the health care setting—they can also help educate patients about things they can do to prevent sepsis. For instance, people with chronic conditions can take good care to avoid infections that could lead to sepsis.  

The campaign website, www.cdc.gov/sepsis, provides fact sheets, infographics, brochures, and other materials to help spread the word.

More than 1.5 million Americans develop sepsis each year, and at least 250,000 die of it. “Detecting sepsis early and starting immediate treatment is often the difference between life and death. It starts with preventing the infections that lead to sepsis,” said CDC Director Brenda Fitzgerald, MD, introducing the CDC’s Get Ahead of Sepsis campaign, which launched in August. “We created Get Ahead of Sepsis to give people the resources they need to help stop this medical emergency in its tracks.”  

The campaign is an educational initiative for both the public and health care professionals in hospitals, home care, long-term care, and urgent care. For many patients, the CDC says, sepsis develops from an infection that begins outside the hospital. Health care professionals are not only in prime positions to monitor for signs and symptoms of sepsis in the health care setting—they can also help educate patients about things they can do to prevent sepsis. For instance, people with chronic conditions can take good care to avoid infections that could lead to sepsis.  

The campaign website, www.cdc.gov/sepsis, provides fact sheets, infographics, brochures, and other materials to help spread the word.

A “wealth of evidence” suggests that nutrition and immunologic status on admission is closely associated with the outcome of patients with cardiovascular disease—especially high-risk elderly patients, say researchers from Chinese People’s Liberation Army General Hospital, Beijing. The researchers note that malnutrition is an independent factor influencing post myocardial infarction complications and mortality in geriatric patients with coronary artery disease (CAD). According to their study of 336 hospitalized patients with hypertension, the Controlling Nutritional Status (CONUT) score can help predict who is at highest risk.

Nutrition indexes are widely used. CONUT scores, which are calculated based on serum albumin concentration, total peripheral lymphocyte count, and total cholesterol concentration, have been found useful in a variety of areas, including cancer. The Geriatric Nutritional Risk Index (GNRI), although a relatively new index for nutrition assessment in the elderly, is the most-used tool to evaluate patients with chronic kidney disease, the researchers say. Both indexes are “widely applied” in evaluation of patients with tumors who are also undergoing dialysis. Some studies also have reported on GNRI as a prognostic factor in cardiovascular diseases.

The researchers conducted their study to assess the effect of nutrition status on survival in patients aged ≥ 80 years, with hypertension, measuring outcomes at 90 days postadmission. All patients had a history of CAD, 167 had type 2 diabetes, and 124 had anemia. Of the enrolled patients, 192 were admitted for respiratory tract infection, with a significantly high proportion of poor nutrition status. Five patients scored > 9 on the CONUT scale. A score of ≥ 5 indicated moderate to severe malnutrition.

During the 90-day follow-up, 27 patients died. No differences in systolic blood pressure were found. The surviving patients, however, showed increased body mass index, hemoglobin, and albumin levels, as well as lower diastolic blood pressure and fasting blood glucose. Surviving patients had improved GRNI scores and reduced CONUT scores, both of which indicated improved nutrition status. Respiratory tract infection, CONUT, and albumin were independent predictors of all-cause mortality.

However, only CONUT accurately predicted all-cause mortality among patients with hypertension during the 90-day follow-up. A CONUT score above 3.0 at admission predicted all-cause mortality with a sensitivity of 77.8% and specificity of 64.7%.

Source:

Sun X, Luo L, Zhao X, Ye P. BMJ Open. 2017;7(9):e015649.

doi: 10.1136/bmjopen-2016-015649.

A “wealth of evidence” suggests that nutrition and immunologic status on admission is closely associated with the outcome of patients with cardiovascular disease—especially high-risk elderly patients, say researchers from Chinese People’s Liberation Army General Hospital, Beijing. The researchers note that malnutrition is an independent factor influencing post myocardial infarction complications and mortality in geriatric patients with coronary artery disease (CAD). According to their study of 336 hospitalized patients with hypertension, the Controlling Nutritional Status (CONUT) score can help predict who is at highest risk.

Nutrition indexes are widely used. CONUT scores, which are calculated based on serum albumin concentration, total peripheral lymphocyte count, and total cholesterol concentration, have been found useful in a variety of areas, including cancer. The Geriatric Nutritional Risk Index (GNRI), although a relatively new index for nutrition assessment in the elderly, is the most-used tool to evaluate patients with chronic kidney disease, the researchers say. Both indexes are “widely applied” in evaluation of patients with tumors who are also undergoing dialysis. Some studies also have reported on GNRI as a prognostic factor in cardiovascular diseases.

The researchers conducted their study to assess the effect of nutrition status on survival in patients aged ≥ 80 years, with hypertension, measuring outcomes at 90 days postadmission. All patients had a history of CAD, 167 had type 2 diabetes, and 124 had anemia. Of the enrolled patients, 192 were admitted for respiratory tract infection, with a significantly high proportion of poor nutrition status. Five patients scored > 9 on the CONUT scale. A score of ≥ 5 indicated moderate to severe malnutrition.

During the 90-day follow-up, 27 patients died. No differences in systolic blood pressure were found. The surviving patients, however, showed increased body mass index, hemoglobin, and albumin levels, as well as lower diastolic blood pressure and fasting blood glucose. Surviving patients had improved GRNI scores and reduced CONUT scores, both of which indicated improved nutrition status. Respiratory tract infection, CONUT, and albumin were independent predictors of all-cause mortality.

However, only CONUT accurately predicted all-cause mortality among patients with hypertension during the 90-day follow-up. A CONUT score above 3.0 at admission predicted all-cause mortality with a sensitivity of 77.8% and specificity of 64.7%.

Source:

Sun X, Luo L, Zhao X, Ye P. BMJ Open. 2017;7(9):e015649.

doi: 10.1136/bmjopen-2016-015649.

A “wealth of evidence” suggests that nutrition and immunologic status on admission is closely associated with the outcome of patients with cardiovascular disease—especially high-risk elderly patients, say researchers from Chinese People’s Liberation Army General Hospital, Beijing. The researchers note that malnutrition is an independent factor influencing post myocardial infarction complications and mortality in geriatric patients with coronary artery disease (CAD). According to their study of 336 hospitalized patients with hypertension, the Controlling Nutritional Status (CONUT) score can help predict who is at highest risk.

Nutrition indexes are widely used. CONUT scores, which are calculated based on serum albumin concentration, total peripheral lymphocyte count, and total cholesterol concentration, have been found useful in a variety of areas, including cancer. The Geriatric Nutritional Risk Index (GNRI), although a relatively new index for nutrition assessment in the elderly, is the most-used tool to evaluate patients with chronic kidney disease, the researchers say. Both indexes are “widely applied” in evaluation of patients with tumors who are also undergoing dialysis. Some studies also have reported on GNRI as a prognostic factor in cardiovascular diseases.

The researchers conducted their study to assess the effect of nutrition status on survival in patients aged ≥ 80 years, with hypertension, measuring outcomes at 90 days postadmission. All patients had a history of CAD, 167 had type 2 diabetes, and 124 had anemia. Of the enrolled patients, 192 were admitted for respiratory tract infection, with a significantly high proportion of poor nutrition status. Five patients scored > 9 on the CONUT scale. A score of ≥ 5 indicated moderate to severe malnutrition.

During the 90-day follow-up, 27 patients died. No differences in systolic blood pressure were found. The surviving patients, however, showed increased body mass index, hemoglobin, and albumin levels, as well as lower diastolic blood pressure and fasting blood glucose. Surviving patients had improved GRNI scores and reduced CONUT scores, both of which indicated improved nutrition status. Respiratory tract infection, CONUT, and albumin were independent predictors of all-cause mortality.

However, only CONUT accurately predicted all-cause mortality among patients with hypertension during the 90-day follow-up. A CONUT score above 3.0 at admission predicted all-cause mortality with a sensitivity of 77.8% and specificity of 64.7%.

Source:

Sun X, Luo L, Zhao X, Ye P. BMJ Open. 2017;7(9):e015649.

doi: 10.1136/bmjopen-2016-015649.

Foot ulcers are a common complication of diabetes, due to macro- and microvascular changes that lead to neuropathy. But despite treatment with standard interventions such as debridement and pressure relief, many diabetic foot ulcers persist as nonhealing wounds, say researchers from Nnamdi Azidiwe University and University of Nigeria.

Oxygenation is key to keep the tissues healthy, the researchers say. We already know that exercise enhances blood circulation and improves vascular blood perfusion and capillary oxygen tension. However, little research has associated increased vascular blood perfusion with wound healing in diabetic foot ulcers, the researchers say. They reanalyzed results from 1 of their earlier studies to find out whether aerobic exercise would lead to healing.

In a 12-week program, 61 patients with type 1 or 2 diabetes mellitus were randomly assigned to an intervention or control group.  Each patient had had a persistent ulcer of at least 1 cm². The intervention group rode a bicycle ergometer at 60% of their maximum heart rate and progressed to 85%. The researchers tested them for oxygen percentage saturation and ankle brachial index (ABI) at baseline every 2 weeks.

At the end of the program, the researchers found a “sharp contrast” between the 2 groups, including a significant difference in the oxygen percentage saturation (99.00 vs 97.20) and the ABI. The reduction in wound size was also significant for the exercise group.

There is evidence, the researchers say, that exercise enhances blood circulation by lowering plasma glucose concentration. Normally, endothelial cells metabolize the circulating blood glucose—unless they are overwhelmed by glucose molecules during hyperglycemia. Previously, the researchers also noted that plasma glucose dropped significantly, mostly at the end of the fourth week of the exercise program.

In this study, increases in ABIs, the researchers say, imply enhanced oxygen supply to the extremities. During the fourth week, they found greater wound size reductions and the ABI significantly correlated with oxygen percentage saturation. The ankle brachial index may be a useful tool, the researchers suggest, for predicting improvement in oxygen percentage saturation.

The researchers’ findings lead them to recommend that nonweight bearing exercise be made a “cornerstone” of management for people with diabetic foot ulcers.

Source:

Nwankwo MJ, Okoye GC, Victor EA, Obinna EA.  Int J Diabetes Res. 2014;3(3):41-48.
doi:10.5923/j.diabetes.20140303.03

Foot ulcers are a common complication of diabetes, due to macro- and microvascular changes that lead to neuropathy. But despite treatment with standard interventions such as debridement and pressure relief, many diabetic foot ulcers persist as nonhealing wounds, say researchers from Nnamdi Azidiwe University and University of Nigeria.

Oxygenation is key to keep the tissues healthy, the researchers say. We already know that exercise enhances blood circulation and improves vascular blood perfusion and capillary oxygen tension. However, little research has associated increased vascular blood perfusion with wound healing in diabetic foot ulcers, the researchers say. They reanalyzed results from 1 of their earlier studies to find out whether aerobic exercise would lead to healing.

In a 12-week program, 61 patients with type 1 or 2 diabetes mellitus were randomly assigned to an intervention or control group.  Each patient had had a persistent ulcer of at least 1 cm². The intervention group rode a bicycle ergometer at 60% of their maximum heart rate and progressed to 85%. The researchers tested them for oxygen percentage saturation and ankle brachial index (ABI) at baseline every 2 weeks.

At the end of the program, the researchers found a “sharp contrast” between the 2 groups, including a significant difference in the oxygen percentage saturation (99.00 vs 97.20) and the ABI. The reduction in wound size was also significant for the exercise group.

There is evidence, the researchers say, that exercise enhances blood circulation by lowering plasma glucose concentration. Normally, endothelial cells metabolize the circulating blood glucose—unless they are overwhelmed by glucose molecules during hyperglycemia. Previously, the researchers also noted that plasma glucose dropped significantly, mostly at the end of the fourth week of the exercise program.

In this study, increases in ABIs, the researchers say, imply enhanced oxygen supply to the extremities. During the fourth week, they found greater wound size reductions and the ABI significantly correlated with oxygen percentage saturation. The ankle brachial index may be a useful tool, the researchers suggest, for predicting improvement in oxygen percentage saturation.

The researchers’ findings lead them to recommend that nonweight bearing exercise be made a “cornerstone” of management for people with diabetic foot ulcers.

Source:

Nwankwo MJ, Okoye GC, Victor EA, Obinna EA.  Int J Diabetes Res. 2014;3(3):41-48.
doi:10.5923/j.diabetes.20140303.03

Foot ulcers are a common complication of diabetes, due to macro- and microvascular changes that lead to neuropathy. But despite treatment with standard interventions such as debridement and pressure relief, many diabetic foot ulcers persist as nonhealing wounds, say researchers from Nnamdi Azidiwe University and University of Nigeria.

Oxygenation is key to keep the tissues healthy, the researchers say. We already know that exercise enhances blood circulation and improves vascular blood perfusion and capillary oxygen tension. However, little research has associated increased vascular blood perfusion with wound healing in diabetic foot ulcers, the researchers say. They reanalyzed results from 1 of their earlier studies to find out whether aerobic exercise would lead to healing.

In a 12-week program, 61 patients with type 1 or 2 diabetes mellitus were randomly assigned to an intervention or control group.  Each patient had had a persistent ulcer of at least 1 cm². The intervention group rode a bicycle ergometer at 60% of their maximum heart rate and progressed to 85%. The researchers tested them for oxygen percentage saturation and ankle brachial index (ABI) at baseline every 2 weeks.

At the end of the program, the researchers found a “sharp contrast” between the 2 groups, including a significant difference in the oxygen percentage saturation (99.00 vs 97.20) and the ABI. The reduction in wound size was also significant for the exercise group.

There is evidence, the researchers say, that exercise enhances blood circulation by lowering plasma glucose concentration. Normally, endothelial cells metabolize the circulating blood glucose—unless they are overwhelmed by glucose molecules during hyperglycemia. Previously, the researchers also noted that plasma glucose dropped significantly, mostly at the end of the fourth week of the exercise program.

In this study, increases in ABIs, the researchers say, imply enhanced oxygen supply to the extremities. During the fourth week, they found greater wound size reductions and the ABI significantly correlated with oxygen percentage saturation. The ankle brachial index may be a useful tool, the researchers suggest, for predicting improvement in oxygen percentage saturation.

The researchers’ findings lead them to recommend that nonweight bearing exercise be made a “cornerstone” of management for people with diabetic foot ulcers.

Source:

Nwankwo MJ, Okoye GC, Victor EA, Obinna EA.  Int J Diabetes Res. 2014;3(3):41-48.
doi:10.5923/j.diabetes.20140303.03

The HPV vaccine has led to “dramatic declines” in HPV infections, according to the CDC. Since the first HPV vaccine was introduced 10 years ago, the percentage of infections that cause cancers and genital warts has dropped by 71% among teenage girls and 61% among young women. According to the annual National Immunization Survey-Teen report, 60% of teens aged 13 to 17 years received ≥ 1 doses of HPV vaccine in 2016, up 4 percentage points from 2015.  

More boys are getting the vaccine, too. About 56% of boys received their first dose (although that is still less than the 65% seen in girls)—representing a 6% increase from 2015; rates for girls remained stable.

As encouraging as those numbers are, there is more work to do, the CDC says. Although most adolescents have received the first dose, only 43% are up-to-date on all the recommended doses. The CDC recommends that 11- to 12-year-olds get 2 doses of HPV vaccine at least 6 months apart. The CDC updated its HPV vaccine recommendations in 2016 when new evidence showed that 2 doses of the vaccine provided levels of protection similar to those seen for 3 doses in older adolescents and young adults. 

Parents can get the vaccine for their child during any doctor’s visit, but the CDC recommends that adolescents get the HPV vaccine during the same visit that they get whooping cough and meningitis vaccine.

The HPV vaccine has led to “dramatic declines” in HPV infections, according to the CDC. Since the first HPV vaccine was introduced 10 years ago, the percentage of infections that cause cancers and genital warts has dropped by 71% among teenage girls and 61% among young women. According to the annual National Immunization Survey-Teen report, 60% of teens aged 13 to 17 years received ≥ 1 doses of HPV vaccine in 2016, up 4 percentage points from 2015.  

More boys are getting the vaccine, too. About 56% of boys received their first dose (although that is still less than the 65% seen in girls)—representing a 6% increase from 2015; rates for girls remained stable.

As encouraging as those numbers are, there is more work to do, the CDC says. Although most adolescents have received the first dose, only 43% are up-to-date on all the recommended doses. The CDC recommends that 11- to 12-year-olds get 2 doses of HPV vaccine at least 6 months apart. The CDC updated its HPV vaccine recommendations in 2016 when new evidence showed that 2 doses of the vaccine provided levels of protection similar to those seen for 3 doses in older adolescents and young adults. 

Parents can get the vaccine for their child during any doctor’s visit, but the CDC recommends that adolescents get the HPV vaccine during the same visit that they get whooping cough and meningitis vaccine.

The HPV vaccine has led to “dramatic declines” in HPV infections, according to the CDC. Since the first HPV vaccine was introduced 10 years ago, the percentage of infections that cause cancers and genital warts has dropped by 71% among teenage girls and 61% among young women. According to the annual National Immunization Survey-Teen report, 60% of teens aged 13 to 17 years received ≥ 1 doses of HPV vaccine in 2016, up 4 percentage points from 2015.  

More boys are getting the vaccine, too. About 56% of boys received their first dose (although that is still less than the 65% seen in girls)—representing a 6% increase from 2015; rates for girls remained stable.

As encouraging as those numbers are, there is more work to do, the CDC says. Although most adolescents have received the first dose, only 43% are up-to-date on all the recommended doses. The CDC recommends that 11- to 12-year-olds get 2 doses of HPV vaccine at least 6 months apart. The CDC updated its HPV vaccine recommendations in 2016 when new evidence showed that 2 doses of the vaccine provided levels of protection similar to those seen for 3 doses in older adolescents and young adults. 

Parents can get the vaccine for their child during any doctor’s visit, but the CDC recommends that adolescents get the HPV vaccine during the same visit that they get whooping cough and meningitis vaccine.

Smoking and poor nutrition—2 of the leading preventable causes of death—are reciprocally linked in many ways, multiplying the public health challenges. For instance, smokers are less likely to eat healthful foods and food insecurity is independently associated with smoking. Researchers from the University at Albany, State University of New York, who conducted both a health interview survey and a food environment assessment with 1,917 adults, found that each indicator of food distress was significantly associated with current smoking. Respondents who consumed ≤ 1 serving of fruits and vegetables per day had significantly higher odds of current smoking, compared with those who consumed ≥ 5 servings. Similarly, the odds of current smoking were significantly higher among respondents who were food insecure, used a food pantry, and received Supplemental Nutrition Assistance Program benefits. Living in a neighborhood with low access to healthful food doubled the prevalence of smoking.

Respondents shopped for food often at a corner store (convenience store), dollar store, or drug store. That highlights one of the challenges:  All the convenience stores, drug stores, and about 63% of the dollar stores also were tobacco retailers, and nearly all of those had tobacco advertising.

The researchers note that research on the link between smoking and food distress is “limited.” A common explanation for it, they say, is the “opportunity cost” argument. Smokers spend up to 24% of their income on cigarettes—leaving less money for food. Other research also has found that smokers tend to have less appetite than do nonsmokers (smoking may alter hunger-satiety sensation). On the other hand, chronic hunger, imbalanced diet and not having enough money to buy adequate food naturally may cause stress and anxiety and can increase dependence on nicotine. Moreover, food-insecure people may smoke to suppress hunger.

The researchers suggest ways to help solve the problem. One would be to disseminate smoking-related educational materials in food pantries and other community nutrition assistance resources. Another would be to prioritize smoking-cessation interventions for stores in “food deserts.” Only a few policy-based interventions exist, the researchers say. They point to a California city that enacted a citywide “healthy corner store” policy that rewards local small business for offering healthful foods and imposes tobacco-control measures, such as eliminating visible tobacco displays at checkout counters.

Smoking and poor nutrition—2 of the leading preventable causes of death—are reciprocally linked in many ways, multiplying the public health challenges. For instance, smokers are less likely to eat healthful foods and food insecurity is independently associated with smoking. Researchers from the University at Albany, State University of New York, who conducted both a health interview survey and a food environment assessment with 1,917 adults, found that each indicator of food distress was significantly associated with current smoking. Respondents who consumed ≤ 1 serving of fruits and vegetables per day had significantly higher odds of current smoking, compared with those who consumed ≥ 5 servings. Similarly, the odds of current smoking were significantly higher among respondents who were food insecure, used a food pantry, and received Supplemental Nutrition Assistance Program benefits. Living in a neighborhood with low access to healthful food doubled the prevalence of smoking.

Respondents shopped for food often at a corner store (convenience store), dollar store, or drug store. That highlights one of the challenges:  All the convenience stores, drug stores, and about 63% of the dollar stores also were tobacco retailers, and nearly all of those had tobacco advertising.

The researchers note that research on the link between smoking and food distress is “limited.” A common explanation for it, they say, is the “opportunity cost” argument. Smokers spend up to 24% of their income on cigarettes—leaving less money for food. Other research also has found that smokers tend to have less appetite than do nonsmokers (smoking may alter hunger-satiety sensation). On the other hand, chronic hunger, imbalanced diet and not having enough money to buy adequate food naturally may cause stress and anxiety and can increase dependence on nicotine. Moreover, food-insecure people may smoke to suppress hunger.

The researchers suggest ways to help solve the problem. One would be to disseminate smoking-related educational materials in food pantries and other community nutrition assistance resources. Another would be to prioritize smoking-cessation interventions for stores in “food deserts.” Only a few policy-based interventions exist, the researchers say. They point to a California city that enacted a citywide “healthy corner store” policy that rewards local small business for offering healthful foods and imposes tobacco-control measures, such as eliminating visible tobacco displays at checkout counters.

Smoking and poor nutrition—2 of the leading preventable causes of death—are reciprocally linked in many ways, multiplying the public health challenges. For instance, smokers are less likely to eat healthful foods and food insecurity is independently associated with smoking. Researchers from the University at Albany, State University of New York, who conducted both a health interview survey and a food environment assessment with 1,917 adults, found that each indicator of food distress was significantly associated with current smoking. Respondents who consumed ≤ 1 serving of fruits and vegetables per day had significantly higher odds of current smoking, compared with those who consumed ≥ 5 servings. Similarly, the odds of current smoking were significantly higher among respondents who were food insecure, used a food pantry, and received Supplemental Nutrition Assistance Program benefits. Living in a neighborhood with low access to healthful food doubled the prevalence of smoking.

Respondents shopped for food often at a corner store (convenience store), dollar store, or drug store. That highlights one of the challenges:  All the convenience stores, drug stores, and about 63% of the dollar stores also were tobacco retailers, and nearly all of those had tobacco advertising.

The researchers note that research on the link between smoking and food distress is “limited.” A common explanation for it, they say, is the “opportunity cost” argument. Smokers spend up to 24% of their income on cigarettes—leaving less money for food. Other research also has found that smokers tend to have less appetite than do nonsmokers (smoking may alter hunger-satiety sensation). On the other hand, chronic hunger, imbalanced diet and not having enough money to buy adequate food naturally may cause stress and anxiety and can increase dependence on nicotine. Moreover, food-insecure people may smoke to suppress hunger.

The researchers suggest ways to help solve the problem. One would be to disseminate smoking-related educational materials in food pantries and other community nutrition assistance resources. Another would be to prioritize smoking-cessation interventions for stores in “food deserts.” Only a few policy-based interventions exist, the researchers say. They point to a California city that enacted a citywide “healthy corner store” policy that rewards local small business for offering healthful foods and imposes tobacco-control measures, such as eliminating visible tobacco displays at checkout counters.

The Substance Abuse and Mental Health Services Administration (SAMHSA) has announced $80.8 million in grants to treatment drug court programs for people with substance use and mental disorders. “Treatment drug courts improve health and recovery outcomes, reduce the burden on the criminal justice system, and help people recover in their communities,” said Kim Johnson, PhD, director for the Center for Substance Abuse Treatment.

Related: California Opens Treatment Center for Native Youth

The grant programs include $17.8 million per year for up to 3 years to 44 existing Adult Treatment Drug courts and adult Tribal Healing to Wellness courts, which use the treatment drug court model to provide alcohol and drug treatment.

Related: IHS Funds Programs to Protect Native Youth from Substance Abuse

Another $8.2 million per year for up to 5 years will go to 20 programs to expand or enhance substance use disorder treatment services in family treatment drug courts.

The Substance Abuse and Mental Health Services Administration (SAMHSA) has announced $80.8 million in grants to treatment drug court programs for people with substance use and mental disorders. “Treatment drug courts improve health and recovery outcomes, reduce the burden on the criminal justice system, and help people recover in their communities,” said Kim Johnson, PhD, director for the Center for Substance Abuse Treatment.

Related: California Opens Treatment Center for Native Youth

The grant programs include $17.8 million per year for up to 3 years to 44 existing Adult Treatment Drug courts and adult Tribal Healing to Wellness courts, which use the treatment drug court model to provide alcohol and drug treatment.

Related: IHS Funds Programs to Protect Native Youth from Substance Abuse

Another $8.2 million per year for up to 5 years will go to 20 programs to expand or enhance substance use disorder treatment services in family treatment drug courts.

The Substance Abuse and Mental Health Services Administration (SAMHSA) has announced $80.8 million in grants to treatment drug court programs for people with substance use and mental disorders. “Treatment drug courts improve health and recovery outcomes, reduce the burden on the criminal justice system, and help people recover in their communities,” said Kim Johnson, PhD, director for the Center for Substance Abuse Treatment.

Related: California Opens Treatment Center for Native Youth

The grant programs include $17.8 million per year for up to 3 years to 44 existing Adult Treatment Drug courts and adult Tribal Healing to Wellness courts, which use the treatment drug court model to provide alcohol and drug treatment.

Related: IHS Funds Programs to Protect Native Youth from Substance Abuse

Another $8.2 million per year for up to 5 years will go to 20 programs to expand or enhance substance use disorder treatment services in family treatment drug courts.

As diabetes becomes more prevalent, so do eye diseases. The good news is that many patients are aware of the risk. However, they may think that they do not need regular eye checkups. Patient awareness of the value of prevention is a key message in a study by researchers from the University of Lausanne in Switzerland.

In their study of 323 patients, 41% of patients with type 1 diabetes (T1DM) and 10% of those with type 2 diabetes (T2DM) had diabetic retinopathy. One-third of patients had myopia, astigmatism, and other common visual defects, 36% had cataract, and 13% had glaucoma. The patients with T1DM were about 5 times more likely to have more than 3 eye diseases than were those with type 2.

But all patients with T1DM and 95% of those with T2DM knew that diabetes could damage the eyes. Further, the “vast majority” of all the patients knew the benefit of maintaining good glycemic control and getting regular eye examinations by an ophthalmologist. About 91% of patients with T1DM and 85% of patients with T2DM knew that controlling blood pressure and lipids also was important. But one-quarter of the participants thought nothing could be done to prevent diabetic eye diseases—that they were the result of bad luck.

About 71% of the participants were examined by an ophthalmologist in the previous year. Exploring the reasons, the researchers found 3 main barriers: Patients said they had no visual symptoms, they felt they didn’t need an exam because their diabetes was well controlled, or they did not get recommendations from their family physician or diabetologist. The researchers say diabetic retinopathy may be underestimated because some patients are not getting eye exams.

Conversely, the 3 main reasons for regular eye exams, according to patient reports, were that health care professionals recommended them, patients were aware of the importance of regular controls, and they knew the risks of diabetes-related retinal problems.

The researchers say physicians can help by emphasizing that preventive care includes regular eye exams. They also suggest that it may be time to “broaden the diabetes education perspective” and include all significant diabetic eye diseases instead of focusing on diabetic retinopathy.

Source:

 Konstantinidis L, Carron T, de Ancos E, et al. BMC Endocr Disord. 2017;17(1):56.

doi: 10.1186/s12902-017-0206-2.

As diabetes becomes more prevalent, so do eye diseases. The good news is that many patients are aware of the risk. However, they may think that they do not need regular eye checkups. Patient awareness of the value of prevention is a key message in a study by researchers from the University of Lausanne in Switzerland.

In their study of 323 patients, 41% of patients with type 1 diabetes (T1DM) and 10% of those with type 2 diabetes (T2DM) had diabetic retinopathy. One-third of patients had myopia, astigmatism, and other common visual defects, 36% had cataract, and 13% had glaucoma. The patients with T1DM were about 5 times more likely to have more than 3 eye diseases than were those with type 2.

But all patients with T1DM and 95% of those with T2DM knew that diabetes could damage the eyes. Further, the “vast majority” of all the patients knew the benefit of maintaining good glycemic control and getting regular eye examinations by an ophthalmologist. About 91% of patients with T1DM and 85% of patients with T2DM knew that controlling blood pressure and lipids also was important. But one-quarter of the participants thought nothing could be done to prevent diabetic eye diseases—that they were the result of bad luck.

About 71% of the participants were examined by an ophthalmologist in the previous year. Exploring the reasons, the researchers found 3 main barriers: Patients said they had no visual symptoms, they felt they didn’t need an exam because their diabetes was well controlled, or they did not get recommendations from their family physician or diabetologist. The researchers say diabetic retinopathy may be underestimated because some patients are not getting eye exams.

Conversely, the 3 main reasons for regular eye exams, according to patient reports, were that health care professionals recommended them, patients were aware of the importance of regular controls, and they knew the risks of diabetes-related retinal problems.

The researchers say physicians can help by emphasizing that preventive care includes regular eye exams. They also suggest that it may be time to “broaden the diabetes education perspective” and include all significant diabetic eye diseases instead of focusing on diabetic retinopathy.

Source:

 Konstantinidis L, Carron T, de Ancos E, et al. BMC Endocr Disord. 2017;17(1):56.

doi: 10.1186/s12902-017-0206-2.

As diabetes becomes more prevalent, so do eye diseases. The good news is that many patients are aware of the risk. However, they may think that they do not need regular eye checkups. Patient awareness of the value of prevention is a key message in a study by researchers from the University of Lausanne in Switzerland.

In their study of 323 patients, 41% of patients with type 1 diabetes (T1DM) and 10% of those with type 2 diabetes (T2DM) had diabetic retinopathy. One-third of patients had myopia, astigmatism, and other common visual defects, 36% had cataract, and 13% had glaucoma. The patients with T1DM were about 5 times more likely to have more than 3 eye diseases than were those with type 2.

But all patients with T1DM and 95% of those with T2DM knew that diabetes could damage the eyes. Further, the “vast majority” of all the patients knew the benefit of maintaining good glycemic control and getting regular eye examinations by an ophthalmologist. About 91% of patients with T1DM and 85% of patients with T2DM knew that controlling blood pressure and lipids also was important. But one-quarter of the participants thought nothing could be done to prevent diabetic eye diseases—that they were the result of bad luck.

About 71% of the participants were examined by an ophthalmologist in the previous year. Exploring the reasons, the researchers found 3 main barriers: Patients said they had no visual symptoms, they felt they didn’t need an exam because their diabetes was well controlled, or they did not get recommendations from their family physician or diabetologist. The researchers say diabetic retinopathy may be underestimated because some patients are not getting eye exams.

Conversely, the 3 main reasons for regular eye exams, according to patient reports, were that health care professionals recommended them, patients were aware of the importance of regular controls, and they knew the risks of diabetes-related retinal problems.

The researchers say physicians can help by emphasizing that preventive care includes regular eye exams. They also suggest that it may be time to “broaden the diabetes education perspective” and include all significant diabetic eye diseases instead of focusing on diabetic retinopathy.

Source:

 Konstantinidis L, Carron T, de Ancos E, et al. BMC Endocr Disord. 2017;17(1):56.

doi: 10.1186/s12902-017-0206-2.

More people living with HIV have the virus under control, according to the most recent national data. In 2014, CDC researchers say, of the estimated 1.1 million people with HIV in the U.S., 85% were diagnosed and 49% were controlling the virus through HIV treatment. By comparison, in 2010, 83% were diagnosed but only 28% were controlling the virus. The data were released recently in the CDC’s report, Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data.

The CDC says making testing and treatment more available in addition to  updated treatment guidelines released in 2012 that recommended treatment for all people with HIV infection, were “likely major contributors” to driving down annual infections by 18% between 2008-2014.

 In 2014, 37,600 new infections were diagnosed. Of HIV infections diagnosed during 2015, 22% were classified as stage 3 (AIDS), although the percentages had declined from 2010. Nine out of 10 HIV infections are transmitted by people who are not diagnosed or are not in care. Young people are at highest risk. According to the CDC researchers’ estimates, only 56% of people aged 13-24 years with HIV were diagnosed and only 27% had the virus under control.

However, patients are getting appropriate care sooner and more often. Of 28,238 people who were diagnosed during 2015, 75% were linked to HIV medical care within 1 month of diagnosis, and 84% within 3 months.

“The Monitoring Report signals that we are making progress on most of our national HIV prevention, care and treatment goals,” said Richard Wolitski, PhD, director, Office of HIV/AIDS and Infectious Disease Policy in his blog on HIV.gov. “It also shows us where we need to do better and reassess our efforts, diagnose the problems and use this information to make the changes to our policies, programs, and services that are needed to turn the results around.”

More people living with HIV have the virus under control, according to the most recent national data. In 2014, CDC researchers say, of the estimated 1.1 million people with HIV in the U.S., 85% were diagnosed and 49% were controlling the virus through HIV treatment. By comparison, in 2010, 83% were diagnosed but only 28% were controlling the virus. The data were released recently in the CDC’s report, Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data.

The CDC says making testing and treatment more available in addition to  updated treatment guidelines released in 2012 that recommended treatment for all people with HIV infection, were “likely major contributors” to driving down annual infections by 18% between 2008-2014.

 In 2014, 37,600 new infections were diagnosed. Of HIV infections diagnosed during 2015, 22% were classified as stage 3 (AIDS), although the percentages had declined from 2010. Nine out of 10 HIV infections are transmitted by people who are not diagnosed or are not in care. Young people are at highest risk. According to the CDC researchers’ estimates, only 56% of people aged 13-24 years with HIV were diagnosed and only 27% had the virus under control.

However, patients are getting appropriate care sooner and more often. Of 28,238 people who were diagnosed during 2015, 75% were linked to HIV medical care within 1 month of diagnosis, and 84% within 3 months.

“The Monitoring Report signals that we are making progress on most of our national HIV prevention, care and treatment goals,” said Richard Wolitski, PhD, director, Office of HIV/AIDS and Infectious Disease Policy in his blog on HIV.gov. “It also shows us where we need to do better and reassess our efforts, diagnose the problems and use this information to make the changes to our policies, programs, and services that are needed to turn the results around.”

More people living with HIV have the virus under control, according to the most recent national data. In 2014, CDC researchers say, of the estimated 1.1 million people with HIV in the U.S., 85% were diagnosed and 49% were controlling the virus through HIV treatment. By comparison, in 2010, 83% were diagnosed but only 28% were controlling the virus. The data were released recently in the CDC’s report, Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data.

The CDC says making testing and treatment more available in addition to  updated treatment guidelines released in 2012 that recommended treatment for all people with HIV infection, were “likely major contributors” to driving down annual infections by 18% between 2008-2014.

 In 2014, 37,600 new infections were diagnosed. Of HIV infections diagnosed during 2015, 22% were classified as stage 3 (AIDS), although the percentages had declined from 2010. Nine out of 10 HIV infections are transmitted by people who are not diagnosed or are not in care. Young people are at highest risk. According to the CDC researchers’ estimates, only 56% of people aged 13-24 years with HIV were diagnosed and only 27% had the virus under control.

However, patients are getting appropriate care sooner and more often. Of 28,238 people who were diagnosed during 2015, 75% were linked to HIV medical care within 1 month of diagnosis, and 84% within 3 months.

“The Monitoring Report signals that we are making progress on most of our national HIV prevention, care and treatment goals,” said Richard Wolitski, PhD, director, Office of HIV/AIDS and Infectious Disease Policy in his blog on HIV.gov. “It also shows us where we need to do better and reassess our efforts, diagnose the problems and use this information to make the changes to our policies, programs, and services that are needed to turn the results around.”

A treatment for cancer is finding a new purpose in treating another life-threatening condition. The FDA expanded approval of Ibrutinib for treatment of adults with chronic graft versus host disease (cGVHD) after ≥ 1 treatments have failed. Ibrutinib was previously approved for certain indications in treating chronic lymphocytic leukemia, Waldenström macroglobulinemia, and marginal zone lymphoma.

An estimated 30% to 70% of patients who receive hematopoietic stem cell transplantation for blood or bone marrow cancer develop cGVHD.

Ibrutinib , a kinase inhibitor, was tested in a single-arm trial of 42 patients with cGVHD. Most had mouth ulcers and skin rashes; > 50% had ≥ 2 organs affected. Their symptoms had persisted despite standard treatment with corticosteroids. In the study, cGVHD symptoms improved in 67%. For nearly half (48%), the improvements lasted for 5 months or longer.

Common adverse effects include fatigue, bruising, diarrhea, and thrombocytopenia. Serious adverse effects include severe bleeding, infections, and cytopenia.

A treatment for cancer is finding a new purpose in treating another life-threatening condition. The FDA expanded approval of Ibrutinib for treatment of adults with chronic graft versus host disease (cGVHD) after ≥ 1 treatments have failed. Ibrutinib was previously approved for certain indications in treating chronic lymphocytic leukemia, Waldenström macroglobulinemia, and marginal zone lymphoma.

An estimated 30% to 70% of patients who receive hematopoietic stem cell transplantation for blood or bone marrow cancer develop cGVHD.

Ibrutinib , a kinase inhibitor, was tested in a single-arm trial of 42 patients with cGVHD. Most had mouth ulcers and skin rashes; > 50% had ≥ 2 organs affected. Their symptoms had persisted despite standard treatment with corticosteroids. In the study, cGVHD symptoms improved in 67%. For nearly half (48%), the improvements lasted for 5 months or longer.

Common adverse effects include fatigue, bruising, diarrhea, and thrombocytopenia. Serious adverse effects include severe bleeding, infections, and cytopenia.

A treatment for cancer is finding a new purpose in treating another life-threatening condition. The FDA expanded approval of Ibrutinib for treatment of adults with chronic graft versus host disease (cGVHD) after ≥ 1 treatments have failed. Ibrutinib was previously approved for certain indications in treating chronic lymphocytic leukemia, Waldenström macroglobulinemia, and marginal zone lymphoma.

An estimated 30% to 70% of patients who receive hematopoietic stem cell transplantation for blood or bone marrow cancer develop cGVHD.

Ibrutinib , a kinase inhibitor, was tested in a single-arm trial of 42 patients with cGVHD. Most had mouth ulcers and skin rashes; > 50% had ≥ 2 organs affected. Their symptoms had persisted despite standard treatment with corticosteroids. In the study, cGVHD symptoms improved in 67%. For nearly half (48%), the improvements lasted for 5 months or longer.

Common adverse effects include fatigue, bruising, diarrhea, and thrombocytopenia. Serious adverse effects include severe bleeding, infections, and cytopenia.