October

A high-dose flu vaccine is one of several standard-dose vaccines approved for adults over 65 in the US. The Centers for Disease Control and Prevention (CDC) recommend that everyone be vaccinated against flu every season from the age of 6 months. Seniors are at particular risk for serious illness and complications from flu, including death.

However, one of the new reports shows that many senior statin users had a significantly reduced immune response to the vaccination, compared with those not taking statins. In the other study, effectiveness at preventing serious respiratory illness was lower among patients taking statins.

One group of researchers analyzed immune response data from an earlier flu vaccine clinical trial conducted during the 2009-10 and 2010-11 flu seasons.

They focused on the potential effect of statin use on patients’ initial immune responses after being immunized against flu. The study involved nearly 7,000 adults over the age 65 in four countries, including the US.

Statin users were found to have a significantly reduced immune response to vaccination compared with those not taking statins, as measured by the level of antibodies to the flu vaccine strains in patients’ blood 3 weeks after vaccination.

Source: Medical News Today

Vaccination protection influenza, injection for the prevention of flu

A study of hospital admission for severe acute respiratory infections (SARIs) in military personnel found that recent flu vaccination lowered the risk of severe disease, while occupational factors and comorbidities may increase SARI risk, according to findings yesterday in Vaccine.

An international team of researchers evaluated data on 11,086 hospitalizations due to pneumonia or influenza from 2000 through 2012 among US military personnel. Hospitalized people had a median age of 32 and were largely male (89.5%).

Chronic disease was also associated with developing SARI following hospitalization. Comorbidities with the highest risk of progression toward severe disease included chronic renal or liver disease; circulatory system disease, diabetes mellitus, obesity, cancer, and chronic obstructive pulmonary disease.

Under multivariate analysis, factors still significant for risk of severe disease included renal and liver disease, circulatory disease, and service in the Coast Guard or Air Force. Investigators cautioned, however, that risk associated with service branch may simply reflect differences in data reporting rather than physiologic risk.

Source: Center for Infectious Disease Research & Policy

A study suggests that physicians may be able to gauge risk by focusing on a patient’s right arm

Moles are usually harmless, but they can be used to assess a person’s risk for developing skin cancer. Someone with more than 100 moles across their body, for example, can be at a greater risk for melanoma, according to experts. Now a new study suggests that physicians may not have to look at a patient’s entire body—instead, doctors can focus on the patient’s right arm, where the presence of 11 or more moles could signal a greater risk of melanoma.

The study, published in the British Journal of Dermatology on Monday, looked at 3,594 twins, and then a larger group of men and women, who all had nurses count how many moles they had on 17 different parts of their body. The researchers found that the number of moles on a person’s right arm was most predictive of their total number of moles on their body. Women with over seven moles on their right arm were nine times more likely to have over 50 moles on their whole body. People with over 11 moles on their right arm were more likely to have over 100 moles on their whole body.

Other areas of the body that stood out as possible predictive regions were above the right elbow, the legs and, for men, the back.

Source: Times

A study in mBio today that was spurred by a 2014 outbreak of listeriosis in caramel apples found that the act of puncturing the apple with a dipping stick produces conditions favorable for growing Listeria monocytogenes, especially at room temperature.

University of Wisconsin researchers swabbed four outbreak L monocytogenes strains onto Granny Smith apples, inserted wooden dipping sticks through half the apples, then dipped them all in hot caramel and allowed them to cool. They then stored the apples at either 25°C (77°F) or 7°C (44.6°F) for up to 4 weeks.

The team found Listeria increased 1,000-fold on caramel apples with sticks stored at room temperature for 3 days, but Listeria growth was delayed on apples without sticks at the same temperature. Refrigeration substantially slowed the growth of the bacteria, but refrigerated apples with sticks had some growth after 1 week that continued for the next 3 weeks, while those without stick had no Listeria growth in the 4 weeks of cold storage.

Dipping the apples in hot caramel killed off much of the surface bacteria, said lead author Kathleen Glass, PhD, in a news release by the American Society for Microbiology (ASM), which publishes mBio. “But those that still survived were the ones that were able to grow. If someone ate those apples fresh, they probably would not get sick. But because caramel-dipped apples are typically set out at room temperature for multiple days, maybe up to 2 weeks, it is enough time for the bacteria to grow.”

The authors conclude that Listeria growth was likely accelerated by apple juice caused by the puncture to pool underneath the caramel, creating a favorable environment. Caramel and apples by themselves are not good substances for promoting bacterial growth. Possible solutions to the problem include disinfection of the apple, adding growth inhibitors, or employee temperature controls.

Source: Center for Infectious Disease Research and Policy

Is Theranos as great as it seems? The blood test company Theranos, which has received widespread acclaim for its development of a cheaper test mainly relying on finger pricks, might not be all that it’s cracked up to be. According to a report published by the Wall Street Journal, based on interviews with anonymous former Theranos employees, only a fraction of the blood samples Theranos handles are actually processed with the company’s proprietary analyzer, which the Journal’s sources referred to as the “Edison” device. The rest, according to the report, are processed with traditional machines. The article’s sources also suggest that the small samples Theranos uses, whether collected by finger stick or by venipuncture using smaller than ordinary needles, do not always produce accurate results.

Theranos released a statement Wednesday calling the report “factually and scientifically erroneous and grounded in baseless assertions by inexperienced and disgruntled former employees and industry incumbents.” The release did not address the WSJ’s reporting that only a portion of the company’s tests were actually performed on its proprietary systems. According to Theranos, the Journal declined an opportunity to try out the “Edison” devices and compare the results to those of traditional tests.

A former senior employee told the WSJ that by the end of 2014, only 15 of the company’s more than 240 offered tests were run through the “Edison” technology. Theranos disputed that claim, though it did not specify how many tests are performed with the technology.

The report said that some employees were concerned about the accuracy of Theranos’ results. Some former employees told the Journal that Theranos may have cheated on proficiency testing of its equipment, processing samples through traditional test machines instead of the “Edison” systems. In other cases, employees alleged that Theranos’ use of small blood samples, diluted for use with the traditional machinery, increased the chance of incorrect results.

Theranos has received FDA approval to perform a test for the herpes simplex virus and has submitted paperwork to approve many more, even though the company is not legally required to do so. “We received our first FDA clearance this summer based on the very proprietary systems the story is asserting don’t work, and have submitted almost 130 pre-submissions at FDA for tests run on those proprietary systems,” Theranos’s statement said.

Source: WSJ

Doctors, hospitals and insurers are bracing for possible disruptions on Oct. 1 when the U.S. health-care system switches to a massive new set of codes for describing illnesses and injuries.

Under the new system, cardiologists will have not one but 845 codes for angioplasty. Dermatologists will need to specify which of eight kinds of acne a patient has. Gastroenterologists who don’t know what’s causing a patient’s stomachache will be asked to specify where the pain is and what other symptoms are present—gas? eructation (belching)?—since there is a separate code for each.

Under a new system, the number of diagnostic codes doctors must use to get paid is expanding from 14,000 to 70,000, including codes for ailments such as “underdosing of caffeine.”

In all, the number of diagnostic codes doctors must use to get paid is expanding from 14,000 to 70,000 in the latest version of the International Classification of Diseases, or ICD-10. A separate set of ICD-10 procedure codes for hospitals is also expanding, from 4,000 to 72,000.

Hospitals and physician practices have spent billions of dollars on training programs, boot camps, apps, flashcards and practice drills to prepare for the conversion, which has been postponed three times since the original date in 2011

Some coding experts warn that claims denials could double as providers and payers get used to the new, more specific codes.

Others are more sanguine. “We’re hoping it will be like Y2K,” when the switch to 2000 dates was expected to crash computers world-wide, says Robert Wergin, president of the American Academy of Family Physicians. “Everybody will worry, and the claims will go through fine.”

Source: WSJ

Despite efforts by lawmakers and manufacturers to protect workers and provide safe working environments, the risk of bladder cancer is still rising in certain industries, according to a review published online Oct. 8 in JAMA Oncology.

James Catto, M.B.Ch.B., Ph.D., of the University of Sheffield in the United Kingdom, and colleagues reviewed data from 263 studies involving 31 million people worldwide. The new analysis revealed an increased risk of developing bladder cancer in 42 out of 61 occupational classes, and an increased risk of dying from bladder cancer in 16 out of 40 occupational classes. Those at greatest risk from the malignancy were workers exposed to aromatic amines. Also at high  risk for bladder cancer and death from the disease were those exposed to heavy metals, and diesel and combustion products.

Workers exposed to these potential carcinogens include metal workers, electricians, mechanics, military service members, chimney sweeps, nurses, waiters, aluminum workers, seamen, and oil/petroleum workers, Catto’s team reported. Meanwhile, lower rates of bladder cancer were found in six out of 61 occupational classes, and reduced mortality risk was identified in just two of 40 classes. People working in agriculture were among those with the lowest risk.

“The profile of contemporary occupations with increased bladder cancer risk is broad and differs for incidence and mortality,” the authors write. “Currently the incidence seems to be increasing, and this increase is occurring faster in women than men. Improved detection mechanisms and screening are possible reasons for this. Workers with aromatic amine exposure have the highest incidence, while those exposed to polycyclic aromatic hydrocarbons and heavy metals have the greatest mortality.”

Source: MPH

Eating more fruits and vegetables can help control weight, but a new study suggests that it depends on which fruits and vegetables you eat.

Researchers recorded diet information for 117,918 men and women in their 30s and 40s at the start of a study and followed them for 24 years, with interviews at four-year intervals.

An overall increase in a daily serving of vegetable or fruit over a four-year period led to less weight gained — 0.25 pounds less for vegetables, and 0.53 pounds for fruit.

Increased intake of berries was linked to a 1.11-pound lower weight gain, and of citrus fruits a 0.27-pound lower gain. Adding a daily serving of tofu or soy was tied to 2.47 pounds less weight gained, and of apples or pears 1.24 pounds less. Carrots and peppers were also linked to smaller gains, but potatoes, peas and corn were not.

The study, in PLOS Medicine, controlled for many health and behavioral variables, including changes in dozens of food and nutrient intakes apart from fruits and vegetables.

The lead author, Monica L. Bertoia, a researcher at the Harvard T.H. Chan School of Public Health, said that Americans’ fruit and vegetable intake was mostly fruit juices and potatoes. But, she said, “There are many fruits and vegetables that may be better choices — apples, pears, berries and nonstarchy vegetables.

Source: New York Times