Katie Lennon

Three professional societies have published an overview of their opinions on the circumstances under which it is most appropriate to use percutaneous left atrial appendage (LAA) occlusion devices.

In the statement, the American College of Cardiology, Heart Rhythm Society, and Society for Cardiovascular Angiography and Interventions provide their takes on the efficacy of various percutaneous LAA occlusion devices at reducing stroke risk and provide recommendations on when and how to use such devices.

For example, the overview includes criteria for those evaluating the appropriateness of using one of the devices on a particular patient and for those performing an LAA occlusion procedure. It additionally describes where to perform the procedures and what the societies consider to be the necessary protocols for care.

The statement also calls for the creation of various guidelines, asserting that professional societies have a responsibility “to set minimal performance standards for LAA procedures, develop training curriculum, and establish the metrics for evaluation,” and that “specific recommendations for training in LAA occlusion need to developed.”

Additionally, the societies recommend that data on the outcomes of using all LAA occlusion devices be collected and recorded in an existing registry or new registry similar to the transcatheter valve therapy registry.

“This document highlights the critical issues surrounding left atrial appendage occlusion therapies,” said Dr. Frederick A. Masoudi, professor of medicine at the University of Colorado in Denver and chair of the writing committee. “We aimed to facilitate the alignment among patients and their families, primary care physicians, general cardiologists, and additional heart team members and procedural specialists.”

Read the full paper at J. Am. Coll. Cardiol. 2015 [doi:10.1016/j.jacc.2015.06.028].

[email protected]

Three professional societies have published an overview of their opinions on the circumstances under which it is most appropriate to use percutaneous left atrial appendage (LAA) occlusion devices.

In the statement, the American College of Cardiology, Heart Rhythm Society, and Society for Cardiovascular Angiography and Interventions provide their takes on the efficacy of various percutaneous LAA occlusion devices at reducing stroke risk and provide recommendations on when and how to use such devices.

For example, the overview includes criteria for those evaluating the appropriateness of using one of the devices on a particular patient and for those performing an LAA occlusion procedure. It additionally describes where to perform the procedures and what the societies consider to be the necessary protocols for care.

The statement also calls for the creation of various guidelines, asserting that professional societies have a responsibility “to set minimal performance standards for LAA procedures, develop training curriculum, and establish the metrics for evaluation,” and that “specific recommendations for training in LAA occlusion need to developed.”

Additionally, the societies recommend that data on the outcomes of using all LAA occlusion devices be collected and recorded in an existing registry or new registry similar to the transcatheter valve therapy registry.

“This document highlights the critical issues surrounding left atrial appendage occlusion therapies,” said Dr. Frederick A. Masoudi, professor of medicine at the University of Colorado in Denver and chair of the writing committee. “We aimed to facilitate the alignment among patients and their families, primary care physicians, general cardiologists, and additional heart team members and procedural specialists.”

Read the full paper at J. Am. Coll. Cardiol. 2015 [doi:10.1016/j.jacc.2015.06.028].

[email protected]

Three professional societies have published an overview of their opinions on the circumstances under which it is most appropriate to use percutaneous left atrial appendage (LAA) occlusion devices.

In the statement, the American College of Cardiology, Heart Rhythm Society, and Society for Cardiovascular Angiography and Interventions provide their takes on the efficacy of various percutaneous LAA occlusion devices at reducing stroke risk and provide recommendations on when and how to use such devices.

For example, the overview includes criteria for those evaluating the appropriateness of using one of the devices on a particular patient and for those performing an LAA occlusion procedure. It additionally describes where to perform the procedures and what the societies consider to be the necessary protocols for care.

The statement also calls for the creation of various guidelines, asserting that professional societies have a responsibility “to set minimal performance standards for LAA procedures, develop training curriculum, and establish the metrics for evaluation,” and that “specific recommendations for training in LAA occlusion need to developed.”

Additionally, the societies recommend that data on the outcomes of using all LAA occlusion devices be collected and recorded in an existing registry or new registry similar to the transcatheter valve therapy registry.

“This document highlights the critical issues surrounding left atrial appendage occlusion therapies,” said Dr. Frederick A. Masoudi, professor of medicine at the University of Colorado in Denver and chair of the writing committee. “We aimed to facilitate the alignment among patients and their families, primary care physicians, general cardiologists, and additional heart team members and procedural specialists.”

Read the full paper at J. Am. Coll. Cardiol. 2015 [doi:10.1016/j.jacc.2015.06.028].

[email protected]

The St. Jude Lifetime Cohort study found obesity in a higher percentage of adult survivors of childhood cancer than previous studies.

Thirty-six percent of the research project’s 1,996 participants were obese, which the study defined as having a body mass index (BMI) of greater than or equal to 30 kg/m². All of the study’s participants previously had received treatment for cancer at St. Jude Children’s Research Hospital, Memphis, Tenn., and had been cancer survivors for at least 10 years.

The prevalence of obesity was even higher in the subset of the sample that had been treated with cranial radiation (CRT). Forty-five percent of such survivors were obese, compared to 29.4% of the study’s participants, who had not been exposed to CRT. Another finding specific to the cancer survivors that had received CRT were associations between obesity, and variations in the regions in and around the genes FAM155A, GLRA3, CDH18, and SOX11.

“Because both CDH18 and SOX11 appear to influence neuronal growth, repair, and connectivity, these genes may be important regulators of neuronal response to radiation-induced damage among CCS,” according to Carmen L. Wilson, Ph.D., and her colleagues. They added that single nucleotide polymorphisms in such genes could alter obesity risk but said more research needs to be conducted to confirm this.

Among the study’s other findings were that older age at evaluation, previous treatment with CRT, and glucocorticoid exposures were independently associated with obesity. Chest, abdominal, or pelvic, radiation exposure, in contrast, were negatively correlated with having a BMI at or above 30 kg/m².

The study has confirmed that “the high prevalence of obesity among [survivors of childhood cancer] persists decades after cancer treatment and appears to be influenced by therapies received during childhood and obesity status at diagnosis,” according to the researchers.

Read the full study in Cancer (doi: 10.10002/cncr.29153).

The St. Jude Lifetime Cohort study found obesity in a higher percentage of adult survivors of childhood cancer than previous studies.

Thirty-six percent of the research project’s 1,996 participants were obese, which the study defined as having a body mass index (BMI) of greater than or equal to 30 kg/m². All of the study’s participants previously had received treatment for cancer at St. Jude Children’s Research Hospital, Memphis, Tenn., and had been cancer survivors for at least 10 years.

The prevalence of obesity was even higher in the subset of the sample that had been treated with cranial radiation (CRT). Forty-five percent of such survivors were obese, compared to 29.4% of the study’s participants, who had not been exposed to CRT. Another finding specific to the cancer survivors that had received CRT were associations between obesity, and variations in the regions in and around the genes FAM155A, GLRA3, CDH18, and SOX11.

“Because both CDH18 and SOX11 appear to influence neuronal growth, repair, and connectivity, these genes may be important regulators of neuronal response to radiation-induced damage among CCS,” according to Carmen L. Wilson, Ph.D., and her colleagues. They added that single nucleotide polymorphisms in such genes could alter obesity risk but said more research needs to be conducted to confirm this.

Among the study’s other findings were that older age at evaluation, previous treatment with CRT, and glucocorticoid exposures were independently associated with obesity. Chest, abdominal, or pelvic, radiation exposure, in contrast, were negatively correlated with having a BMI at or above 30 kg/m².

The study has confirmed that “the high prevalence of obesity among [survivors of childhood cancer] persists decades after cancer treatment and appears to be influenced by therapies received during childhood and obesity status at diagnosis,” according to the researchers.

Read the full study in Cancer (doi: 10.10002/cncr.29153).

The St. Jude Lifetime Cohort study found obesity in a higher percentage of adult survivors of childhood cancer than previous studies.

Thirty-six percent of the research project’s 1,996 participants were obese, which the study defined as having a body mass index (BMI) of greater than or equal to 30 kg/m². All of the study’s participants previously had received treatment for cancer at St. Jude Children’s Research Hospital, Memphis, Tenn., and had been cancer survivors for at least 10 years.

The prevalence of obesity was even higher in the subset of the sample that had been treated with cranial radiation (CRT). Forty-five percent of such survivors were obese, compared to 29.4% of the study’s participants, who had not been exposed to CRT. Another finding specific to the cancer survivors that had received CRT were associations between obesity, and variations in the regions in and around the genes FAM155A, GLRA3, CDH18, and SOX11.

“Because both CDH18 and SOX11 appear to influence neuronal growth, repair, and connectivity, these genes may be important regulators of neuronal response to radiation-induced damage among CCS,” according to Carmen L. Wilson, Ph.D., and her colleagues. They added that single nucleotide polymorphisms in such genes could alter obesity risk but said more research needs to be conducted to confirm this.

Among the study’s other findings were that older age at evaluation, previous treatment with CRT, and glucocorticoid exposures were independently associated with obesity. Chest, abdominal, or pelvic, radiation exposure, in contrast, were negatively correlated with having a BMI at or above 30 kg/m².

The study has confirmed that “the high prevalence of obesity among [survivors of childhood cancer] persists decades after cancer treatment and appears to be influenced by therapies received during childhood and obesity status at diagnosis,” according to the researchers.

Read the full study in Cancer (doi: 10.10002/cncr.29153).

Higher-than-normal body mass index and inflammation in late adolescence may be associated with colorectal cancer risk, a cohort study of 239,658 Swedish men showed.

The study’s results suggest that body mass index (BMI) and inflammation in early life may be important to the development of colorectal cancer (CRC), said Dr. Elizabeth D. Kantor and her colleagues.

The study’s participants, who were all between the ages of 16 and 20, were drawn from a cohort of men who underwent a compulsory conscription assessment for the Swedish military between 1969 and 1976 – when only men with severe disability or chronic diseases were exempt from serving in the military.

During the assessments, each young man’s height and weight was measured, which the study’s researchers used to calculate BMIs in kg/m² for the sample. The BMIs were categorized in the following ways: 15 to <18.5 was underweight, 18.5 to <25 was normal, 25 to <27.5 was the lower category of overweight, 27.5 to <30 was the upper category of overweight, and 30 to <55 was obese. Venous blood samples of the entire cohort were also collected during the assessment. These were used to assess inflammation levels as indicated by erythrocyte sedimentation rate (ESR), a nonspecific biomarker of inflammation. The researchers classified each study participant’s ESR as low, moderate, or high. The researchers tracked the incidences of malignant CRC in the cohort for an average of 35 years using the Swedish Cancer Registry. Men who had been categorized as being in the upper category of overweight at the time of assessment were 2.08 times more likely to get CRC than normal weight men; obese men were 2.38 times more likely to get the disease. Both of these findings were statistically significant. The researchers also determined that a high ESR was associated with a significant 63% increased risk of CRC, using a multivariable adjustment.

“While no other studies have directly addressed the association between early-life inflammation and CRC risk, evidence supports the role of inflammation early in carcinogenesis,” the researchers wrote.Another novelty of this study is that adolescents’ BMIs were measured instead of being based on recall, as they had been in other researchers’ attempts to determine the relationship between adolescent BMI and CRC risk in adulthood.

“With additional follow-up, and therefore, statistical power, future studies may address how adolescent inflammation and BMI interact to affect cancer risk. Further research is needed to better disentangle BMI and inflammation from associated exposures, and similarly, from exposures at other points in the life coarse,” the researchers wrote.

Read the full study in Gut (doi:10:1136/gutjnl-2014-309007).

[email protected]

Higher-than-normal body mass index and inflammation in late adolescence may be associated with colorectal cancer risk, a cohort study of 239,658 Swedish men showed.

The study’s results suggest that body mass index (BMI) and inflammation in early life may be important to the development of colorectal cancer (CRC), said Dr. Elizabeth D. Kantor and her colleagues.

The study’s participants, who were all between the ages of 16 and 20, were drawn from a cohort of men who underwent a compulsory conscription assessment for the Swedish military between 1969 and 1976 – when only men with severe disability or chronic diseases were exempt from serving in the military.

During the assessments, each young man’s height and weight was measured, which the study’s researchers used to calculate BMIs in kg/m² for the sample. The BMIs were categorized in the following ways: 15 to <18.5 was underweight, 18.5 to <25 was normal, 25 to <27.5 was the lower category of overweight, 27.5 to <30 was the upper category of overweight, and 30 to <55 was obese. Venous blood samples of the entire cohort were also collected during the assessment. These were used to assess inflammation levels as indicated by erythrocyte sedimentation rate (ESR), a nonspecific biomarker of inflammation. The researchers classified each study participant’s ESR as low, moderate, or high. The researchers tracked the incidences of malignant CRC in the cohort for an average of 35 years using the Swedish Cancer Registry. Men who had been categorized as being in the upper category of overweight at the time of assessment were 2.08 times more likely to get CRC than normal weight men; obese men were 2.38 times more likely to get the disease. Both of these findings were statistically significant. The researchers also determined that a high ESR was associated with a significant 63% increased risk of CRC, using a multivariable adjustment.

“While no other studies have directly addressed the association between early-life inflammation and CRC risk, evidence supports the role of inflammation early in carcinogenesis,” the researchers wrote.Another novelty of this study is that adolescents’ BMIs were measured instead of being based on recall, as they had been in other researchers’ attempts to determine the relationship between adolescent BMI and CRC risk in adulthood.

“With additional follow-up, and therefore, statistical power, future studies may address how adolescent inflammation and BMI interact to affect cancer risk. Further research is needed to better disentangle BMI and inflammation from associated exposures, and similarly, from exposures at other points in the life coarse,” the researchers wrote.

Read the full study in Gut (doi:10:1136/gutjnl-2014-309007).

[email protected]

Higher-than-normal body mass index and inflammation in late adolescence may be associated with colorectal cancer risk, a cohort study of 239,658 Swedish men showed.

The study’s results suggest that body mass index (BMI) and inflammation in early life may be important to the development of colorectal cancer (CRC), said Dr. Elizabeth D. Kantor and her colleagues.

The study’s participants, who were all between the ages of 16 and 20, were drawn from a cohort of men who underwent a compulsory conscription assessment for the Swedish military between 1969 and 1976 – when only men with severe disability or chronic diseases were exempt from serving in the military.

During the assessments, each young man’s height and weight was measured, which the study’s researchers used to calculate BMIs in kg/m² for the sample. The BMIs were categorized in the following ways: 15 to <18.5 was underweight, 18.5 to <25 was normal, 25 to <27.5 was the lower category of overweight, 27.5 to <30 was the upper category of overweight, and 30 to <55 was obese. Venous blood samples of the entire cohort were also collected during the assessment. These were used to assess inflammation levels as indicated by erythrocyte sedimentation rate (ESR), a nonspecific biomarker of inflammation. The researchers classified each study participant’s ESR as low, moderate, or high. The researchers tracked the incidences of malignant CRC in the cohort for an average of 35 years using the Swedish Cancer Registry. Men who had been categorized as being in the upper category of overweight at the time of assessment were 2.08 times more likely to get CRC than normal weight men; obese men were 2.38 times more likely to get the disease. Both of these findings were statistically significant. The researchers also determined that a high ESR was associated with a significant 63% increased risk of CRC, using a multivariable adjustment.

“While no other studies have directly addressed the association between early-life inflammation and CRC risk, evidence supports the role of inflammation early in carcinogenesis,” the researchers wrote.Another novelty of this study is that adolescents’ BMIs were measured instead of being based on recall, as they had been in other researchers’ attempts to determine the relationship between adolescent BMI and CRC risk in adulthood.

“With additional follow-up, and therefore, statistical power, future studies may address how adolescent inflammation and BMI interact to affect cancer risk. Further research is needed to better disentangle BMI and inflammation from associated exposures, and similarly, from exposures at other points in the life coarse,” the researchers wrote.

Read the full study in Gut (doi:10:1136/gutjnl-2014-309007).

[email protected]

Both the incidence of bipolar disorder and the standardized mortality ratio of patients with bipolar disorder, compared with the general population, significantly increased, according to a Danish cohort study.

The study was of 15,334 patients with a first-ever diagnosis of bipolar disorder, according to the International Classification of Diseases (ICD)-10 criteria, between Jan. 1, 1995, and Dec. 31, 2012. Patients were followed until Dec. 31, 2012, or death, whichever came first. Data came from the Danish Psychiatric Central Research Register, a national electronic registry containing all psychiatric hospitalizations since 1969 and all psychiatric outpatient contacts and emergency room visits since 1995. Those diagnosed with schizophrenia subsequent to being diagnosed with bipolar disorder and patients who received one of several specific ICD-8 diagnoses before 1995 (when the ICD-8 was in use) were excluded.

Bipolar disorder became significantly more common, especially throughout the 2000s. The total incidence rate was 18.5/100,000 person-years (PY) in 1995 and, at its lowest, was 14.8/100,000 PY in 1997. The most recent and highest incidence of the disorder was 28.4/100,000 PY in 2012. Such findings represent a higher incidence of bipolar disorder than was found in studies conducted in England during the same period, according to Clara Reece Medici of Aarhus University Hospital, in Risskov, Denmark, and her colleagues.

Significantly more females than males were diagnosed with bipolar disorder, with 9,132 females and 6,202 males having suffered from the disease.

Mortality in patients with bipolar disorder was higher, compared with the general population, with the mean standardized mortality ratio (SMR) for patients with bipolar disorder vs. the general population having been 1.7. Deaths of the bipolar patients were mostly tied to natural causes, but as many as 9% of the bipolar patients committed suicide.

Another of the study’s findings was that age at diagnosis of bipolar disorder decreased by more than 10 years, with the average age at diagnosis having been 54.5 in 1995, compared with 42.4 in 2012. The researchers said increased awareness among clinicians may explain this, but that they will test whether “increased use of antidepressants and medication against [attention-deficit/hyperactivity disorder] in Denmark in the same time period may have contributed to unmasking a latent bipolar episode earlier.”

According to the researchers, “studies on lowering physical illlness in patients with bipolar disorder are needed to lower death by natural causes.”

Read the full study in the Journal of Affective Disorders (doi:http://dx.doi.org/10.1016/j.jad.2015.04.032).

[email protected]

Both the incidence of bipolar disorder and the standardized mortality ratio of patients with bipolar disorder, compared with the general population, significantly increased, according to a Danish cohort study.

The study was of 15,334 patients with a first-ever diagnosis of bipolar disorder, according to the International Classification of Diseases (ICD)-10 criteria, between Jan. 1, 1995, and Dec. 31, 2012. Patients were followed until Dec. 31, 2012, or death, whichever came first. Data came from the Danish Psychiatric Central Research Register, a national electronic registry containing all psychiatric hospitalizations since 1969 and all psychiatric outpatient contacts and emergency room visits since 1995. Those diagnosed with schizophrenia subsequent to being diagnosed with bipolar disorder and patients who received one of several specific ICD-8 diagnoses before 1995 (when the ICD-8 was in use) were excluded.

Bipolar disorder became significantly more common, especially throughout the 2000s. The total incidence rate was 18.5/100,000 person-years (PY) in 1995 and, at its lowest, was 14.8/100,000 PY in 1997. The most recent and highest incidence of the disorder was 28.4/100,000 PY in 2012. Such findings represent a higher incidence of bipolar disorder than was found in studies conducted in England during the same period, according to Clara Reece Medici of Aarhus University Hospital, in Risskov, Denmark, and her colleagues.

Significantly more females than males were diagnosed with bipolar disorder, with 9,132 females and 6,202 males having suffered from the disease.

Mortality in patients with bipolar disorder was higher, compared with the general population, with the mean standardized mortality ratio (SMR) for patients with bipolar disorder vs. the general population having been 1.7. Deaths of the bipolar patients were mostly tied to natural causes, but as many as 9% of the bipolar patients committed suicide.

Another of the study’s findings was that age at diagnosis of bipolar disorder decreased by more than 10 years, with the average age at diagnosis having been 54.5 in 1995, compared with 42.4 in 2012. The researchers said increased awareness among clinicians may explain this, but that they will test whether “increased use of antidepressants and medication against [attention-deficit/hyperactivity disorder] in Denmark in the same time period may have contributed to unmasking a latent bipolar episode earlier.”

According to the researchers, “studies on lowering physical illlness in patients with bipolar disorder are needed to lower death by natural causes.”

Read the full study in the Journal of Affective Disorders (doi:http://dx.doi.org/10.1016/j.jad.2015.04.032).

[email protected]

Both the incidence of bipolar disorder and the standardized mortality ratio of patients with bipolar disorder, compared with the general population, significantly increased, according to a Danish cohort study.

The study was of 15,334 patients with a first-ever diagnosis of bipolar disorder, according to the International Classification of Diseases (ICD)-10 criteria, between Jan. 1, 1995, and Dec. 31, 2012. Patients were followed until Dec. 31, 2012, or death, whichever came first. Data came from the Danish Psychiatric Central Research Register, a national electronic registry containing all psychiatric hospitalizations since 1969 and all psychiatric outpatient contacts and emergency room visits since 1995. Those diagnosed with schizophrenia subsequent to being diagnosed with bipolar disorder and patients who received one of several specific ICD-8 diagnoses before 1995 (when the ICD-8 was in use) were excluded.

Bipolar disorder became significantly more common, especially throughout the 2000s. The total incidence rate was 18.5/100,000 person-years (PY) in 1995 and, at its lowest, was 14.8/100,000 PY in 1997. The most recent and highest incidence of the disorder was 28.4/100,000 PY in 2012. Such findings represent a higher incidence of bipolar disorder than was found in studies conducted in England during the same period, according to Clara Reece Medici of Aarhus University Hospital, in Risskov, Denmark, and her colleagues.

Significantly more females than males were diagnosed with bipolar disorder, with 9,132 females and 6,202 males having suffered from the disease.

Mortality in patients with bipolar disorder was higher, compared with the general population, with the mean standardized mortality ratio (SMR) for patients with bipolar disorder vs. the general population having been 1.7. Deaths of the bipolar patients were mostly tied to natural causes, but as many as 9% of the bipolar patients committed suicide.

Another of the study’s findings was that age at diagnosis of bipolar disorder decreased by more than 10 years, with the average age at diagnosis having been 54.5 in 1995, compared with 42.4 in 2012. The researchers said increased awareness among clinicians may explain this, but that they will test whether “increased use of antidepressants and medication against [attention-deficit/hyperactivity disorder] in Denmark in the same time period may have contributed to unmasking a latent bipolar episode earlier.”

According to the researchers, “studies on lowering physical illlness in patients with bipolar disorder are needed to lower death by natural causes.”

Read the full study in the Journal of Affective Disorders (doi:http://dx.doi.org/10.1016/j.jad.2015.04.032).

[email protected]

Years without reports of acute flaccid paralysis – the clinical manifestation of polio – does not mean that the wild poliovirus is gone, according to a new study.

The study of the prevaccination cases of polio in the United States also has debunked the previously held belief that improvements in sanitation and hygiene fueled the spread of the disease after the mid-1940s. Instead, the new research found the surging birth rate of the post-war baby boom to have caused the steep rise in instances of polio.

The study involved the examination of monthly polio case reports that predated the introduction of the polio vaccine. The data came from the U.S. Public Health Service’s Morbidity and Mortality Weekly Reports on the 48 contiguous states and the District of Columbia, dating from January 1931 to December 1954. The number of births by state, beginning at least as early as 1933 from Vital Statistics, and state population sizes from the population distribution branch of the U.S. Census Bureau also were examined. For exploratory analyses, the researchers quantified the relationship between disease fade-outs, which it defined as having at least 3 months without a reported infection, and population size.

The researchers used the polio data to fit and simulate mechanistic transmission models to track poliovirus and reconstruct the millions of unobserved subclinical infections that spread the disease.

“We demonstrate that you can have sustained chains of silent transmission in populations for more than 3 years, without a single person ever showing up as a reported polio case,” Micaela Martinez-Bakker, a graduate research fellow at the University of Michigan, Ann Arbor, said in a statement.

The study showed that widespread polio transmission likely occurred during multiyear periods when no cases of the disease were reported. “We estimate that over 99% of [polio] infections were subclinical, with the reporting of total infections regularly below 1%,” said Ms. Martinez-Bakker and her colleagues. “Importantly, subclinical infections are likely more common today than in the period we studied.”

The researchers advocate for the completion of future studies using similar transmission models on how demographic and environmental factors interact with polio vaccine coverage in endemic countries.

Read the full study in PLOS Biology (2015 June 19 [doi:10.1371/journal.pbio.1002172]).

[email protected]

Years without reports of acute flaccid paralysis – the clinical manifestation of polio – does not mean that the wild poliovirus is gone, according to a new study.

The study of the prevaccination cases of polio in the United States also has debunked the previously held belief that improvements in sanitation and hygiene fueled the spread of the disease after the mid-1940s. Instead, the new research found the surging birth rate of the post-war baby boom to have caused the steep rise in instances of polio.

The study involved the examination of monthly polio case reports that predated the introduction of the polio vaccine. The data came from the U.S. Public Health Service’s Morbidity and Mortality Weekly Reports on the 48 contiguous states and the District of Columbia, dating from January 1931 to December 1954. The number of births by state, beginning at least as early as 1933 from Vital Statistics, and state population sizes from the population distribution branch of the U.S. Census Bureau also were examined. For exploratory analyses, the researchers quantified the relationship between disease fade-outs, which it defined as having at least 3 months without a reported infection, and population size.

The researchers used the polio data to fit and simulate mechanistic transmission models to track poliovirus and reconstruct the millions of unobserved subclinical infections that spread the disease.

“We demonstrate that you can have sustained chains of silent transmission in populations for more than 3 years, without a single person ever showing up as a reported polio case,” Micaela Martinez-Bakker, a graduate research fellow at the University of Michigan, Ann Arbor, said in a statement.

The study showed that widespread polio transmission likely occurred during multiyear periods when no cases of the disease were reported. “We estimate that over 99% of [polio] infections were subclinical, with the reporting of total infections regularly below 1%,” said Ms. Martinez-Bakker and her colleagues. “Importantly, subclinical infections are likely more common today than in the period we studied.”

The researchers advocate for the completion of future studies using similar transmission models on how demographic and environmental factors interact with polio vaccine coverage in endemic countries.

Read the full study in PLOS Biology (2015 June 19 [doi:10.1371/journal.pbio.1002172]).

[email protected]

Years without reports of acute flaccid paralysis – the clinical manifestation of polio – does not mean that the wild poliovirus is gone, according to a new study.

The study of the prevaccination cases of polio in the United States also has debunked the previously held belief that improvements in sanitation and hygiene fueled the spread of the disease after the mid-1940s. Instead, the new research found the surging birth rate of the post-war baby boom to have caused the steep rise in instances of polio.

The study involved the examination of monthly polio case reports that predated the introduction of the polio vaccine. The data came from the U.S. Public Health Service’s Morbidity and Mortality Weekly Reports on the 48 contiguous states and the District of Columbia, dating from January 1931 to December 1954. The number of births by state, beginning at least as early as 1933 from Vital Statistics, and state population sizes from the population distribution branch of the U.S. Census Bureau also were examined. For exploratory analyses, the researchers quantified the relationship between disease fade-outs, which it defined as having at least 3 months without a reported infection, and population size.

The researchers used the polio data to fit and simulate mechanistic transmission models to track poliovirus and reconstruct the millions of unobserved subclinical infections that spread the disease.

“We demonstrate that you can have sustained chains of silent transmission in populations for more than 3 years, without a single person ever showing up as a reported polio case,” Micaela Martinez-Bakker, a graduate research fellow at the University of Michigan, Ann Arbor, said in a statement.

The study showed that widespread polio transmission likely occurred during multiyear periods when no cases of the disease were reported. “We estimate that over 99% of [polio] infections were subclinical, with the reporting of total infections regularly below 1%,” said Ms. Martinez-Bakker and her colleagues. “Importantly, subclinical infections are likely more common today than in the period we studied.”

The researchers advocate for the completion of future studies using similar transmission models on how demographic and environmental factors interact with polio vaccine coverage in endemic countries.

Read the full study in PLOS Biology (2015 June 19 [doi:10.1371/journal.pbio.1002172]).

[email protected]

Food manufacturers will no longer be allowed to include partially hydrogenated oils (PHOs) in human food when a new requirement by the Food and Drug Administration becomes effective.

The FDA finalized its determination that PHOs, which are the primary dietary source of artificial trans fat in processed foods, are not “generally recognized as safe” for use in human food. This action was preceded by the FDA having requested comment on a tentative version of the determination in a Nov. 8, 2013 notice.

©Mark Poprocki/Thinkstockphotos.com

“This determination is based on extensive research into the effects of PHOs, as well as input from all stakeholders received during the public comment period,” said Susan Mayne, Ph.D., director of the FDA’s Center for Food Safety and Applied Nutrition, in a written statement.

The order follows the FDA’s requirement that food manufacturers include trans fat content information on nutrition facts labels, which became effective in 2006. Currently, the FDA allows companies to state on the labels of foods containing less than 0.5 grams of trans fat per serving that such foods are made with 0 grams of trans fat.

The FDA’s new requirement “is expected to reduce coronary heart disease and prevent thousands of fatal heart attacks every year,” said the FDA’s Acting Commissioner Stephen Ostroff in the written statement.

The agency is giving food producers 3 years to remove PHOs from their products and/or petition the FDA to permit specific uses of PHOs. A notice of the order is scheduled to be published in the Federal Register tomorrow (June 17, 2015).

[email protected]

Food manufacturers will no longer be allowed to include partially hydrogenated oils (PHOs) in human food when a new requirement by the Food and Drug Administration becomes effective.

The FDA finalized its determination that PHOs, which are the primary dietary source of artificial trans fat in processed foods, are not “generally recognized as safe” for use in human food. This action was preceded by the FDA having requested comment on a tentative version of the determination in a Nov. 8, 2013 notice.

©Mark Poprocki/Thinkstockphotos.com

“This determination is based on extensive research into the effects of PHOs, as well as input from all stakeholders received during the public comment period,” said Susan Mayne, Ph.D., director of the FDA’s Center for Food Safety and Applied Nutrition, in a written statement.

The order follows the FDA’s requirement that food manufacturers include trans fat content information on nutrition facts labels, which became effective in 2006. Currently, the FDA allows companies to state on the labels of foods containing less than 0.5 grams of trans fat per serving that such foods are made with 0 grams of trans fat.

The FDA’s new requirement “is expected to reduce coronary heart disease and prevent thousands of fatal heart attacks every year,” said the FDA’s Acting Commissioner Stephen Ostroff in the written statement.

The agency is giving food producers 3 years to remove PHOs from their products and/or petition the FDA to permit specific uses of PHOs. A notice of the order is scheduled to be published in the Federal Register tomorrow (June 17, 2015).

[email protected]

Food manufacturers will no longer be allowed to include partially hydrogenated oils (PHOs) in human food when a new requirement by the Food and Drug Administration becomes effective.

The FDA finalized its determination that PHOs, which are the primary dietary source of artificial trans fat in processed foods, are not “generally recognized as safe” for use in human food. This action was preceded by the FDA having requested comment on a tentative version of the determination in a Nov. 8, 2013 notice.

©Mark Poprocki/Thinkstockphotos.com

“This determination is based on extensive research into the effects of PHOs, as well as input from all stakeholders received during the public comment period,” said Susan Mayne, Ph.D., director of the FDA’s Center for Food Safety and Applied Nutrition, in a written statement.

The order follows the FDA’s requirement that food manufacturers include trans fat content information on nutrition facts labels, which became effective in 2006. Currently, the FDA allows companies to state on the labels of foods containing less than 0.5 grams of trans fat per serving that such foods are made with 0 grams of trans fat.

The FDA’s new requirement “is expected to reduce coronary heart disease and prevent thousands of fatal heart attacks every year,” said the FDA’s Acting Commissioner Stephen Ostroff in the written statement.

The agency is giving food producers 3 years to remove PHOs from their products and/or petition the FDA to permit specific uses of PHOs. A notice of the order is scheduled to be published in the Federal Register tomorrow (June 17, 2015).

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Marijuana use was higher in states that legalized treatment of medical conditions with marijuana, but the increased use was present both before and after such laws were passed, according to annual, repeated cross-sectional surveys.

“[T]he overall effect of medical marijuana laws on adolescent use before versus after passage of the law remained nonsignificant, although (as for the overall results), use was significantly reduced in 8th- but not for 10th- or 12th-graders,” noted Dr. Deborah S. Hasin, professor of epidemiology (in psychiatry) at Columbia University Medical Center, New York, and her colleagues.

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The findings were based on responses to surveys from 1,098,270 students in the 8th, 10th, and 12th grades between 1991 and 2014. Respondents were from the 48 contiguous states, 21 of which had passed medical marijuana laws by 2014. Mean response rates for 1991-2013 were 81%-91% for almost all years and grades.

Students were asked if they had used marijuana in the previous 30 days; 15.87% of them said they had, in states that had passed a medical marijuana law between 1991 and 2014. In states that had not passed that type of a law, the prevalence of marijuana use was 13.27%.

The study showed no evidence for an increase in adolescent use of marijuana in the year of passage of a medical marijuana law, or in the first or second years after passage.

Prior to passage of a law permitting the use of marijuana for medicinal purposes, 16.25% of the survey’s participants said they had used marijuana within the previous 30 days. Following such legislative changes, the prevalence of use was 15.45%.

“Our two main findings, in conjunction with other evidence, suggest that state-level factors other than medical marijuana laws influence adolescent marijuana use,” the researchers wrote.

Dr. Hasin and her colleagues declared no conflicts of interest.

Read the full study here.

Marijuana use was higher in states that legalized treatment of medical conditions with marijuana, but the increased use was present both before and after such laws were passed, according to annual, repeated cross-sectional surveys.

“[T]he overall effect of medical marijuana laws on adolescent use before versus after passage of the law remained nonsignificant, although (as for the overall results), use was significantly reduced in 8th- but not for 10th- or 12th-graders,” noted Dr. Deborah S. Hasin, professor of epidemiology (in psychiatry) at Columbia University Medical Center, New York, and her colleagues.

©ron hilton/iStockphoto.com

The findings were based on responses to surveys from 1,098,270 students in the 8th, 10th, and 12th grades between 1991 and 2014. Respondents were from the 48 contiguous states, 21 of which had passed medical marijuana laws by 2014. Mean response rates for 1991-2013 were 81%-91% for almost all years and grades.

Students were asked if they had used marijuana in the previous 30 days; 15.87% of them said they had, in states that had passed a medical marijuana law between 1991 and 2014. In states that had not passed that type of a law, the prevalence of marijuana use was 13.27%.

The study showed no evidence for an increase in adolescent use of marijuana in the year of passage of a medical marijuana law, or in the first or second years after passage.

Prior to passage of a law permitting the use of marijuana for medicinal purposes, 16.25% of the survey’s participants said they had used marijuana within the previous 30 days. Following such legislative changes, the prevalence of use was 15.45%.

“Our two main findings, in conjunction with other evidence, suggest that state-level factors other than medical marijuana laws influence adolescent marijuana use,” the researchers wrote.

Dr. Hasin and her colleagues declared no conflicts of interest.

Read the full study here.

Marijuana use was higher in states that legalized treatment of medical conditions with marijuana, but the increased use was present both before and after such laws were passed, according to annual, repeated cross-sectional surveys.

“[T]he overall effect of medical marijuana laws on adolescent use before versus after passage of the law remained nonsignificant, although (as for the overall results), use was significantly reduced in 8th- but not for 10th- or 12th-graders,” noted Dr. Deborah S. Hasin, professor of epidemiology (in psychiatry) at Columbia University Medical Center, New York, and her colleagues.

©ron hilton/iStockphoto.com

The findings were based on responses to surveys from 1,098,270 students in the 8th, 10th, and 12th grades between 1991 and 2014. Respondents were from the 48 contiguous states, 21 of which had passed medical marijuana laws by 2014. Mean response rates for 1991-2013 were 81%-91% for almost all years and grades.

Students were asked if they had used marijuana in the previous 30 days; 15.87% of them said they had, in states that had passed a medical marijuana law between 1991 and 2014. In states that had not passed that type of a law, the prevalence of marijuana use was 13.27%.

The study showed no evidence for an increase in adolescent use of marijuana in the year of passage of a medical marijuana law, or in the first or second years after passage.

Prior to passage of a law permitting the use of marijuana for medicinal purposes, 16.25% of the survey’s participants said they had used marijuana within the previous 30 days. Following such legislative changes, the prevalence of use was 15.45%.

“Our two main findings, in conjunction with other evidence, suggest that state-level factors other than medical marijuana laws influence adolescent marijuana use,” the researchers wrote.

Dr. Hasin and her colleagues declared no conflicts of interest.

Read the full study here.