Jan Dyer

Unless someone has already had a heart attack or other cardiovascular event, daily low-dose aspirin does not prolong healthy independent living, according to the ASPirin in Reducing Events in the Elderly (ASPREE) trial.

The study began in 2010, enrolling 19,114 adults aged ≥ 65 years. The participants were treated with 100 mg/d of aspirin or placebo and followed for an average of 4.7 years. Of participants randomly assigned aspirin, 90.3% were still alive at the end of the treatment without persistent physical disability or dementia, as were 90.5% of those on placebo. Rates of dementia were almost identical in both groups. Major cardiovascular events were similar: 448 in the aspirin group and 474 in the placebo group.

The aspirin group had a slightly higher risk of death (5.9% vs 5.2%). The researchers advise interpreting this cautiously: Most of the deaths were due to cancer. A small increase in new cases of cancer was reported for the aspirin group but may have been due to chance. Heart disease accounted for 19% of deaths and major bleeding for 5%. People taking aspirin were more likely to have significant bleeding (3.8% vs 2.7%).

The researchers emphasize that, study findings notwithstanding, older adults should follow their physician’s advice about daily aspirin use. The new findings do not apply to people with an indication for aspirin, including stroke, heart attack, or other cardiovascular disease.

Unless someone has already had a heart attack or other cardiovascular event, daily low-dose aspirin does not prolong healthy independent living, according to the ASPirin in Reducing Events in the Elderly (ASPREE) trial.

The study began in 2010, enrolling 19,114 adults aged ≥ 65 years. The participants were treated with 100 mg/d of aspirin or placebo and followed for an average of 4.7 years. Of participants randomly assigned aspirin, 90.3% were still alive at the end of the treatment without persistent physical disability or dementia, as were 90.5% of those on placebo. Rates of dementia were almost identical in both groups. Major cardiovascular events were similar: 448 in the aspirin group and 474 in the placebo group.

The aspirin group had a slightly higher risk of death (5.9% vs 5.2%). The researchers advise interpreting this cautiously: Most of the deaths were due to cancer. A small increase in new cases of cancer was reported for the aspirin group but may have been due to chance. Heart disease accounted for 19% of deaths and major bleeding for 5%. People taking aspirin were more likely to have significant bleeding (3.8% vs 2.7%).

The researchers emphasize that, study findings notwithstanding, older adults should follow their physician’s advice about daily aspirin use. The new findings do not apply to people with an indication for aspirin, including stroke, heart attack, or other cardiovascular disease.

Unless someone has already had a heart attack or other cardiovascular event, daily low-dose aspirin does not prolong healthy independent living, according to the ASPirin in Reducing Events in the Elderly (ASPREE) trial.

The study began in 2010, enrolling 19,114 adults aged ≥ 65 years. The participants were treated with 100 mg/d of aspirin or placebo and followed for an average of 4.7 years. Of participants randomly assigned aspirin, 90.3% were still alive at the end of the treatment without persistent physical disability or dementia, as were 90.5% of those on placebo. Rates of dementia were almost identical in both groups. Major cardiovascular events were similar: 448 in the aspirin group and 474 in the placebo group.

The aspirin group had a slightly higher risk of death (5.9% vs 5.2%). The researchers advise interpreting this cautiously: Most of the deaths were due to cancer. A small increase in new cases of cancer was reported for the aspirin group but may have been due to chance. Heart disease accounted for 19% of deaths and major bleeding for 5%. People taking aspirin were more likely to have significant bleeding (3.8% vs 2.7%).

The researchers emphasize that, study findings notwithstanding, older adults should follow their physician’s advice about daily aspirin use. The new findings do not apply to people with an indication for aspirin, including stroke, heart attack, or other cardiovascular disease.

People living with HIV who inject drugs often encounter multiple obstacles, both personal and system related, to beginning and adhering to treatment. But NIH researchers found that an “integrated and flexible intervention” not only helped patients overcome those barriers, but also cut deaths by 50%.

The study, HPTN 074, took place in Indonesia, Ukraine, and Vietnam—3 countries with HIV epidemics driven by injection drug use. Researchers enrolled 502 adults with HIV who inject drugs, and 806 adults without HIV, who inject drugs with them (their injection partners). At ≥ 1 injection partner of every person in the study enrolled. The HIV participants were assigned either the national standard of care for HIV infection and drug use, or the standard of care plus the intervention designed to facilitate treatment. The participants were followed for 1 to 2 years.

In the intervention group, participants were referred to local health care providers for anti-HIV therapy. They were also each assigned a systems navigator, who helped the patient identify and overcome structural barriers to starting and staying in care, such as unfamiliarity with how to enroll in medical care, or difficulty keeping appointments. Psychosocial counselors helped each participant overcome their unique psychological obstacles, such as lack of interest in therapy or fear of stigma.

At the end of the study, 15% of participants with HIV who received standard care had died, compared with 7% of the intervention patients. About 26% of deaths among HIV participants were “clearly” HIV related; 3% were due to drug overdose. Among the 42% of patients who died of unknown cause, 24% had weak immune systems.

The intervention had a “remarkably positive impact” on the participants, said Protocol Chair William Miller, MD, PhD. After 1 year, 41% of the intervention group had undetectable levels of HIV, compared with 24% of the standard-care group. Moreover, 72% of the intervention group were still in treatment, compared with 43% of the standard-care group. Similarly, 41% of intervention patients were in treatment for substance use, compared with 25% of standard-care patients.

The study is designed to be scalable to other settings. Investigators have offered the intervention to all the study participants living with HIV. They will be followed for a second year to find out whether the positive impact is sustained.

Source:

National Institutes of Health.  Novel intervention halves rate of death among people living with HIV who inject drugs. https://www.nih.gov/news-events/news-releases/novel-intervention-halves-rate-death-among-people-living-hiv-who-inject-drugs. Published August 31,2018. Accessed October 25, 2018.

People living with HIV who inject drugs often encounter multiple obstacles, both personal and system related, to beginning and adhering to treatment. But NIH researchers found that an “integrated and flexible intervention” not only helped patients overcome those barriers, but also cut deaths by 50%.

The study, HPTN 074, took place in Indonesia, Ukraine, and Vietnam—3 countries with HIV epidemics driven by injection drug use. Researchers enrolled 502 adults with HIV who inject drugs, and 806 adults without HIV, who inject drugs with them (their injection partners). At ≥ 1 injection partner of every person in the study enrolled. The HIV participants were assigned either the national standard of care for HIV infection and drug use, or the standard of care plus the intervention designed to facilitate treatment. The participants were followed for 1 to 2 years.

In the intervention group, participants were referred to local health care providers for anti-HIV therapy. They were also each assigned a systems navigator, who helped the patient identify and overcome structural barriers to starting and staying in care, such as unfamiliarity with how to enroll in medical care, or difficulty keeping appointments. Psychosocial counselors helped each participant overcome their unique psychological obstacles, such as lack of interest in therapy or fear of stigma.

At the end of the study, 15% of participants with HIV who received standard care had died, compared with 7% of the intervention patients. About 26% of deaths among HIV participants were “clearly” HIV related; 3% were due to drug overdose. Among the 42% of patients who died of unknown cause, 24% had weak immune systems.

The intervention had a “remarkably positive impact” on the participants, said Protocol Chair William Miller, MD, PhD. After 1 year, 41% of the intervention group had undetectable levels of HIV, compared with 24% of the standard-care group. Moreover, 72% of the intervention group were still in treatment, compared with 43% of the standard-care group. Similarly, 41% of intervention patients were in treatment for substance use, compared with 25% of standard-care patients.

The study is designed to be scalable to other settings. Investigators have offered the intervention to all the study participants living with HIV. They will be followed for a second year to find out whether the positive impact is sustained.

Source:

National Institutes of Health.  Novel intervention halves rate of death among people living with HIV who inject drugs. https://www.nih.gov/news-events/news-releases/novel-intervention-halves-rate-death-among-people-living-hiv-who-inject-drugs. Published August 31,2018. Accessed October 25, 2018.

People living with HIV who inject drugs often encounter multiple obstacles, both personal and system related, to beginning and adhering to treatment. But NIH researchers found that an “integrated and flexible intervention” not only helped patients overcome those barriers, but also cut deaths by 50%.

The study, HPTN 074, took place in Indonesia, Ukraine, and Vietnam—3 countries with HIV epidemics driven by injection drug use. Researchers enrolled 502 adults with HIV who inject drugs, and 806 adults without HIV, who inject drugs with them (their injection partners). At ≥ 1 injection partner of every person in the study enrolled. The HIV participants were assigned either the national standard of care for HIV infection and drug use, or the standard of care plus the intervention designed to facilitate treatment. The participants were followed for 1 to 2 years.

In the intervention group, participants were referred to local health care providers for anti-HIV therapy. They were also each assigned a systems navigator, who helped the patient identify and overcome structural barriers to starting and staying in care, such as unfamiliarity with how to enroll in medical care, or difficulty keeping appointments. Psychosocial counselors helped each participant overcome their unique psychological obstacles, such as lack of interest in therapy or fear of stigma.

At the end of the study, 15% of participants with HIV who received standard care had died, compared with 7% of the intervention patients. About 26% of deaths among HIV participants were “clearly” HIV related; 3% were due to drug overdose. Among the 42% of patients who died of unknown cause, 24% had weak immune systems.

The intervention had a “remarkably positive impact” on the participants, said Protocol Chair William Miller, MD, PhD. After 1 year, 41% of the intervention group had undetectable levels of HIV, compared with 24% of the standard-care group. Moreover, 72% of the intervention group were still in treatment, compared with 43% of the standard-care group. Similarly, 41% of intervention patients were in treatment for substance use, compared with 25% of standard-care patients.

The study is designed to be scalable to other settings. Investigators have offered the intervention to all the study participants living with HIV. They will be followed for a second year to find out whether the positive impact is sustained.

Source:

National Institutes of Health.  Novel intervention halves rate of death among people living with HIV who inject drugs. https://www.nih.gov/news-events/news-releases/novel-intervention-halves-rate-death-among-people-living-hiv-who-inject-drugs. Published August 31,2018. Accessed October 25, 2018.

Coffee drinking has been linked to the reduced risk of fibrosis progression, liver cirrhosis, and hepatocellular carcinoma in some patients, including those with hepatitis C virus (HCV) infection, but the results of studies in patients with hepatitis B virus (HBV) infection have been inconsistent. Given the “global impact of HBV infection and the wide consumption of coffee,” researchers from Tzu Chi University in Taiwan, wanted to find out more.

They analyzed data from 328 patients with chronic HBV infection who were enrolled in a population-based gastroesophageal reflux disease study. Of those, 155 patients also entered into a 5-year follow-up study. 

Among the patients with chronic HBV, 137 did not drink coffee. Of the 191 who did, 61 drank it on < 4 days a week, and 130 drank it ≥ 4 days.

Initially, the researchers observed an inverse association between coffee drinking and serum aspartate aminotransferase (AST) levels, as well as predicting indices of liver fibrosis in patients with HBV infection. Patients who drank ≥ 4 cups of coffee per day had a 70% decrease of serum AST, a 70% decrease of the AST to platelet ratio index, and a 70% decrease of fibrosis-4 index values. 

Those findings indicated that coffee might have a “generally beneficial” effect on liver inflammation and fibrosis progression in patients with chronic liver disease, the researchers say. However, at the end of the 5-year follow-up, the incidences of liver cirrhosis complications and changes of serum predicting indices of liver fibrosis were comparable between HBV coffee drinkers and nondrinkers. That indicated, the researchers believe, that the beneficial effect “seems to be outweighed” in patients with chronic HBV infection.

The researchers suggest that the protective effects of coffee consumption on liver inflammation and insulin resistance may not be able to surpass the direct carcinogenic effect of HBV, and even the HBV virus replication.

Coffee drinking has been linked to the reduced risk of fibrosis progression, liver cirrhosis, and hepatocellular carcinoma in some patients, including those with hepatitis C virus (HCV) infection, but the results of studies in patients with hepatitis B virus (HBV) infection have been inconsistent. Given the “global impact of HBV infection and the wide consumption of coffee,” researchers from Tzu Chi University in Taiwan, wanted to find out more.

They analyzed data from 328 patients with chronic HBV infection who were enrolled in a population-based gastroesophageal reflux disease study. Of those, 155 patients also entered into a 5-year follow-up study. 

Among the patients with chronic HBV, 137 did not drink coffee. Of the 191 who did, 61 drank it on < 4 days a week, and 130 drank it ≥ 4 days.

Initially, the researchers observed an inverse association between coffee drinking and serum aspartate aminotransferase (AST) levels, as well as predicting indices of liver fibrosis in patients with HBV infection. Patients who drank ≥ 4 cups of coffee per day had a 70% decrease of serum AST, a 70% decrease of the AST to platelet ratio index, and a 70% decrease of fibrosis-4 index values. 

Those findings indicated that coffee might have a “generally beneficial” effect on liver inflammation and fibrosis progression in patients with chronic liver disease, the researchers say. However, at the end of the 5-year follow-up, the incidences of liver cirrhosis complications and changes of serum predicting indices of liver fibrosis were comparable between HBV coffee drinkers and nondrinkers. That indicated, the researchers believe, that the beneficial effect “seems to be outweighed” in patients with chronic HBV infection.

The researchers suggest that the protective effects of coffee consumption on liver inflammation and insulin resistance may not be able to surpass the direct carcinogenic effect of HBV, and even the HBV virus replication.

Coffee drinking has been linked to the reduced risk of fibrosis progression, liver cirrhosis, and hepatocellular carcinoma in some patients, including those with hepatitis C virus (HCV) infection, but the results of studies in patients with hepatitis B virus (HBV) infection have been inconsistent. Given the “global impact of HBV infection and the wide consumption of coffee,” researchers from Tzu Chi University in Taiwan, wanted to find out more.

They analyzed data from 328 patients with chronic HBV infection who were enrolled in a population-based gastroesophageal reflux disease study. Of those, 155 patients also entered into a 5-year follow-up study. 

Among the patients with chronic HBV, 137 did not drink coffee. Of the 191 who did, 61 drank it on < 4 days a week, and 130 drank it ≥ 4 days.

Initially, the researchers observed an inverse association between coffee drinking and serum aspartate aminotransferase (AST) levels, as well as predicting indices of liver fibrosis in patients with HBV infection. Patients who drank ≥ 4 cups of coffee per day had a 70% decrease of serum AST, a 70% decrease of the AST to platelet ratio index, and a 70% decrease of fibrosis-4 index values. 

Those findings indicated that coffee might have a “generally beneficial” effect on liver inflammation and fibrosis progression in patients with chronic liver disease, the researchers say. However, at the end of the 5-year follow-up, the incidences of liver cirrhosis complications and changes of serum predicting indices of liver fibrosis were comparable between HBV coffee drinkers and nondrinkers. That indicated, the researchers believe, that the beneficial effect “seems to be outweighed” in patients with chronic HBV infection.

The researchers suggest that the protective effects of coffee consumption on liver inflammation and insulin resistance may not be able to surpass the direct carcinogenic effect of HBV, and even the HBV virus replication.

A group of teenage 4-H members take part in a state agricultural fair, after which one of the boys comes sick. But luckily they have also attended the CDC’s Disease Detective Camp in Atlanta and use their newly acquired detective skills to find out why their friend got sick.

That is the story in “The Junior Disease Detectives: Operation Outbreak,” the new graphic novel the CDC has developed with the Department of Agriculture and 4-H.

Spoiler alert: it was the flu. The novel is designed to help young people understand the potential health risks of human influenza viruses that normally circulate in swine, known as variant flu infections.

Four new variant virus infections have been associated with attendance at agricultural fairs in 2 US states, the CDC reports. Most are connected to infected pigs or their environments in fair settings. While variant flu infections in people are rare, the CDC says, they can lead to hospitalization and death. In 2017, 67 variant virus infections were reported in the US; 6 resulted in hospitalization, including 2 ICU admissions.

The novel is intended for use in middle and high school science, technology, engineering, and mathematics (STEM) classrooms. It is the first of a planned series of educational activities being rolled out throughout the 2018-2019 school year.

The novel is available as a free mobile app, and can be downloaded at https://www.cdc.gov/flu/resource-center/freeresources/graphic-novel/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fflu%2Fgraphicnovel%2Findex.html.

A group of teenage 4-H members take part in a state agricultural fair, after which one of the boys comes sick. But luckily they have also attended the CDC’s Disease Detective Camp in Atlanta and use their newly acquired detective skills to find out why their friend got sick.

That is the story in “The Junior Disease Detectives: Operation Outbreak,” the new graphic novel the CDC has developed with the Department of Agriculture and 4-H.

Spoiler alert: it was the flu. The novel is designed to help young people understand the potential health risks of human influenza viruses that normally circulate in swine, known as variant flu infections.

Four new variant virus infections have been associated with attendance at agricultural fairs in 2 US states, the CDC reports. Most are connected to infected pigs or their environments in fair settings. While variant flu infections in people are rare, the CDC says, they can lead to hospitalization and death. In 2017, 67 variant virus infections were reported in the US; 6 resulted in hospitalization, including 2 ICU admissions.

The novel is intended for use in middle and high school science, technology, engineering, and mathematics (STEM) classrooms. It is the first of a planned series of educational activities being rolled out throughout the 2018-2019 school year.

The novel is available as a free mobile app, and can be downloaded at https://www.cdc.gov/flu/resource-center/freeresources/graphic-novel/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fflu%2Fgraphicnovel%2Findex.html.

A group of teenage 4-H members take part in a state agricultural fair, after which one of the boys comes sick. But luckily they have also attended the CDC’s Disease Detective Camp in Atlanta and use their newly acquired detective skills to find out why their friend got sick.

That is the story in “The Junior Disease Detectives: Operation Outbreak,” the new graphic novel the CDC has developed with the Department of Agriculture and 4-H.

Spoiler alert: it was the flu. The novel is designed to help young people understand the potential health risks of human influenza viruses that normally circulate in swine, known as variant flu infections.

Four new variant virus infections have been associated with attendance at agricultural fairs in 2 US states, the CDC reports. Most are connected to infected pigs or their environments in fair settings. While variant flu infections in people are rare, the CDC says, they can lead to hospitalization and death. In 2017, 67 variant virus infections were reported in the US; 6 resulted in hospitalization, including 2 ICU admissions.

The novel is intended for use in middle and high school science, technology, engineering, and mathematics (STEM) classrooms. It is the first of a planned series of educational activities being rolled out throughout the 2018-2019 school year.

The novel is available as a free mobile app, and can be downloaded at https://www.cdc.gov/flu/resource-center/freeresources/graphic-novel/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fflu%2Fgraphicnovel%2Findex.html.

In 2015, researchers showed that polioviruses could travel in groups—or “packets”—that is, membrane-bound vesicles containing multiple virus particles. The researchers used the Trojan horse analogy to describe it. But they could not say whether the system applied to animals and humans, or how effective the “horses” were in infecting host cells.

To find out, the researchers focused on rotaviruses and noroviruses, which are mainly spread through stool-contaminated food or liquids. And they found that the viruses were indeed shed as packet-enclosed clusters in the stool. Moreover, the virus clusters were significantly more infectious than the free, unbound viruses in the fecal samples tested.

The researchers say the high level of infectiousness is likely due to the vesicles delivering many viruses at once to the target tissue. The vesicles also protect their “viral cargo” from being destroyed by prolonged exposure to enzymes and may even make it invisible to the antibodies in the stool or gut.

The virus packets are not only extremely potent, but aggressive. More studies are needed, and more antivirals, the researchers say, but in the meantime, soap and water can help keep them down.

In 2015, researchers showed that polioviruses could travel in groups—or “packets”—that is, membrane-bound vesicles containing multiple virus particles. The researchers used the Trojan horse analogy to describe it. But they could not say whether the system applied to animals and humans, or how effective the “horses” were in infecting host cells.

To find out, the researchers focused on rotaviruses and noroviruses, which are mainly spread through stool-contaminated food or liquids. And they found that the viruses were indeed shed as packet-enclosed clusters in the stool. Moreover, the virus clusters were significantly more infectious than the free, unbound viruses in the fecal samples tested.

The researchers say the high level of infectiousness is likely due to the vesicles delivering many viruses at once to the target tissue. The vesicles also protect their “viral cargo” from being destroyed by prolonged exposure to enzymes and may even make it invisible to the antibodies in the stool or gut.

The virus packets are not only extremely potent, but aggressive. More studies are needed, and more antivirals, the researchers say, but in the meantime, soap and water can help keep them down.

In 2015, researchers showed that polioviruses could travel in groups—or “packets”—that is, membrane-bound vesicles containing multiple virus particles. The researchers used the Trojan horse analogy to describe it. But they could not say whether the system applied to animals and humans, or how effective the “horses” were in infecting host cells.

To find out, the researchers focused on rotaviruses and noroviruses, which are mainly spread through stool-contaminated food or liquids. And they found that the viruses were indeed shed as packet-enclosed clusters in the stool. Moreover, the virus clusters were significantly more infectious than the free, unbound viruses in the fecal samples tested.

The researchers say the high level of infectiousness is likely due to the vesicles delivering many viruses at once to the target tissue. The vesicles also protect their “viral cargo” from being destroyed by prolonged exposure to enzymes and may even make it invisible to the antibodies in the stool or gut.

The virus packets are not only extremely potent, but aggressive. More studies are needed, and more antivirals, the researchers say, but in the meantime, soap and water can help keep them down.

“Diabetes in America was written to serve as the go-to book for anything you ever wanted to know about diabetes,” says Catherine Cowie, PhD, editor and senior advisor for the National Institute of Diabetes and Digestive and Kidney Diseases’  Diabetes Epidemiology Program. “It’s a resource for everyone, because diabetes affects just about everyone.”

Written by recognized experts who “represent every facet of diabetes,” the book covers relevant research, data and trends, complications and related conditions, and prevention and medical care. It is “rich in data,” says Dr. Cowie, and includes cross-sectional national data, as well as smaller geographic community and longitudinal studies. This edition includes both published and unpublished data that were specifically analyzed for the book.

Clinical trial data are summarized to show the strongest evidence available for the effectiveness of interventions, but the book also emphasizes “points of hope” found through research: For example, people at high risk can prevent or delay type 2 diabetes by losing a modest amount of weight, and rates of some complications, such as lower extremity amputations, are on the decline.

Cowie says Diabetes in America is designed to be useful to a variety of readers. Patients can use it to better understand their condition or risk factors; practitioners can use it to assess patients’ risk of diabetes and associated complications; health policy makers who need “sound quantitative knowledge” can use it to guide decision making; scientists can use it to help identify areas of needed research.

To download, visit: https://www.niddk.nih.gov/about-niddk/strategic-plans-reports/diabetes-in-america-3rd-edition.

“Diabetes in America was written to serve as the go-to book for anything you ever wanted to know about diabetes,” says Catherine Cowie, PhD, editor and senior advisor for the National Institute of Diabetes and Digestive and Kidney Diseases’  Diabetes Epidemiology Program. “It’s a resource for everyone, because diabetes affects just about everyone.”

Written by recognized experts who “represent every facet of diabetes,” the book covers relevant research, data and trends, complications and related conditions, and prevention and medical care. It is “rich in data,” says Dr. Cowie, and includes cross-sectional national data, as well as smaller geographic community and longitudinal studies. This edition includes both published and unpublished data that were specifically analyzed for the book.

Clinical trial data are summarized to show the strongest evidence available for the effectiveness of interventions, but the book also emphasizes “points of hope” found through research: For example, people at high risk can prevent or delay type 2 diabetes by losing a modest amount of weight, and rates of some complications, such as lower extremity amputations, are on the decline.

Cowie says Diabetes in America is designed to be useful to a variety of readers. Patients can use it to better understand their condition or risk factors; practitioners can use it to assess patients’ risk of diabetes and associated complications; health policy makers who need “sound quantitative knowledge” can use it to guide decision making; scientists can use it to help identify areas of needed research.

To download, visit: https://www.niddk.nih.gov/about-niddk/strategic-plans-reports/diabetes-in-america-3rd-edition.

“Diabetes in America was written to serve as the go-to book for anything you ever wanted to know about diabetes,” says Catherine Cowie, PhD, editor and senior advisor for the National Institute of Diabetes and Digestive and Kidney Diseases’  Diabetes Epidemiology Program. “It’s a resource for everyone, because diabetes affects just about everyone.”

Written by recognized experts who “represent every facet of diabetes,” the book covers relevant research, data and trends, complications and related conditions, and prevention and medical care. It is “rich in data,” says Dr. Cowie, and includes cross-sectional national data, as well as smaller geographic community and longitudinal studies. This edition includes both published and unpublished data that were specifically analyzed for the book.

Clinical trial data are summarized to show the strongest evidence available for the effectiveness of interventions, but the book also emphasizes “points of hope” found through research: For example, people at high risk can prevent or delay type 2 diabetes by losing a modest amount of weight, and rates of some complications, such as lower extremity amputations, are on the decline.

Cowie says Diabetes in America is designed to be useful to a variety of readers. Patients can use it to better understand their condition or risk factors; practitioners can use it to assess patients’ risk of diabetes and associated complications; health policy makers who need “sound quantitative knowledge” can use it to guide decision making; scientists can use it to help identify areas of needed research.

To download, visit: https://www.niddk.nih.gov/about-niddk/strategic-plans-reports/diabetes-in-america-3rd-edition.

Cetuximab plus radiation therapy has worse outcomes than the current standard of radiation and cisplatin for patients with human papillomavirus-positive (HPV+) oropharyngeal cancer. In fact, the researchers, who reported preliminary findings from a phase 3 study funded by the National Cancer Institute (NCI), were “surprised by the loss of tumor control with cetuximab.”

Cetuximab with radiation is an accepted standard of care, especially for patients who cannot tolerate cisplatin, and it is approved for patients with head and neck cancer, including oropharyngeal cancer. Researchers and the NCI are looking for more ways to “de-escalate” therapies for cancers that have a good prognosis, such as HPV+ cancer of the oropharynx. The goal of this trial was to find an alternative to cisplatin that would control the cancer as effectively but with fewer side effects.

The researchers enrolled 849 patients to randomly receive either cetuximab or cisplatin with radiation. The third, final interim analysis, after a median follow-up of 4.5 years, found that overall survival on the cetuximab arm was significantly inferior to the cisplatin arm. Moreover, serious adverse events were similar in both groups, although toxic side effects were more common in the cisplatin arm.

The study is the first randomized clinical trial specifically designed for patients with HPV+ oropharyngeal cancer, and “it establishes cisplatin with radiation as the standard of care.”

Cetuximab plus radiation therapy has worse outcomes than the current standard of radiation and cisplatin for patients with human papillomavirus-positive (HPV+) oropharyngeal cancer. In fact, the researchers, who reported preliminary findings from a phase 3 study funded by the National Cancer Institute (NCI), were “surprised by the loss of tumor control with cetuximab.”

Cetuximab with radiation is an accepted standard of care, especially for patients who cannot tolerate cisplatin, and it is approved for patients with head and neck cancer, including oropharyngeal cancer. Researchers and the NCI are looking for more ways to “de-escalate” therapies for cancers that have a good prognosis, such as HPV+ cancer of the oropharynx. The goal of this trial was to find an alternative to cisplatin that would control the cancer as effectively but with fewer side effects.

The researchers enrolled 849 patients to randomly receive either cetuximab or cisplatin with radiation. The third, final interim analysis, after a median follow-up of 4.5 years, found that overall survival on the cetuximab arm was significantly inferior to the cisplatin arm. Moreover, serious adverse events were similar in both groups, although toxic side effects were more common in the cisplatin arm.

The study is the first randomized clinical trial specifically designed for patients with HPV+ oropharyngeal cancer, and “it establishes cisplatin with radiation as the standard of care.”

Cetuximab plus radiation therapy has worse outcomes than the current standard of radiation and cisplatin for patients with human papillomavirus-positive (HPV+) oropharyngeal cancer. In fact, the researchers, who reported preliminary findings from a phase 3 study funded by the National Cancer Institute (NCI), were “surprised by the loss of tumor control with cetuximab.”

Cetuximab with radiation is an accepted standard of care, especially for patients who cannot tolerate cisplatin, and it is approved for patients with head and neck cancer, including oropharyngeal cancer. Researchers and the NCI are looking for more ways to “de-escalate” therapies for cancers that have a good prognosis, such as HPV+ cancer of the oropharynx. The goal of this trial was to find an alternative to cisplatin that would control the cancer as effectively but with fewer side effects.

The researchers enrolled 849 patients to randomly receive either cetuximab or cisplatin with radiation. The third, final interim analysis, after a median follow-up of 4.5 years, found that overall survival on the cetuximab arm was significantly inferior to the cisplatin arm. Moreover, serious adverse events were similar in both groups, although toxic side effects were more common in the cisplatin arm.

The study is the first randomized clinical trial specifically designed for patients with HPV+ oropharyngeal cancer, and “it establishes cisplatin with radiation as the standard of care.”

Millions of VA health care appointments are missed each year. But VEText aims to change that by sending reminders to veterans via their cell phones.

Five months after the automated interactive text-message system was introduced, > 3 million patients have received reminder texts—and have then canceled 319,504 appointments, freeing up time slots for other veterans to use.

More than 100 VA facilities are using VEText. Veterans who have used the health care system and have a cell phone number listed in their electronic health records (EHR) are automatically enrolled in VEText. The first text message reminder is sent 7 days before the appointment, and a second reminder is sent 2 days before the appointment. (The timing and frequency may vary by facility.) Veterans with multiple appointments on the same day receive multiple remainders. Veterans can also opt out of the text-messaging reminders.

Because it is integrated with the VA’s EHR system, VEText does not require manual action by VA staff, which can mean staff have more time to provide more personalized care, the VA says.

For more information about VEText, visit https://www.va.gov/HEALTH/VEText.asp.

Millions of VA health care appointments are missed each year. But VEText aims to change that by sending reminders to veterans via their cell phones.

Five months after the automated interactive text-message system was introduced, > 3 million patients have received reminder texts—and have then canceled 319,504 appointments, freeing up time slots for other veterans to use.

More than 100 VA facilities are using VEText. Veterans who have used the health care system and have a cell phone number listed in their electronic health records (EHR) are automatically enrolled in VEText. The first text message reminder is sent 7 days before the appointment, and a second reminder is sent 2 days before the appointment. (The timing and frequency may vary by facility.) Veterans with multiple appointments on the same day receive multiple remainders. Veterans can also opt out of the text-messaging reminders.

Because it is integrated with the VA’s EHR system, VEText does not require manual action by VA staff, which can mean staff have more time to provide more personalized care, the VA says.

For more information about VEText, visit https://www.va.gov/HEALTH/VEText.asp.

Millions of VA health care appointments are missed each year. But VEText aims to change that by sending reminders to veterans via their cell phones.

Five months after the automated interactive text-message system was introduced, > 3 million patients have received reminder texts—and have then canceled 319,504 appointments, freeing up time slots for other veterans to use.

More than 100 VA facilities are using VEText. Veterans who have used the health care system and have a cell phone number listed in their electronic health records (EHR) are automatically enrolled in VEText. The first text message reminder is sent 7 days before the appointment, and a second reminder is sent 2 days before the appointment. (The timing and frequency may vary by facility.) Veterans with multiple appointments on the same day receive multiple remainders. Veterans can also opt out of the text-messaging reminders.

Because it is integrated with the VA’s EHR system, VEText does not require manual action by VA staff, which can mean staff have more time to provide more personalized care, the VA says.

For more information about VEText, visit https://www.va.gov/HEALTH/VEText.asp.

Nearly 1.5 million veterans and more than 500,000 already enrolled in the VA health care system identify as being Hispanic or Latino. “Our veteran population is made up of an increasingly diverse group of people,” said VA Secretary Robert Wilkie. “It’s our duty to expand the ways we communicate with all veterans, so they’re properly informed about the benefits they’ve earned.”

To that end, the VA has released a Spanish version of the application for health benefits, “to simplify and improve the health care enrollment process.” The new language version follows on the VA Advisory Committee on Minority Veterans’ recommendation.

The form is available at VA medical facilities and online at https://www.va.gov/vaforms/medical/pdf/10-10EZ_Spanish.pdf.

Nearly 1.5 million veterans and more than 500,000 already enrolled in the VA health care system identify as being Hispanic or Latino. “Our veteran population is made up of an increasingly diverse group of people,” said VA Secretary Robert Wilkie. “It’s our duty to expand the ways we communicate with all veterans, so they’re properly informed about the benefits they’ve earned.”

To that end, the VA has released a Spanish version of the application for health benefits, “to simplify and improve the health care enrollment process.” The new language version follows on the VA Advisory Committee on Minority Veterans’ recommendation.

The form is available at VA medical facilities and online at https://www.va.gov/vaforms/medical/pdf/10-10EZ_Spanish.pdf.

Nearly 1.5 million veterans and more than 500,000 already enrolled in the VA health care system identify as being Hispanic or Latino. “Our veteran population is made up of an increasingly diverse group of people,” said VA Secretary Robert Wilkie. “It’s our duty to expand the ways we communicate with all veterans, so they’re properly informed about the benefits they’ve earned.”

To that end, the VA has released a Spanish version of the application for health benefits, “to simplify and improve the health care enrollment process.” The new language version follows on the VA Advisory Committee on Minority Veterans’ recommendation.

The form is available at VA medical facilities and online at https://www.va.gov/vaforms/medical/pdf/10-10EZ_Spanish.pdf.

The number of women with opioid use disorder (OUD) at labor and delivery more than quadrupled between 1999 and 2014, according to a first-ever multistate analysis of trends by the CDC.

Researchers found that the national prevalence rate of OUD rose from 1.5 per 1,000 delivery hospitalizations in 1999 to 6.5 in 2014. On average, the national prevalence rate grew by 0.39 cases per 1,000 each year.
 

The increases were significant and seen in all of the 28 states with at least 3 years of data available for analysis. The average increases were lowest in California and Hawaii and highest in Maine, New Mexico, Vermont, and West Virginia.

Opioid use disorder during pregnancy has been associated with a range of negative health outcomes, including maternal death, preterm birth, stillbirth, and neonatal abstinence syndrome (NAS).

The CDC’s recommended strategies include:

• Implementing universal substance use screening at the first prenatal visit;
• Ensuring pregnant women with OUD have access to medication-assisted therapy and related addiction services; and
•  Ensuring that mothers with OUD receive adequate patient-centered postpartum care, including mental health and substance use treatment, relapse-prevention programs, and family planning services

The CDC also is supporting state-based perinatal quality cooperatives, networks of teams working to better identify women with OUD during pregnancy and to standardize care for mothers and NAS-affected infants.

The number of women with opioid use disorder (OUD) at labor and delivery more than quadrupled between 1999 and 2014, according to a first-ever multistate analysis of trends by the CDC.

Researchers found that the national prevalence rate of OUD rose from 1.5 per 1,000 delivery hospitalizations in 1999 to 6.5 in 2014. On average, the national prevalence rate grew by 0.39 cases per 1,000 each year.
 

The increases were significant and seen in all of the 28 states with at least 3 years of data available for analysis. The average increases were lowest in California and Hawaii and highest in Maine, New Mexico, Vermont, and West Virginia.

Opioid use disorder during pregnancy has been associated with a range of negative health outcomes, including maternal death, preterm birth, stillbirth, and neonatal abstinence syndrome (NAS).

The CDC’s recommended strategies include:

• Implementing universal substance use screening at the first prenatal visit;
• Ensuring pregnant women with OUD have access to medication-assisted therapy and related addiction services; and
•  Ensuring that mothers with OUD receive adequate patient-centered postpartum care, including mental health and substance use treatment, relapse-prevention programs, and family planning services

The CDC also is supporting state-based perinatal quality cooperatives, networks of teams working to better identify women with OUD during pregnancy and to standardize care for mothers and NAS-affected infants.

The number of women with opioid use disorder (OUD) at labor and delivery more than quadrupled between 1999 and 2014, according to a first-ever multistate analysis of trends by the CDC.

Researchers found that the national prevalence rate of OUD rose from 1.5 per 1,000 delivery hospitalizations in 1999 to 6.5 in 2014. On average, the national prevalence rate grew by 0.39 cases per 1,000 each year.
 

The increases were significant and seen in all of the 28 states with at least 3 years of data available for analysis. The average increases were lowest in California and Hawaii and highest in Maine, New Mexico, Vermont, and West Virginia.

Opioid use disorder during pregnancy has been associated with a range of negative health outcomes, including maternal death, preterm birth, stillbirth, and neonatal abstinence syndrome (NAS).

The CDC’s recommended strategies include:

• Implementing universal substance use screening at the first prenatal visit;
• Ensuring pregnant women with OUD have access to medication-assisted therapy and related addiction services; and
•  Ensuring that mothers with OUD receive adequate patient-centered postpartum care, including mental health and substance use treatment, relapse-prevention programs, and family planning services

The CDC also is supporting state-based perinatal quality cooperatives, networks of teams working to better identify women with OUD during pregnancy and to standardize care for mothers and NAS-affected infants.