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Experts from the World Health Organization and National Institute of Allergy and Infectious Diseases are warning that the 2017-2018 flu season may be worse than past years due to an ineffective vaccine. Currently the influenza A strain H3N2 is sweeping through the southern hemisphere. Australia, which had 59,000 cases of the H1N1 swine flu virus confirmed by mid-October in 2009, had 215,000 cases of H3N2 by mid-October this year. Preliminary data suggests that the flu vaccine for H3N2 in 2017-2018 is only 10% effective. Earlier this year the WHO recommended that flu vaccines block against the same strains that were recommended in 2016-2017, which could be contributing to the low efficacy as other strains that aren’t blocked arise. It will be extra important this flu season to focus on washing hands, covering coughs, and disinfecting to prevent the spread of germs.
For more information please visit MedScape, and the New England Journal of Medicine.
Did you receive the 2017-2018 flu vaccine this season and still got the flu? Have you noticed more patients asking for flu remedies this year?
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An analysis of emergency room visits for adolescent and teenage girls has discovered an alarming increase in self harm over the past decade. From 2009 to 2015 the rate of self-harm emergency visits for girls aged 10-14 increased 18.8% yearly from 110 per 100,000 to 318 per 100,000. Comparatively, the rate for girls aged 15-19 increased 7.2% yearly from 2008-2015 and for age 20-24 by 2.0% yearly from 2001-2015. Experts and psychologists believe that the higher rate increase for younger girls may be related to smartphones, the internet, and social media. Jean Twenge, a psychologist at San Diego State University, has found in her research that teens who spend 5 or more hours on the internet daily have a 71% increased likeliness of having a suicide risk factor (such as depression or suicidal thoughts) compared to teens who spend one hour or less. The original iPhone was released in mid-2007, and in 2015 surveys showed that nearly 74% of girls age 13-17 have their own smartphone, up from less than 40% in 2012.
For more information please visit The Washington Post, and the original letter via the Journal of the American Medical Association.
How old were you when you got your first phone? Have you ever had to talk to a child about body image or self-harm? What can we do to combat the rising rates of teenage depression, internet bullying, and self-harm in America?
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A study published in the American Journal of Preventative Medicine examined the relationship of tap water consumption to blood lead levels and tooth decay in children aged 2-19 years old. Researchers from the University of North Carolina reviewed data from the National Health and Nutrition Examination Survey conducted from 2011-2014. From this data they found that children who reported not drinking tap water were 38% less likely to have a blood lead level ≥3 μg/dL, but also 13% more likely to have dental caries upon examination. Elevated blood lead levels, defined by the CDC as ≥5 μg/dL, are associated with lower IQ, decreased attention span, and decreased academic achievement. Dental caries lead to cavities, tooth decay, and other dental problems. Much of the tap water in the United States contains fluoride, which helps to kill bacteria in the mouth that cause dental caries.
For more information please visit ScienceDaily, and the original study via the American Journal of Preventative Medicine.
Do you encounter many parents who are concerned about lead levels in tap water and will only drink bottled water? Did you know that Britta water filters will remove lead and other contaminants from tap water while preserving fluoride? If you are avoiding tap water do you make sure to use fluoridated toothpaste and brush teeth diligently?
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A study recently published in the Journal of Experimental Medicine has shown that breastfeeding newborns is linked to their protection against common food allergies. The study was conducted in mice by researchers at Boston Children’s Hospital and Harvard Medical School. Milk from mice that had been exposed to egg protein provided egg allergy protection to their offspring, as well as to offspring of other mice who had not been exposed to egg protein. The study found that the offspring of egg protein exposed mothers did not receive a sufficient amount of egg allergy protection if they were not also breast fed. The the offspring with the greatest allergy protection came from egg protein exposed mothers that both birthed and nursed the newborn. The results of the study are consistent with new dietary recommendations which promote consumption of commonly allergenic foods such as milk, egg, peanut, tree nuts, soy, wheat, fish and shellfish, while pregnant and nursing.
For more information please visit FoodAlergy.org, and the original study via JEM.
How often do you discuss breastfeeding with new mothers or counsel them about food allergies? Do you discuss the consumption of highly allergenic food during pregnancy?
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A recent study of over 3.4 million people conducted in Sweden has found a link between dog ownership and a significant reduction in risk of heart attack, stroke, cardiovascular death, and all cause death. The study, published in the journal Scientific Reports, found that when adjusted for age and sex, dog owners had a 23% reduced risk of cardiovascular related death and 20% reduced risk of all cause death. Interestingly, compared to people who live alone, single dog owners had a 33% reduced risk of death and 11% reduced risk of heart attack. People who own dogs are more likely to be physically active, have social contact, and be exposed to different beneficial bacteria that a non-owner might not be. The dog breed with the largest risk reduction were hunting dogs such as pointers (40%) and scent hounds (37%).
For more information please visit the BBC, and the original study via Scientific Reports.
Do you think that the reduced risk of death in this study was more related to the effect of owning a dog, or the type of person who owns a dog? Should we consider recommending that people who live on their own get a dog given the huge death risk reduction for that population?
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Preliminary results from a safety clinical trial showed an increased risk of heart-related death with Febuxostat (Uloric) compared to another medication used for gout called Allopurinol. Clinical trials conducted prior to the drug approval showed a higher rate of heart-related problems including heart attack, stroke, and heart-related deaths in patients treated with Febuxostat compared to Allopurinol. As a result, the FDA required the drug manufacturer, Takeda Pharmaceuticals, to conduct an additional safety clinical trial in 2009 after the drug was approved. This trial was recently finished, showing an increased risk of heart-related deaths and death from all causes. Once the final results from the manufacturer are received, the FDA will conduct a review and update the public with any new information.
For more information visit FDA.gov.
Do you know anyone taking Febuxostat (Uloric)? Why do you think the drug was approved even though it showed a higher rate of heart related problems? As a healthcare professional, do you know how and where to report adverse effects related to medications your patients are taking?
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The FDA issued a public health advisory this week regarding the herbal supplement Kratom, warning of the potential for misuse, addiction, and death when used improperly. Kratom is a plant grown in Southeast Asia that is believed to work by activating the same receptors as opioid pain killers with less respiratory depression. Some use Kratom safely to self-manage pain and depression, while others abuse Kratom recreationally in combination with other drugs for its euphoric effects. The FDA is concerned as there is currently no reliable scientific data for either the risks or benefits, and Kratom related calls to poison control centers increased ten-fold from 2010-2015 with 36 related deaths in 2016. Some drug companies are beginning to research Mitragyna (the plant Kratom powder is derived from) as an opioid replacement in pain management.
For more information please visit The Washington Post and the FDA.
Have you ever discussed Kratom with patients who used the substance? What was their experience? Do you think that large opioid companies may be lobbying the FDA against Kratom?
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A recent study published in the Journal of the American Medical Association examined the link between obesity during pregnancy and increased birth weight. Researchers found that at 32 weeks gestation in pregnant women with a pre-pregnancy BMI greater than 30, the fetus on average has greater arm length, leg length, head circumference, and overall body weight than in pregnant women with a pre-pregnancy BMI of 30 or less. Increased complications of obesity during pregnancy include fetal overgrowth, gestational diabetes, hypertension, increased risk of bone fracture during delivery, and increased incidence of C-section birth. The lead author of the study stressed the importance of attaining a healthy weight prior to pregnancy and careful monitoring of all pregnancies in obese women.
For more information please visit National Institutes of Health, and JAMA Pediatrics
How will the results of this research change your counseling practices of expecting mothers? Were you aware that your physical health as a pregnant mother could have such a profound effect on the growth of the fetus? What steps have you taken to improve your health before attempting to have a child?
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The World Health Organization just published new guidelines on the use of medically important antibiotics in food-producing animals. These recommendations include overall reduction in use of medically important antibiotics, complete restriction of all medically important antibiotics for growth promotion and undiagnosed infectious disease, and restriction of the use of critically important to human antibiotics in food-producing animals. Overuse of antibiotics in animals over the past few decades has led to increased antibiotic resistance. These new guidelines aim to reduce the risk of increased antibiotic resistance that could lead to untreatable bacterial infections in the future.
For more information, please visit WHO
Questions: Were you aware that many animals we eat have been receiving antibiotics improperly? How often do you pay attention to the packaging at the grocery store and buy antibiotic free meats?
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There is a newly identified type of Diabetes, Type 3c. It occurs due to pancreatic disease or injury that often happens before a diabetes diagnosis. Researchers from the University of Surrey examined records of more than 2 million patients and discovered that up to 97.3% of those with pancreatic disease were misdiagnosed with type 2 diabetes. Type 3c Diabetes patients have a greater need for insulin and may benefit from taking digestive enzymes with food. Improper diabetes treatment can result in long term nerve, eye, and kidney damage.
For more information, go to WebMD.
Questions: Do you know someone who may be misdiagnosed with Type 2 diabetes? How familiar are you with pancreatic disease in patients with Diabetes?